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Michael Sallah

May, 2011

Why did you decide to look into neglect and abuse at homes for the aged and mentally ill?

We received a tip from a former agent for the Florida attorney general's office that frail elders were routinely being abused and neglected in group homes -- especially assisted living facilities -- but the state was doing very little to crack down on the caretakers. He basically came to us in frustration. He said people were regularly being beaten, caged, and in some cases, starved, but that the state agency in charge of licensing and monitoring homes rarely took action to stop the abuse. Since assisted living facilities surpassed nursing centers as the primary homes for the elderly and mentally ill in Florida, we wanted to see for ourselves whether state regulators were doing their jobs to protect the residents.

What surprised you as you did your research?

So many people were dying of abuse and neglect in Florida's ALFs -- nearly one a month. A 71-year-old man with schizophrenia burned to death after he was left in a bathtub of scalding water. A 74-year-old woman was strapped down so tightly to her bed, the restraints ripped into her skin and killed her. One 75-year-old man with Alzheimer's disease was torn apart by an alligator after he wandered from the facility for the fourth time. These are homes that are supposed to protect and watch over frail residents, but were mistreating and in some cases, killing them. While Florida boasts one of the nation's toughest elder abuse laws, few caregivers are ever charged for killing the people under their watch. Out of 70 death cases we obtained from the state's confidential files, only two caregivers were charged in the past eight years. Neither one spent a day in prison -- both getting probation from the courts. We also found the state was routinely catching homes using illegal restraints, including doping residents with powerful tranquilizers, caging them and tying them with ropes, but most of the facilities are still operating, even after they were found repeating the violations. Three decades ago, Florida passed one of the first ALF laws in the nation -- including a celebrated residents bill of rights -- with lawmakers promising that elderly people would always be able to live with dignity and respect in the Sunshine State. But we found the state failed at every level, from investigating shoddy operators to disciplining bad homes to shutting down the worst offenders. In the past two years, the state could have closed 70 homes for serious violations, including residents dying of abuse and neglect, but shuttered just seven.

What has the response been since you published it?

Several lawmakers have pledged to overhaul Florida's enforcement system overseeing the 2,800 assisted living facilities in the state as well as the law created to protect the residents. Just days after the Herald series was published in May, state lawmakers dropped several pieces of legislation that would have removed regulations and protections from the homes.

Is there something you wish you had room to include in the piece but could not?

Yes, but we are in the process of reporting the story now, so we can't give that away.

What kind of effect do you think this piece could have on oversight of these centers?

We believe Florida legislators will enact a tougher law, including increased penalties for bad caretakers and more frequent inspections of ALFs. Two leading state senators -- a Republican and a Democrat -- have already promised to raise the state qualifications for ALF managers. These are people in positions of great responsibility, often making life and death decisions -- dispensing powerful psychotropic drugs and monitoring changes in medical conditions of their residents. Right now, a person with a high school degree and four days of training can open an ALF -- far less than the state requirements for a barber, cosmetologist and auctioneer.

The Miami Herald

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