SUFFERING IN SECRET: Flawed investigations ignore victims of neglect

On her last night at a Lockport group home, Tina Marie Douglas tossed her few possessions in the trash and warned caregivers that she planned to run away in the morning.

It was not an idle threat. In the last three months, the 48-year-old state ward diagnosed with psychiatric and intellectual disabilities had slipped out of the home eight times and repeatedly run into the street. Her caregivers were considering moving her to a different home, one on a block with less traffic.

But that never happened. Shortly before dawn in October 2013, she broke away again, sprinted down a four-lane state road and was fatally struck by a car.

The Illinois Department of Human Services, which licensed the group home, assigned its inspector general's office to conduct a comprehensive review.

But a Tribune investigation found the inspector general's staffers never interviewed a witness, never visited the group home, never left their desks. Instead, they relied on group home employees to help investigate their own business and, based on those findings, determined the home was not at fault.
The Douglas investigation is one of hundreds in which self-policing played a role in determining whether neglect had occurred, including many where group home employees played an even more significant role — not only gathering evidence but drafting the state's final investigative reports.

These group home employees — dubbed "buddy investigators" by the Office of the Inspector General — handled at least 550 cases, the Tribune determined. And in the vast majority of instances, employees helped clear their own group homes of wrongdoing.

No other state has bestowed full-fledged investigative powers on caregivers at group homes serving people with intellectual and developmental disabilities, according to federal regulators.

The Tribune investigation, the first comprehensive examination of the state's secretive network of 3,000 group homes, also found that Human Services officials routinely obscured evidence of harm from the public.

The inspector general's office sealed 3,239 cases in which they found some evidence of abuse or neglect, a Tribune analysis of previously undisclosed state records from the last six years found.

Neither the public nor family members — not even group home residents — are allowed to know the nature of those investigations, the strength of the evidence or what reforms, if any, were mandated or made.

It's a flawed system that conceals the silent victims of abuse and neglect — some, literally voiceless — while allowing investigators to close as many cases as possible with the fewest consequences.

In one such case, the Tribune found, the inspector general's own investigators overlooked obvious clues pointing to neglect and were easily misled by a group home employee who later admitted she made up her story about what had transpired.

As a result of the Tribune's investigation, Human Services Secretary James Dimas said this month that he will seek to make public the records of all unsubstantiated cases. "We're working hard to push the envelope to become more transparent," he said. "And we're prepared to seek a change to the legislation if we decide that becomes necessary."

Additionally, Human Services Inspector General Michael McCotter has reopened both the investigation of Douglas' death and the neglect case involving the employee who gave false information.

McCotter credited the Tribune for sparking an agencywide audit and reform of investigative practices.

Human Services' oversight of group homes is fragmented, and McCotter acknowledged that his staff routinely didn't send its case reports to the division that licenses the homes — even when his investigators cited a business or its employees for abuse or neglect. He vowed to change that.

McCotter also said group home employees are no longer leading state investigations. In a policy change from the beginning of the year, McCotter began ordering his staff to visit group homes, conduct their own interviews and write all final reports.

As for state practices that have prohibited the public from knowing where abuse and neglect have occurred, he said, "It doesn't seem right, does it?" (Continue Reading)

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SUFFERING IN SECRET:  Flawed investigations ignore victims of neglect

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Part 1: Illinois hides abuse and neglect of adults with disabilities

Arkansas Judge Resigns Amid Misconduct Probe

LITTLE ROCK, Ark. (CN) – An Arkansas judge has resigned from the bench and is facing a criminal investigation over claims that he exchanged judicial rulings for sexual favors and money.

Former Carroll County District Court Judge Timothy Parker denied the allegations but agreed to never serve on an Arkansas bench again after resigning Saturday, the last day of his term, as part of a negotiated resolution.

In a Dec. 31 letter of removal, the Arkansas Judicial Discipline and Disability Commission notified Parker that its investigators were prepared to charge him with judicial violations, including evidence that he “engaged in a pattern of personal relationships with many female litigants” who appeared in his court from approximately 2013 to 2016.

