Nursing Homes in Florida

According to Medicare.gov, Florida has 691 nursing homes. While 438 (63%) of these facilities rank average or above on the level of care they provide, the remaining 253 (37%) have below-average and much below-average ratings. This substandard level of care falls below the acceptable rating allowed by federal and state regulators at Medicaid and Medicare.

We understand the difficult decisions regarding placing our loved ones in long-term health facilities. It's hard to imagine nurses and nurse aides caring for someone they don't know well during a very emotional moment. Sadly, many cases of neglect or mistreatment of the elderly occur in Florida nursing homes.

Nursing homes often provide poor quality care by failing to give their residents necessities, including adequate shelter, food, water, hygienic assistance, and medical care. Caregivers may neglect some people who need help with daily activities because they cannot move. They may also suffer from severe health conditions that require constant care.

Federal and State Rules and Regulations

Federal and state regulators regularly inspect skilled nursing care facilities to see if they follow established rules and regulations. When inspectors have to intervene, impose monetary fines, and take action to enforce compliance, they often do so.

Here is a small sampling of the serious concerns and health violations occurring in Florida nursing facilities as outlined on Medicare.Gov.

Failure to Protect Residents From all Forms of Abuse

Abuse and mistreatments can occur anywhere, even in Florida's most well-kept nursing homes. According to statistics from the National Center on Elderly Abuses, approximately 10 percent of all patients in nursing homes have been abused.

Below is an overview of the various types of abuse that have occured in Florida nursing homes.

• Failure to ensure a resident was free from neglect when the resident eloped from the facility into the parking lot to a stop sign approximately ten feet from a busy road, and the staff members were unaware. (Avante at Ocala Nursing Home)
• Failure to provide care, services, and supervision to prevent suicide for one resident who suffocated himself by placing a trash bag over his head, resulting in his death. (Coral Reef Subacute Care Center)
• Failure to provide essential life support and initiate cardiopulmonary resuscitation (CPR) when a resident was found unresponsive with abnormal color to her skin when an RN disregarded a Full Code order believing that the resident was already dead. (Courtenay Springs Village Nursing Home)
• Failure to ensure a resident was free from abuse when a CNA witnessed another Certified Nursing Assistant punching the resident several times in the face. (Balance Healthcare Nursing Home)
• Failure to ensure a resident was free from neglect after reaching for a grab bar and falling in a shower when transferring to the shower chair, fracturing the left wrist. (Terrace of Jacksonville)
• Failure to ensure all residents are free from neglect after a resident eloped from the facility was found .7 miles away and involved in a motor vehicle accident. The resident did not survive. (Suwannee Health and Rehabilitation Center)
• Failure to install, maintain and check locks to ensure a secure environment prevents a vulnerable, cognitively impaired resident from exiting the facility, placing him at risk for severe injury, impairment, or death after the resident leaves the facility unsupervised. (Rockledge Health and Rehabilitation Center)
• The facility neglected to determine the appropriate size for a body lift sling before lifting the resident from the floor who fell headfirst while suspended. They did not immediately notify the assigned nurse of a possible head injury. (Rehabilitation Center of Winter Park)
• Failure to ensure the resident's right to be free from neglect when an agency nurse failed to respond when repeatedly notified that there was a change in the resident's condition eventually resulted in finding the expired resident in an upright position with her head wedged between the mattress and bed rail. (Palm Garden of Jacksonville)

Failure to Protect Residents from Accident Hazards

Accidents can happen if long-term care nurses fail to follow safety procedures to create and maintain a clean and safe environment. Residents may be exposed to harmful chemicals and dangerous situations at the nursing facility.

Florida nursing homes may violate state regulations by failing to provide adequate supervision for residents using walkers or wheelchairs.

• Failure to provide adequate supervision and manage risk associated with accident prevention for a resident at risk for elopement when a resident exited the building and a four-wheeled walker while wearing a wander guard monitoring device that did not function properly. (Concordia Village of Tampa)

When the Nursing Home Does Not Stop Patient Negligence Against It Patients

The skilled nursing facility in Florida should not tolerate abuse, neglect, or mistreatment of its patients. Patients are vulnerable and rely on the staff to provide appropriate care. When this does not occur, it can lead to severe physical and psychological consequences for the skilled nursing patient.

Families need to take legal action when the nursing homes do not stop patient negligence against their patients. Nursing home abuse and neglect can cause physical and emotional injuries, which is why it is crucial to hold the facility accountable.

