‘The situation is dangerous.’ Parents sound alarm over troubled in-home care provider

Andrew Simmons, right, blows bubbles with his father Bo last spring. Andrew, who's profoundly autistic and mostly non-verbal, lives in a supported living home in Snohomish County operated by Aacres WA, a troubled state contractor. Bo Simmons says conditions in the home over the past year have deteriorated to the point of being dangerous for Andrew and his housemates.

By Austin Jenkins 

In February of this year, Leigh Anne Francisco’s severely autistic 21-year-old son Angus moved into a home for people with developmental disabilities operated by Aacres WA, LLC in Snohomish County.

Almost immediately, Francisco grew concerned about conditions in the home.

First, she noticed mysterious bruises on her son, including a large dark purple one on his inner thigh.

Then Angus and his housemate were left unsupervised one night because the overnight staff member never showed up.

There were other issues too.

Francisco said Angus was overfed and rarely taken out for a walk or to kick a soccer ball into the net she had set up for him in the backyard. He quickly gained 30 pounds.

When she visited, Francisco said she often found Angus’ hygiene had been neglected. The condition of the house also dismayed her — food and garbage on the floor, shampoo and toothpaste spilled in the bathroom. To make matters worse, Francisco said the staff was often “lounging around and on their phones.”

There were also medication errors. By September of this year, Francisco was frantic and trying to get Angus moved out of Aacres’ care.

“This is not what I had imagined for my son!” Francisco wrote in an email summarizing her concerns.

Francisco is one of two parents who, independently of each other, contacted the public radio Northwest News Network in September regarding concerns about Aacres in Snohomish County. The second was Bo Simmons whose 23-year-old son Andrew is also profoundly autistic and lives with three other Aacres clients in a home in Lynnwood.

In his message to the Northwest News Network, Simmons said Aacres was “very much not living up to expectations as a residential care provider for the state.”

“We’re talking about a serious burn which was never communicated to us, repeated times where there is a single staff member for four residents, never taking our son out into the community,” Simmons wrote.

In recent weeks, the parents’ pleas for oversight and accountability have reached state regulators who say they’re now investigating the company’s Snohomish County operations.

The complaints are just the latest against Aacres, a long-troubled care provider that currently has contracts with Washington’s Developmental Disabilities Administration (DDA) to provide in-home support to developmentally disabled clients in Clark, Pierce, Thurston, as well as Snohomish Counties.

Canceled contracts

In 2019, DSHS cancelled three contracts it had with Aacres WA to provide care for vulnerable clients in Spokane County. DDA said it took the action “based on serious non-compliance with the law and regulations.”

One of the contracts was terminated following the death of a client who was given household cleaning vinegar in lieu of colonoscopy prep medication. A former Aacres caregiver was subsequently charged with third-degree assault, and reckless endangerment in connection with the death. Her trial is scheduled for January.

In a statement at the time, the then-assistant secretary of DDA, Evelyn Perez, said: “We have lost confidence in Aacres Spokane. Not being in compliance with regulations and ensuring the health and safety of our clients is unacceptable.”

Previously, Aacres had also operated in King County. But in November 2018, Aacres announced it was pulling out of King County because of a lack of affordable housing and challenges related to recruiting and retaining staff. The move came after the state had put the company’s King County operation on 90-day provisional status for failing to correct serious deficiencies that "jeopardized clients' health, safety and welfare."

Nevertheless, DDA allowed Aacres to continue serving vulnerable clients elsewhere in Washington under separate contracts with the state.

Records show that during the 2019 to 2021 biennial budget, Washington’s Department of Social and Health Services (DSHS) paid Aacres more than $92 million making it the agency’s seventh largest contractor. So far this budget cycle, which started July 1, state payments to Aacres total $16.3 million.

As of the end of 2020, Aacres served approximately 220 clients across the four counties, according to DDA.

Founded in 1974, Aacres is one of several human services companies operated by Spokane-based Embassy Management, LLC. According to the website for Bregal Partners, a New York private equity fund, Embassy is one of its portfolio companies.

Aacres and Embassy Management did not respond to multiple requests for comment.

In previous statements, the company has said that shortcomings in care “in no way reflects our passion, commitment and resolve to our mission to safely serve individuals in their homes and communities.”

A beleaguered industry

Historically, people with developmental disabilities in Washington were served in state institutions known as Residential Habilitation Centers. But over the decades those facilities have downsized as part of a state and national shift to serving individuals in the community.

DDA’s largest community residential program for people with developmental disabilities and significant support needs is called Supported Living Services.

Today, roughly 140 supported living agencies, including Aacres, serve about 4,600 clients who qualify for DDA services.

Under the program, clients live in their own home with up to three other housemates while being supported, often around-the-clock, by agency staff.

The clients pay for rent, food and other expenses while the state’s Medicaid program covers the cost of the support staff. In 2020, Washington’s supported living expenditures were $768 million, according to DDA. That included a temporary COVID-19 rate increase for contracted agencies paid for with federal relief dollars.

But Scott Livengood, the legislative chair for the state’s Community Residential Services Association, said the industry has not caught back up since rates were cut during the Great Recession.

“Due to funding increases not keeping pace with the cost of living and the steady increase in our statewide minimum wage, the average starting wage for a [direct support professional] is now around $15 per hour, which is only 5% above the statewide minimum wage [that takes effect] next month and 25% below a self-sufficient wage,” Livengood said in a statement.

As a result, he said, most frontline support staff work two to three jobs and average turnover in the industry is about 50 percent. Livengood estimated the current vacancy rate is approaching 20 percent as agencies lose workers faster than they can hire them.

“The pandemic has made the situation even worse, as we are competing with fast food and retail jobs offering $18 to $20, along with attractive benefit packages and hiring bonuses,” said Livengood who is also CEO of Alpha Supported Living Services, a nonprofit serving clients in King, Snohomish and Spokane counties.

To try to slow the attrition, supported living agencies have offered signing bonuses and “hazard pay” during the pandemic. But the federal stimulus dollars that funded those enhancements are scheduled to expire at the end of the year making it even harder to recruit new employees, Livengood said.

It’s not just the pay, but the nature of the work that makes finding and keeping employees difficult. Staff are often required to work nights and weekends. And the clients can exhibit challenging and even violent behaviors.

In the past, Aacres has pointed to the challenge of recruiting and retaining front-line staff as a factor in its quality of care lapses.

State records show that since 2018 Aacres in Snohomish County has been subject to four inspections, two investigations and one enforcement action.

In January 2019, Aacres was fined $1,000 after the subflooring in one of its Snohomish County homes failed and a client fell into the space below and was injured.

Then in August of this year, an unannounced inspection of Aacres homes in Snohomish County found a number of deficiencies — especially around COVID-19 protocols. Among the findings was that visitors, staff and clients weren’t properly screened for COVID symptoms.

The concerns of family members have also reached state regulators. The state’s Residential Care Services (RCS), a division of DSHS, confirmed to the Northwest News Network that it has active investigations underway into multiple complaints about substandard care at Aacres homes in Snohomish County.

