by Orlando Sentinel’s Kate Santich
March 3, 2017
If you want to check on conditions at a Florida nursing home where your elderly loved one is living, you might be surprised at what you don’t find in state inspection reports that are legally required to be open to the public.
Like dates. Or places. Or pivotal words.
“On Sunday morning,” one such report reads, “——— at 6:30 a.m., she stated she entered the resident’s ———, found the resident in the bathtub, with the water running, slumped over and ———-.”
The leader of a national watchdog group, Brian Lee of Families For Better Care, calls the heavily censored reports — which cover inspections of nursing homes and assisted living facilities — “shocking.” He first noticed a difference in the amount of information withheld late last year.
“The state is stripping these reports of critical information that the public would use to make sense of what is happening,” Lee said.
Others are concerned that the problem is part of a pattern of state officials holding back information on long-term care facilities.
“I’ve been looking at these reports for 20 years, and I know what they used to look like and what they look like now,” said Nathan Carter, an Orlando personal injury attorney whose clients have included nursing home residents and their families. “It has become arbitrary and inconsistent what they redact — but I think it’s all part of a bigger purpose to confuse people and make the reports useless.”
The Florida Agency for Health Care Administration, which is responsible for the reports, denied that allegation, saying state officials are merely trying to “provide additional protection of personal health information” as required by federal privacy laws, which were bolstered in 2009.
Although residents’ names, Social Security numbers and dates of birth have never been included in reports made available to the public, AHCA press secretary Shelisha Coleman said additional information “could potentially be used to independently or in combination with other information identify an individual’s protected health information.”
But when asked, she also said such a scenario had never happened and did not say what had prompted the change, nor when it took place. An email from another AHCA official dated Dec. 12, 2016, refers to the “new redaction process.”
Coleman also said her agency has implemented an automated process “to redact documents efficiently” and that “there is (a) possibility that some items may be inadvertently redacted.”
“We are working through our quality assurance process to try and reduce this as much as possible, but there is the potential for this to continue to happen,” she said.
Debbie Dahmer, 56, whose family won a $2 million wrongful death case against a Lake Worth nursing home, finds that unacceptable. Her father died in 2008 after entering a Lake Worth nursing home where he was over-medicated, malnourished, dehydrated and neglected.
Though Dahmer’s mother won an initial judgment in 2012, the nursing home appealed — and lost — three times. Trying to get inspection records on the facility from AHCA required the intervention of a state legislator, she said.
“I got nothing from them — not even a response,” she said. “We have the right as consumers to know. There should be nothing hidden.”
The state conducts routine inspections of Florida’s 683 nursing homes once a year, on average, and once every two years for the more than 3,000 assisted living facilities. But the sites can face additional investigations for serious complaints — including imminent danger to residents. The resulting reports are typically posted on FloridaHealthFinder.gov within about six weeks, officials said, and the site’s archives date back to at least 2008. For earlier years, consumers can file public records requests, the site notes.
At Families For Better Care — a nonprofit advocacy group dedicated to creating public awareness of conditions in the nation’s nursing homes — Lee said the state should suspend its automated redaction program until it can figure out a better system.
“I haven’t seen anything this blatant, as far as the disregard of the public records laws, as what’s coming out of the Agency for Health Care Administration right now,” he said. “And their attitude is very nonchalant, that this is just a computer glitch. It’s crazy — and, most importantly, it’s a disservice to residents and their families.”
As an example, he pointed to a report from a Miami assisted living facility that reads: “On ——— at 3:14 p.m., interview with the detective in charge of Resident #1’s case stated that they received an anonymous call from a person that said there was a body floating in the ———.”
Barbara Petersen, president of the Tallahassee-based First Amendment Foundation, called the state’s reasoning for the redactions “absurd.”
Medical privacy laws, she said, “are intended to protect your personally identifying medical information, not the bad actions of a facility. My dad is 95 and living in an assisted living facility, so do I want to know if there are bodies floating in the whatever? Absolutely.”
Coleman said her agency would be willing to process “specific requests” for inspection reports but could charge a fee to do so, as state law allows. There also would be a delay of at least eight business days.
In contrast, the website where inspection reports are posted is free and available at all times.
Michael Milliken, the state’s long-term care ombudsman, a position Lee once held, said he is aware of the issue and has contacted AHCA about it. But Milliken, who works for the Florida Department of Elder Affairs, said it was not something his agency could change.
“We have reached out to them about it,” he said. “We always want residents to have all the information possible, and we know they [AHCA officials] are aware of the situation.”
Carter, the attorney, said he believes the problem goes beyond a simple misstep.
“Now they’re redacting substantive information,” he said. “It’s definitely a pattern and not a mistake.” [READ MORE]