Signs that a long-term care facility is being neglected might involve:

• Lack of basic needs: Patients in skilled nursing homes should be provided with adequate food, water, clothing, and shelter. If your loved one goes without these basic needs, it's likely due to neglect.
• Poor hygiene: Nursing home patients should be bathed and have their hair and nails groomed regularly. It may indicate neglect if they are not taken care of this way.
• Weight loss/malnutrition: One of the most evident signs that a skilled nursing home resident is being neglected is if they have lost a significant amount of weight or are not given enough food.
• Bed sores: Pressure wounds are a common sign of neglect in a long-term care home, especially if patients are not appropriately treated or getting worse.
• Infections in Florida nursing homes are common. Residents are often susceptible to infection, so any signs of an infection - such as fever, redness, swelling, or discharge - should be cause for concern.
• Unsanitary conditions: Florida nursing homes should be clean and clutter-free. If the home is dirty or has an unpleasant smell, it may indicate neglect.
• Poor medical care: Florida residents in nursing homes should receive appropriate medical care based on their needs. If they are not being seen by a doctor regularly or their nursing home care is not up to acceptable standards, it could be a sign of neglect.
• Untreated injuries/illnesses: Nursing home patients should receive timely treatment for injuries or illnesses that could indicate neglect if they are not being treated or delayed.
• Elder abuse: Elderly residents can also be victims of elder abuse, such as physical abuse, emotional abuse, or sexual abuse. Any signs that your loved one is being abused should be investigated immediately.
• Limited socialization: Nursing home patients should have opportunities to socialize with other people their age. If they seem to be spending most of their time alone in their room, it may be a sign that they are being neglected.
• No visitors: Family members and friends should be able to visit Florida nursing homes whenever they want to check on their loved ones. If the resident rarely has visitors or the visits are always supervised by staff members, it could be a sign that they are being neglected.
• Poor living conditions: Skilled nursing facilities should provide access to comfortable furniture, adequate lighting, and fresh air. If these things are not available, it could be a sign that the resident is being neglected.
• Limited contact with family members: One of the best ways to ensure that loved ones receive appropriate skilled nursing care is to keep in close contact with their family. If family members feel like they can't get in touch with their loved ones or that their calls and visits in nursing homes aren't being welcomed, it could be a sign that the resident is being neglected.
• Depression/anxiety: It's common for nursing home patients to experience depression or anxiety due to their circumstances. However, worsening symptoms might be due to the resident being neglected.

Florida Nursing Homes Must Implement an Infection Prevention and Control Program

As a part of the CMS mandate, nursing homes in Florida are required to implement an infection prevention and control program. This IPC program is designed to help avoid spreading infections and ultimately improve the quality of care provided to the disabled or elderly at a Florida nursing home.

The program must include strategies for preventing, detecting, and controlling infections and policies and procedures for responding to outbreaks. The most common contributing factors that lead to infections spreading through skilled nursing facilities include:

• Urinary Incontinence: Nursing home residents who are incontinent are more likely to develop pressure ulcers, as they often do not have time to change their clothes or bedding regularly. Incontinence often leads to bacteria build-up and an increased risk for infection.
• Fecal Incontinence: Fecal incontinence is another major cause of infection in Florida nursing homes. When feces come into contact with skin, it can cause several severe infections.
• Urinary Tract Infection (UTI): UTIs are among the most common infection among nursing home residents. They can be caused by several things, including catheters and exposure to fecal matter.
• Respiratory infections can be deadly for nursing home residents, especially those with compromised immune systems. These infections can be spread through contact with respiratory secretions, such as saliva and mucus.
• Skin infections are another common infection among nursing home residents. They can be caused by several factors, such as moisture, poor hygiene, and contact with contaminated objects or surfaces.
• Staph infections are a severe threat to nursing home residents. They can be spread through contact with infected skin lesions or respiratory secretions.
• Clostridium Difficile is a bacterium that can cause severe diarrhea and other health problems that can be spread through contact with feces or vomit.
• Norovirus is a highly contagious virus that can cause severe vomiting and diarrhea and spread through contact with contaminated surfaces or food.
• Streptococcus is a bacteria that can cause many health problems, including pneumonia, meningitis, and blood poisoning. The bacteria can spread through contact with respiratory secretions or infected skin lesions.

Florida Agency for the Healthcare Administration States Any Abusive Behavior in Nursing Homes in Florida is Unacceptable

The Florida Agency for Healthcare Administration (AHCA) is committed to ensuring that all individuals residing in nursing homes in Florida are treated with respect and dignity. Any abusive behavior, whether physical, sexual, or verbal, is unacceptable and will not be tolerated.

AHCA takes allegations of abuse very seriously and investigates all complaints thoroughly. If you believe that you or a loved one has been the victim of abuse in a nursing home, please contact the AHCA Abuse Hotline at 1-800-955-8773.

