FINR Brain Injury Center Seeks Bankruptcy as Bank Sees Default

Florida regulators are demanding that a brain-injury treatment center with patients from across the U.S. prove that it’s financially viable, as the facility seeks bankruptcy protection.

The Chapter 11 filing by the Florida Institute for Neurologic Rehabilitation Inc. followed Bloomberg News stories about the alleged abuse and neglect of patients by their caregivers at the 200-bed residential facility southeast of Tampa. It’s one of the largest in the country treating people with long-term disabilities brought on by brain trauma.
The filing came hours after Regions Bank sued the institute, known as FINR, in U.S. District Court in Tampa, claiming it’s in default on $31 million in real-estate loans. The lawsuit by the Birmingham, Alabama-based unit of Regions Financial Corp. (RF) says FINR stopped paying on the debt in August.

FINR’s owner, Joseph Brennick, said in a statement yesterday that he was “confident” the facility could properly care for the people living there while it undertakes a financial restructuring. Media coverage led to “a significant decline in revenue making FINR unable to meet is financial obligations,”Brennick said in the statement.

Negotiations with Regions Bank are “ongoing and we are making strides to resolve this successfully as we look for a long-term solution,” he said.

After the bank sent FINR a default letter in September, Brennick withdrew at least $466,000 from center coffers, the suit alleges. In addition, FINR has failed to give the government the payroll taxes withheld from employees’ wages and hasn’t paid real estate taxes and routine operating expenses, Regions Bank says in the suit.

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Brain Injury Center Seeks Bankruptcy as Bank Sees Default

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Caregivers Bloodied Patients as Complaints Drew Laughter

FINR: Caregivers Bloodied Patients as Complaints Drew Laughter

Caregivers at a Florida center for the brain-injured beat patients, goaded them to fight each other and fondle female employees and in one instance laughed at complaints of mistreatment, according to investigative reports released under a court order to Bloomberg News.

The center, the Florida Institute for Neurologic Rehabilitation, is fighting a state directive that it move about 50 patients to other facilities. That order followed a Bloomberg story revealing a history of violence at the center southeast of Tampa. At least five patients have died from alleged abuse or neglect there since 1998, two in the last two years.
The newly released records summarize 15 probes conducted by the Florida Department of Children and Families since 2008, including 12 that have never been disclosed before. Leon County Circuit Court Judge Kevin J. Carroll ordered the state to provide the reports, with the names of victims blacked out, after Bloomberg petitioned the court, arguing there was a compelling public interest.

The Wauchula-based facility, known as FINR, draws patients from across the U.S. and abroad and is said by competitors to be the largest such rehabilitation center in the country. It often finds customers among the relatively few brain injured with legal settlements or insurance payments that enable them to pay premium prices. FINR charges some of them $300,000 a year.

In all of the 15 cases summarized in the reports --involving 17 patients and 20 staff members -- the allegations were classified by investigators as verified, meaning they were supported by a “preponderance of credible evidence.”

‘Difficult Population’

Until now, the state had released only a summary of complaints, indicating there have been 526 allegations of abuse and neglect since 2005. Of those, 37 were deemed verified. Another 117 fell into a category defined by state regulations as when “there is credible evidence that does not meet the standard of preponderance.” The rest are still being investigated or involved cases where the agency discovered no evidence of abuse.

Joe Brennick, FINR’s owner and chief executive officer, declined to comment on individual cases. In an e-mailed statement, Brennick said the center “has consistently acted in the best interest of its patients, and has one of the toughest self-reporting policies in place for a facility of its kind.”

“It is important to understand that FINR serves one of the most difficult populations of patients in the country,” he said, “and that these patients often act out aggressively and are extremely difficult to manage. This is not to absolve wrongdoing by staff members, but is a fact that is often overlooked in media reports.”

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Caregivers Bloodied Patients as Complaints Drew Laughter

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Florida Brain Injury Center Fights Order to Move Patients

Florida Brain Injury Center Fights Order to Move Patients

A Florida brain-injury facility accused of abusive and substandard practices is fighting a state order to move out scores of patients, saying regulators are overstepping their authority.

