How Jackson, Homeless Trust paid millions to woman whose ALFs state punished

Jackson Memorial Hospital, Miami’s steadfast sanctuary, accepts the patients no one else wants. Elderly people with no money, no insurance, no family and nowhere else to go always found an open door and a warm bed for their taxpayer-funded healthcare.

But when it came time to discharge some of the neediest elders, Jackson often faced a dilemma: Dump helpless patients onto the street, or keep them in hospital limbo, where they take up expensive space and risk exposure to infection.

Jackson had a multimillion-dollar problem. Roxana Solano knew how to fix it.

For the past 10 years, Jackson paid Solano more than $35 million to place scores of patients into assisted living beds around the county, then manage their long-term care. She chose to move many of them — more than 1 in 4 — to her own chain of homes, Villa Serena. She sent patients to two of her homes the state would later shut down due to unsafe conditions and a third she was forced to sell after a resident ran away.

In January, Solano incorporated a new venture, called Solara, an “independent living” and “housing stabilization” program for elders who do not need specialized care. She has placed 37 Jackson patients there already.

She placed other Jackson patients in homes state health regulators considered so dangerous they initiated proceedings to close them. One home crammed residents into rooms where they had less personal space than they would in a Florida prison cell. In another, a resident died following a brain bleed and two broken jaws when staff did nothing to prevent repeated falls.

In response to detailed questions from the Miami Herald, Jackson administrators acknowledged they could do more to safeguard the welfare of the patients they discharge. To “further strengthen” oversight, Jackson will now “ensure timely and direct notification… of any complaint, disruption, regulatory matter or other issue involving an ALF serving our patients,” Jackson spokeswoman Krysten Brenlla wrote in an Aug. 13 statement to the Herald.

The Miami-Dade Homeless Trust also relied on Solano to care for homeless seniors. The Trust, a county agency, hired Solano during the peak of the COVID pandemic to run a shelter and find beds at assisted living facilities for incapacitated elders. Since 2023, when the county bought the shelter site, the Trust has paid Solano $5.7 million. Before that, the Trust paid $4.3 million to house homeless seniors, but that amount was shared between the property owner and Solano, who managed the facility.

Her current contract, which ends in September, is for $1.7 million.

Solano has acted as her own matchmaker. But using her contracts with two of Miami-Dade’s most respected institutions as conduits for funneling patients to her own homes raises ethical questions, health and social service leaders say.

In the world of elder care, beds equal dollars, except when they’re empty. Jackson Health System and the Homeless Trust — both entities funded with taxpayer dollars — helped Solano keep hers filled, despite the problems state regulators found at her homes.

“That a person is managing care arrangements and self-referring — that is more than a red flag,” said Jess McDonald, the former director of the Illinois Department of Children and Family Services who oversaw social welfare programs for a decade. “The ability to manage care and do the selection of providers — and refer to your own organization without any oversight — as a matter of principle should not exist.”

The elders being discharged into these ALFs are among Florida’s most frail. Their loved ones either can’t care for them or won’t, creating a grim last chapter for many of them.

“Jackson does not believe the solution is discharging these individuals to the street, nor is it appropriate to keep them indefinitely in an acute-care hospital setting where they no longer require that level of care,” said Brenlla in the Herald statement.

“Jackson assumes the responsibility of this vulnerable population beyond the walls of our hospitals, investing approximately $25 million annually to help ensure these patients have a safe and appropriate place to receive the care and support they need. It is a substantial commitment – one that reflects our role as the community’s safety net health system. This is our mission in action.”

Of the nearly $35.2 million Jackson paid Unlimited Senior Solutions, Solano’s Miami company, $12 million, or 34 percent, involved patients discharged to a home Solano owned, Brenlla said.

Ron Book, the longtime chairman of the Homeless Trust, in a recent Herald interview, questioned his organization’s decision to allow Solano to steer clients to her own homes. “We should have gone deeper when we had even the remotest reservation about Roxana,” he said.

Through her lawyer, Solano, 57, declined to discuss this story with the Herald.

