Nursing home where 8 died in sweltering heat had poor record with state regulators

As the Rehabilitation Center of Hollywood Hills became a sweltering death trap Wednesday morning, administrators could have evacuated some of the 140 frail elders who lived there to Memorial Regional Hospital, which never lost its power and electricity.

Its emergency room entrance was directly across the street.

But by the time nursing home workers began to evacuate the facility, several already were in extreme distress. By late Wednesday, police said, eight residents of the nursing home were dead.

Hollywood police have begun a criminal investigation into the deaths at the nursing home, at 1200 N. 35th Ave., while the Agency for Health Care Administration and Department of Children & Families have begun their own investigations. Hollywood Police Chief Tom Sanchez said precautionary checks would be done on Hollywood’s 42 other nursing homes, and other local governments had began evacuating elders from other long-term care facilities across South Florida that had lost power.

The Broward Medical Examiner’s office released the names of those who died Wednesday afternoon, but declined to state the cause of any of the deaths. The deceased: Carolyn Eatherly, 78; Miguel Antonio Franco, 92; Estella Hendricks, 71; Betty Hibbard, 84; Manuel Mario Medieta, 96; Gail Nova, 71; Bobby Owens, 84; and Albertina Vega, 99.

The Hollywood Hills nursing home has a history of poor inspections and is affiliated with a South Miami hospital with a troubled past of its own.

The Rehabilitation Center at Hollywood Hills has a health inspection rating of “much below average” by the Florida Agency for Healthcare Administration, or AHCA, which evaluates all long-term care facilities in the state for the U.S. government, which administers the Medicare and Medicaid insurance programs for older and impoverished Americans. The home’s “overall rating,” which includes staffing, fire safety and health inspections, was “below average.”

An inspection of the nursing home by state health regulators last February revealed a host of violations, ranging from an ill-kept building to poor medical care. Nursing homes should not have an error rate of more than five percent while administering medication, meaning residents don’t get the wrong drug, or the wrong dose of the right drug. The rehab center’s error rate was close to 26 percent.

Nursing home staff, the inspection said, “failed to ensure meals were provided timely.” On Feb. 15, one woman, identified as “Resident #60, was seen “screaming she wantes lunch as strolled back and forth with her wheelchair dressed in a patient gown,” the report said. “She was yelling that she was hungry. Three days later, inspectors wrote, “Resident #186 “was observed calling out for food, come, come. I want food, food, food.”

Resident 186 was waiting outside the dining hall for her turn to eat, and a staff member later acknowledge “it is not fair to her to see others eat,” but that “this is normally how it is done,” the report said.

One resident had been kept in her room for hours with the drapes drawn shut staring at a dark television set. Other residents were wheeled outside for a sing-along, and a creative art and exercise were scheduled that day. But the woman was never taken out of her dark room. A man was observed to have knife-like fingernails with a “blackish substance” in them. One man complained that he had been waiting months for glasses, hearing aids and new dentures — after he began to lose weight and his old pair no longer fit.

The building itself was in disrepair, with missing and cracked tiles, holes in the floor, peeling paint, overflowing trash cans, loose door knobs and soiled bathtubs, the inspection said. Refrigerator and freezer gaskets were “full of dirt and debris.” A toilet seat was loose.

The fine for those violations: $5,500.

The nursing home’s licensee is Rehabilitation Center at Hollywood Hills, LLC, which is owned by a doctor named Jack Michel. State healthcare records list Michel as an officer and board member of the nursing home, with a controlling interest.

But the home also has a relationship with Larkin Community Hospital, which has a long history of running afoul of healthcare regulators. Michel is listed in state corporate records as Larkin’s president, as well. In 2006, the U.S. Justice Department fined Larkin and its owners $15.4 million in a settlement of a civil fraud complaint.

Eight of the nursing home’s residents died Wednesday after they fell ill in a building that had been left without air conditioning after Irma blasted South Florida, according to authorities at the scene. The facility is across the street from Memorial Regional Hospital, which never reported losing power during Hurricane Irma.

