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ACCOUNTABILITY IS ABSENT IN CASES OF FATAL NEGLECT

Florida's assisted living facilities are seldom held liable for causing deaths of patients.

By MICHAEL SALLAH, CAROL MARBIN MILLER and ROB BARRY

Miami Herald

While his caretakers watched him die, William Hughes shivered under the covers in a cramped and dirty bedroom.

They didn't give him food. They didn't give him water. Despite doctor's orders, they never gave him the medicine that would have saved his life.

Instead, they let him languish for days at the Tampa assisted living facility where he lived in 2006 - vomiting and defecating in his bed - refusing to clean him because of the stench.

Despite pleas from residents that he needed help, caretakers never called paramedics to try to save the severely diabetic man.

"They let this man just die," said resident Kevin Conway. "It just boggles my mind to this day."

His body was sent to the Hillsborough County morgue and cremated at state expense - his ashes sent to his mother in Ohio, the state investigation closed.

The 55-year-old musician was among dozens who died at the hands of their caretakers in assisted living facilities across Florida.

One starved to death, another burned in a tub of scalding water. Two were fed lethal doses of drugs. Three died from the ravages of gangrene when their wounds were ignored for weeks.

The state Agency for Health Care Administration - the entity entrusted with overseeing assisted living facilities - refuses to release the records of more than 300 questionable deaths during the past decade, citing state law.

But the Miami Herald obtained confidential records of 70 people who died in the past eight years from the actions of their caregivers.

The records from the Department of Children and Families show people are routinely abused and neglected to death in assisted living facilities.

"There comes a point when you need to say people's lives are in danger and we need to do more," said Nick Cox, a former DCF regional administrator and Florida's statewide prosecutor.

Though Florida boasts one of the toughest elder-abuse laws in the country, the Herald found few caretakers are ever charged in the deaths of the people they are supposed to protect.

In an analysis of each of the deaths, the Herald found:

-Nearly once a month, law enforcement agents were called to investigate cases of residents who died from abuse or neglect - with caretakers even admitting to breaking the law - but almost never made arrests.

-In the two cases in which arrests were made, caregivers were granted plea agreements, never spending a day in prison. One caregiver was given probation in the death of a 74-year-old woman who was strapped so tightly to her bed that she suffered blood clots and died. The charges were later expunged.

-Four caretakers were caught forging and shredding medical records during death investigations. None was charged.

Insulin withheld

When Suzanne Hughes got the call from the Hillsborough County Medical Examiner's Office in 2006, she was told her younger brother William died at Escondido Palms from complications of diabetes.

What she wasn't told: He didn't get his insulin for 27 days, and caretakers refused to call an ambulance as he slipped into diabetic shock.

Though a state attorney general's agent called for prosecutors to charge chief caretaker Charlotte Allen with neglect after she admitted to never reading his charts, the case took a familiar turn. Instead of pursuing charges, the State Attorney's Office dropped the case, saying there wasn't enough evidence to prove culpable negligence.

"We were looking to make a case against her," Assistant State Attorney Jay Pruner said. "This was a horrific situation."

But under Florida law, prosecutors have won criminal neglect convictions against facilities.

Baseball-size sore

When Dorothy Archer arrived at a Pasco County hospital two years ago, rescue workers discovered a blackened hole the size of a baseball festering on her back.

When agents tried to find out how the 90-year-old got the septic sore, they hit a barrier: Key records on her final two months at the Edwinola facility in Dade City disappeared. Nurses' notes detailing the wound appeared fabricated.

"For such a serious wound to develop undetected in the ALF ... was inexplicable," DCF agents wrote after she died.

The home's only punishment: a $1,000 fine levied by the Agency for Healthcare Administration for failing to seek medical care or keep proper records.

'Lack of justice'

George Sheldon, the former DCF secretary, said prosecutors fail to hold caretakers accountable. He said his former agency - which investigates abuse of the elderly and children - has been frustrated by cases that don't get prosecuted.

"A lot of attention is paid to children," he said. "Somehow, we don't have the same kind of outrage when a person is 70 or 80. There's clearly a lack of justice."

Miami Herald staff writer Jared Goyette contributed to this report.

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