Her attorney, Kristen Jackwin, issued a short statement on Solano’s behalf: “For over 30 years, my client has served mental health and indigent communities. She has always complied with the law, put patients first, and treated them with respect and professionalism. Her reputation for excellence and the utmost integrity is well-earned. Any assertions or allegations to the contrary are patently false.”

‘Huge mountain of conflict’

How Solano came to have her hand on the spigot of a senior citizen pipeline is a story distinct to Miami-Dade County. The county has the largest number of older adults in Florida, more than half a million age 60 or older. About one-fifth of Florida’s impoverished elderly people live in the county, state records show.

Miami-Dade is confronting a demographic truth: The population is aging. More than 17 percent of Miami-Dade’s residents are 60 or older. In less than 15 years, demographers predict 25 percent of the county, about 800,000 people, will be 60 and older.

Many are impoverished, lack health insurance and have no ties to family who can assume their care. Jackson cannot simply push them out the door.

Hospitals can discharge patients who still require care following emergency treatment — but only to an appropriate facility willing and able to accept them, according to the federal Emergency Medical Treatment and Labor Act.

Solano sent 673 Jackson patients into Miami-Dade assisted living facilities from 2016 to the end of July 2026, according to records. She admitted 28 percent of them, or 189, to the chain of eight Miami ALFs she owns or had owned. She admitted another 37 to her independent living program, Solara. Together, the self-admissions account for 33.6 percent of all Jackson discharges — one in three.

The state’s Agency for Health Care Administration halted new admissions to one home, Villa Serena VIII, in 2019 after a resident vanished, and two years later closed Villa Serena I and II after they had accumulated 131 violations. The two homes “violated the minimum requirements of law,” the state said.

A settlement kept Villa Serena III open after the state sought to close it in 2020; it has logged 41 violations since 2013, including three Class 1 or Class 2 infractions, the most serious.

Three of her other homes have been cited for at least another 145 violations since 2012, records show. Among the violations: Not preventing or documenting falls; failing to store medication properly; failing to “serve food in a safe manner;” and failing to “provide a safe living environment.”

The laundry list of violations — plus the state shutting down two of Solano’s ALFs — should have caused alarm immediately, say elder care experts.

“Taking care of elders who suffer from self-abuse, neglect and the inability to care for themselves is a national scandal. And not just in Florida,” said Arthur Caplan, head of medical ethics at the New York University Grossman School of Medicine. “We live in a culture that wants to forget about these people. They are not the happy grandparents, the sharp or vigorous elders of The Villages.”

Caplan said the apparent self-dealing is a particular concern, because it robs elders of a layer of protection: “It is obvious that you can’t assign discretion about placements to someone who has ownership interest in the facilities where people go,” Caplan said. “It’s a huge mountain of conflict of interest.”

Brenlla said Jackson administrators will “once again conduct a competitive request for proposal process to ensure we have the strongest possible network of providers to meet the complex needs of this vulnerable population” when the current contracts expire. Solano’s contract will end on Sept. 30 if it is not extended or renewed.

The Homeless Trust faced similar challenges to Jackson when, in 2020, it needed a home for what its leaders believed to be scores of elders sleeping in cars, parks, libraries and shopping center parking lots – and at great risk of contracting COVID.

The Trust began moving elders into Mia Casa of North Miami, a 118-bed planned ALF that Solano was managing for a real estate company, in April 2020, a month after the pandemic struck.

Four months later, state health administrators filed a complaint seeking to shut down Villa Serena I for its infection-control practices.

“During COVID we were all learning new things every day in crisis mode,” said Book. “I rented Mia Casa because she had just renovated it … We needed room for 123 elderly homeless people.”

In January 2023, the county bought Mia Casa from FVP Eden Gardens for $6.4 million. The Trust, supported by a 1 percent food-and-beverage restaurant tax, used it as a quarantine site for homeless elders imperiled by COVID.

Too fast, too big

Records obtained by the Herald from the Trust show leaders were aware of Solano’s problems with the state early on.

