The Sun Sentinel had a great article on new reforms to increase safety in Florida nursing homes.  A dozen bills to reform nursing homes are under consideration in the Florida Legislature after 14 people died at a Hollywood, Florida, nursing home that lost power during Hurricane Irma.  Many of the bills require nursing homes and assisted living facilities to have generators capable of powering air conditioning in the event of a power loss.

The latest give new teeth to Florida’s Long-Term Care Ombudsman program, which records show has regularly turned up fewer complaints each year under Gov. Rick Scott.  The Ombudsman program, which is supposed to look out for residents in Florida’s 683 nursing homes and thousands of assisted living facilities, would be allowed to conduct undercover operations inside nursing homes, posing as patients or employees, to look for abuse and neglect.

The big boost to the state Ombudsman program is unique among the many bills. Another novel portion requires facilities to allow residents’ families to monitor them electronically as a safeguard against abuse.

The multitude of other bills includes:

SB 284: Filed by state Sen. Lauren Book, D-Plantation, this bill requires nursing homes and assisted living facilities to have generators that can power air conditioning in the event of a loss of power, and requires the Agency for Health Care Administration to conduct an unannounced inspection at least every 15 months to check and make sure the generator is in working order. The bill requires facilities to have enough fuel to power generators for five days.

HB 479: Filed by state Rep. Patricia Williams, D-Lauderdale Lakes, this bill requires an unannounced inspection by AHCA every four months. It also requires nursing homes and assisted living facilities to have generators to power air conditioning and enough fuel to last for five days.

HB 327: Filed by state Rep. David Richardson, D-Miami Beach, this bill requires AHCA to carry out an announced inspection each May before hurricane season and requires facilities to have generators that can power air conditioning and enough fuel to last four days.

SB 372: Filed by state Sen. Rene Garcia, R-Hialeah, this bill would require generators to power air conditioning and enough fuel for four days. It also requires AHCA to carry out an announced inspection in May before the start of hurricane season. Additionally, it requires the Public Service Commission to ensure that utility companies treat nursing homes and assisted living facilities with at least 50 residents that offer critical medical care as high priorities, similar to hospitals.

HB 443: Filed by state Rep. Emily Slosberg, D-Boca Raton, requires nursing homes and assisted living facilities to have current contact information on file with both residents and the state Long-Term Care Ombudsman. It also mandates that residents be allowed to access personal records on file at the facility.

SB 830: Filed by Farmer, this bill is identical to HB 443.

SB 558: Filed by state Sen. Daphne Campbell, D-Miami, this bill requires all health care facilities that provide overnight care — including nursing homes and assisted living facilities — to have generators that can power air conditioning and enough fuel for four days. The generators must be able to maintain conditions throughout an entire facility.

HB 435: Filed by state Rep. Larry Lee, D-Port St. Lucie, this bill establishes a matching grant program, funded with $5 million every year through 2023, so that facilities buying generators can get a dollar-for-dollar matching grant from the state on a first-come, first-serve basis. The grant is open to both public and private facilities.

HB 437: Filed by Lee as well, this bill requires facilities to have generators and enough fuel for seven days.

HB 331: Filed by Slosberg, this bill adds new language to the state’s patients bill of rights, requiring facilities to send an explanation for any relocation in writing to both a resident and the Long-Term Care Ombudsman.


The state is now investigating a local nursing home days after a Channel 9 investigation exposed allegations of abuse. [Nursing home faces lawsuits after employee pleads guilty to sexually assaulting patient].

The Channel 9 investigation aired Thursday and by the weekend, state investigators were at Lake Park Nursing and Rehabilitation Center in Indian Trail. Eyewitness News anchor John Paul went back to the facility looking for answers.  Paul talked to new family members who said they’re concerned about some of the conditions they’ve witnessed there.

Before this investigation, two lawsuits were filed on behalf of residents who are now deceased. The suits alleged sexual assault, poor treatment and untimely death.

According to Nursing Home Compare on the Medicare website, Lake Park is a one-star facility owned and operated by PRINCIPLE LONG TERM CARE, INC tha tis on the Special Focus facility watch list. On January 15, 2016, the facility was fined $132, 600 and then again on November 2, 2016 for $277,052.

WDTN reported on the sad state of nursing homes in Ohio.  Nursing homes are supposed to be a place of care, rehabilitation, and cleanliness but many are not living up to that standard.