However, Aacres in Snohomish County has not been put on “stop placement” status, where an agency is barred from accepting new clients, or put on provisional certification status which is the last step before decertification.

“If the complaints are found to be substantiated, Aacres, like any other provider, will be held accountable for its deficiencies,” said RCS director Mike Anbesse in a statement.

Aacres isn’t the only supported living agency to draw scrutiny this year. Over the past 11 months, the state has issued 171 citations and 48 statements of deficiency against supported living providers for violations, according to data provided by DDA.

An unreported burn

For months, Bo Simmons and his former wife Louise had been uneasy about the care their son Andrew was receiving from Aacres. They noticed staff turnover was high and sometimes there was only one caregiver on duty in the home, despite there being four clients to care for.

Often Andrew would spend much of the day in bed. Occasionally, the staff failed to get him to dental and doctor appointments. He even missed virtual meetings with a job coach.

But concern turned to alarm earlier this year when Louise went to visit Andrew and discovered the palm of his hand had been burned, possibly from touching the stove.

Adding to their distress was the fact no one told them about the injury. Andrew had also not been taken to the doctor for treatment of the burn.

Then, about a month ago, there was another upsetting incident. Andrew, who has migraines and often bangs his head on surfaces because of the pain, slammed his head into a plaster wall in the bathroom. Shortly after that he knocked a staff member to the floor and in the tussle hit his head a second time.

Medics were called to the house. They evaluated Andrew, but did not take him to the hospital. Simmons said the staff was supposed to monitor Andrew for signs of a concussion. Instead, he said, they gave Andrew a sedative and let him go to sleep. When Louise came to visit Andrew that afternoon, she found him in bed soaked in urine.

For Andrew’s parents, that was the last straw.

“He’s a very amazing young man, and he deserves better,” Simmons said tearfully during an interview.

In his desperation, Simmons launched what he described as a “full court press” to bring attention to the plight of his son and other Aacres clients in Snohomish County.

Working closely with Louise, he's urged the state to conduct a “complete review” of Aacres and its parent company, Embassy Management. He's also lobbied DDA to move Andrew to a different supported living provider. And, recently, he retained an attorney who specializes in representing the interests of people with special needs.

In September, Simmons summarized his concerns about Aacres in an email to a top DDA official.

“Andrew has languished in their care,” Simmons wrote. “We suspect that there are many other clients who are not well represented who are in a similar state and we want to advocate for them as well.”

Last month, Simmons followed up with an even more desperate message to DDA’s regional administrator in Snohomish County.

“The situation is dangerous. Seriously dangerous,” Simmons wrote. “The residents and the caregivers are being placed in an extremely unsafe and dangerous environment. It is Aacres management who are to blame for this situation, not the caregivers.”

In response, DDA officials said they’re aware of the concerns.

“I do understand that we are experiencing some challenges right now up in Snohomish County with Aacres,” said Shaw Seaman, DDA’s quality assurance chief.

Seaman said the state is committed to quality improvement and interested in supporting Aacres so that it can get back on track.

Getting results

Lately, Bo Simmons said he’s seen some signs of progress.

First, DDA dispatched an inspector to visit all of the Aacres homes in Snohomish County to document immediate health and safety hazards. Aacres is now required to submit weekly reports on progress in correcting any deficiencies, according to email communications Simmons shared with the Northwest News Network.

Simmons also met with Aacres management and received assurances that the company would address his concerns. Soon after, Aacres held a retraining session for the staff who work with Andrew.

Aacres management also sent a behavioral clinician and its clinical director to visit Andrew and observe him in his environment. The behavioral clinician plans to continue twice weekly visits with the goal of modeling “for staff how to work with him,” according to an email Aacres’ area director sent Simmons.

Then, on the evening before Thanksgiving, both parents attended a virtual meeting with DDA officials. In a post-meeting email, Simmons said the DDA staff showed “empathy and compassion for our situation.”

The state has also agreed to make a referral for Andrew to a state-operated home for people with developmental disabilities, although there’s no guarantee of a bed being available for him.

Simmons is hopeful Andrew’s care will improve. But he also continues to question whether Aacres is deserving of the $726.28 a day that the state pays the company to care for his son.

“Andrew is most definitely not receiving what the state is paying for,” Simmons wrote in his September email to DDA.

Leigh Anne Francisco, Angus’ mother, also reported her concerns to DDA and RCS, but said months went by before she heard back from anyone. Separately, she was contacted by Adult Protective Services (APS) and provided the investigator with a statement. APS would neither confirm nor deny if it's currently investigating Aacres.

Like Simmons, Francisco also decided that she needed to get Angus moved out of the Aacres home. Her final straw came when her son and his housemate were left unattended overnight earlier this year.

“He’s not safe there, the other roommate is not safe,” Francisco said.

But in the months since, she’s had no luck finding another provider to take him.

“I feel as if I’ve failed as a mother because I haven’t gotten him out of there,” Francisco said.

Francisco recently had a conference call with the new area administrator for Aacres who apologized and told her they want to do better.

Even before that call there were some hopeful signs. The waist-high lawn in front of Angus’ house was finally mowed and damage the residents had done to the walls, which had previously been covered by cardboard, was repaired.

“I’m always cautiously optimistic,” Francisco said: “But the story that I’ve been given so many times is ‘we’re going to make this better, we’re so sorry, we’re retraining everybody.'"

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‘The situation is dangerous.’ Parents sound alarm over troubled in-home care provider

PA Releases Details On Nursing Home Investigations

Facilities understaffed following the pandemic failed to provide basic care in some nursing homes, investigators found.

 

by Justin Heinze 

PENNSYLVANIA — Pennsylvania has released the details of hundreds of investigations into complaints at nursing homes across the state in October, including dozens related to COVID-19 response and safety measures.

Three nursing homes were sanctioned as a result of the investigations, resulting in a total of $16,500 in fines. Investigations addressed a wide variety of issues, ranging from policy deficiencies to overworked staff and the consequences of understaffed facilities.

At Abington Manor in Montgomery County, for example, an inspection found that understaffing amid the pandemic had led, in certain cases, to significantly reduced quality of care.

"It was determined that the facility failed to provide and/or efficiently deploy sufficient nursing staff to consistently provide timely quality of care and services, including toileting/incontinence care, response to residents' requests for assistance with activities of daily living, and medication administration to maintain the physical and mental well-being of the residents in the facility," the report states.

Full details of all inspections conducted by the state in October are available at the Department of Health's website here.

State officials, who oversee 688 homes in Pennsylvania, say they're working to respond to these issues. But enforcement only goes so far.

"The Department of Health continues to investigate complaints to ensure nursing home residents receive the best quality of life and care," Acting Secretary of Health Alison Beam said in a statement. "If you see something that may jeopardize patients' safety or well-being, you can file an anonymous complaint by calling, filling out an online form, emailing or even mailing a letter to the department."

At Guardian Healthcare and Rehabilitation Center in Luzerne County, staff similarly failed to provide fundamental care, the investigation found. Some residents did not "consistently receive showers as planned to maintain good personal and oral hygiene."

