Leaders erode protections for seniors.
In the aftermath of Hurricane Irma, people were stunned to learn that eight South Florida nursing-home residents had died in their sweltering rooms at the Rehabilitation Center at Hollywood Hills. Gov. Rick Scott even called it “unfathomable.” If you know the history of how the Florida Legislature has treated nursing-home residents over the past 30 or so years, it is quite fathomable how this happened.
If a kennel owner mistreated and killed eight dogs, he would go to jail. If a day-care owner mistreated and killed eight children, he would go to jail.
In this Hollywood tragedy, it is doubtful anyone will go to jail. It’s unlikely the families of the residents who died will get justice.
Florida has the largest elderly population in the nation; yet nursing-home residents get horribly mistreated like this. In most cases, there is no outrage, and no accountability.
Florida law treats its seniors worse than dogs.
The Joint Commission on Accreditation of Healthcare Organizations requires accredited hospitals and facilities to maintain functioning emergency generators capable of running the air-conditioning and other key systems in the event of a power failure. Florida does not require nursing homes to maintain this basic life-safety feature.
After a Miami Herald investigation in the 1980s about how Florida nursing homes were horribly mistreating residents with impunity, Florida passed the Nursing Home Residents’ Rights Act, a series of statutes designed to protect elderly and vulnerable nursing-home residents. However, since the early 1990s, the Legislature has steadily eroded those residents’ rights under the guise of tort reform.
While the nursing-home industry lobby was pumping millions of campaign dollars to their causes, Florida’s governors and Legislatures restricted punitive damages, lowered staffing levels, weakened safety regulations and made it much harder to hold nursing-home owners accountable.
Florida is one of the only states in America where you can operate a nursing home with no liability insurance. Pennsylvania requires nursing home owners to carry at least $1 million in liability insurance coverage. New Jersey requires $500,000. You have to carry insurance to drive a car in Florida, but you can operate a nursing home that cares for hundreds of sick, elderly and vulnerable residents without any insurance at all.
Florida also allows out-ofstate shadow limited-liability companies to be the owners. Most nursing homes in Florida are owned by a maze of corporate LLCs. That makes it difficult to determine who is legally responsible when residents get mistreated or die and to get justice for the victims and their families.
There is no legitimate reason for systematically eroding residents’ rights and allowing outof-state shadow LLCs to operate uninsured nursing homes in Florida without basic life-safety features like generators.
The Agency for Health Care Administration used to be tough on nursing homes that violate minimum standards. Our governors and Legislatures weakened this agency so much that nursing homes rarely get punished. One in five of the state’s nursing homes are on a state “watch list” for substandard care. Many more should be.
Another insidious trick the Florida Legislature has allowed nursing-home owners to unleash against elderly and vulnerable citizens is the mandatory arbitration clause. When a loved one is admitted into a nursing home, families are usually frightened and confused. They are handed a stack of papers upon admission. Most of the papers they sign discuss bed-hold policies, Medicare and Medicaid reimbursements, and other innocuous administrative issues.
What most residents and their families don’t realize is that almost every nursing home in Florida now makes residents sign away their constitutional rights to a jury trial in favor of mandatory arbitration. Many times the terms of the arbitration are secret and designed to protect the facility that wrote the agreement. Florida law allows this.
Brian Lee was Florida’s longterm-care ombudsman for more than a decade. He had a reputation for protecting residents and making sure their families could gather transparent nursinghome financial and ownership information. When the nursinghome industry did not like what Lee was doing, Gov. Rick Scott fired him in 2011 and replaced him with a long string of shorttimers the nursing-home industry liked.
The fox is now guarding the henhouse. Unfathomable, indeed.