Bev Laubert is Ohio’s Long Term care ombudsman. She’s an expert on nursing homes. She says these surveys can tell you if nursing homes follow the rules. “These are minimums, so if a nursing home isn’t meeting the minimums it calls into question how high do they go. How high of quality do they provide?” said Long-term Care Ombudsman Bev Laubert. CMS tries to answer that question for families. It even has a rating system in place.  “A one star home is a problem,” said Laubert.

Before you put your loved one in a nursing home, do your homework, visit the facility and ask questions.

“You just intuitively pick up stuff. It tells you, look at the residents. Look at how their hair is combed, look at whether they are shaved. Are they out of their rooms? Simple little things,” said Jones.

The Republic reported that advocates for the elderly are objecting with Kansas Gov. Sam Brownback’s choice of Barbara Hickert to be the state’s long-term care ombudsman, raising concerns that consumers’ best interests will be ignored, and abuse and neglect will be covered up.  This is the third person coming from the nursing home industry to hold the post.  Brownback has appointed several people with nursing home ties, including Aging Secretary Shawn Sullivan and Joe Ewert as commissioner for licensure, certification and evaluation. Sullivan was a Wichita nursing home administrator and Ewert worked for LeadingAge Kansas.

"I’m not overstating it, it’s life or death," said Mitzi McFatrich, executive director of Kansas Advocates for Better Care. "Right now, there’s a heavy weight on the provider side. The concern is that consumer needs will be second to industry."

It’s extremely rare for someone from the nursing home industry to be appointed as state ombudsman.  Mark Miller, the ombudsman for New York and vice president of the National Association of State Long-Term Care Ombudsman Programs, said "I can’t think of a single colleague. I think that’s something the average person would have a question about," Miller said. "’Where do this person’s allegiances lie?’"




Critics and health care experts fear that Iowa Governor Terry Branstad’s relationship to the nursing home industry will cause premature deaths of vulnerable and disabled elderly.  Disability Rights Iowa, which is part of a national network of advocacy groups established by Congress in the 1970s, published a scathing, open letter to Branstad, questioning the governor’s lax supervision of Iowa’s nursing homes.

Sylvia Piper, executive director, Disability Rights Iowa, Des Moines recently wrote "Terry Branstad believes nursing home residents, many who have witnessed or experienced abuse or neglect, no longer need anyone to protect them. Rod Roberts, director of the Iowa Department of Inspections and Appeals, gets his marching orders directly from Branstad. They both agree that no inspectors are needed; the nursing homes should be left to police themselves."  Sylvia Piper told Branstad in the letter that because of his “political choices, people are suffering and dying on a regular basis in Iowa’s nursing homes.”  In March, Roberts who has no prior management experience, eliminated the positions of 10 nursing home inspectors and two abuse prosecutors, citing budget constraints. After lawmakers restored funding for the positions, the department opted to spend the money elsewhere, saying the inspectors were not needed.

"Branstad has a lucrative arrangement with the nursing home lobby. They give his campaign tens of thousands of dollars, he helps them run under the radar by removing those who would hold them accountable. Under this egregious arrangement, nursing home residents are left alone and helpless in an environment historically notorious for abuse and neglect."

The (Republican) state auditor, long-term care ombudsman, and Iowa citizen’s aid ombudsman cited him for failing to adequately regulate nursing homes. Clearly, he wants to protect his campaign contributors. There has been an increase in complaints regarding nursing homes and other types of care facilities in Iowa.

Piper said her organization has investigated specific cases in which residents have died or been injured as a result of negligent care that could have been prevented through more aggressive action by the inspections department. 


See articles at Des Moines Register, here and here.



Jim Patterson wrote an enlightening commentary for The Register-Guard in Eugene, Oregon about the widespread abuse and neglect in long term care facilities.  Below are excerpts:

Every day an elderly resident in an assisted living facility or nursing home in Oregon is neglected or abused. Usually little is done to stop it.

If a resident or family member reports neglect or abuse to their local Adult and Protective Services agency, chances are the facility won’t be fined, as allowed by law. If a fine is levied by the state Department of Human Services, it is usually only a few hundred dollars, which most for-profit long-term care companies have written into their budgets as one of the costs of doing business.

In short, the system for protecting some of our most vulnerable citizens isn’t working well due to bureaucratic inertia, profit-driven long-term care facilities, and legislators who care more about other issues.

While sexual assaults are one of the worst kinds of senior abuse, countless other abuses occur in facilities on a daily basis. I was a volunteer certified long-term care ombudsman for 2½ years, and on almost every visit to facilities in Lane County observed problems such as residents with bedsores, unchanged sanitary underwear, and colorless and tasteless meals. I learned about theft of residents’ personal property, occasional dirty kitchens, well-meaning but poorly trained staff (and a few who weren’t well-meaning), underpaid young facility directors who had little experience in the business, and medication mistakes — which can lead to death.