The Florida Institute for Neurologic Rehabilitation, located 50 miles southeast of Tampa in rural Wauchula, told the state Friday that it would not begin the process of discharging any patients until a judge hears an appeal it filed on Aug. 28.

That action, before the Division of Administrative Hearings, alleges state regulators exceeded their authority in ordering the removal of patients and acted in an “arbitrary and capricious” way.

The dispute stems from a surprise inspection last month by three state agencies. Regulators moved in after Bloomberg News reported on dozens of cases of alleged abuse and neglect at the for-profit facility, known as FINR. Patients’ families or state agencies have accused the center’s staffers of abuse or care lapses in at least five residents’ deaths since 1998, two of them in the last two years.

State investigators determined FINR was breaching its license by treating 50 patients who weren’t brain or spinal cord injured. That represented more than half of the 98 patients whose records the state reviewed.

The state ordered FINR to submit a plan to relocate those patients to facilities “appropriate to meet their needs.”

In its response Friday, FINR said it would begin that process only if its legal challenge is unsuccessful.

The state is exceeding its authority by trying to enforce a narrow definition of brain injury limited only to patients who suffered a traumatic event, such as a car accident, FINR said. Such an interpretation unfairly denies treatment to people with other kinds of brain injuries, the company’s filing said, without specifying the injuries in question.

FINR said it was acting to address other concerns raised by regulators, including an allegation it was keeping patients too long. The company said its chief medical officer will review the length of stay for all residents to ensure appropriateness. It said such a review of current patients found they all required the treatment they were receiving or were making progress in their rehabilitation.

After initially balking at providing investigators its internal reports on incidents involving patients from the past year, FINR said Friday that it had recently made those records available.

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Florida Brain Injury Center Fights Order to Move Patients

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Allstate Sues Florida Brain Injury Center, Claiming Fraud

Allstate Sues Florida Brain-Injury Center, Claiming Fraud

Allstate Corp. (ALL), the second-largest U.S. auto insurer, is seeking fraud damages in a lawsuit alleging that a Florida brain-injury facility warehoused patients who were beaten and abused by staff.

The suit, filed Friday in U.S. District Court in Tampa, seeks $7.6 million that the insurer says it paid the Florida Institute for Neurologic Rehabilitation to treat its claimants, as well as triple damages under federal racketeering laws and other costs.

Allstate alleges patients from Michigan, which mandates unlimited lifetime medical benefits for automobile injury coverage, were recruited to the Florida facility through an aggressive marketing campaign that promised an array of services that were never provided.

Some patients washed the cars of the center’s employees, an activity that was considered vocational training, according to the lawsuit.

Wayne J. Miller, an attorney representing the facility, known as FINR, said the company would not comment on matters in litigation.

The lawsuit, which also named FINR owner Joseph Brennick as a defendant, follows a Bloomberg News report last month on dozens of cases of alleged abuse at the facility. Patients’ families or state agencies have accused FINR of abuse or care lapses in at least five residents’ deaths since 1998, two of them in the last two years. Three former employees face criminal charges of abusing FINR patients -- one of whom was allegedly hit repeatedly for two hours in a TV room last September.

Removals Ordered

Last week, the Florida Agency for Health Care Administration said FINR was treating people without brain injuries -- in breach of its license -- and ordered the company to move dozens of patients to other facilities.

Allstate said it began investigating the treatment of its insured patients at FINR in 2011. Its review included interviewing patients, hiring experts to study medical records and ordering exams with a neuropsychologist. The lawsuit covers the cases of a dozen patients -- identified only by initials in the legal filing -- whose care was paid for by the Northbrook, Illinois-based insurance company.

In some cases, patients were kept too long at the facility or shouldn’t have been there in the first place, the lawsuit alleges.


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Allstate Sues Florida Brain-Injury Center, Claiming Fraud

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Florida Orders Brain-Injury Center to Move Some Patients

Florida Orders Brain-Injury Center to Move Some Patients

A Florida brain-injury center facing allegations of abuse has been ordered to move dozens of its patients to other facilities, according to a state report released today.

The Florida Institute for Neurologic Rehabilitation, one of the largest facilities of its kind in the country, is treating patients without brain injuries -- a breach of its license, say Florida regulators.

