The Orlando Sentinel had an editorial about a grave injustice in Florida.
There are few more consequential or critical decisions for families than choosing the right nursing home or assisted-living facility for a parent or other elderly relative who needs long-term care. For those families, Florida’s licensing agency for health care promises some peace of mind: “easy access” to its information on “provider performance.” Such reporting “is a key element that promotes enhanced patient care and consumer choice,” according to the website of the state Agency for Health Care Administration.
But as the Sentinel’s Kate Santich reported this week, AHCA has not been keeping its promise on inspection reports for nursing homes and assisted-living facilities, where more than 160,000 of Florida’s most vulnerable residents live. Basic information — dates, places and key details — has been blacked out in those reports.
AHCA officials blamed the redactions on the need to comply with federal health-privacy laws, which were made more stringent in 2009. But regular followers of the state inspection reports told Santich that they observed a trend toward withholding details within the past few months.
And the censored words go well beyond personally identifying medical information, such as names, Social Security numbers or dates of birth. Those details have always been exempt from public disclosure requirements.
Santich’s story included a passage from one inspection report of “a resident in the bathtub, with the water running, slumped over and ——-.” Another report referred to “a body floating in the ——.”
Nathan Carter, an Orlando personal injury attorney who said he has been reviewing the reports for 20 years, told Santich that the state’s redaction process has become “arbitrary and inconsistent.” He accused the agency of trying to make the reports “useless” by removing “substantive information.”
Deleting substantive information from inspection reports or, even worse, withholding them, would make long-term care facilities less vulnerable to lawsuits alleging abuse or neglect. The daughter of a man who died in 2008 in a Lake Worth nursing home told Santich she needed the intervention of a state legislator to get AHCA to release its inspection reports on the facility. The man’s family eventually won a $2 million wrongful death case against the nursing home.
A spokeswoman for AHCA told Santich that the agency is now using an automated process “to redact documents efficiently.” She conceded that “there is [a] possibility that some items may be inadvertently redacted.” The agency is trying to “reduce this as much as possible, but there is the potential for this to continue to happen.”
On the eve of Sunshine Week, an annual commemoration that spotlights the state of open government, censored inspection reports for nursing homes and assisted living facilities are a timely reminder of the need for Floridians and their legislative representatives, now meeting in Tallahassee for their annual session, to protect the right to know.
Brian Lee, who served as the state’s ombudsman for long-term care for seven years, accused AHCA of “blatant” disregard of Florida’s open-records requirements. Michael Milliken, the current ombudsman, said he has contacted AHCA about the problem with the inspection reports, but doesn’t have the authority as an employee of another agency, the Florida Department of Elder Affairs, to change the policy.
Lee, now head of a national watchdog group called Families for Better Care, was forced out of his state position by Gov. Rick Scott in 2011 after clashing with the nursing home industry. Lee has offered an eminently reasonable suggestion to AHCA: Suspend its current automated redaction program until it can come up with a better system.
If the agency won’t comply voluntarily, it’ll be up to legislators who care about the health, safety and dignity of Florida seniors to make sure the veil on AHCA’s inspection reports is lifted.