In three facilities I saw demented, sexually predatory male residents, and missed by a day seeing one of these residents shot to death by an offended fellow resident who then killed his wife and himself. This happened at the Alpine Court Memory Care Facility in Eugene.

From November 2009 through April 2011, Lane County Adult and Protective Services received 866 complaints about incidents of neglect or abuse in long-term care facilities under its jurisdiction. Of these, 44 percent were substantiated by APS caseworkers and passed on to the state DHS, which contracts with APS to do the investigations in the facilities. Of those reviewed by the state during this 18-month period, 28 percent of the 44 percent sent on to the state were upheld by DHS. Of the 28 percent substantiated by the state, 20 percent resulted in fines.

Thus, out of a total of 866 complaints, only 22 were found severe enough to incur a fine.

The Oregon Health Care Association is the main lobbying group for the for-profit long-term care industry in Oregon. It has already convinced our legislators this year that increasing those penalties would be bad for business.

One bright spot in this depressing picture is the state Office of the Long-Term Care Ombudsman. The office’s staff of deputies and its volunteers across the state are committed to advocating for seniors and their rights. But at a meeting in May with DHS officials, the ombudsman’s office was told that imposing fines doesn’t do any good because they only amount to a few hundred dollars. Instead, DHS said it would go after the few “bad apples” in the industry. That may be why DHS regularly reverses a significant number of findings of sustainability of neglect or abuse by the Lane County agency.

What can be done about this mess? I suggest the following:

When you hear of neglect or abuse, report it to the Lane County Adult and Protective Services office in Eugene. Also call the state Office of the Long-Term Care Ombudsman. If it’s a criminal matter, call the police.

Call Gov. John Kitzhaber’s office in Salem and demand more rigorous enforcement by DHS of the existing laws against facilities that neglect or abuse their residents. The governor has recently appointed Erinn Kelley-Siel as director of the Department of Human Services.

Call your state representative and senator, and ask that they change the law in the 2012 legislative session to impose much stiffer penalties on an industry that, according to the evidence, puts profits above the well-being of the people they are supposed to serve and protect.

To grow old and have to go into a facility, and then not to feel safe or protected or well-cared for in the place where you live, is demeaning at best and terrifying at worst. Public outcry can change this.


Diane Derby at WSPA did a 7 On Your Side Investigation called State of Care that reported the problems that families like the Sextons have with Magnolia Manor-Inman.   Dorothy Sexton was a resident at Magnolia Manor-Inman, a nursing home owned and operated by Sparks, Maryland based Fundamental Long Term Care Holdings, L.L.C.

Sexton’s family who visited often complained about the neglect but the administrator, Dale Lyles, ignored their pleas for help.  "All Dale will ever tell you is he’s looking into it," said Sexton. Some of the issues include giving the resident the wrong medication, not responding to call bells, and allowing her to sit in a dirty diaper for hours without help.

Pam Dukes is DHEC’s Deputy Commissioner of Health Regulation and admitted that due to numerous complaints DHEC has inspected Magnolia Manor in Inman three times this year.  Dukes claimed DHEC would be making at least four mandatory unannounced visits each year, instead of once every two years to more than 480 facilities statewide.  DHEC will limit the focus of inspections to issues involving quality of care.  Dukes told WSAP there still is a way to check out many facilities online. (Click here to check out a facility)   The ratings are based on health inspections for topics like proper management of medications or protecting residents from abuse, staffing, and quality measures like how well the nursing home prevents and treats skin ulcers.

Magnolia Manor in Inman received 1 out of 5 stars on it’s overall rating from Medicare. The Medicare website says the total number of health deficiencies for this facility is 15. In South Carolina the average is six.

Click here to make a FOIA request.   To file a complaint against a nursing home or assisted living facility contact your local Long Term Care Ombudsman’s office. Click here to locate one in your area. You can also file a complaint with SC DHEC by clicking here.


Consumer advocates and industry experts are calling for an investigation into Republican Gov. Rick Scott’s  dismissal of Florida Ombudsman Brian Lee claiming that the governor’s “interference” was illegal.  Federal and state laws prohibit political interference with and retaliation against the ombudsman.  Lee, who had held the post for seven years, previously worked under Republican Govs. Jeb Bush and Charlie Crist and was a champion of residents’ rights.