In one case, a resident who was dependent upon staff for basic needs was not given a shower for the first 20 days after admission. Investigators noted a "pattern" of neglect but were unable to name a cause beyond the obvious lack of personnel. "The Director of Nursing was unable to state why Resident 1 had not had a shower since her admission 20 days ago or why direct care staff were not aware that that the resident had dentures."

A resident at Embassy of Hearthside in State College told inspectors about the staffing issue. "He confirmed that he would like to get two showers a week," the report states, "But feels the facility does not have enough staff to be able to do this."

State officials conducted a total of 504 inspections of nursing homes throughout October month, covering 345 separate homes. Out of those investigations, 306 were launched due to complaints, and 67 were specifically due to COVID-19 complaints.

Nursing home residents and the public can file complaints by calling 1-800-254-5164, filling out the a form online, emailing c-ncomplai@pa.gov, or sending a complaint in the mail.

 

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PA Releases Details On Nursing Home Investigations

Florida watchdog allowed 8 professional guardians who violated state law to continue practicing

'Mitigating circumstances' cited in letters

Florida’s professional guardians have been in the headlines this past year and under arrest for stealing, abuse and neglect.

By: Adam Walser

TALLAHASSEE, Fla. — Florida’s professional guardians have been in the headlines this past year and under arrest for stealing, abuse and neglect.

But the I-Team has uncovered that even when the state’s own investigators found guardians broke the law, they continued with business as usual.

Teresa Kennedy provided us with a 2018 video showing a reunion with her aunt Lillie White, herself and her mother Jane Kennedy at an assisted living facility where White was placed by her court-appointed guardian.

White, a retired school administrator who once sang at Harlem’s Apollo Theater, brightened up as she sang a hearty rendition of “All of Me” with her niece during the visit.

White’s guardian banned most of her family from contacting her years ago.

“We didn't know where she was for two years and then we found her through private investigators in November 2018,” said Kennedy.

After a family dispute over money, a judge appointed a professional guardian to care for White.
“I never thought anything like this could've happened,” White said, in the 2018 video.

White was removed from her home in August 2016 and taken to an assisted living facility.

“They’re saying you don't want to see your sister Jane. Do you want to see her?” Kennedy asked her aunt in the video.

“See how lies can get out? Oh my goodness,” said White. “I've always wanted to see her.”

But before Lillie's family tracked her down, they contacted the Florida Office of Public and Professional Guardians (OPPG).

That’s the watchdog agency set up to investigate complaints against guardians.

“I finally received a call from the inspector general's office saying 'we're opening up an investigation.' So I was very excited,” said Kennedy.

That call came in 2017, about a year after she filed a complaint, but she heard nothing more until almost two years later.

“Every month, I'm calling and saying another year, another week, another month. Where's the report?” said Kennedy.

The I-Team obtained that report showing investigators found Lillie's guardian was not registered as a professional guardian with the state and had billed White’s bank account for attorney fees that were not allowed.

But despite finding problems, the state’s watchdog did not take any disciplinary action.

In a letter to White’s guardian, Department of Elder Affairs Secretary Richard Prudom said her conduct was “mitigated by the complexity of the family relationships.”

“I was so angry when I got the OPPG letter,” said Kennedy.

The I-Team uncovered eight other cases in which investigators found guardians violating the law. But the state never moved to take away the license of any of those guardians, each time ruling the problem had been "mitigated".

One guardian was cited for paying a concierge dentist $73,000 for unnecessary visits.

Investigators found another guardian charged a person under her care hourly fees for a caretaker to accompany the ward on a cruise without getting permission from the court.

Another guardian billed a woman’s estate for providing care services using a side business he owned without telling the court, which is also a violation of the state guardianship law.

Those guardians' actions were all mitigated by taking 16 hours of continuing education courses

Kathleen Zagaros complained to the state after her mother's guardian ignored her mother's advanced care directives, then requested a do not resuscitate order.

“She wanted all measures done. She appointed me as her surrogate healthcare provider. And they were ignored by the guardian,” Zagaros said.

The investigator substantiated that allegation. But a letter to the guardian dated October 14, 2019, said the conduct was mitigated by the actions of the guardian to honor veterans at Arlington National Cemetery.

Click to read

What does that mean?

The state did not take any disciplinary action against the guardian because she bought five wreaths for $150 through an organization that lays wreaths at Arlington National Cemetery.

Department of Elder Affairs Secretary Richard Prudom, who oversees OPPG, declined an on-camera interview but provided the following statement by email:

“The Department of Elder Affairs is committed to transparency and education regarding this process. Several factors are used to appropriately determine disciplinary actions regarding complaints received against professional guardians. In cases where evidence of intent to cause harm is found, the Department will refer the matter to law enforcement. We are thankful to have the ongoing partnership of Representative Colleen Burton and Leader Kathleen Passidomo to make revisions to existing law to help ensure the Department has more tools to hold bad actors accountable.”

A guardianship reform bill sponsored by those lawmakers was passed during the 2020 legislative session. It was signed into law by Gov. Ron DeSantis and took effect July 1.

At least five guardians have been charged with crimes since the OPPG was created, but OPPG has not been able to substantiate which of those cases they referred to law enforcement.

“OPPG to date has been there to protect guardians and not the senior. It's very, very clear,” said Kennedy.

We first spoke to Kennedy about her case in early March, before the pandemic shutdown. We followed up with her recently and she says she’s still not allowed to have any contact with her aunt, including phone calls.

“People who do have loved ones in nursing homes right now during COVID-19 might get a little sense of it, not being able to hug their mother, having to talk to them through the window. But at least they can do that. We can’t,” Kennedy said.

She has filed a new complaint with OPPG involving her aunt’s guardian and is hoping her last reunion with her aunt Lillie in 2018 won't be her last.

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Florida watchdog allowed 8 professional guardians who violated state law to continue practicing

Nursing home where woman was 'eaten alive' by mites receives over $8M in taxpayer money

LAFAYETTE, Ga. — A Georgia nursing home once criticized for allowing an elderly woman to die from a scabies infestation is back in the spotlight. The latest complaints come from a widower, whose wife lived at the facility, and a former nursing home manager.

Frances Palmer moved into Shepherd Hills Nursing Home in LaFayette, Georgia in the summer of 2018. In the time she lived there, her husband Jim, documented injuries related to three different falls reported to him by staff.

After her second fall this past September, he filed an incident report with the LaFayette Police Department alleging that staff abused her. The police department said it forwarded the case to Adult Protective Services, a part of the Division of Aging Services. A spokesperson of the agency declined to confirm it received the report, but said the state typically forwards nursing home related complaints to another agency – the Georgia Department of Community Health (DCH).

After the fall, the 70-year-old said he then requested padding around his wife’s bed.

“I asked them to put one on the floor and they said no, she might trip over it. And I said if she trips over it, at least she is gonna land on something soft,” Palmer said.

Eleven days later, Frances fell again.