Abusive behavior in Florida nursing homes, assisted living communities, skilled nursing facilities, assisted living centers, and rehabilitation centers include:

• Physical Abuse can involve slapping, punching, pushing, and other forms of physical violence. It can lead to severe injury and even death in Florida nursing homes.
• Sexual Abuse includes unwanted touching, sexual assault, and rape. It can leave victims feeling traumatized and violated.
• Emotional Abuse can involve verbal attacks, humiliation, intimidation, and other forms of psychological maltreatment. It can cause immense emotional pain.
• Financial Exploitation often involves stealing money or possessions from the elderly victim. It can leave them feeling helpless and vulnerable.
• Neglect often occurs when caregivers in Florida nursing homes don't provide the necessary care and attention to elderly patients. It can lead to health problems and even death.
• Abandonment happens when caregivers leave elderly patients alone and unsupervised. It can leave them feeling frightened and alone.
• Institutional Abuse occurs in nursing homes, hospitals, and other institutions where elderly patients are housed. It can include physical abuse, sexual abuse, emotional abuse, and financial abuse.
• Isolation occurs when nursing staff members separate a patient from the general population, family, or friends, even if residing in a semi-private room.
• Self-Neglect occurs when elderly skilled nursing home patients fail to properly care for themselves due to neglect or ignorance. It can lead to severe health problems.
• Medical Services Neglect includes failing to provide necessary medical care or ignoring medical problems. It can have devastating consequences for elderly patients.
• Food Neglect includes not providing enough food or proper nutrition to elderly patients. It can lead to malnutrition and other health problems.
• Environmental Neglect includes not providing adequate heat or ventilation or leaving elderly patients in dangerous or unsanitary conditions.
• Psychological Abuse includes humiliating or insulting elderly skilled nursing home patients, threatening them, or engaging in other mental cruelty.
• Medication Abuse includes giving excessive or incorrect doses of medication to elderly patients.

Nursing homes in Florida that violate regulations by abusing or injuring patients can face penalties from the Centers for Medicare and Medicaid Services (CMS). These penalties levied again skilled nursing facilities can include citations, fines, and even Medicare and Medicaid funding loss.

Heavy fines can cripple the financial assistance Florida nursing homes count on, as these government programs account for a large percentage of their income.

Were you victimized by abuse or neglect while receiving nursing care? You can contact numerous federal and state agencies to report what happened, obtain financial assistance, and receive basic information on what to do for your loved one or disabled veterans in your family being abused.

• Florida Department of Elder Affairs at (800) 962-2873
• Florida Department of Health – Long Term Care Ombudsman – File a complaint here
• Florida Agency for Health Care Administration – File a complaint here
• US Department of Veterans Affairs at (800) 488-8244

Abusing Elderly and Disabled Residents with Physical and Chemical Restraints

• Not Responding to Cues: Staff who do not respond to a resident's cues or cries for help can cause that resident to feel anxious and abandoned.
• Safety of the Resident: Staff may use restraints to protect the resident from harming themselves or others in nursing homes.
• Inability to Control Behavior: Some may be unable to control their behavior, which can lead to injury or harm.
• For the convenience of staff: In some cases, restraints may be used as a convenience for staff to more efficiently manage a resident's care.
• Not Responding to Cues: Staff who do not respond to a resident's cues or cries for help can cause that resident to feel anxious and abandoned.
• Staff are Easier to Control: When a patient is physically restrained, it can be easier for staff to manage them and complete their tasks.
• Lack of Training: Some staff may restrain someone due to a lack of training on effectively dealing with problematic behaviors.
• Fear of Lawsuits: Staff may use restraints to avoid being sued if a resident becomes injured or causes harm to another person.
• Lack of Time: Staff may feel like they do not have enough time to deal with challenging behaviors and, thus, use restraints to pacify the resident.
• Ineffective Behavior Management Strategies: When staff does not have an effective plan for managing challenging behaviors, nursing staff may turn to restraints as a last resort.
• Personal Bias: Some staff may have personal biases against certain patients and use restraints to control them.
• Poor Facility Conditions: If the facility is in poor condition, patients may act out to communicate their frustration. Restraints may be used as a way to stop the behavior from continuing.
• Poor Resident Care: When staff is overworked and understaffed, they may not be able to provide quality care to all patients. This can lead to patients acting out and staff using restraints to contain the behavior.
• Mental Illness: Some patients may exhibit complex behaviors due to mental illnesses such as dementia or bipolar disorder. In these cases, restraints may be necessary for the resident's safety and those around them.

Resources:

• Healthcare Providers Violations: | Medicare
• Nursing Home Facilities | CMS