Solano’s lawyer wrote two letters to AHCA in the spring and summer of 2021. In one, his goal was to convince the state to reconsider its decision to close Villa Serena I — a 14-bed home in Miami.

The lawyer acknowledged in the letters AHCA’s concerns that Villa Serena may have “grown too fast and/or too big, resulting in overstretching its operational capabilities.” But he reminded AHCA that no one had died from COVID at Solano’s ALFs.

Book, who was forwarded the letter, did not find Solano’s explanations convincing: “There is nothing in the letter that does anything to move any level of concern I might have,” he wrote in a September 2021 email to his staff.

When reminded of the email exchange in a recent interview with the Herald, Book acknowledged he was “terribly embarrassed” that he and agency staff failed to properly vet the contractor. He said wryly that perhaps his agency should have insisted on a higher standard than no reported deaths.

Book said Mia Casa appears to be well run, with residents well cared for.

“I go to Mia Casa and the people are happy. They are getting what they need as formerly homeless people. I don’t have a problem with Mia Casa,” Book said. “My staff thinks she is honest and we don’t have a better provider. Her bills and invoices all seem to check out. I don’t believe she has cut corners on care.”

Book said his staff has been evaluating the Trust’s partnership with Solano since the Herald questioned him about the contract months ago.

“I don’t know if she did anything wrong with us because we haven’t been able to find it,” he said.

The Miami Herald reviewed hundreds of pages of emails involving Solano and leaders of the Homeless Trust. They illustrate Solano’s role in finding beds for frail, sickly seniors whose misfortune left them stranded.

The sister of a man who was homeless, disabled and chronically ill contacted Mayor Daniella Levine Cava’s office seeking help. He was about to be evicted, said an email from a county public housing worker, “and will find himself homeless” — again.

The Chapman Partnership, a non-profit overseeing efforts to ease homelessness in Miami-Dade, needed a home for a man who was nearly blind and couldn’t walk, feed himself or use the bathroom without help. “We are unable to continue this level of care,” an executive wrote.

Camillus House, the county’s flagship homeless assistance program, needed a home for an 80-year-old with dementia: “This poor man is walking around forgetting his ID, wallet, watch and other items,” the home’s security director wrote. “When asked for his ID, he looks down and tries to remember but can’t. Then he starts to cry.

“Truly, he does not belong here.”

Miami-Dade Commissioner Oliver Gilbert sought help for a Miami Gardens constituent, a cancer patient dependent on an oxygen tank who was surviving on $850-a-month in Social Security payments and was being evicted.

All found their way to Solano’s inbox.

“A lot of people on [Trust Executive Director Vicki Mallette’s] radar went to Roxana’s,” Book said in a Herald interview. “Some people went from Mia Casa to Villa Serena, but we don’t know how many.”

Rodent droppings and a chicken

With more than 800 licensed assisted living facilities in Miami-Dade, caseworkers and discharge planners have a full buffet of choices. Yet records show Solano placed Jackson patients in homes – which she did not own – with woeful records of care, including facilities state health administrators have sought to close.

Residents at the Tropical Heaven elder care home in southwest Miami-Dade were jammed so tightly into shared bedrooms that inspectors reported they had only 30 feet of personal space – smaller than an average Florida prison cell. Inspectors found a caregiver bathing a nude and terminally ill patient in front of two roommates. One resident left the home and was found next to a wheelchair in the middle of the road.

Inspectors reported seeing rodent droppings, cracked tiles in a shower, a tarp on the roof, a crack in the ceiling, debris and furniture dumped outside.

And a chicken. Tied up to a laundry hamper in the yard.

Despite these conditions, Jackson Memorial helped keep its beds full.

In the 28 months after the home’s license expired on Oct. 27, 2020 – and before the state closed it in March 2023 – Jackson, through Solano, made 27 separate discharges to the home – some patients were discharged more than once to Tropical Heaven. The home was, overall, the third-largest destination for discharged patients not owned by Solano.

Jackson records show 99 patient discharges to a chain called Villa Rosa, 24 of them to Villa Rosa I, a 40-bed home on West Ninth Street in Hialeah.