“The bonds or release of these women or their family or friends were done by their request in exchange for sexual favors,” the JDDC letter states. “Allegations also exist about trading cash or prescription pills for sexual favors or money with many of the same women, as well as other women in the community.”

The commission says it has video statements from over a dozen women to support the allegations, recordings of conversations he had with jailed women, and printouts of text messages between the former judge and female litigants.

Special Prosecuting Attorney Jason Barrett is reportedly investigating the evidence against Parker, who was appointed to the judgeship in 2013, to determine if charges will be filed.

According to the JDDC, Parker admitted that he improperly performed probable cause determinations, lowered bail settings, released defendants who were friends or former clients of his, and in some cases, gave rides to defendants.

“The other allegations were not litigated, as you resigned and agreed to a permanent bar from holding judicial office in this state,” the removal letter states.

Parker told the commission that his decision to resign was influenced by the effect litigation would have on his family, as well as the time and expense issues.

Parker began his career as an attorney in private practice before serving as an elected municipal court judge from 1999 to 2004.

He will no longer be eligible to serve as a judge in Arkansas.

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Arkansas Judge Resigns Amid Misconduct Probe

Aging in Place Needs Out of the Box Thinking

The election is over. Happy or not, we can’t predict what the new administration will do. But two things are certain. First, aging issues won’t disappear. Second, we can’t expect more federal funding or new entitlements. But this could be a good thing if it pushes us to think out of the box, particularly regarding aging in place.

What Out of the Box Means for Aging in Place

What do I mean by “out of the box?” I mean focusing on the situation facing middle-income older Americans.

While low-income older adults desperately need funding and support, 70 percent of older Americans (70 million people) do not qualify for government or not-for-profit programs but, at the same time, cannot afford expensive retirement communities or 24/7 care. These people have some resources and most want to age in place. Many own their homes and spend out-of-pocket for care, which is often difficult to locate and manage.

70 million older Americans do not qualify for government or not-for-profit programs but cannot afford expensive retirement communities or 24/7 care. 

Without question, this is a cadre that needs better supports.

Out of the box is preparing homes in advance so health costs are avoided or reduced in the future. An age-friendly home helps people stay healthy longer, which reduces costs for health payers and for families. Falls are reduced. And people who do fall can return to a prepared home more quickly, saving rehab costs and improving recovery.

When a home is prepared for aging in place, family and informal and paid caregivers there are injured less frequently. That means available resources go farther.

What Business and Government Could Do

Out of the box is also looking to private investment and business to generate solutions for housing and providing services to older citizens.

Increased sales of age-friendly products would mean new jobs and training to manufacture and install the kinds of products that would transform American housing into homes to age in place.

Out of the box is applying the service and delivery innovations, efficiencies and economies that emerge in privately-financed age-friendly homes to all incomes and payers. Higher concentrations of age-friendly homes will be fertile ground for a robust consumer-driven marketplace where all types of service providers can innovate, integrate and scale economically. This is an innovation and opportunity zone.

Increased government spending was probably not in the cards no matter who was next in the Oval Office. So shifting to incentivized private investment is a good strategy in today’s political climate. Incentivizing age-friendly home updates amounts to a privately- financed demonstration project. The results will be far reaching, crossing lines of business as well as government silos. What’s learned will improve the aging experience for less affluent citizens as well.

Out of the box is about government incentives for consumers to age in place, too. Just as incentives helped the solar industry take off like a rocket, government incentives could make it less expensive to update homes using age-friendly improvements.

Government incentives can leverage private retirement savings as well. For example, why not allow the use of a portion of 401(k), IRA and other health and retirement savings — without tax or penalty — to purchase appropriate technology and building products for age-friendly home updates?

Success Comes From Interdependence

Out of the box is recognizing that success really comes from interdependence. Though we idealize independence, the reality is that family, neighborhoods, community, services and networks are the foundation underlying individual success at every age — including healthier, dignified and economical aging.

