Florida nursing homes, under fire, phasing out pediatric wings

Miami HeraldAugust 28, 2013 

Even as Florida health regulators vigorously defend against two federal lawsuits accusing them of warehousing sickly and disabled children in geriatric nursing homes, the homes themselves are quietly getting out of the kids business.

The most recent nursing home to abandon the pediatric market is Orlando Health & Rehabilitation Center, which operates a 40-bed pediatric wing called “Grandma’s House.” Orlando Health & Rehab, in Orlando, notified the state Agency for Healthcare Administration last week that it will voluntarily close the wing, said Michelle Dahnke, an AHCA spokeswoman in Tallahassee. Earlier this year, a troubled Miami Gardens nursing home, Golden Glades Nursing & Rehabilitation, shuttered its pediatric wing after the Miami Herald reported extensively about the deaths of two children who had been admitted there.

In July, the Lakeshore Villas nursing home in Tampa announced it would shut its doors after the U.S. Centers for Medicare and Medicaid Services cut off all federal funding. At the time, AHCA had also announced its intention not to renew the home's license. Lakeshore Villas had been one of the state’s most troubled nursing homes, racking up hundreds of thousands of dollars in fines.

The latest closure comes at a time of significant change and controversy over Florida’s methods for financing the care of severely disabled and medically complex children, whose housing and treatment can be enormously costly.

Florida health regulators will pay more than $500 each day to care for a child in a nursing home, more than double the rate for elders at the same home.

Both the U.S. Justice Department’s civil rights division and a Miami lawyer have sued the state, alleging health and social service administrators have so badly underfunded community-based care for sickly children that their parents have no choice but to place them in nursing homes, sometimes far from their loved ones.

Advocates also say the homes provide little education or stimulation for the children, who sometimes are raised from infancy in hospital beds with few activities.

Orlando Health & Rehab “made the business decision to cease providing pediatric nursing facility services,” Dahnke said, adding that “this decision did not result from regulatory action by AHCA.”

“Florida does not own or control nursing facilities, and must respect a facility’s business decisions concerning whom they wish to serve,” Dahnke said. “We will continue to support the children and their families at OHRC, and we will assist the families with evaluating care options and developing appropriate transition plans for each child’s unique needs.

A spokeswoman for the Orlando nursing home largely blamed the Justice Department for the unit’s closure, saying DOJ lawyers had been contacting the parents and guardians for the 31 children who live there, and making it more difficult for the home to keep the pediatric unit open.

The spokeswoman, Vicki Johnson, said the home will phase out its pediatric unit slowly, so as to disrupt the children’s lives as little as possible. There is no firm deadline, Johnson said, and none of the children will be forced to leave the home until social workers have been able to “ensure a smooth transition.”

“Unfortunately, recent actions by the federal government, including direct outreach to families of some of our pediatric patients to encourage them to find alternative solutions, have made operating a pediatric unit in our facility an untenable option,” Johnson said.

“We are proud of the unique and progressive intergenerational program we created and the benefits it has provided to both the children and adults we’ve served for more than 13 years,” she said.

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