Retirement home had bad bed bugs. It’s closing, but could residents wind up somewhere worse?

Oct. 31--The Fort Lauderdale Retirement Home had a cozy name, but if state records are any indication, it was not a place for people to live out their golden years in comfort. The dingy facility, scheduled to shut down on Friday, has been plagued by a host of problems since the early 1980s, most recently facing ongoing scrutiny by the Florida Department of Health for a severe bed bug infestation.

But it's not Florida regulators who decided to close the assisted living facility, home to 80 or more residents, many with mental health or past drug problems.

Instead, longtime owners and operators Rick and Jacqueline Heath are quietly giving up their license in a government-supported industry long troubled by inadequate budgets, sketchy operators and lax oversight. As South Florida ALFs go, the inspection record for the facility just south of downtown Fort Lauderdale wasn't all that unusual, and it also served clients whose health issues can make them challenging to care for and place.

Rick Heath would not discuss details behind the closure, saying in a brief interview outside the building that he and his wife had managed the place for several decades and now were ready to retire to their ranch near Lake Okeechobee.

The future home for many residents was less clear, which is common in a strained state mental health care system that critics say perpetually struggles to meet rising costs and demands.

"Facilities will just kind of send people out and that is inappropriate," said Eric Carlson, directing attorney for Justice in Aging, a senior advocacy organization. "You are deciding where you live. It is a big deal. And that should be based on what the person wants, not on what is most convenient for the professionals and facility people who are involved in this process."

Earlier this month, several of the residents, who did not want to give their names, said they were confused and worried about where they might wind up. On one day, one elderly woman sat on the lobby stairs, chin resting in her hands, her possessions stuffed in four black trash bags by the front door as other residents shambled about with their own bags and boxes.

"Where are you sending me?" she asked. A woman who appeared to be a staffer from another ALF told her she would be going to a place she would enjoy. The elderly woman dragged her garbage sacks to a car outside and sat waiting. Other residents -- who could frequently be found walking the streets surrounding the ALF -- expressed similar concerns.

"I'm glad I'm leaving here," said one. "But I'm not happy about where I'm going."

Residents had learned they'd be losing their home in an abrupt manner. In late September, the owners handed out "Dear Resident" letters, citing a lease expiring on Nov. 1 and telling residents to seek help from state case managers or their insurance companies in finding new homes. The letter, provided to the Herald, added, "This facility is in no way responsible to assist in relocation."

That last statement was wrong, according to Florida's Agency for Health Care Administration, which oversees ALFs.

"As required by their licensure with the agency, the assisted living facility is responsible for relocating residents and must work with the residents or their representatives to ensure a safe relocation," AHCA spokesman Patrick Manderfield said in an email statement to the Herald.

Manderfield said that other agencies, such as the Department of Children and Families and the Department of Elderly Affairs' Long-Term Care Ombudsman's office, would work with residents to inform them of their rights and assist them in relocation if needed. State law also requires facilities to notify residents or their "next of kin, legal representative, or agency acting on each resident's behalf" of impending closures, he said.

Manderfield said AHCA had been properly notified by owners about the closure, but that more than a week after the ALF handed out its notice to residents, word had not reached a key state monitor tasked with protecting residents' rights. Broward's district ombudsman manager, Gloria Freyre, said she was not aware of the facilities closing until contacted by a Herald reporter early this month.

"I haven't heard any residents calling," Freyre said. "That's usually how we know."

Brian Lee, executive director of Families for Better Care, an advocacy group for elders in nursing homes and ALFs, said that's a gap in oversight rules. He believes facilities should be obligated to notify the ombudsman, who can ensure residents' rights are protected while they seek a new home but right now there is technically not a legal requirement to do so.

"They (the ombudsman) are paid for by taxpayers to fulfill that role as an advocate," said Lee, a former long-term care ombudsman. "That's their job. Too many facilities just kind of run roughshod over residents and their rights."

Another agency, the Broward Behavioral Health Coalition, was also "supporting these customers throughout the relocation process to ensure their needs are met and they can maintain stability in the community," said DaMonica Smith, a DCF spokeswoman, in an emailed statement.

Despite the initial uncertainty, the retirement home emptied out over the month. The ring of chairs outside the two-story home's entrance, normally a popular gathering spot for residents to talk or smoke, was almost empty, with only one woman sitting there late last week. She said she did not want to speak to a reporter. By Monday, DCF and AHCA both reported that no residents remained there.

