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State bans new patients from ALF associated with nursing home where 12 died after Irma

The assisted living facility had come under scrutiny before.
The web site of Floridian Gardens Assisted Living Facility in South Miami-Dade. Floridian Gardens ALF
The web site of Floridian Gardens Assisted Living Facility in South Miami-Dade. Floridian Gardens ALF
Published Apr. 22, 2018

TALLAHASSEE  — The state healthcare agency banned new admissions on Friday to a troubled South Miami-Dade assisted living facility associated with the Broward nursing home where a dozen residents died after the home lost power during Hurricane Irma.

Citing "an immediate serious danger to the public health, safety or welfare" and to residents at the facility, the Agency for Health Care Administration stopped Floridian Gardens Assisted Living Facility from admitting any new residents. The action came after a survey on Thursday identified at least two deaths and multiple falls involving "deficient practices" in care, supervision and followup.

The 180-bed facility at 17250 SW 137th Ave. is owned by Jack Michel and Larkin Community Hospital, the same entities that operated the Rehabilitation Center at Hollywood Hills.

The Hollywood facility was shuttered after power to its air conditioning failed during Hurricane Irma, leading to 12 deaths and the evacuation of its remaining residents. But Floridian Gardens, which was also cited shortly after the post-Irma tragedy, has apparently still been caring for residents despite attempts by regulators to shut down the assisted living facility in late September.

The facility's license status, according to the healthcare agency's website, is still in litigation. The agency did not respond to additional questions about the facility's license status Friday night after it announced the moratorium. According to the order, the facility had 109 residents as of Friday.

Read more: Nursing homes swamped Rick Scott's cellphone after Irma

An administrator at the facility declined to comment and referred all questions to the moratorium order, saying it was a public record. A staff member also refused to confirm if any residents were still at the facility before she hung up on a reporter.

Inspections in the last two years had found widespread deficiencies at the facility, from understaffing and repeated incidents of falls requiring hospitalization to failures in training and record keeping and ignored complaints of sexual harassment. In December 2016, the state healthcare agency attempted to deny a renewal of the facility's license and imposed a moratorium on new residents.

But last August, less than a month before Hurricane Irma hit, the state lifted the first moratorium, suggesting that the facility had undergone "necessary corrections."

After the storm, the healthcare agency moved again to deny Floridian Gardens' license. Larkin filed an appeal of the decision, which has been suspended until the licensing of the Rehabilitation Center at Hollywood Hills is resolved.

But inspectors moved to reinstate the moratorium on admissions at Floridian Gardens Friday, after a survey Thursday found several cases of unsafe conditions and deficient practices, including the deaths of two residents.

In the case of one resident who died on April 4, a videotape showed their final hours sitting at the nurses' station. Though staffers tried to make the resident more comfortable and called the resident's spouse and child, a supervisor didn't call emergency services until the resident's arm went limp.

No staffers started resuscitation efforts or used the defibrillator on site. According to the order, none of the seven staffers on duty that night was able to tell inspectors how to determine if cardiopulmonary resuscitation was needed or how to perform it. A supervisor on duty who did have that training did not follow those procedures or direct staffers to check for pulse or breathing, according to the order.

Another resident died in the hospital on March 10, about a month after falling twice in two days at the facility. Even though the resident's records indicated they were at risk of falling and precautions needed to be taken, no precautions were documented. There was also no record of followup care — despite directions to do more lab work and provide a walker. The resident had to be hospitalized twice more and died during the last hospitalization, after the failure of multiple organs, septic shock and a heart attack.

The order noted three other cases of residents falling whose records did not show they received additional care they were supposed to get.

The moratorium order states that the cases are "violations of minimum standards related to the provision of care and services appropriate to resident need," and also allows the state healthcare agency to regularly monitor the facility.

Read more: Nursing homes need improved emergency plans. But who will verify them?