Community supports are necessary resources for self-reliance.

The Power of Consumers

And out of the box is engaging consumers to consolidate their political and market power.

Legislators will pay attention to a coordinated campaign from (mostly older) consumers. Awakening consumers to the strength in their numbers, experience and shared goals is a different message than cajoling them to avoid frailty, be fearful of falling and reduce the burden on their loved ones. Acting from strength encourages self-reliance.

HomesRenewed™, the coalition of business, consumer and nonprofit stakeholders that I founded, has a goal of enabling the 70 million boomers to follow their desire to age in place. Together, we can drive policy and investment, unlocking market-based solutions to increase the number of age-friendly homes.

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Aging in Place Needs Out of the Box Thinking

Part 1: Illinois hides abuse and neglect of adults with disabilities

The house had no address; the dead man had no name.

Illinois officials blacked out those details from their investigative report. Nobody else was supposed to learn the man's identity or the location of the state-funded facility where his body was found.

The investigation was closed as it began, with no public disclosure, and the report was filed away, one of thousands that portray a hidden world of misery and harm.

No one would know that Thomas Powers died at 3300 Essington Road in unincorporated Joliet, in a group home managed for adults with developmental and intellectual disabilities.

Or that his caregivers forced a 50-year-old man with the intellect of a small child to sleep on a soiled mattress on the floor in a room used for storage.

Or that the front door bore a building inspection sticker that warned, "Not approved for occupancy."

Not even Powers' grieving family knew the state had looked into his death and found evidence of neglect.

As Illinois steers thousands of low-income adults with disabilities into private group homes, a Tribune investigation found Powers was but one of many casualties in a botched strategy to save money and give some of the state's poorest and most vulnerable residents a better life.

In the first comprehensive accounting of mistreatment inside Illinois' taxpayer-funded group homes and their day programs, the Tribune uncovered a system where caregivers often failed to provide basic care while regulators cloaked harm and death with secrecy and silence.

The Tribune identified 1,311 cases of documented harm since July 2011 — hundreds more cases than publicly reported by the Illinois Department of Human Services.

Confronted with those findings, Human Services officials retracted five years of erroneous reports and said the department had launched reforms to ensure accurate reporting.

To circumvent state secrecy, the Tribune filed more than 100 public records requests with government agencies. But state files were so heavily redacted and unreliable that the newspaper had to build its own databases by mining state investigative files, court records, law enforcement cases, industry reports, federal audits, grant awards and Medicaid data.

The Tribune found at least 42 deaths linked to abuse or neglect in group homes or their day programs over the last seven years. Residents fatally choked on improperly prepared food, succumbed to untreated bed sores and languished in pain from undiagnosed ailments.

Other residents suffered forced indignities and loss of freedom, state records show. Some were mocked for their intellectual limitations, barricaded in rooms, abandoned in soiled clothing and deprived of food.

A male group home resident, accused of stealing cookies, was beaten to death by his caregiver. Employees at one home bound a woman’s hands and ankles with duct tape, covered her head with a blanket and left her for several hours on the kitchen floor. For their own amusement, employees at another home repeatedly ridiculed residents to provoke outbursts, a game the caregivers called "breaking them."

And, all too often, vulnerable residents' health and safety has been left to unlicensed, scantly trained employees. Front-line caregivers failed to promptly call 911, perform CPR or respond to medical emergencies that resulted in death.

In hundreds of cases, the department allowed employees of group homes to investigate allegations of neglect and mental abuse in their own workplaces, the Tribune discovered. That alliance between group homes and Human Services' investigative arm, the Office of the Inspector General, is not specifically disclosed in state investigative reports.

Citing patient privacy laws, state officials maintain that the addresses of the more than 3,000 state-licensed group homes are secret. Illinois officials refuse to disclose the enforcement history of any home, even in cases of fatal abuse and neglect.

In contrast, Illinois nursing homes must maintain copies of investigative reports and surveys for public inspection. Additionally, state health officials publish a quarterly report detailing violations accompanied by nursing home names and addresses. There are no similar disclosure requirements for group homes.