During a surprise inspection earlier this month, state officials say they found that 50 of 98 patients whose records were reviewed did not meet the licensing criteria for treatment at the center’s main facility near Wauchula, about 50 miles Southeast of Tampa.

The state said the institute, commonly called FINR, must submit a plan to relocate those patients to a facility “that is appropriate to meet their needs.”

The Florida Agency for Health Care Administration also found that FINR was keeping patients too long, another violation of its “transitional living facility” license. It ordered the center to develop a new protocol for discharging patients.

Wayne J. Miller, an attorney representing FINR, didn’t immediately return messages seeking comment.

Surprise Inspection

Investigators from three state agencies conducted a surprise inspection on Aug. 2 and 3 following a Bloomberg News report of dozens of cases of alleged abuse and neglect at the facility. FINR, a for-profit company, treats patients from across the country.

Related: Abuse Of Brain Injured Americans Scandalizes U.S.

Patients’ families or state agencies have alleged abuse or care lapses in at least five residents’ deaths since 1998, two of them in the last two years. Three former employees face criminal charges of abusing FINR patients -- one of whom was allegedly hit repeatedly for two hours in a TV room last September.

Florida’s Department of Children and Families has received 514 allegations of abuse or neglect at FINR since 2005, including 37 that were “verified” by its investigations, according to records released by the agency. Investigators are still reviewing 23 of the claims.

Amid the heightened regulatory scrutiny, 10 lobbyists from four different firms registered with Florida officials this month with the state to represent FINR, according to state records.


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Florida Orders Brain-Injury Center to Move Some Patients

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Abuse of Brain Injured Americans Scandalizes U.S.

Florida Ended Death Probe at Private Brain Rehab Center

Florida's Most Vulnerable in Danger of Abuse

Florida Brain-Injury Center Gets Surprise Inspection

Connecticut Pulls Disabled From Site of Alleged Beatings

Police Probe Death of State Psychiatric Patient in Florida

Connecticut Pulls Disabled From Site of Alleged Beatings

A Connecticut agency plans to pull at least four disabled state residents out of a Florida rehabilitation center facing allegations that its patients were abused and neglected.

Terrence Macy, commissioner of the Connecticut Department of Developmental Services, said he was “outraged” watching video that police describe as footage of two autistic patients being beaten at the Florida Institute for Neurologic Rehabilitation.

Macy said his department doesn’t plan to make any further placements at FINR and is taking steps to withdraw four of the 10 patients it already has sent to the facility in rural Wauchula, Florida. Last week, investigators from three state agencies conducted a surprise inspection of the treatment center, without disclosing what they found.

Wayne J. Miller, an attorney for closely held FINR, said the patients slated to leave the facility “have vastly improved as a result of the care they were given at FINR and are now well enough to be transferred to a facility in Connecticut that provides a lower level of care.” He said FINR has been working with Connecticut officials for a “few months” on the discharge of those patients.

Connecticut is responsible for certain disabled and mentally ill patients under laws entitling them to adequate care.

Incident Video

“Watching the video, I saw things that were reprehensible to me and horrific and would never be tolerated in this state,” Macy said.

In one video recorded last year, 21-year-old autistic patient Danny Silva sits on a couch between two large male staffers who punch, elbow and slap him at least 30 times.

The video was taken by a third employee using a mobile phone, according to police, and posted online last month by Bloomberg News. The two staffers have pleaded not guilty to criminal charges of abuse.

Melinda Jakobowski, a mentally ill patient sent to Wauchula by Connecticut, died at a Tampa hospital last year after she was found unresponsive in her room at FINR. Investigations by Florida regulators determined that staff members failed to watch Jakobowski as required, including one who slept on the job.

The state will step up monitoring of Connecticut patients who remain at FINR, Macy said.



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Connecticut Pulls Disabled From Site of Alleged Beatings

Florida Brain-Injury Center Gets Surprise Inspection

Investigators from three state agencies conducted a surprise inspection today of the Florida Institute for Neurologic Rehabilitation, a brain-injury treatment center where some patients were allegedly abused or neglected.

Florida state officials didn’t say what they found at the 196-bed institute, a closely held company known as FINR. The center is one of the largest in the country and draws patients from across the U.S.

