Investigative Reports

Disability Rights Florida (DRF) conducted multiple investigations into patient deaths and injuries at South Florida State Hospital (SFSH). As a result of these investigations, DRF has significant concerns about recurring patient safety failures at this facility. These concerns are not new: DRF identified similar concerns in past investigations, including those outlined in DRF’s report Preventable Harm: Patient Safety Failures in Florida’s State Mental Health Treatment Facilities, released in February 2026.

To highlight the ongoing patient safety failures at SFSH, DRF has compiled three separate investigations, all conducted over the last year, into a single report: Recurring Patient Safety Failures at South Florida State Hospital. In each case, staff at SFSH were negligent in providing patient care, and that negligence contributed to patient injury and death. The report highlights several failures by staff and administrators at SFSH.

DRF finds these failures especially concerning because the residents involved had documented vulnerabilities and required specialized monitoring, supervision, or precautionary measures. Additionally, in some cases, DRF had already brought concerns to the attention of SFSH administrators during prior investigations. The recurrence of similar deficiencies despite prior notice and corrective action raises serious concerns about the effectiveness of SFSH’s remedial measures, adequacy of staff training, and leadership’s verification of staff competency in emergency response.