Associated Press and Brandenton Herald: Florida Launches an "Unprecedented Assault" on Watchdogs for the Oldest and Sickest; Federal Administration on Aging Launches Investigation Into Brian Lee's Dismissal

As turmoil continues in the face of new Florida laws that curtail litigation against nursing homes, the federal Administration on Aging has launched an investigation into former Florida Nursing Home Ombudsman Brian Lee's dismissal  . . . the Associated Press reports below (reprinted from the Bradenton Herald).

Fla. nursing home watchdogs see turmoil in agency



By MATT SEDENSKY
Associated Press
Updated: Sunday, May. 22, 2011


Florida, long one of America's most revered retirement spots, has launched what critics call an unprecedented assault on watchdogs for its oldest and sickest they believe amounts to political kowtowing to the powerful nursing home industry.


Since Gov. Rick Scott assumed office, the state's top nursing home watchdog has been replaced with someone seen as far more favorable to the industry, the watchdog's subordinates have been muzzled from speaking to the press and its outspoken head volunteer have been fired, cumulatively triggering two whistleblower complaints and a federal investigation.


"The state is succumbing to the demands of the nursing home industry," said Janet Wells, director of public policy at The National Consumer Voice for Quality Long-Term Care, a nonprofit that advocates for long-term care residents.


The long-term care ombudsman program, as the watchdog agency is known, costs about $3 million annually, with most of that coming from the federal government. Most of its work is done by volunteers who go out to facilities to investigate the complaints of residents and advocate on their behalf. All states have such agencies, which are mandated by the Older Americans Act, though they're largely invisible to the general public.


Unless a personnel change implodes into a high-visibility tussle.


It started in February, a month after Scott took office, when program leader Brian Lee says he was told to resign or he'd be fired. He left, saying he felt he was forced out because he sometimes butted heads with the nursing home industry, but the dismissal prompted a wave of complaints from volunteers in the program.


Chief among them was Lynn Dos Santos, a volunteer and state chairwoman of the ombudsman program who helped oversee its roughly 300 other volunteers and repeatedly called Lee's firing unjust to anyone who would listen.


The state responded by issuing an order to volunteers and other ombudsman workers that they were no longer allowed to talk to the press. It replaced Lee with Jim Crochet, who had been suggested for the job by the nursing home lobby. And it notified Dos Santos she was fired.


The federal Administration on Aging has, in turn, launched an investigation into Lee's dismissal. And Lee and Dos Santos have each filed whistleblower complaints with the Florida Commission on Human Relations that have not yet been resolved.


"The program is in serious trouble," said Lee, who says he doesn't want his ombudsman job back. Lee now heads Families for Better Care, a nonprofit advocate for nursing home residents.


Scott spokesman Lane Wright said the importance of the ombudsman program has not been diminished.


"It is vital we have someone in that role committed to the agency's core mission of caring for some of Florida's most vulnerable while also protecting Florida tax payers," Lane said.


Ashley Marshall, a spokeswoman for the state Department of Elder Affairs, which oversees the ombudsman program, said personnel change such as the replacement of Lee is normal in a government transition.


She said Dos Santos was dismissed for repeated Sunshine Law violations, claiming her e-mail conversations on ombudsman business amounted to breaking the freedom of information law. And she says Crochet's friendliness with the industry is a benefit, not a liability.


"The secretary of the Department of Elder Affairs has nothing but confidence in our new ombudsman and the missions and goals that he has set forth for the program, which includes a focus on the resident which has been lost in all this," Marshall said.


Still, as if the turmoil within the program weren't enough, it also became a magnet for legislation seeking to curtail its power.


State lawmakers proposed bills that, among other things, would have removed the requirement for ombudsmen to conduct on-site assessments of nursing homes; repealed a law requiring the collection and analysis of data related to complaints in long-term care facilities; remove a requirement to disseminate a list of facilities that have been fined; and make it more difficult to sue nursing homes and place a lower cap on damages that could be awarded.


All of those measures ultimately failed, though another legislative change, to lower the staff-to-resident ratio requirements for nursing homes, did pass, seen as a cost-cutting measure in the face of reductions to Medicaid reimbursements. It reduces the average amount of direct care provided residents by 18 minutes each day.


"Eighteen minutes can be the difference between someone coming in and putting food on the tray and not having time to feed someone," said Jeff Johnson, AARP's interim state director. "Or it's another 18 minutes that someone has to sit in a soiled diaper."


AARP did not take a position on the changes within the ombudsman program in Florida, which has a higher percentage of seniors than any other state. But Johnson said he found the sheer number of bills focusing on it and other aspects of nursing home care troubling.


"In terms of the amount of attention that was placed on the overarching theme of eroding the rights of nursing home residents and eroding the nursing home quality standards that we've had in place for over a decade and then reducing oversight of the ombudsman program," he said, "You put those things together and that's a very disturbing trend."


Lee said he expects the legislative measures that failed this session to emerge again next year.


"They didn't get some of the stuff they wanted done but it does lay a foundation for what direction they're headed next session," he said.


"And now that they have their people in place - their man as governor and their man as ombudsman - they don't have anything in their way."


The turmoil has eclipsed politics. Lee was appointed by former Gov. Jeb Bush, a Republican, and served under his successor, former Gov. Charlie Crist. Both Lee and Dos Santos are registered Republicans who say they voted for Scott.


That has prompted many to question the loyalties of Scott, who made billions running the Columbia/HCA hospital chain, and who founded Solantic, a chain of urgent care centers.


Marshall said Crochet, who was recommended for his job by the Florida Assisted Living Association, was traveling and unable to be interviewed. She said his good relationship with the industry will be helpful in advocating for residents.


"You have to be able to maintain a cooperative relationship with those in the industry to be able to affect the change you seek," she said.


Dos Santos was notified of her dismissal just before she was set to deliver a state chair report at a gathering of ombudsmen. Her speech, which criticized "troubling and unthinkable actions" and "the systematic dismantling of our program," was never delivered.


A former special education teacher, Dos Santos retired to Florida nine years ago. If nothing else, the experience has triggered her to make some long-term care plans of her own.


"I've already instructed my entire family if I ever need a nursing home, get me out of this state," she said.



Read more: http://www.bradenton.com/2011/05/22/v-print/3214127/fla-nursing-home-watchdogs-see.html#ixzz1N6snch7q

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