In this culture of secrecy, even seemingly benign records get shielded from sight. For example, the Tribune requested a state-funded PowerPoint presentation that included a list of needed improvements to community care programs, including group homes.

The state responded. Except for the word "Recommendations," the entire slide was blacked out.
Citing the Tribune investigation, Human Services Secretary James Dimas has ordered widespread reforms to improve public accountability and streamline investigations.

"My concern is that too often agencies hide behind their confidentiality statutes, which makes it harder for the public to know what is going on," said Dimas, who was appointed last year.
Dimas said he will push for legislative changes, if necessary, to allow public disclosure of group home enforcement histories.

The shift in Illinois from large institutional facilities to less costly residential homes reflects the philosophy that these individuals, if supported, will lead fuller lives in the community, and more than 11,400 now live in group homes statewide.

Known as Community Integrated Living Arrangements, or CILAs, these homes accommodate eight or fewer adults in ordinary apartment buildings or houses.

The Arc of Illinois, a statewide advocacy group, reports that hundreds of people with disabilities have successfully transitioned into group homes in recent years. In 2011, a lawsuit brought by individuals who wanted to leave state-funded facilities resulted in a court decree that has forced Illinois to move more people into community settings.

State officials have touted group homes as a preferred option, citing cost savings that can be used to fund more community care. The annual cost of care for an institutionalized resident is about $219,000 compared with $84,000 at a group home, according to state records.

But Illinois has not increased reimbursement rates for group home staff wages in nearly nine years, leading to what industry leaders say are catastrophic conditions in which even the best operators are struggling to provide basic care. Illinois ranks among the five worst states for adequately funding community options, according to federal reports and studies by advocacy groups.

Shirley Perez, who directs a family advocacy program for the Arc of Illinois, said: "Some of the phone calls I get from families are that they are afraid."

Powers, born with a condition that led to brain damage, spent decades inside state institutions, unable to talk, unpredictable in behavior. When state officials promised him a better life in a real home and told his family he'd gain independence, Powers said yes the only way he knew how. He giggled.

But this was not the life that Powers found. Nor did thousands of other adults with developmental and intellectual disabilities, left to the mercy of a system designed to be invisible.

Failures of care

In one Will County group home, state records show, a caregiver left a frail woman alone in the bathroom after filling the bathtub with water, unaware that it was scalding because a maintenance worker forgot to install a temperature-control valve. The woman tumbled into the tub and was severely burned. The Trinity Services caregiver put the woman to bed, later pulled socks over her peeling, bleeding skin and didn't seek medical help for more than an hour. The woman died days later.

At a Springfield home owned by Sparc, a caregiver forgot to give a man his anti-seizure medication before sending him to a day program in 2013. Rather than deliver the pills, investigators found, the caregiver told a colleague to throw them into the trash. The man suffered a major seizure, turned blue and was treated at a hospital.

A caregiver at a Macomb group home managed by Mosaic allowed a man to sleep with a stuffed snowman even though he had been diagnosed with pica — a disorder that compels people to eat nonfood items — and had a history of consuming stuffing, according to inspector general records. In 2012 the man tore open the snowman, ate the filling and choked to death.

In case after case, group home businesses have delegated frontline care to inexperienced caregivers with negligible training, a cost-cutting combination that has led to harm, the Tribune investigation found.

Indeed, when the newspaper reviewed more than 200 substantiated cases of abuse and neglect, it found the vast majority of injuries and deaths are linked to inadequate staffing levels and failure to closely monitor fragile residents. Records show caregivers trying to cover up mistakes, failing to understand dangers of missed medications and underestimating the complex nature of disabilities.

Sparc's chief operating officer, Ryan Dowd, said his company fired the caregiver who directed a colleague to throw out anti-convulsant medicine, added more surveillance cameras in its group homes and switched from paper to electronic medication records so a nurse can better catch mistakes.