Hollywood Fire Rescue evacuated residents from the rehab center, 1200 N. 35th Ave., after some residents awoke sick. Like many places in South Florida, the nursing home has been without power since being battered by tropical storm winds and hurricane gusts on the edge of Hurricane Irma.

A kitchen worker, Jean Lindor, told the Miami Herald the center had power from a generator to cook — but no air conditioning.

On Wednesday afternoon, Gov. Rick Scott said he would “aggressively demand answers on how this tragic event took place.”

“I am absolutely heartbroken to learn of news reports of the deaths of multiple individuals in a nursing home in Broward County. Protecting the lives of Floridians is my top priority and that’s why we have worked all week to help Floridians prepare and respond to Hurricane Irma,” Scott said. He added: “Although the details of these reported deaths are still under investigation, this situation is unfathomable.“

The rehab center’s administrator, Jorge Carballo, said the home “is cooperating fully with relevant authorities to investigate the circumstances that led to this unfortunate and tragic outcome. Our hearts go out to the families and friends of those who were affected.

“The Rehabilitation Center at Hollywood Hills has evacuated this morning due to a prolonged power failure to the transformer which powered the facility’s air conditioning system as a result of the hurricane. Unfortunately, early this morning several patients experienced distress and there were three fatalities at the facility and three at the hospital they were transferred to,” Carballo added. The toll was updated to eight later in the afternoon.

The Florida Health Care Association, a long-term care industry group, released a statement Wednesday morning framing the deaths within the context of Irma’s brutal blow to the state.

“Our centers’ first priority is always the safety and well-being of every resident in their care and they are doing everything in their power to meet their immediate and ongoing needs,” wrote the association’s executive director, Kristen Knapp.

“As with millions of other Floridians, our centers are coping with the loss of power and infrastructure in the communities that were most affected by the devastation. Approximately 150 facilities out of the nearly 700 facilities in the state do not currently have full power services restored.

“The loss of these individuals is a profound tragedy within the larger tragedy of Hurricane Irma, and we extend our deepest sympathies to the families of these residents,” Knapp said.

In July 2015, Larkin Community Hospital issued a news release announcing it had won a bankruptcy auction and was taking over operations of the 152-bed Rehabilitation Center at Hollywood Hills, as well as other properties. The reason for the auction: The previous owner was in prison for Medicare fraud.

Both the nursing home and adjacent psychiatric hospital, Hollywood Pavilion, were owned by the family of former CEO Karen Kallen-Zury.

Larkin and Michel bid $24.6 million for the properties, the news release said. “This acquisition represents another step in the evolution of our hospital into an integrated delivery system,” Michel, identified as Larkin’s president, said in the news release.

Larkin Community Hospital, which is based in South Miami, and its owner, Michel, have had a long relationship with a now-indicted healthcare businessman, Philip Esformes.

His attorney, Michael Pasano, said Esformes “has no interest or involvement” in Michel's ownership of the nursing home in Hollywood where the patients died.

In 2006, Esformes, his father, Morris Esformes, Larkin’s Michel and the hospital’s previous owner, James Desnick, settled a civil dispute with the U.S. government for $15.4 million over allegations that they paid kickbacks to physicians in exchange for referring patients to Larkin.

Back then, Esformes owned a chain of Miami-Dade assisted-living facilities and supplied patients to Larkin. The patients then were returned to his facilities and recycled again, according to the settlement.

In a similar scheme, Esformes was indicted last year in a $1 billion Medicare fraud case that prosecutors called the largest in the nation.

Esformes, a wealthy Miami Beach executive who has been held without bond since his arrest, is accused of exploiting a network of about 20 Miami-Dade skilled-nursing and assisted-living facilities to fleece the taxpayer-funded Medicare program. His network filed false claims for services that were not necessary, or, in some instances, not provided to about 14,000 patients, the indictment says.

Larkin, though not identified in the Esformes indictment, referred many of those Medicare patients to his network through kickbacks to doctors and other medical professionals, prosecutors say. Esformes, in turn, recycled the same patients back through the hospital after they stayed in his network.

Larkin’s owner, Michel, is not identified in the Esformes indictment.

This story was originally published September 13, 2017 at 7:09 PM with the headline "Nursing home where 8 died in sweltering heat had poor record with state regulators."