Villa Rosa I also had been cited for multiple violations by health administrators, including a $5,500 fine in December 2019 for failing to report an alleged rape to authorities. A caregiver accused the resident of lying without investigating the claim, the report said.

State health records don’t indicate how the allegations were resolved, only that several residents of the home reported incidents involving sexual aggression.

AHCA cited Villa Rosa I for failing to report the allegations, as required.

Subsequent inspections cited the home for failing to follow proper infection-control precautions, for using staff with inadequate training and for failing to have toilet paper or paper towels in the bathrooms. “Sometimes they give you sheets of paper,” a resident told an inspector investigating a complaint. “It’s not very sanitary.”

The home’s owner, Amanda Perez Martinez, did not return a call from the Herald, and screened out subsequent calls.

Solano also arranged for 30 Jackson patients to go to the 14-bed Dulce Hogar ALF on Northwest 26th Avenue between 2016 and the end of 2023.

State health inspectors said a resident was sleeping in a folding bed in the living room, and reported “multiple, necrotic” pressure sores on another resident’s thigh, ankle and foot. Staff had been using full bed rails as restraints on two residents without consent, a November 2021 complaint said.

The state fined Dulce Hogar $5,000 in January 2022.

In the months after the state filed its complaint, Unlimited Senior Solutions, Solano’s company, placed 20 Jackson patients in the home.

The home’s administrator, Dania Lima, said the home was very clean, and that “all the patients are bathed and dressed. They are given good food. All their needs are attended to.” Lima added: “They are given their therapy if they need it. They get the care that they need. The doctor comes once a month to check on them.”

The largest number of Jackson patients went to homes owned by Solano, Jackson records show. Among 1,423 total discharges from 2016 through Nov. 30, 2025, three Villa Serena homes were among the top six destinations.

Solano has said she entered the elder care industry by accident. Her website says she earned a doctoral degree in 1992 from the Dominican Dental University in Santo Domingo, the Dominican Republic capital. Several years later, at age 28, she was hired as activities director at a senior living center, she said in an interview published by the Homeless Trust.

“She learned everything she could about the business,” the article stated.

She began buying her own elder care homes. Solano opened Villa Serena, which calls itself a “community” of Miami-area ALFs, in 2004, the chain’s website says.

In less than a decade, Solano became an influential figure in the long-term care industry. Then-Gov. Rick Scott appointed her in 2011 to a state task force assigned to study ALF oversight after a Miami Herald series documented rampant neglect of elders.

She’s chair of the Florida Assisted Living Association’s Miami chapter, and on the board of directors of Thriving Mind, a Miami mental health care provider group. Thriving Mind’s website says she has “extensive experience collaborating across public-private systems including hospitals, aging services, behavioral health systems, supportive housing organizations” and others.

Rousting caregivers at night

Villa Serena’s ALFs have been repeatedly cited by the Agency for Health Care Administration, which regulates nursing homes and ALFs in Florida. The agency has fined Solano’s homes $38,125 since the early 2010s.

Health regulators issued an “immediate” moratorium on admissions to Villa Serena VIII when a resident vanished after warning caregivers that “he did not want to stay [there] and would leave,” a 2019 report said. After reappearing at a hospital two days later injured, “unresponsive and dehydrated,” he was returned to the home — only to bolt the next day.

Health regulators also accused the ALF of ignoring state law by having no caregivers awake at night. The home provided nightly care “only if the resident has the wherewithal to roust a caregiver” from bed — a practice that “clearly places all residents at immediate risk,” an administrative complaint said.

Solano signed a settlement agreement with the state in December 2019, requiring her to pay an $18,500 fine and sell Villa Serena VIII within 90 days — which she did.

A 2019 complaint found violations at Villa Serena VII, a 12-bed home off 24th Terrace and Southwest 33rd Avenue: One resident suffered from partial paralysis following a stroke and needed help eating, moving in and out of bed and with other activities. The resident tried to stand up and fell, requiring emergency rescue.

