A state appeals court thwarted a move by Florida's health care regulators to rescind the license of a Destin nursing home facility and to require more than 100 patients to be transferred to different centers or return to the community to live.
Florida's 1st District Court of Appeal on Saturday issued a one-page ruling that quashed an April 16 emergency order from the Agency for Health Care Administration that revoked the license of the Destin Healthcare and Rehabilitation Center and directed it to transfer all its residents.
The appellate court's one-page order provided no additional details.
The state issued the emergency order after the facility, which failed to meet minimum mandated nursing requirements for nearly two months, continued to accept new residents. The nursing facility accepted 57 new residents during a two-month period despite having insufficient staff, according to the state health care agency.
Agency for Health Care Administration Communications Director Brock Juarez would not say Tuesday whether the state was going to appeal the ruling. But he did tell Florida Politics that 27 residents continue to call the long-term care facility home.
AHCA staff, Juarez said, also are on site monitoring residents.
John Bradley, an attorney for the nursing home, filed a motion with the court on April 26 arguing the state did not provide sufficient facts to justify an emergency order that deprived the nursing facility of its due rights.
Bradley said the state failed to demonstrate that the nearly two-month staffing shortfall experienced by the nursing home put the residents in immediate serious danger or caused harm. The 'purported" comments from 12 residents included in AHCA's emergency order underscored that the patients weren't in danger, Bailey argued.
"Not a single resident indicated missing or late medication administration, missed physician visits, missed therapy sessions, missed care, lack of meals, lack of visitors or any serious care related issue," Bradley wrote. Instead, the comments focused on hygiene and lack of personal attention from the staff.
And if the residents had been in danger, he argued, the state would not have voluntarily issued a second order giving the facility another week to transfer the residents.
"The agency's actions in the case speak louder than its words. An emergency order is not something you extend for a week," Bradley wrote in the brief. "The agency's actions are tantamount to calling law enforcement stating that there is an emergency then calling again asserting that the rescue should not take place for a week."
AHCA attorney Tracy Cooper George countered in a court filing that the state was forced to extend the deadline by a week because the facility "dragged its feet."
George also argued that the nursing home's decision to bring additional nurses into the facility with the help of staffing should not be misconstrued. She said the regional vice president of the nursing home "still" is complaining about the costs of increasing nursing staff, something she called a "red flag."
"In short, AHCA is not satisfied that the facility will continue to meet the minimum staffing levels required by law and necessary to adequately protect and care for its residents if the emergency order is stayed," she wrote.
Florida law requires nursing homes that fail to meet the minimum staffing requirements for two consecutive days to stop accepting new residents until staffing issues are resolved. Despite having insufficient staff for nearly two months, AHCA regulators questioned why the nursing home continued to bring in new residents.
The move put undue strain on the existing staff and put the residents' health and welfare at risk, AHCA Deputy Secretary Kimberly Smoak said, adding that the "misplaced weight on financial concerns over immediate resident care and the legal requirements of Florida law must be addressed."
"While it is understandable that nursing home residents will soil themselves, it is not acceptable to let them go for days, perhaps weeks on end without bathing. One resident was even observed with a dark brown substance under all the resident's fingernails. All of the interviewed residents have complained about the lack of showers. They have had to endure the indignity of the personal body odor."
AARP Florida spokesperson Jamie Champion told Florida Politics that the association had not seen the ruling but that it was going to study it to better understand the reasoning behind the decision.
"(The) AHCA emergency order clearly showed that the conditions inside this facility were failing residents and putting them in danger," Champion said in a prepared statement. "It's concerning that the facility would be permitted to continue operations in spite of AHCA's grave findings. "
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