“We are all concerned about the care, safety and well- being of the residents of the Florida Institute of Neurological Rehabilitation,” said Liz Dudek, secretary of the state Agency for Health Care Administration, which licenses the center.

In addition to that agency, investigators from the Department of Children and Families and the Department of Health participated in the inspection of the FINR campus in Wauchula, Florida, about 50 miles from Tampa.

The agencies said in a news release that they will review the information gathered and determine the most appropriate plan of response depending on the findings.

Full Article and Source:
Florida Brain-Injury Center Gets Surprise Inspection

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Abuse of Brain Injured Americans Scandalizes U.S.

Florida's Most Vulnerable in Danger of Abuse

Recent newspaper investigations have found rampant abuse and neglect in Florida's assisted-living facilities and now at a rehabilitation center for brain-injured patients in Hardee County. What these stories have in common is an indictment of Florida's regulators. Whether it is due to a lack of resources, regulatory tools or will, the state is failing to protect some of its most vulnerable residents. The result is that the state's frail, elderly and injured are left to try to protect themselves.

The latest scandal involves the Florida Institute for Neurologic Rehabilitation, a 196-bed for-profit facility that is one of the largest brain-injury centers in the country. This is where patients who often can't make decisions for themselves are sent to recover from traumatic brain injuries. But an investigation by Bloomberg News found that abuse is common at FINR. One patient was so desperate to escape his beatings that he swallowed fishhooks to get transferred out.

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Florida's most vulnerable in danger of abuse

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Abuse of Brain Injured Americans Scandalizes U.S.

Patients Tell of Beatings at Rehabilitation Center

Florida Ended Death Probe at Private Brain Rehab Center

State regulators ended inquiries into a patient’s death and alleged abuse at the Florida Institute for Neurologic Rehabilitation last year over doubts about their legal authority.

The 196-bed institute, a closely-held company known as FINR, is one of the largest brain-injury centers in the U.S. and draws patients from around the country.

The Florida Department of Health brought an end to inquiries over the February 2011 death of Melinda Jakobowski, a mentally ill Connecticut woman sent to FINR, after other state regulators had already concluded there were care lapses in her case, according to inter-agency e-mails reviewed by Bloomberg News.

The e-mails also showed a top Department of Health official believed FINR was operating outside its brain-injury license in treating Jakobowski and others who didn’t have such injuries at its facility in Wauchula, 50 miles southeast of Tampa. The department has taken no action against FINR over the alleged unlicensed care.

The state’s decision not to further scrutinize the brain- injury company preceded a second death in Wauchula last year and charges of criminal abuse of FINR residents by employees.

Patients’ families or state agencies have alleged abuse or care failures in five FINR residents’ deaths since 1998, as reported by Bloomberg News last week.

FINR denied the allegations in three of those cases, which led to lawsuits. One resulted in a $5 million verdict against the company and the other two ended in settlements. FINR has declined to comment on the Jakobowski case or the later death, which have not been the subject of any lawsuits.

‘Proactive Approach’

Officials from three Florida agencies will meet tomorrow to discuss cases at FINR, said Victor Johnson, a state Department of Health Official who oversees its brain-injury program.

“All of us have to change the way we have done or responded to these issues in past,” Johnson said. “We want to go with a more proactive approach to respond to these issues with one state response.”

Wayne J. Miller, a lawyer for FINR, said “there is probably no health care provider in the state that has as much oversight.” He said the facility is subject to inspections and regularly visited by police, state agencies, disabled-protection groups, guardians, family members and others. When a problem is identified at FINR it is “immediately evaluated and corrected,” Miller said.

Jakobowski, 24, died five months after the state of Connecticut sent her to FINR. She was found unresponsive in her bed with her hair wrapped around her neck and died later at a Tampa hospital in what was ruled a cardiac arrhythmia.

E-mails Released

Florida released internal e-mails in that case and others to Bloomberg News under an open records law request. Although her name was redacted, Florida officials confirmed Jakobowski is the person referenced in the e-mails.

Three Florida agencies that deal with FINR -- the Department of Children and Families, the Agency for Health Care Administration and the Department of Health -- passed their findings in the case around internally, the e-mails show. None of the agencies believed it had authority to take regulatory action.