Staff failed to report the fall, as required, and did nothing to prevent it from happening again, the report said. The report cited administrators for denying the fall had occurred, though internal records documented it.

A second resident, diagnosed with dementia, was also hospitalized after a fall. The facility did not notify the resident’s doctor or family members, as required.

When COVID was raging in long-term care facilities throughout Florida, AHCA filed administrative complaints in August 2020 against Villa Serena I and Villa Serena II, claiming the homes failed to follow state and federal infection control precautions. At Villa Serena I, 13 of 15 residents contracted the illness. At Villa Serena II, all 15 residents were hospitalized.

Seven of Villa Serena III’s 13 residents contracted COVID. A “handwritten document,” not signed by a doctor or lab, with purported test results seemed to have been falsified, as “dates appeared to be changed and the numbers were written over,” the complaint alleges.

AHCA wrote that it intended to revoke the licenses of all three homes.

Solano was fighting to keep five of her homes alive.

Keeping the doors open

Solano surrendered two of her homes to the state on March 12, 2021, signing a settlement agreement to sell Villa Serena I and II to an “independent” party.

The state also had forced her to sell Villa Serena VIII — the home where a resident disappeared and officials did not notify anyone.

She agreed to pay fines of $23,500 for the violations at Villa Serena I, II, III and VII. The fines had originally totalled $47,000.

Solano agreed to hire a professional management consultant to improve operations for two years. She was forbidden from opening any new facilities that received Medicaid dollars or were licensed by the state before June 2025.

Solano insisted in an email to Homeless Trust leadership that “litigation had a very high possibility of success according to my counsel, but it could jeopardize my other licenses, so I decided to settle.”

Solano’s lawyers also said that, even after the settlement was inked, Solano was being singled out for financial ruin.

In an April 27, 2021, letter to the health agency, Solano’s lawyer wrote that inspections during that time “in what may have been the worst weeks of the pandemic [did] not provide a fair picture of Villa Serena’s operational capabilities.”

The lawyer argued that no one had died at a Villa Serena home, that some of the agency’s findings were false or misleading, and that the state’s proposed punishment far exceeded the chain’s mistakes.

“When placed in context, the allegations against Villa Serena do not warrant the Draconian result of putting the company out of business,” the letter said.

Solano kept the doors open on her five remaining ALFs, and benefited from infusions of cash from Jackson Health System and the Homeless Trust.

Jackson Health signed its first contract with Solano in 2016, for $819,060 – a three-year agreement with renewals. The hospital modified the contract two years later to add another $800,000, for a total of about $1.6 million. The contract was modified again in 2018, 2019, 2020 and 2021, increasing its value.

ln 2022, Jackson Health System’s then-CEO Carlos Migoya signed a new, four-year contract with Solano’s company for $31.5 million. This was well after her troubles with state health regulators had been documented. The contract remains active.

Jackson’s approval of Solano did sway the Trust’s decision to partner with her, Book said.

“Jackson signing with her mattered to us,” he said. “If someone has a contract with Jackson you assume they’ve been vetted. You still have to be astute enough to do your own check.”

Though Jackson discharged hundreds of largely incapacitated patients into homes chosen, and sometimes owned, by Solano, there is little evidence that the hospital engaged in any meaningful, routine oversight.

“We maintain ongoing communication with the management teams of these assisted living facilities and conduct formal quarterly meetings with the vendor to review placement challenges, clinical quality measures and overall performance,” Brenlla wrote.

Solano’s 2022 contract proposal, accepted by Jackson, in fact, left her in charge of all grievances, complaints or disputes over quality of care for Jackson patients she discharged. The contract made no provisions for residents of the homes she owned and operated herself.

When the Herald asked Jackson administrators for records showing any and all contract monitoring activities, the hospital supplied quarterly vendor performance evaluations which each measured only three criteria, none of which assess resident care or the ALF’s compliance with state standards. In every report, monitors said only that Solano “meets standard.”

Miami Herald staff writers Andres Viglucci, Shirsho Dasgupta, and Ana Claudia Chacin contributed to this report.

This story was originally published August 21, 2026 at 5:30 AM.