Nancy Davis, a Mosaic vice president, said her organization dismissed the caregiver who allowed the man to sleep with a stuffed snowman, hired outside behavioral experts to address the needs of residents with pica and retrained caregivers on how to protect those individuals.

Caring for adults with profound intellectual and developmental disabilities can be challenging. Some have the strength of a weightlifter with the impulsiveness of a child. In the blink of an eye, they can find themselves in crisis.

Yet caregivers in group homes earn an average of $9.35 an hour, according to the Illinois Association of Rehabilitation Facilities. That wage is below the federal poverty level for a family of three. Low pay is a contributing factor in high staff turnover — more than 40 percent annually in some homes.

"Staff turnover — it's like a cancer that affects care," said UCP Seguin of Greater Chicago CEO John Voit, who has worked in the industry since the 1970s.

Group home executives complain that inadequate state funding has not allowed the industry to increase entry-level pay or raise existing salaries to retain skilled supervisors. They say caregivers can earn more money in many other industries, citing the experienced employees who recently resigned to take higher-paying jobs at Amazon warehouses.

To fill vacancies, business operators said they have turned to workers whose backgrounds would have disqualified them from jobs in the past.

"You're scraping the barrel," said Little City Executive Director Shawn Jeffers, whose agency's services include group homes for adults with disabilities in the Chicago area. "I have some folks who do some really dumb stuff."

Responding to what group home owners call a staffing crisis, state lawmakers in both houses this summer overwhelmingly approved $330 million in funding to boost pay for caregivers. But Gov. Bruce Rauner vetoed the measure in August, citing a lack of state funds.

The Tribune also found that the group home industry is exempt from basic staffing standards required elsewhere in the state's long-term care system.

Nursing homes, state institutions and other extended-care facilities are required by law to employ on-site registered nurses who can detect and react to sudden changes in patient conditions. Even low-level employees must be state-certified aides who update skills through continuing education.

Group homes are not bound by these requirements. Many group home residents are not examined by a licensed nurse for weeks at a time, sometimes for many months, state enforcement records show. Instead, registered nurses often work from remote locations and supervise dozens of residents over the telephone.

Some unlicensed workers also are allowed to pass out prescription medications — a practice prohibited by law at nursing homes and state-owned facilities.

These and many other relaxed policies place group home residents at greater risk of undetected complications.

Few daily activities underscore the dangers of thin staff or the critical role of competent caregivers like the simple act of eating.

In 2014, a UCP Seguin group home resident attending the company's day program in Cicero choked to death on a marshmallow that a caregiver handed out as a treat. The victim had dysphagia, putting him at high risk of choking, and staff were supposed to give him only pureed or finely chopped foods, the inspector general found. UCP Seguin CEO Voit said his organization, one of the state's largest group home providers, has retrained staff on choking risks and revised safety protocols.

That same year, a man at a Trinity Services group home in Peoria fatally choked on a cheeseburger, carrots and applesauce when a caregiver stepped away. The victim's medical files warned he often swallowed food too fast and needed close supervision, but staff members were not properly trained about his special needs, state records show.

In response, Trinity Service officials said, they created a training manual for each group home that details how to monitor residents with diet restrictions and choking risks, including pictures that illustrate how to chop or puree food properly.

For Loren Braun, death came from a McDonald's hamburger and an inattentive caregiver who had been hired specifically to watch him.

At 61, Braun had no teeth and couldn't wear dentures. Born with developmental disabilities and diagnosed with schizophrenia, he had lived since 1997 in a North Side group home managed by Anixter Center.

Braun had a history of choking. His food had to be soft and cut into tiny pieces, and someone had to coach him at every meal to eat slowly and drink water between bites.

Braun's sister, Barbara Chyette, tried to protect her younger brother as best she could. (Click to Continue)

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Part 1: Illinois hides abuse and neglect of adults with disabilities

Attorney General Laxalt announces third elder exploitation guardianship abuse prosecution

Attorney General Adam Laxalt announced that 27-year-old Yohannes Habtemicael of Washoe County was arrested on one count of exploitation of an elder person, one count of theft and one count of embezzlement of an older person, all category "B" felonies.

