In Florida the Agency for Health Care Administration (AHCA) is a statutorily created administrative agency that serves as the chief health policy and planning entity for the state by regulating over 41,000 health care facilities and administering its $21.2 billion Medicaid program. Elizabeth Dudek is the head of AHCA, and she and her organization oversee everything from background checks of nurses to the licensing and inspection of hospitals.
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Assisted Living Facilities are designed to provide people who need help and cannot live alone with personal services and nursing care in a home-like setting. ALFs in Florida range in size from a single residence, where one person literally lives in a room in a home, to apartment-like complexes that house hundreds of residents.
The state requires each facility, regardless of how many residents it holds, to be licensed to provide either a minimum “standard” of care, or elevated and specific “specialized” care. The goal of the “Specialty Licenses” is to allow individuals to “age in place” in a familiar setting and still receive appropriate care as their needs change and increase. Healthcare facilities in each of Florida’s 67 counties are divided into eleven regions that are managed by eight Field Offices; for instance, Miami-Dade County is in Region 11, and Arlene Mayo-Davis serves as Miami’s AHCA Field Office Manager.
MIAMI ALF PERMANENTLY SHUT DOWN
On February 27, 2012, AHCA inspectors received a complaint that an elderly resident was being abused at Miami’s San Martin de Porras ALF, a 12-bed facility located at 840 NW 15th Street and operated by Maritza Huaitlalla.
When inspectors entered San Martin de Porras, they were shocked to find an elderly resident who suffered from seizure disorders, insulin-dependent diabetes, and psychosis. She was found strapped down to her wheel chair–forcing her to sit on life-threatening bed sores on her buttocks. She also was not being administered her prescribed medications.
Disappointingly, it took Secretary Dudek and the AHCA almost a year and half to finally order that the San Martin de Porras facility pay $20,000 in fines and permanently close its doors. The AHCA order issued on June 3, 2013 gives the ALF 30 days to complete its closure, and in the meantime prohibits it from accepting new residents. One of the reasons given for the delay in issuing the closure order was that the ALF had shredded the patient’s medical records. According to a recent story in the Miami Herald, it is very rare for the AHCA to actually revoke the licence of a healthcare facility. The records in the San Martin de Porras investigation revealed that the abused patient should never have been in an ALF, but rather needed to be in a skilled-nursing home.
What makes the AHCA’s slow action so egregious is that this incident was neither the first nor last time the San Martin de Porras facility failed inspections. In 2010, the AHCA cited it for improper record-keeping and violations of timely administration of medication.
When that particular ALF failed the February 2012 inspection, the ACHA permitted the ALF to continue operating, resulting in several subsequent citations and penalties. In August of last year, the ACHA cited the home for permitting staff members to sleep in the same rooms as residents. Nevertheless, the AHCA allowed the facility to keep its doors open. Then again in both February and March of this 2013, the AHCA faulted the facility for not having adequate staff on duty. In addition to operating this facility, its owner MARITZA HUAITALLA also operates another similarly named six-bed ALF in Miami that was also found to be in violation of the law in 2008 and fined $1,000.
If you are considering placing a loved one or family member in an ALF, it is important to do as much research as possible. Be wary of referrals to particular ALFs by people you do not know or trust, as it is a misdemeanor of the second degree or a non-criminal act in Florida to refer a patient to an ALF.
10 THINGS TO KNOW WHEN SELECTING AN ALF IN FLORIDA
As a patient-abuse lawyer in Miami who investigates cases against ALFs, nursing homes, and hospitals, I recommend the following investigations to help locate the best ALFs in Florida:
1. Confirm that the facility is in fact licensed. Click here to verify the license of any healthcare facility in Florida. Check a Florida facility’s license here.
2. Does your loved one require a mechanical lifting device, such as a Hoyer Hoist, to assist in moving the patient in and out of bed or to and from the wheelchair? If so, an ALF is not an appropriate place for your loved one as those devices are prohibited in ALFs.
3. Check the variety and quality of the daily and weekly menu, as well as the availability of food and snacks.
4. Ask about the facility’s policy on administering medication and documenting the administering.
5. What are the facility’s policies and protocols in response to missing residents?
6. Verify that no restraints are used because they are prohibited in ALFs.
7. Does the building have the requisite safety equipment, such as fire alarms, fire extinguishers, emergency lighting, and adequate exits?
8. Look at the general hygiene of residents; do they appear to be dirty or neglected?
9. Ask how resident complaints and grievances are handled.
10. Does your loved one suffer from or have a history of bed sores? If a resident is admitted with a Stage 2 pressure sore, the ALF must qualify for Limited Nursing Services (LNS) or hold an Extended Congregate Care (ECC) license and provide the appropriate nursing care.
Our lawyers are experienced in representing patients who have been abused or neglected in hospitals, nursing homes, and assisted living facilities. Bed sores or pressure sores are almost always preventable with proper care and nutrition, and they are signs of unforgivable nursing abuse. I believe they should never be permitted to occur, but they frequently do and can develop into painful, infected wounds that can prove fatal.
If you or a member of your family has been abused or mistreated in a Florida nursing home, I recommend that you immediately report the abuse to the AHCA by clicking here and contact our offices for a free initial consultation regarding your legal rights, by calling Toll Free: 866-597-4529 or 305-441-0440 or by emailing me, Spencer Aronfeld.