“Her face was swelled up, black eyes. She was cut across her nose. She was just black and blue,” Palmer recalled.

Hospital records show she suffered fractured bones in her face and bleeding in her brain. Doctors told Palmer the damage was irreversible.

“I actually feel like I killed her by putting her in that place,” said Palmer. Frances was 75-years-old when she died.

While state inspectors have not determined if Shepherd Hill played a role in Frances’ death, the facility has a long history of alleged neglect.

HISTORY OF ALLEGED NEGLECT

In 2015, 93-year-old Rebecca Zeni died from a scabies infestation while living there. After reviewing her autopsy, forensic pathologist Dr. Kris Sperry estimates millions of mites were living inside Zeni at the time of her death.

“This is one of the most horrendous things I’ve ever seen in my career as a forensic pathologist,” said Sperry in an interview with 11Alive's investigative team, The Reveal, back in 2018.



Since Zini’s death, inspectors with the DCH have cited the nursing facility four years in a row for multiple violations. That includes violations for medication errors in 2016; inaccurate patient records in 2017; a hole found in the ceiling of a room in 2018 and failing to provide a safe and clean environment in 2019.

The Reveal has confirmed the state is currently investigating 2019 neglect allegations related to a current resident who lives at Shepherd Hills. His name is Andy Coleman.

Coleman's sister, the nursing home’s former nursing director, filed the complaint with the state. Pictures provided to The Reveal show a bruise on his forehead and black eyes. The family says the injuries are a result of the staff allegedly not following fall prevention protocols.

► READ | DCH inspection reports for Shepherd Hill at the bottom of this story

During roughly the same time period, the LaFayette Police Department has responded to the nursing home at least 57 times. Incident records show the allegations range from theft involving staff, simple battery between residents and unaccounted for patients.

CEO HAS "NO COMMENT"

The Reveal reached out to Pruitt Health for an interview with Neil Pruitt, the CEO and chairperson. The public relations firm, Edelman, contacted us back to say they would facilitate the interview request.

After a few weeks they emailed us back to say "Pruitt Health has declined the interview opportunity and asked us to let you know that they do not have information or comment to share at this time,” read Edelman's email.

A few weeks later, we took advantage of the opportunity to talk with Pruitt in person at a public meeting. The CEO is also a board member on the Georgia Board of Regents.

Before the board’s February meeting started, The Reveal Investigator Andy Pierrotti asked Pruitt multiple times if he would like to respond to the state violation.

“We have no comment. We don’t respond to this type of journalism,” said Mr. Pruitt, as he walked away.

TAX PAYER FUNDED

The Reveal provided our findings to Rep. Steve Tarvin. The lawmaker represents the district where Shepherd Hills is located.

“I haven’t talked to anyone officially about those complaints, but it’s disturbing to see those things and you hear and read about them, but I wasn’t aware of anything at Shepherd Hills, this kind of problem,” said Tarvin.

The long-time Chickamauga lawmaker said he forwarded The Reveal’s findings to the DCH to investigate.

While state inspectors were citing the facility year after year, state records show its owner, Pruitt Health, received Georgia taxpayer money.

From 2018 to 2019, DCH documents obtained from a public records request, show the company received $8.1 million in Medicaid reimbursements from the Shepherd Hills facility alone.

The same records request shows Pruitt Health received more than $453 million dollars in Medicaid reimbursements from its 56 Georgia facilities during the same time period.

Pruitt Health is the largest nursing home provider in the state.

When asked if Pruitt deserved taxpayer money, Rep. Tarvin said he’s unsure without knowing more from DCH.

“All I can tell you is that I’ve known three or four residents and the families have been perfectly happy with it. I would just have to look into to see what has gone on for sure,” explained Tarvin.

The Reveal posed the same question to Pruitt. “No comment. I don’t know how else to explain that to you,” said the CEO.

READ DCH REPORTS ON SHEPHERD HILL NURSING HOME:

2019 DCH REPORT
2018 DCH REPORT
2017 DCH REPORT
2016 DCH REPORT

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Nursing home where woman was 'eaten alive' by mites receives over $8M in taxpayer money

Troubled Rastelle Manor assisted living facility in Daytona Beach will change ownership

Rastelle Manor in Daytona Beach

CIJ Ventures & Properties LLC began to take over the assisted-living facility after Florida’s Agency for Health Care Administration issued a final order in July to the former owners.

After five years of “deplorable” conditions and multiple calls to local law enforcement regarding dangerous residents and other issues, Rastelle Manor in Daytona Beach may soon be getting a new owner after the state told the current owners they had to sell.

But records show the troubled assisted living facility’s current owner once shared an address with the prospective new owner. Documents from the Florida Secretary of State office show that the facility’s current owners and the people who want to buy Rastelle Manor once shared an address for separate businesses in 2009.

According to the Florida Department of State Division of Corporations, Jeffery Gasmena is listed as the owner of CIJ Ventures & Properties, the company wanting to take over Rastelle Manor, the 25-bed facility at 934 S. Ridgewood Ave. Rastelle Manor’s current owner is Bersonn LLC, which has owned the facility since 2005.

In April 2009, state records show Gasmena was the owner of Holy Hands Assisted Living and Care Services. That company shared an address — 815 W. Daughtery Road, Lakeland — with New Era Assisted Living Facility, which is also owned by Bersonn LLC.

Bersonn LLC, owned by Cheryl and Winston Bernabe, took over the New Era facility in Lakeland in August 2009, according to Florida’s Agency for Health Care Administration. Holy Hands, which is not listed with AHCA, had the same address as New Era until changing their address in April 2010, according to state records.

But Jhuelian Gasmena, who will now serve as an administrator for Rastelle Manor with Robyne Gasmena and Cherwai Jan Gasmena, told The News-Journal he does not know anything about Holy Hands and he’s had no previous interaction with the Bernabes. Cheryl Bernabe also said does not know the Gasmena family.

Brian Lee has seen many assisted-living facilities change ownership over to acquaintances during the nearly 20 years he’s been executive director of Families for Better Care, a national non-profit citizen advocacy group dedicated to bringing awareness to the conditions of assisted-living facilities. His experience makes him wonder about the shared address.

“A shared address, that is more than just a coincidence,” Lee said.

But nothing is set in stone yet. In July, AHCA issued a final order to the Bernabe’s that required them to pay a $36,000 fine, restricted them from renewing or applying for another license to operate an assisted-living facility and required them to find a buyer for Rastelle Manor or shut the doors for good by Sept. 13.

Then, last week, AHCA decided to extend the Bernabe’s licence for another month because the change of ownership application is still pending. This will give the agency time to complete a final inspection to make sure the outstanding reporteed issues — such as unsanitary bathrooms, bug infestations lack of social and leisure activities, lack of medication monitoring and background screenings for employees — have been corrected.

Asked if the past shared mailing address between the Bernabes and the Gasmenas presented any issue, ACHA replied in an emailed statement that “CIJ Ventures & Properties does not have a regulatory record that would disqualify them from purchasing this facility.”

Jhuelian Gasmena said he looks forward to turning the troubled facility around.

