This summer was a busy one for the owners of Avante at Boca Raton, Inc.,
the operators of the skilled nursing home of the same name in central
Boca Raton. On four different visits from field office representatives of the
Agency for Health Care Administration, or AHCA, the governing regulatory body of all heath care facilities in
the state of Florida, dozens of deficiencies were cited between April
2014 and June 2014.
One of the visits, conducted over three days beginning on May 27
th, 2014, generated a Statement of Deficiencies summary report that is 81
pages long. This visit was a standard re-certification visit, which is
required of a nursing home on the agency's "Watch List".
Another report documents 59 pages of violations after agency workers were
called to the facility unannounced in mid-May to investigate an official
complaint of mistreatment and physical neglect.
Avante certainly isn't the only poorly-performing Palm Beach County
skilled nursing facility, more commonly known as a
nursing home. But it is one that stands out among other homes in our area. The facility
is currently on the ACHA's Watch List for three active cases. The
agency's Watch List allows a nursing home to operate under a particular
conditional status, allowing the owners the opportunity under direct scrutiny
to cure extraordinary deficiencies or violations. In the most recent of
the three pending cases, the facility was placed on the Watch List for
a conditional timeframe of 103 days, beginning on May 16
th, 2014 – the same date the unannounced ACHA conducted its on-site
investigation following the patient complaint described above.
Failure to resolve the deficiencies, or perpetuation of violations of applicable
State and Federal law could result in the permanent revocation of Avante's
license to operate this particular facility, forcing a shutdown.
To be fair to Avante and other nursing homes in our area, the mere issuance
of a Statement of Deficiencies does not constitute a penalty. It is only
the results of an on-site inspection by the ACHA. Any facility cited with
deficiencies has the right to appeal the findings. The Statement of Deficiencies
requires the facility to create and implement a plan of correction for
each deficiency cited. If and when the facility does correct the cited
issues, and the agency can verify the correction on a follow-up visit,
often there are no further civil or criminal penalties of any sort.
No Gold Stars for Avante
A quick and handy tool for consumers who are considering or comparing nursing
homes is the
Nursing Home Inspection Ratings ranker, which categorizes inspection and deficiency reports into a sortable data
table on an ACHA-run website.
The tool uses graphical stars to depict how well one facility ranks against
another based on several customizable inspection components. One easy
way to see the "best" and "worst" is to simply rank
the results by the "Overall Inspection" column, and then sort
the results based on the highest stars (5), or the lowest stars (1). Avante
at Boca Raton ranks at the very bottom of only seven facilities in Palm
Beach County that have just one star. On the other end of the scale, Willowbrooke
Court at St. Andrews Estates in Boca Raton has the highest number of stars
across all categories.
Granted, the "one-star" approach doesn't tell the whole story.
The rankings are compiled in relation only to peer facilities in the same
county. So for a county or state with a record of relatively high instances
of care and scoring, a facility with only one star may still be "better"
than a high-ranking facility in another county or state, and vice-versa.
How does Florida compare to other states? According to a 2010 Government
Accountability Office Report to Congressional Requesters on "poorly
performing nursing homes", Florida is ranked #8 in the nation for
the highest scores of Special Focus Facilities, or SFFs, which are nursing
homes that have caught the attention of Federal regulators for continually
poor performance. (
GAO - Special Focus Facilities
The ranker gives Avante a one-star score for most of its categories, including
Overall Inspection, Quality of Care, Quality of Life, Nutrition and Hydration,
Restraints and Abuse, and Decline.
The other six Palm Beach County facilities included in the ranker with
only one star for Overall Inspection are:
- Coral Bay Heathcare (West Palm Beach)
- Darcy Hall (West Palm Beach)
- North Lake Rehabilitation (Lake Park)
- Signature Healthcare of Palm Beach (Lake Worth)
- Terraces of Lake Worth
- Wood Lake Health and Rehab (West Palm Beach)
Legal Actions Against Avante
Avante at Boca Raton has defended itself against more than
half a dozen lawsuits brought by the State of Florida and the AHCA in only the last decade (records prior to 2014 were not immediately available
on the FloridaHealthFinder.gov website at the time of publishing.) According
to the most recent complaint filed in 2012, with a final order settled
in January of 2013, Avante was charged with violating the dignity standards
of at least six named patients. Some of these violations mentioned in
the complaint, among many others, include:
- Failing to respond or deliberately ignoring resident call bells
- Deliberate restriction of patient access to common area bathrooms
- Staff behaving or responding rudely while fulfilling or performing basic
and necessary tasks at the requests and care of patients, or ignoring
those requests all together
- At least one instance in which a staff member placed a soiled bed pan among
a resident's personal items
According to available records, Avante has been fined at least $21,125
in the last ten years for various cases, violations, and complaints. In
2009, a complaint was filed by the AHCA alleging serious violations of
the Life Safety Code, which are Florida laws that mandate minimum standards
for safety precautions. On various occasions, the AHCA cites Avante at
Boca Raton for the property's deficient or improperly configured fire
and smoke alarm systems during routine Life Safety Survey visits. The
complaint described how management failed to adequately correct the violations,
which are documented on multiple follow-up visits, leading to a long and
arduous legal case that eventually settled for a $16,500 fine.
According to the research conducted and presented in and for this article,
there is no other skilled nursing home facility in Palm Beach County with
a record like Avante at Boca Raton's record. The facility is the lowest-scoring
of the bottom 10% of Palm Beach County facilities, according to the Nursing
Home Inspection Ratings on the FloridaHealthFinder.gov website, a division
of the Florida Agency for Health Care Administration. The facility has
had more Statements of Deficiencies and lawsuits filed against it in ten
years than its peers. Avante is also the only facility in Palm Beach County
to be placed on three separate Watch Lists concurrently, as the result
of and pending three separate, active, complaint-driven cases.
We highly suggest that you conduct your own research when comparing available
nursing homes in Palm Beach County. If you suspect you or someone you
love has been the victim of nursing home neglect or abuse, call the Law
Offices of Craig Goldenfarb at (561) 697-4440 to receive a complimentary
consultation with Mr. Goldenfarb about your potential lawsuit. There is
no up-front cost to hire our firm to represent you or your family. Call
our office today.