The last straw, Lee believes, was his Jan. 31 letter to nursing homes directing them to submit information on their ownership, as permitted under the new federal health care legislation. It’s a contentious issue in the industry; critics say that’s because facilities are often broken into multiple businesses to make lawsuits against them more difficult.   After Lee’s departure, a new letter was sent out to nursing homes telling them to disregard the order.

“This is really a disaster for the residents of Florida nursing homes,” said Kate Ricks, chair of Voices for Quality Care, a Maryland-based nonprofit that supports patients’ rights.  “There are problems in nursing homes and assisted-living facilities across the country, and there are very few resources to help — but the ombudsman is one. The ombudsman’s only job is to be an advocate for those residents. He has to be independent.”

The federal Administration on Aging sent a letter to Voices for Quality Care confirming there will be a review of Florida’s long-term-care ombudsman program, “including the circumstances surrounding [the] resignation” of the former head of that program, Brian Lee.   The Administration on Aging will conduct the review into long-term care ombudsman Brian Lee’s dismissal, and will take "all the steps we can to see that the law was followed," said agency spokeswoman Moya Thompson.

In a letter to Charles Corley, the secretary of the state Department of Elder Affairs, the Administration on Aging warned the job must be filled by someone with credibility among advocates for the elderly and disabled and untainted by conflicts of interest.

Governor Scott, who previously ran the Columbia/HCA hospital chain which was found guilty of Medicaid fraud, also founded Solantic, a chain of urgent care centers in Florida.  Scott took money from the nursing home industry in campaign contribution and seems to repaying their generosity now.

See articles from the Miami Herald, the Orlando Sentinel here and here.

McKnight’s had an article about the tragic case of Brian Lee who was fired by the infamous new governor of Florida Rick Scott.  Lee was fired as the director of Florida’s Long-term Care Ombudsman Program (after seven years) for doing his job.  He requested ownership information from nursing homes that are given tax payer funds through Medicare and Medicaid.  The request was authorized under new federal healthcare legislation which will promote transparency and accountability.  Scott fired Lee after operators and industry lobbyists had complained about the request.  Rick Scott is owned by Big Insurance.

Consumer Voice Statement on Florida Ombudsman Resignation:


The independence and effectiveness of the Florida long-term care ombudsman program were dealt a severe blow last week by the forced resignation of state ombudsman Brian Lee. The Consumer Voice is shocked that Gov. Rick Scott forced out the ombudsman, who represents some of the state’s most vulnerable residents, on the recommendation of nursing home and assisted living operators who are the subject of the ombudsman program’s oversight.


The ombudsman is mandated under the Older Americans Act to be an independent voice for residents and free of conflicts of interest. Ombudsmen investigate resident complaints and serve as advocates to ensure that residents in nursing homes and assisted living facilities are protected under the law.


"Brian was recognized by his colleagues in Florida and nationally for his commitment to protecting the rights of long-term care residents and working with residents, families and providers to improve care," said Sarah F. Wells, Consumer Voice executive director. Wells said the office must be independent and free of political interference to perform its statutory functions.


Lee was asked to resign after he asked the state’s nursing homes for names of companies and individuals with an ownership and operational interest in their facilities. State ombudsmen were given authority to request the information from Medicare and Medicaid-funded nursing homes in transparency provisions in the health care reform law. The law was the subject of congressional hearings in which witnesses testified that it is often impossible to hold nursing homes accountable for quality because of complex ownership and operating structures. In a recent report, the Government Accountability Office said, "To determine the effect of ownership on nursing home quality of care, it is necessary to have complete and accurate ownership information that provides a clear understanding of the relationship of each owner to the nursing home and any other owners."


Ombudsmen in some states report that nursing homes routinely provide the information when it is requested. In 2012, a summary of the ownership data will be reported on the federal government’s Nursing Home Compare website, which is designed to help families choose a nursing home.


"We are very concerned that the governor of Florida has yielded to industry demands to dismiss an effective advocate for residents in a state that so many elderly Americans choose as their retirement home," said Wells. "As a national voice for long-term care residents, we strongly urge the governor to follow the law and allow the ombudsman program to operate without interference."

The National Consumer Voice for Quality Long-Term Care is a 501(c)(3) nonprofit organization founded as the National Citizens’ Coalition for Nursing Home Reform (NCCNHR) in 1975 by Elma Holder. The organization represents the consumer voice at the national level for quality long-term care, services and supports by advocating for public policies that support quality care and quality of life responsive to consumers’ needs in all long-term-care settings; empowering and educating consumers and families with the knowledge and tools they need to advocate for themselves; training and supporting individuals and groups that empower and advocate for consumers of long-term care; and promoting the critical role of direct-care workers and best practices in quality-care delivery.