Local health inspectors have more authority over where people cook crawfish than over who can operate makeshift nursing homes with no medical training.

That’s the picture Brad Philips, district manager of inspection services at the Mobile County Health Department (MCHD), painted when asked about unregulated boarding homes in the area.

“It’s very frustrating to know that, unless you can get the city or county to cite [an unlicensed facility] for a building or zoning violation, really all you can do is document what’s going on and try to see if somebody has some teeth they can sink into it,” Philips said.

Such facilities are not licensed through any state agency and are not inspected to ensure quality of care, adequate staff training or basic living standards. They hide in plain sight.

The Alabama Department of Public Health (ADPH) acknowledges there are many of these homes locally, though exactly where is a guessing game. Typically located in residential neighborhoods, some of these homes house patients with mental illnesses, the elderly or both.

Even when such a facility is suspected, the task of addressing it often falls between the cracks of regulatory authorities. When MCHD inspectors receive reports about an unlicensed facility, Philips said there are very few options to do anything about it.

“With hotels, we’ve got regulations we go by that clearly define what the conditions need to be, the standards for how it’s supposed to be built and the level of cleanliness required,” He said. “With homes, though, there’s nothing to go on, and there’s usually not anything we can do unless we see signs of definite abuse or neglect.”

The ADPH licenses and inspects hundreds of nursing homes and assisted living facilities, which are required to comply with dozens of detailed health and safety standards. The regulatory burden is even higher for those housing residents with cognitive impairments such as Alzheimer’s.

With the closure of Searcy Hospital in 2012, the area has also seen an increase in the number of group homes licensed through the Alabama Department of Mental Health (ADMH) housing patients with mental illnesses, developmental disabilities or substance abuse problems.

“Community service providers” go through ADMH certification to provide these services in residential homes or apartments. In recent years, ADMH has logged inspections at more than 300 residences in Mobile County, including 88 with mentally ill patients.

Then there are the homes offering similar services but without any certification or oversight.

Over the past three months, two citizens have reached out to Lagniappe after complaining to state agencies about what they believe are unlicensed group homes operating in the neighborhoods they live in. Both said they’ve seen little done, though.

But Cynthia Granger, a registered nurse and ADPH inspector, said there are hurdles to address group homes at the state level, too. With limited funding, she said, it’s difficult for ADPH to find time and the personnel needed to investigate reports of unlicensed homes and regulate hundreds of licensed facilities across Alabama.

“We’re down to four and a half surveyors for 350 licensed facilities throughout the entire state of Alabama,” Granger said. “We have shut down [unlicensed] places in the past, but that would be based on lots of time spent investigating egregious things.”

ADPH has shut down unlicensed group homes before, including one in Mobile County, as recently as 2008, but those efforts require lengthy litigation and have even faced pushback in the past because — in some cases — the residents there may have no place else to go.

One homeowner in Mobile, who did not wish to be identified, said she’s spoken with ADPH investigators as well as the Alabama Department of Human Resources about what she suspects is an unlicensed home in the Park Forest subdivision off Zeigler Boulevard.

So far, though, the only action she’s seen has been from the city of Mobile.

The home, located on Challen Circle, is associated with businesses run by Meoshi Nelson, though a relative appears to be listed as the actual owner. Nelson owns and manages By Faith Living Transitional Housing and has declined to discuss her business operation multiple times.

Posts to her public Facebook account as well as a page set up for By Faith Living Transitional Housing indicate Nelson operates at least a dozen homes in Mobile, Prichard and Whistler, but there is no record of those facilities being licensed through ADPH or ADMH.

One of the only available records pertaining to Nelson’s business activities is a business license for a By Faith Cleaning Service LLC filed with the Alabama Secretary of State’s office in 2010 — a business tied to federal fraud charges Nelson pleaded guilty to in 2015.

According to her sentence, Nelson should still be serving a five-year probation sentence for submitting more than $100,000 worth of fraudulent claims after the 2010 BP oil spill, though the probation office would not confirm the current status of her sentence.

Court records indicate the city of Mobile recently cited Nelson with a zoning violation for operating a business in a residential area at the Challen Circle address subject to the 311 complaint mentioned above, which the complainant confirmed.

City Attorney Ricardo Woods said Nelson was scheduled to appear in municipal court April 11 over the zoning citation but never showed up, adding that a bench warrant had since been issued for her arrest.

However, over a month later, jail records indicate no arrest has been made. In the time since, By Faith Living Transitional Housing has continued to operate openly.

In fact, it was recently named “Best Group Home” at the 2nd annual Black Owned Business Awards hosted by Unique Enterprises Worldwide LLC — an award the business has taken home two years in a row.