The alleged crimes were committed between August 2014 and November 2015.

According to the complaint, Habtemicael was appointed as the permanent guardian of his 67-year-old father Tewolde Habtemicael and his estate after it was determined that he was unable to take care of himself.

As a guardian, Yohannes was entrusted with funds for limited purpose of providing his father's care. He allegedly subsequently converted more than $80,000 of his father's funds for his own personal use.

The State of Nevada V. Habteicael criminal complaint represents the third guardianship exploitation criminally charged by the Nevada Attorney General's Office.

Laxalt said, “I will continue to work collaboratively with local law enforcement and district attorneys to protect the rights of our elderly and ensure they are treated with the dignity and respect they deserve.”

A criminal complaint contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty in a court of law.

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Attorney General Laxalt announces third elder exploitation guardianship abuse prosecution

Tampa lawyer accused of bilking nearly $1 Million from clients' trust accounts

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TAMPA, Fla. - Hiring a lawyer may be one of the most important decisions you will ever make, but when an attorney fails to represent their clients' best interest, the fallout can be devastating.

As the I-Team uncovered, a local attorney is now under suspension by the Florida Bar, after bank records show he spent nearly a million dollars of clients' money at casinos, gun stores and fancy restaurants.

“We loved that house. It hurt to leave,” said Janet Crawford.

Janet and her husband Tom hired Tampa attorney James Lee Clark to save their Wesley Chapel home from foreclosure.

“We were getting behind in payments on the house. My husband was sick, he had a heart attack,” said Janet Crawford.

They paid Clark thousands, then followed his advice and signed their deed over to a company owned by Clark's paralegal and former roommate Eric Liebman.

“They all worked together. They seemed like they were a team. And I trusted my lawyer,” said Janet Crawford.

The Crawfords moved out, after they say they were told Liebman would pay them $5,000 and the bank would forgive their loan.

But they say they got nothing.

Liebman quickly leased the house to another of Clark's clients, who made a down payment and made monthly payments for nearly two years, believing they were leasing to own the home.

She filed for bankruptcy to try to keep the bank from taking it, but the bank ended up foreclosing, giving them just days to move out.

The Crawfords didn't know that Clark had been placed on probation by the Florida Bar while he was handling their case for failing to diligently represent other clients.

“I didn't do research. I should have done research,” said Janet Crawford.

“It appears as though Mr. Clark removed over $900,000 of my client's money,” said Morgan & Morgan Attorney L. Reed Bloodworth.

Bloodworth’s clients are now suing Clark, alleging Clark took money the client received from selling two assisted living facilities.

“I don't know if that are any assets left to recover for my clients,” Bloodworth said.

The Florida Bar subpoenaed hundreds of pages of bank records related to that case, which appear to show Clark transferred money from his client's trust accounts into his own bank account.

They show Clark spent more than $518,000 at the Hard Rock Casino, $13,000 at bars and liquor stores, $21,000 at gun stores and $17,000 on meals at a casino steakhouse.

Clark also paid for vacations in the Bahamas, London, Paris and Amsterdam.

“Using other people's money to enjoy himself, it makes me pissed off. I want him disbarred and thrown in jail as well,” said Janet Crawford.

The Florida Supreme Court issued an emergency suspension of Clark's law license, which went into effect last month.

After multiple attempts to locate Clark, we found him working on his BMW at his South Tampa home, which is under foreclosure.

“I can't talk about it. I'm sorry,” Clark told us.

“Hiring an attorney is an important decision, whatever that matter may be. I think clients should look into their attorneys,” said Bloodworth.

Bloodworth says clients should consult the Bar and avoid attorneys who have been in trouble.

The Crawfords agree.

“Get comments from other people. Check it out before you sign on any dotted line,” Janet Crawford said.

“Do the footwork or you could end up like my wife and myself,” said Tom Crawford.

You can log on to the Florida Bar’s website to find out if any licensed attorney has been disciplined.