“I’m aware of the history with the place and I’m very much wanting to get involved in turning that around and hopefully improving its overall image,” Gasmena said. “We actually hired a contractor to come by and give us a quote on renovations that we may be doing.”

But the issues at the facility seem to go deeper than the conditions AHCA has highlighted after recent inspections. A News-Journal investigation into the facility’s history found that from January 1, 2016 until Aug. 15, 2019 there were 108 calls to police about assaults, suspicious activity, civil complaints and disturbances at Rastelle Manor.

Since 2016, 22 incident reports have been filed about the facility with the Daytona Beach Police Department. The complaints included missing residents, residents beating each other, residents throwing chairs through windows, residents threatening employees, suicide attempts, Baker Acts due to suicidal or threatening behavior, death and former residents trespassing on the property.

Three arrest warrants were issued against residents in the same time period for domestic violence charges and failing to appear in court. Many of the residents listed in the incident reports and arrest warrants have been arrested in Volusia County multiple times.

Lee said while it’s good for police to intervene in possibly dangerous situations, the amount of calls made in the almost four-year time period at Rastelle Manor is disturbing.

“It’s frightening to think there’s a regular presence of law enforcement at a facility because of significant criminal issues occurring,” Lee said. “We don’t want to see that. We want to make sure the residents are safe.”

There are currently 23 residents at Rastelle Manor, which determines a monthly payment based on income and is receives Medicaid reimbursement. The lowest monthly payment is $775 a month, according to the Bernabe’s.

“It wasn’t my plan to have to give it up,” Cheryl Bernabe said last week.

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Troubled Rastelle Manor assisted living facility in Daytona Beach will change ownership

California hospices face lax oversight and few rules. The sick and dying pay the price

South Lake Tahoe resident Tracy Sellers recounts her mother's drug overdose while she was under home hospice care. Sellers filed a complaint claiming the hospice nurse brought painkillers that weren’t properly labeled and lacked written directions. 

By Elaine Chen

One day after her 80-year-old mother started hospice care at home last August, Tracy Sellers found herself racing into an emergency room, pushing a wheelchair carrying her mother.

“The moment we got to the ER, she passed out, her eyes rolled back, her face was white as a sheet,” Sellers said about her mother.

“And her head rolled back, her face was rolled to the ceiling.”

“I grabbed her, and I said, ‘Mom, wake up. Wake up. Mom!’ ”

The nurse rushed over to look at her mother’s eyes, Sellers said. “Pinholes. They’re the size of pinholes.”

Hours later, with IVs pumping fluids in and out of her, Sellers’ mother woke up. Sellers discharged her, signing papers listing the reason her mother was admitted: “narcotic overdose.”

Two weeks later, Sellers filed a complaint with the California Department of Public Health, claiming the hospice nurse had brought to their home a bag of opioid painkillers that weren’t properly labeled and weren’t accompanied with written instructions. She said the nurse gave her verbal instructions that resulted in her mother’s overdose.

Then she waited.

The department took 201 days to finish its investigation. By the time it was done, concluding that the hospice did not violate any regulations, her mother had died. Sellers said that no one in the Department of Public Health formally interviewed her or looked at the bag of painkillers she said was brought to the house by the visiting hospice nurse.

In California, where the population is rapidly aging and end-of-life care is on the rise, patient advocates and researchers say the state’s oversight of hospice facilities and hospice care has not caught up. Largely subsidized by federal money through Medicare, hospice care consists of nurses entering hospitals, nursing homes or patients’ homes to ease patients’ pain in their last months of living.

Interviews and documents reviewed by The Sacramento Bee show a system marred by lax oversight and an inability of regulators to take meaningful action against hospices that may have violated rules and jeopardized the health of patients.

Many elderly patients are being transferred to hospice care too quickly, advocates say, taking them away from remedial treatment and costing Medicare more money.

The Department of Public Health has taken months, and in some cases years, to investigate complaints filed for patients who are meant to have six months or less to live.

When the department has investigated complaints and found deficiencies, hospices are not fined, as the state has no penalty system for hospices as it does for nursing homes.

Further, the majority of regular surveys of California hospices are now conducted by private accreditation agencies. Unlike nursing homes, hospices can pay the agencies to inspect them in place of the state, posing what advocates claim is a conflict of interest as the agencies have incentives to approve the hospices that are paying them.

Tracy Sellers, a resident of Tahoe, holds a picture of her mother in her home, Monday, August 5, 2019. Her mother, Dolores Sellers was on hospice care and was allegedly given an overdose of drugs administered by a hospice nurse in August of 2018. Later Sellers died of natural causes in October of last year. Daniel Kim dkim@sacbee.com

The problems in California mirror what the federal Office of the Inspector General found last month in a report outlining the ways hospices have not complied with federal guidelines. The report found that nationwide, 87 percent of hospices surveyed violated at least one federal guideline. Among the hospices surveyed in California, the number was 94 percent.

The federal report found that hospice workers had left one patient’s pressure ulcers untreated, resulting in gangrene and a lower leg amputation, while another patient in Missouri was discovered with a “maggot infestation” where a feeding tube was inserted into his abdomen.

Patient advocates and researchers say they recognize that the Department of Public Health has a wide mandate that covers a state with 40 million people, but they believe hospice care should not be overlooked. David Stevenson, a health policy professor at Vanderbilt University, said that the people placed in hospice care are exactly the ones that needs the most attention.

“Hospice agencies have escaped close scrutiny and it’s hard to know why,” he said, “given the vulnerable population being cared for.”

Sellers learned of that vulnerability when she discharged her mother from the emergency room. She said the doctor told her to stop giving her mother opioid painkillers, and instead switched her to steroids.

“The doctor said, ‘Don’t give her morphine, it’s too strong for her. If you do that every single day, she’ll die.’ ”

A booming industry

California is on the cusp of a “silver wave.” The California Department of Finance predicts that in 2033, there will be twice as many Californians who are 80 or older as there are today, and in 2043, there will be three times as many. This growth rate is higher than that of any other age group in the state.

As the population ages, the number of people in hospice care has increased. According to Centers for Medicare and Medicaid Services, the number of hospice patients in California covered by Medicare has increased 55 percent in 10 years, to about 71,000 people in 2017.

With that, Medicare spending on hospice care in California has skyrocketed, growing 99 percent in 10 years to reach $1.1 billion in 2017, adjusted for inflation.

Some advocates believe that the growing number of hospice patients could also be attributed to elderly people being transferred to hospice too quickly. Hospice care is meant for people expected to live six months or less, as hospices provide comfort care to ease patients’ pain and not remedial care intended to cure patients of illnesses.

Tony Chicotel, a staff attorney with California Advocates for Nursing Home Reform, said that people could be pushed into hospices by hospitals and nursing homes, which may want to transfer patients to hospice to lighten their workload, and in some cases, to replace patients covered by public insurance with higher-paying patients.

On the receiving end, hospices — particularly ones seeking profit — may be incentivized to admit patients who will stay longer.