An AHCA investigation found that FINR failed to maintain proper supervision of Jakobowski and that she was left alone despite a history of trying to hurt herself. It said in an e- mail that it had no authority to regulate patient treatment -- and sent a request for further investigation to the Department of Health.

Reimbursement Sought

William Reineking, the administrator for the brain-injury program in that department, responded in April 2011 that he might not investigate the case unless his office was reimbursed for its costs.

The case provided evidence “again” that “FINR is treating people not covered by the license,” Reineking said in another e-mail to AHCA the following month.

Although Jakobowski was suffering from mental illness, she was not brain-injured. The health department says it only has the authority to regulate the care of FINR patients under a “transitional living facility” license covering those suffering from traumatic-brain or spinal-cord injuries.

Both the health department and AHCA, which licenses health- care facilities, declined to say why the state has permitted FINR to treat patients at its brain-injury center when they don’t have brain injuries.

Regulatory Gap

Other cases of alleged abuse involving patients who were severely mentally ill or autistic, but not brain-injured, also have fallen into the regulatory gap, the e-mails show.

Full Article and Source:
Florida Ended Death Probe at Private Brain Rehab Center

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Police Probe Death of State Psychiatric Patient in Florida

Abuse of Brain Injured Americans Scandalizes U.S.

Soon after Peter Price arrived at the Florida Institute for Neurologic Rehabilitation to recover from a brain injury, he pleaded for a rescue.

“Jess, they beat me up,” Price told his sister, Jessica Alopaeus, in May 2009. “You have to get me out of here.”

Staffers at his new home held him down and punched him in the face and groin, Price said. When Alopaeus’s efforts to transfer him stalled, Price said his desperation led him to a step aimed at speeding his release.

He swallowed five fish hooks and 22 AA batteries he’d picked up during a patient outing at Wal-Mart. After emergency surgery to remove the objects, he was allowed to transfer to another facility.

Residents at the Florida Institute have often been abused, neglected and confined, according to 20 current and former patients and their family members, criminal charges, civil complaints and advocates for the disabled.

These sources and over 2,000 pages of court and medical records, police reports, state investigations and autopsies contain an untold history of violence and death at the secluded institute known as FINR, which is located amid cattle ranches and citrus groves in Hardee County, 50 miles southeast of Tampa.

Patients’ families or state agencies have alleged abuse or care lapses in at least five residents’ deaths since 1998, two of them in the last 18 months. Three former employees face criminal charges of abusing FINR patients -- one of whom was allegedly hit repeatedly for two hours in a TV room last September.

Sparse Care

The complaints underscore the problems that 5.3 million brain-injured Americans are having finding adequate care. Their numbers are growing, according to the U.S. Centers for Disease Control and Prevention, as better emergency medicine and vehicle safety mean that fewer die from traffic accidents, bullet wounds and other causes of traumatic brain injuries.

The long-term ills range from memory loss and physical handicaps to the inability to control violent anger or sexual aggression. Yet because insurance benefits for rehabilitation are scarce, less than half of those who need it receive it, according to the Brain Injury Association of America.

Organized as a company and operated for profit since 1992, FINR has become one of the largest brain-injury centers in the country, with 196 beds. Three rival providers say they know of no place bigger. Multi-site operator NeuroRestorative, owned by a holding of buyout firm Vestar Capital Partners, handles more patients.

FINR hasn’t grown by opening its doors to anyone who needs rehabilitation, customers say. Rather, its marketing is focused on the relative few who can pay bills that reach $1,850 a day.

Michigan Mandate

That includes those injured on jobs with generous worker’s compensation benefits, and car-crash victims in Michigan --which mandates unlimited lifetime benefits for automobile injury coverage.

Those who have clashed with the company over the treatment of patients say its efforts to keep costs down and extend the duration of stays take priority over care and rehabilitation.

“All people are to them is a monetary gain,” said Jana Thorpe, a professional guardian who removed one of her wards from the company’s care in 2008. “They don’t care if they do anything for them.”

Full Article and Source:
Abuse of Brain Injured Americans Scandalizes U.S.

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Patients Tell of Beatings at Rehabilitation Center