Whether they wound up somewhere better is another question. Medical and mental health privacy laws make it impossible for outside advocates to track where residents wind up or what options they might have. But it can be difficult for residents or their families to research choices on their own.

AHCA, for instance, told the Herald that it does not maintain information on vacancies in the facilities that it regulates. Yet early this month, the agency's website showed just three facilities in Broward licensed to care for people with mental illnesses that had any beds available -- a total of 79 openings. But the Fort Lauderdale Retirement Home, and an adjacent annex, had 109 beds -- meaning some displaced residents might face relocation to another county.

"The choice is going to be limited," said Lee, the elderly care advocate. "They are probably going to be shuttled out to other counties to get the services they need. And they are not going to be able to have the selection of quality."

AHCA's website, FloridaHealthFinder.gov, indicated little room in the 745 facilities statewide with limited mental health licenses. Overall, there were approximately 639 beds available out of 12,217 total -- about a 5 percent vacancy rate. However, about half of those beds were available in just five facilities. Data on the state site was incomplete, however, with 107 facilities not listing occupancy rates.

Most of the beds in Broward County were available in Grand Court, a facility in Pompano Beach with a sordid past. An AHCA inspection cited numerous deficiencies earlier this year. The facility was found to be understaffed with unqualified workers improperly distributing medication and keeping "unclear and inconsistent" medical records. The staff allegedly put the wrong clothes on residents and one woman had her bra "put on twisted and so tight to where the skin turned red." There were complaints from female residents of harassment by male residents, also about scant activities and bad food. At least one resident died from neglect in 2005.

After the Herald asked about vacancies at places that might take in the retirement home's residents, the previously available occupancy on AHCA's website vanished.

AHCA communications director Mallory McManus said the information should not have been publicly available in the first place, calling it a "technical glitch." McManus said "it would be incorrect to report the occupancy data."

She added: "While the agency does not routinely track available beds, our agency is focused on ensuring that residents who have decided to reside in an assisted living facility with a limited mental health license have access to a safe and clean environment, and that their health and well-being are monitored."

AHCA's own inspection reports and citations show that the Fort Lauderdale Retirement Home did not always live up to those standards.

Years of reports exposed persistent problems: The facility failed to ensure that residents were receiving their scheduled medications, did not keep proper medical records and potentially falsified documentation, according to inspection reports. It was staffed with untrained employees and lacked proper food, among other citations.

The living conditions also were subpar, according to the reports. Paint peeled and plaster flaked on the walls, mold-like black stains formed on air conditioning vents, and there was a "foul odor that exists in and throughout the facility."

Bed bug droppings covered mattresses, stained linens, encrusted walls and windows, and one of the insects was observed crawling up the leg of a resident, a report from this year stated. Employees of a pest control company working to eradicate the infestation called it "the worst ever seen" in all of their years of work. The facility had been under review from the Department of Health and had failed to resolve the agency's concerns, records show.

In communication with AHCA and in the note to residents, the Heaths cited an expiring lease as the reason for closing the ALF.

But records show the Heaths own the corporation that holds the lease and the property. Jacqueline Heath leased the properties to 2065 INC., a corporation in which she and her husband were joint shareholders. The nearby annex also previously had a for sale sign, which was removed sometime this month, and was for a time listed as being sale for $799,000 on the website of the commercial real estate firm The Fitzgerald Group -- that's almost twice its appraised value, according to Broward County records.

The area surrounding the home, near the busy corner of U.S. 1 and Davie Boulevard, has seen increasing redevelopment. Over the last decades, aging structures like the retirement home, once a two-story apartment building now painted the color of pea soup, have been razed and replaced with new legal and medical offices. More upscale townhouses are also going up not far away.

Rick Heath said he doubts the property will sell anytime soon and had been taken off the market. He declined to answer further questions and threatened to call police on a visiting reporter.

At least one former resident, a man in his late 50s named Jessie, told the Herald by phone he had been recently relocated to a new facility in Dania Beach, though he did not know its name. He asked a nurse, who told him she did not know either. Jessie said he was happy with the new place, particularly the cuisine.

"They said they had real food here," Jessie said. "I wouldn't eat it at the other place. It was disgusting."

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