A federal Inspector General report published last year noted concerns about the current system of subsidizing hospices, in which Medicare pays hospices for each day a patient is in their care. The report showed that in an analysis of 2013 data, the median length of stay for Medicare patients in for-profit hospices was nearly one month longer than that for Medicare patients in nonprofit hospices.
Among the 1,413 hospices in California, 9 percent are nonprofit.

People working for hospices counter these concerns. Sheila Clark, president of the California Hospice and Palliative Care Association, a trade association representing hospice workers, believes that patients are being transferred into hospice too late.

She said that families of hospice patients tell her they wished they had made the transfer to hospice sooner and that patients are largely in hospice care for less than six months, noting that in 2017, the median length of stay for Medicare patients in California hospices was 31 days. Hospice doctors are also required to regularly check in with patients to determine if end-of-life care would continue to be appropriate for them.

Even for people with family members who are certain to be terminal, though, the process of transferring family members to hospice can still feel rushed.

Last December, Alexander Sheldon transferred his mother, who was being treated for leukemia at O’Connor Hospital in San Jose, to the care of Bridge Hospice, which is run by a limited liability company.

He felt pressure transfer his mother, Sheldon said. “The hospital was pushing me as if my mother was being evicted.”

He also felt that the hospice misinformed him. A representative from Bridge told him that his mother would be able to continue taking her leukemia medication once she went on hospice, he said. However, hospice nurses began giving her the medication only several weeks after she got on hospice care, a few days before she died.

Tere Johnson, executive director of Bridge Hospice’s Bay Area office, said that due to patient privacy laws, Bridge cannot comment about Sheldon’s experience.

Sheldon said he is still frustrated when he thinks back to the hospice representative’s early assurances, and how they did not reflect that staff’s actual treatment of his mother: “There was a disconnect.”

Long investigations

As the population of hospice patients has grown, oversight and regulations have lagged, advocates and researchers say.

One of the main ways the Department of Public Health keeps track of hospice conditions is through investigating complaints filed by patients, their family members or hospice staff — which, in several people’s experiences, has not been done quickly or thoroughly.

After Sellers’ mother experienced an overdose, Sellers sought help from Carole Herman, an advocate at Foundation Aiding the Elderly who helps families file complaints with the Department of Public Health. Herman repeatedly called department officials to get them to investigate Sellers’ claims that Barton Hospice’s nurse left opioid painkillers in Sellers’ home that were not labeled properly or accompanied with written instructions, and then gave verbal instructions that resulted in an overdose.

Drugs given to Tracy Sellers sits on a table in her home in Tahoe, Calif. Monday, August 5, 2019. Sellers claims the drugs were given to her without proper labeling and without written instructions. Daniel Kim dkim@sacbee.com

According to notes taken by Herman during her calls, department officials offered the possibility that Sellers could have been at fault by retrieving the drugs herself and throwing out labels and instructions — a proposition that Sellers and Herman both found perplexing. Herman kept calling, telling department officials to go look at the drugs themselves and talk to Sellers, and they told her they would.

Sellers said they never visited.

201 days after the complaint was filed, Herman received a notice that the investigation was closed and the department did not find a violation of any regulations.

When asked to comment, the department reiterated the notice, saying “all the allegations were investigated through observations, interviews, and record review. There were no regulatory violations cited.”

Mindi Befu, director of public relations at Barton, echoed the department’s statement, saying that “Barton Health fully cooperated with the investigation.” Citing patient privacy laws, Befu said Barton would not be able to share information about Sellers’ mother’s care.

The Department of Public Health appears to not have the resources to investigate complaints quickly and thoroughly, said Joyce McKee, whose mother was under hospice care with the Milpitas office of VITAS healthcare in January 2017.

McKee attempted to file a complaint because, she said, hospice staff arrived to care for her mother days after her mother’s doctor requested them to come, and just several hours before her mother died. Claudia Quintana, public relations director of VITAS, said VITAS could not comment due to patient privacy laws.

McKee said that when she called the Department of Public Health describing her mother’s situation and asking them to investigate promptly, the department official “would tell me, ‘I want to do all that, I just don’t have the humans to do all that.’”

“She doesn’t have the wherewithal,” McKee said. “They do the best they can but they are completely backlogged.”

The long period of time officials take to investigate could affect the results of the investigation, said Charlene Harrington, a UC San Francisco professor who researches elderly care and used to work in the Department of Public Health.

Investigators with the department “often don’t visit to investigate a complaint in a timely way, and then too often it’s too late to verify things,” she said.

According to data from the department obtained by The Bee, in the past ten years, the department has received 2,209 complaints and has investigated 89 percent number of them. Of the complaints it has investigated, it has taken an average of 62 days, more than two months, to begin investigations once complaints have been filed.

Harrington noted that the amount of time the department takes to begin investigations is not always an accurate measure of the department’s promptness, because investigators may record an early start date but not properly investigate until later.

Data from the department shows that to finish investigations, the department has taken an average of 129 days, more than four months. Seven percent of complaint investigations took one year or longer to finish.

While the department has grown quicker with investigating complaints — for example, for complaints filed in 2018, the department took an average of 31 days to begin investigations and an average of 86 days to finish them — the process is still slow compared to existing policy for nursing homes, which requires the department to close nursing home investigations within 60 days.

Currently, the department is not required to finish hospice investigations within a certain number of days.

The department said it “has continued to improve its timeliness for health facility investigations and is currently implementing new systems to be able to investigate complaints more efficiently.”

No fines, no reforms

When the state does investigate promptly and find deficiencies, the hospice must submit to the state a plan it will follow to correct its faults; however, it does not receive any fines. Researchers and advocates say this means hospices don’t face an effective form of punishment that would prevent them from continuing to mistreat patients.

On the federal level, the only punishment that hospices can receive is the extreme measure of being removed from the Medicare program. Stevenson, a professor at Vanderbilt University, said he believes that federal authorities should institute a penalty system they can use to punish hospices while the hospices are still in business and receiving Medicare subsidies.

He added that it may be possible for states to form their own penalty system, noting that in California, there are “state requirements for nursing homes that go over and above federal standards.”
Currently, California hospices can be fined for disclosing patients’ medical information. No other state penalty system exists.

In 2014, the daughter of a woman who died in the care of Bristol Hospice in Roseville filed a complaint with the Department of Public Health, claiming that under Bristol’s care, pressure sores in her mother’s right leg were left unattended, and the sores developed into sepsis and gangrene that ultimately caused her to die.

While the department found that the hospice did violate regulations through its investigation, it did not issue any penalties.

Records from the Department of Public Health obtained by The Bee show that Bristol Hospice continued to violate regulations even after the department released results of its investigation to Bristol. Eight subsequent complaints were filed by patients’ family members and hospice staff. The department ruled in five of them that Bristol had failed to properly train its staff as well as update or follow treatment plans for patients — the same deficiencies the department found in the daughter’s complaint.

As this was occurring, the daughter continued to pursue a lawsuit she had filed against Bristol soon after her mother died.

