A bill to make it harder to sue people who make money from Florida nursing homes cleared its first hurdle last week, but advocates for residents warn it’s a bad move in a state with one in five homes on a growing watch list for safety concerns.
“All this legislation does is immunize corporate decision-makers from any accountability,” said Brian Lee, the state’s former long-term care ombudsman and now the executive director of an advocacy group, Families for Better Care.
Not so, the Florida Health Care Association says. In its view, bills by Rep. Bill Hager, R-Delray Beach, and Sen. Bill Galvano, R-Bradenton, “strike a balance to ensure those who need redress have access to the courts while ensuring that those not directly involved in providing care — investors, creditors and other individuals who have no role in the alleged act — are not included in nursing home claims.” The bill passed its first House subcommittee Wednesday.
As the debate in Tallahassee escalates, executives who controlled nursing homes in Palm Beach and two other counties face felony charges in a $2.75 million Medicaid fraud case. A Pahokee nursing home paid more than $26,000 for an assistant CEO’s BMW and a Gainesville affiliate paid more than $50,000 for her Cadillac convertible, according to documents supporting the arrests. The Gainesville home is on the watch list.
Lee said inspection reports at watch-list homes can be chilling, such as a woman who fell from a window three stories to her death last year in Hialeah. Or the woman at a Boca Raton nursing home who fell and suffered with a punctured lung for more than nine hours before officials noticed and got her to a hospital.
By his count, 15 nursing homes recently joined the state watch list, joining some 123 others already on it, based on state Agency for Health Care Administration records. That was more than left the list, 11 homes.
Legislation in 2001 made it more difficult to pursue lawsuits against nursing homes in Florida, Lee said, weakening one form of pressure on companies to ensure care meets appropriate standards. He says industry reports show Florida had the most dramatic changes in liability costs in the country, with claims per 1,000 beds dropping by half from 2000 to 2007 and severity falling from $450,000 to $100,000 per claim.
The Florida Health Care Association, which represents more than 500 of the state’s 683 nursing homes, says such figures represent a small subset of homes and liability costs in Florida are still higher than those across the country. The group says more legislation is needed.
In the case of “vicarious liability,” HB 869 says, punitive damages may not be imposed unless “an officer, director, or manager of the actual employer, corporation, or legal entity condoned, ratified, or consented to the specific conduct.”
The association also wants the legislature to restore Medicaid funding that has been cut for nursing homes.
“Rising liability costs add to the chronic funding challenges already facing the long-term care sector,” executive director Emmett Reed said in a statement. “Our members are committed to caring for Florida’s most frail elders at a high level of quality they expect and deserve. Reckless accusations by trial lawyers divert valuable time, attention and resources and unfairly tarnish the reputation of a trusted, high-quality facility.”
Nursing homes remain of the most highly regulated industries around, an association spokeswoman said, and more than half the state’s facilities get four- or five-star ratings from the Centers for Medicare and Medicaid Services. The number of federal citations is decreasing and “constant demonizing” of nursing homes is not helping anyone, she said.
Still, homes with problems have made news. Executives who controlled nursing homes in Pahokee, Gainesville and Bradenton stand accused of fraudulently spending $2.75 million on excessive salaries, cars and other perks. The pair were spotlighted in investigative stories since 2009 in The Palm Beach Post.
The CEO and assistant CEO of the Council on Aging of Florida, Maxcine Darville and her daughter JoAnne Carter, have denied wrongdoing.
Carter entered a plea of not guilty. State documents maintain she benefited from a BMW paid by one nursing home and a Cadillac paid by another, among other alleged improprieties. Attorney Scott Flint said he had no comment on particular allegations but said, “We believe she will be vindicated.”
The Post reported in 2009 that Darville’s compensation ranged up to $404,000 a year, double industry norms for the company’s size. Perks included $30,000 in annual expenses, a $50,000 loan and $1,200 a month to board a “visiting executive” at a property she owned. State investigators eventually flagged spending on mortgage payments, Internet service, utility bills, cellphone service, maid service and personal long-distance calls, along with a Cadillac for Darville’s use.
Darville pleaded not guilty and her next appearance is set for April 16 in Alachua County Circuit Court. Her attorney, Mark Thomas, declined comment.
The families of residents told the Post they found executive spending “frustrating” at homes where maggots were found in one man’s eye wound and an 88-year-old woman died of internal bleeding after an apparent fall or blow to the head. That woman’s granddaughter said taxpayers’ money is “not being spent sufficiently where it should be.”