Ed Dudensing, the daughter’s lawyer, said the daughter did not give up on the lawsuit for five years in part because she “felt that [the department’s] deficiency finding against Bristol would have absolutely no impact on its conduct going forward.”

“Without a penalty system, Bristol had no fear that its egregious failures in care would result in any interruptions of the operations of this facility,” Dudensing said.

Bristol finally settled. Dudensing said that during negotiations, the daughter demanded Bristol change ownership and Bristol eventually agreed, selling its operations to a different company before the final settlement was reached.

Bristol did not respond to multiple requests for comment.

In the hands of private agencies

Complaints are one way for the state to keep track of hospice conditions, but complaints often do not fully reflect issues in hospices.

“Some people don’t know that you can file complaints at all,” Stevenson from Vanderbilt University said. “Most likely people aren’t thinking about [filing a complaint] after their loved one dies.”

The other key way the state keeps track of hospice conditions is through regular surveys of hospices. To qualify for Medicare subsidies, hospices must undergo surveys every three years. States are tasked with conducting these surveys, but hospices have the option of getting “accredited”: paying private accrediting agencies to survey them in place of the state.

Data from the Department of Public Health obtained by The Bee show that 63 percent of hospices in California are accredited. Nationally, approximately 40 percent of hospices are accredited.

Of all the hospices nationally that are accredited, more than one-third are in California.

Michael Connors, an elderly care advocate with California Advocates for Nursing Home Reform, said that the Department of Public Health has incentives to push hospices toward accreditation , as that “reduces [Department officials’] workload and saves them money if they don’t have to go out and inspect facilities.”

That raises issues, Connors said, because accreditation agencies, which are not required to release their survey results publicly, can pose a conflict of interest.

“Accreditation agencies get their business from these hospices and if they were to make findings and release the findings to the public, the likelihood that hospices to do business with them is very low,” he said. The agencies “rely on a friendly relationship with the hospice entities, not the general public.”

Barton Hospice, whose care Sellers’ mother was under, is currently accredited with The Joint Commission, which has given Barton a “gold seal of approval.” Out of all the accreditation agencies, The Joint Commission surveys the greatest number of hospices in California.

Tracy Sellers, a resident of Tahoe, holds a picture of her mother in her home, Monday, August 5, 2019. Daniel Kim dkim@sacbee.com

Maureen Lyons, a spokeswoman for The Joint Commission, said, “Our goal is to protect the public by identifying deficiencies in care and having organizations correct those deficiencies as quickly and sustainably as possible.”

Addressing the concern that accreditation agencies’ inspections are not transparent to the public, Lyons said, “While accredited organizations may choose to release their reports, The Joint Commission provides them as confidential reports of our surveyors’ standards deficiency findings for organizations to implement corrections within a specific time frame.”

Lyons added, “Of all health care accrediting organizations, The Joint Commission shares the most information with the public,” noting that The Joint Commission uploads reports on survey outcomes online.

The Joint Commission’s reports rate hospices’ general care in comparison to hospices nationwide and statewide, but do not show what regulations the hospices have violated, if any.

Hospice care is difficult

Hospice care can be one of the most taxing types of care to provide and one of the most anxiety-inducing to see family members experience.

“Due to the short length of stays, hospice workers and the patients and families they serve are stressed with decision-making in an already difficult time,” said Clark, president of the California and Palliative Care Association.

Many advocates and researchers feel that especially because hospice is such a sensitive area of care, reforms need to be made.

“Hospices are rarely inspected,” Connors said. “Most hospice inspections are conducted by private agencies that have strong incentives to ignore poor care.”

“Nothing is done when serious violations are detected,” he continued, “and findings of neglect are covered up.”

People who have come to the difficult realization that their family members are close to dying can often only find peace of mind when they know that their family members will be able to enjoy ease and comfort in their last periods of living.

“If somebody has eight weeks, or nine weeks, or six months, I feel like [hospice staff] should be treating you with pain until you pass away, they shouldn’t be overdosing you,” Sellers said about her mother’s time in hospice.

“I feel like they don’t care if someone dies in hospice before their time,” she continued. “So I feel hurt that they did that.”

Full Article & Source:
California hospices face lax oversight and few rules. The sick and dying pay the price

Outrage grows over care, conditions at Sodus nursing home

SODUS, N.Y. (WHEC) -- The outrage is growing after a News10NBC investigation exposed new complaints about the quality of care at Sodus Rehabilitation and Nursing Center in Wayne County.

News10NBC Investigative Reporter Jennifer Lewke has been covering the story for nearly two years, tracking down the owner, the inspectors and the commissioner of the health department but the problems persist.

On Thursday morning, News10NBC sent Governor Andrew Cuomo's office the last 10 stories we've done on the care and conditions inside the facility.

Cuomo scheduled an event on Friday morning in Rochester so News10NBC Investigative Reporter Jennifer Lewke attended, hoping to speak with him about the topic.

Following his event at the JCC in Rochester, the News10NBC crew waited for the governor outside by his SUV.

A press aide saw the crew and came outside to ask if they were planning to approach the governor. Shortly after, they responded yes. The governor approached the door and then turned away.

The driver of his waiting SUV then hit the gas, raced around the corner of the building, picked up Cuomo at another door, and took off.

Apparently, the governor didn't have time to answer the concerns of families with loved ones inside Sodus Rehabilitation and Nursing Center.

Those like Joi Ann Mitchell-Kenly who found her friend Bill Tanner with life-threatening bedsores just 40 days after he was moved into the facility.

"It needs to be closed and not when their done with their investigations and looking into it and health department calls and slaps on the wrist, it needs to be closed and those people transported to different places," she told News10NBC.

After avoiding the News10NBC crew in the parking lot, a spokesman for the governor did get back to us with a statement late Friday afternoon.

"The State has proposed legislation to place an independent monitor in poorly performing nursing homes, strengthen nursing home oversight, and impose more stringent penalties for violations. The allegations that have been raised are extremely troubling. Moving a loved one to a nursing home is often a very difficult decision, and people should not have to worry that the quality of care will be inadequate. The state takes every complaint extremely seriously and will hold accountable any bad actor to the fullest extent possible," says Jason Conwall.

We also wanted to know what the state's top law enforcer is doing about the situation at Sodus Rehabilitation and Nursing Center.

When Tish James was a candidate for attorney general last fall, she watched our investigation and told us, "It's horrific, it's horrendous, no one should have to live like that."

So, what is she doing about it now that she's the attorney general?

Her spokeswoman told News10NBC in an email that she wouldn't be able to get us any information but would be in touch for future opportunities on the topic.

Earlier this week, Judson McCaull, the administrator at Sodus Rehabilitation and Nursing Center, sent News10NBC the following statement:

"As you know, we are restricted in disclosing any information pertaining to our residents under both the nursing home code and HIPAA. Therefore, we are not able to discuss any particular resident matters with you. There is a process in New York for the confidential investigation of complaints involving residents and reports concerning residents which is accomplished by the New York State Department of Health. We cooperate in this process fully and provide all information requested by the State which is then subject to the confidentiality provisions of the Public Health Law. This process is very intensive and applies to all nursing homes in this State. Any resulting survey findings arising from such complaints are published by DOH without identifying residents or staff while also publishing the plan of correction developed by a facility to address the root cause of such findings. Our facility conscientiously and actively seeks to assure compliance in all areas of resident care."

New Yorkers who have a complaint or concern about Sodus Rehabilitation and Nursing Center or any nursing home should contact the Centralized Complaint Intake directly at 1-888-201-4563, so appropriate action can be taken.

All complaints are reviewed and kept confidential.

Full Article & Source:
Outrage grows over care, conditions at Sodus nursing home

Unprotected: Swindlers rarely jailed for exploiting the elderly

Ohio swindlers posing as caregivers are rarely jailed for crimes involving financial exploitation of the elderly, despite thousands of complaints statewide, a 5 On Your Side investigation found.

Financial crimes against the elderly have increased. One in 5 elderly people are victims to the tune of $3 billion a year, according to a report released last year by the National Conference of State Legislators.

County-operated offices of Adult Protective Services (APS) are charged with protecting the elderly. They are mandated to investigate complaints of abuse, neglect and financial exploitation within three days of a complaint. They then decide on whether they will refer a case to law enforcement, including county prosecutors and police.

But we found an alarmingly low number of financial exploitation cases are actually referred to law enforcement despite a growing number of complaints.

Complaints mount, few referred

No agency tracks the outcome of investigations by law enforcement, and data is not kept on how many cases actually result in convictions.

But Cuyahoga County data shows in 2017, there were 586 allegations of financial exploitation there. This increased to 810 allegations last year.

There could be even more incidents. A 2018 report by the U.S. Securities and Exchange Commission revealed, “the overwhelming majority of elder financial exploitation go unreported to authorities.”

We reviewed statewide data filed with the Ohio Department of Jobs and Family Services , collected from county-operated offices of APS, to find out how often complaints are made.

· In 2017, we found 2,955 complaints filed statewide alleging exploitation.

· Last year, that increased to 4,442 complaints. Only 124 complaints were referred to law enforcement for further investigation and prosecution.

One of those complaints involved 89-year-old Chuck Bauer.


Bauer, who passed away in January, was recently widowed and befriended by 37-year-old Latasha Wisniewski who moved in and promised to take care of him.

Instead, she’s charged with stealing hundreds of thousands of dollars from Bauer’s accounts and even adding her name to the deed to his home.

Wisniewski was indicted last November and has pleaded not guilty in the case that is scheduled for trial on March 25 in Cuyahoga County Common Pleas Court.


But Bauer’s family insisted Cuyahoga County APS failed to investigate the case despite repeated calls for help, allowing Bauer’s finances to be wiped out.

Both Bauer’s daughter and granddaughter said they quickly grew suspicious of the 37-year-old’s interest and turned to protective services for help.

“We had to constantly contact them — they would never even contact us,” said Bauer’s granddaughter, Jennifer Bugnar.

Parma Heights Police launched its own investigation after the Bauer family reached out to an FBI agent for help.

“I am grateful to the detectives that stepped in but not so much to Adult Protective Services,” said Bauer’s daughter, Debbie Sheridan, “because I don’t think they did their due diligence on this.”

Cuyahoga County APS denied it failed to act quickly and said it is limited in what it can do when the victim fails to cooperate.

Cuyahoga County Prosecutor Brent Kirvel, who is prosecuting the case against Wisniewski, said that even though family members were suspicious, Bauer initially refused to cooperate, believing Wisniewski had his best interests at heart.

In addition, county APS said Bauer was “found to be competent,” and that finding makes it even more difficult to investigate and prosecute “because the elderly have their own rights” to self-determination.

Those limitations are echoed by the National Adult Protective Services Association in a 2018 report that found, “APS cannot take action on behalf of adults who have cognitive capacity to make informed decisions.”

Bauer’s family finally convinced him he was being swindled, but only after his life savings was drained.

A lack of funds

We found APS in Ohio is a fragmented system of underfunded and understaffed agencies — each operated independently across the state.

“You have to understand,” said Marlene Robinson-Statler, Executive Director of Cuyahoga County’s Adult Senior Services , “that we are limited based on funding and based on our state mandate of what we have to do.”

We also uncovered APS is not required to do criminal background checks.

This is critical because our investigation found Bauer’s caregiver had a long criminal history prior to becoming his caregiver, including two prison sentences. One stemmed from a theft from a disabled victim.

Cuyahoga County officials admitted they never checked.

Poor funding and inadequate training have long been a concern to the Ohio Coalition for Adult Protective Services (OCAPS), the state’s leading advocacy group for adult protection.

OCAPS Executive Director Susan Marshall said she is “absolutely convinced” cases of financial exploitation are going without investigation and prosecution across Ohio.

“Some of it might be a misunderstanding of just how much information law enforcement needs to progress in something,” Marshall said.

We found those investigating financial exploitation also have limited training and resources.

“Are they mandated to be licensed social workers? No, they are not,” admitted Robinson-Statler, agreeing that investigators “essentially take a couple of courses and go out.”

In addition, funding varies across the state and is barely enough to hire one staff member.

Unprotected

Last year, Cuyahoga County received only $30,000 in state funding. The remainder is up to county taxpayers through taxes raised by adult senior levies.

Each county across Ohio is on their own, and we found 14 counties that have no APS at all — leaving nearly half a million seniors in those counties unprotected from swindlers.

For example, Cuyahoga County has the highest number of seniors over age 60 with 290,762 residents. The county’s senior tax levy raises $16 million dollars that supports a wide range of programs offered by county APS, including $4 million designated for adult protection.

Overall, the county APS serves 30,722 clients in programs including protective services, homes support, community social programs and options for independent living.

But the funding levels vary dramatically from county to county, and according to a 2018 report by the Center for Community Solutions that analyzed senior tax levies, the inconsistencies result in “a system where your address alone can determine what level of services is available.”

Another report , issued by the same group which functions as a non-partisan think tank, found, 1 in 10 individuals ages 60 and older are living at home, and a “growing number of Ohioans who choose to remain in their homes may experience abuse, neglect or exploitation,” posing an increased risk of financial exploitation and abuse.

Policy Matters is another non-profit group stressing the need for increased funding for adult protection.

In a report they released last year, they found “the state underfunds protective services, leaving counties without enough to address growing needs.”

The Ohio Association of Area Agencies on Aging reports Ohio has the sixth largest overall population age 65 and over in the nation. The Association called on legislators to increase funding with a base allocation of at least $65,000 per county per year, with additional dollars allocated by formula.

Looking ahead

There have been some recent efforts to strengthen adult protective services on a state level.

The Ohio Department of Jobs and Family Services is investing $1.3 million to develop an online referral system for reporting suspected elder abuse and develop online training for individuals required by law to report suspicions of elder abuse that recently expanded to include bank employees, financial planners and real estate agents.

Full Article & Source:
Unprotected: Swindlers rarely jailed for exploiting the elderly