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Tampa lawyer accused of bilking nearly $1 Million from clients' trust accounts

Three arrested in New York death of ventilator-dependent resident

In a December 28th press release, Eric Schneiderman, the Attorney General of New York, announced the arrest of two registered nurses and a certified nurse aide in connection with the death of an 81-year-old ventilator dependent resident of the A. Holly Patterson Extended Care Facility in Uniondale, NY.

According to the press release

The resident, whose identity is being kept confidential, lived on a specialized ventilator unit at the facility. She required a mechanical ventilator to breathe and was entirely dependent on the nursing staff; the resident passed away after the defendants failed to respond to the ventilator alarms. If convicted, the defendants, none of whom still work at the facility, each face up to seven years in prison.

“These allegations paint a picture of blatant neglect that ultimately resulted in the death of a patient,”

“My office will always hold accountable those medical professionals and others who knowingly ignore a patient’s basic needs or recklessly place any nursing home resident in a life-threatening situation.”

The media release described the case:

The complaint alleges that on the morning of December 20, 2015, the resident–who was wheelchair bound and ventilator dependent–became disconnected from her ventilator. The resident was unable to breathe without the assistance of her mechanical ventilator. A visual and audible alarm was immediately triggered which notified nursing staff on the floor that this resident was in an emergency, life-threatening situation.

Sijimole Reji, Annieamma Augustine and Martine Morland were at the nursing station near the resident’s room when the alarm sounded throughout the unit. All nursing staff who work on the ventilator unit at A. Holly Patterson Extended Care Facility are required to immediately respond to resident ventilator alarms. These three defendants–Reji, Augustine and Morland–ignored the emergency ventilator alarm for more than nine minutes and failed to provide any assistance to the resident who languished without oxygen.

Eventually, when staff entered her room, they discovered that the resident was unresponsive and unconscious. The resident was transported from A. Holly Patterson Extended Care Facility to Nassau University Medical Center, where she died the following day, December 21, 2015.

Deaths and abuse in care homes is not uncommon. Recently a nurse was charged in the deaths of eight people who lived in care homes in Woodstock and London Ontario.

The victim’s life was in the hands of her care-givers. Data from Belgium shows that a significant number of lives are ended each year without request. Usually these people are incompetent or completely dependent on their care-givers.

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Three arrested in New York death of ventilator-dependent resident

5 Things Sociopaths and Narcissists Say to Make You Feel Crazy

When you hear the word "psychopath", you might think of Hannibal Lecter or Ted Bundy, but most psychopaths are actually non-violent and non-incarcerated members of society. In fact, there's a good chance they'll seem exceptionally altruistic and innocent to the average onlooker.

As described in the Psychopath Free book, psychopaths are first and foremost social predators. With no conscience, they're able to use charm and manipulation to get what they want from others—whether it be families, friendships, relationships, cults, the workplace, or even politics. The bottom line is, they modify their personalities to become exactly the person they think you want them to be. And they’re good at it.

But when they no longer need anything from you, that's when the crazy-making behavior begins. Here are some common phrases you'll hear from a psychopath who's trying to make you doubt your sanity:

1. "You over-analyze everything."

Of course there are people who DO read too much into situations. The difference with psychopaths is that you'll always discover you were correct in retrospect. They intentionally do things to make you feel on-edge or paranoid, like flirt with a once-denounced ex over social media for the whole world to see. When you question them, they accuse you of over-analyzing the situation. But then a month later, you discover they were actually cheating with that person. Psychopaths want you to doubt your intuition by making you feel like a crazy detective, constantly planting hints to make you feel anxious and then blaming you for having that anxiety.

2. "I hate drama."

And yet, you’ll soon come to discover there’s more drama surrounding them than anyone you’ve ever known. Psychopaths will first idealize you above everyone else, praising you for your perfect easy-going nature. But because they are perpetually bored, this never lasts long. They are pathological liars, serial cheaters, and eternal victims. Before long, these qualities inevitably start to surface and cause you overwhelming confusion. Any time you mention your concerns or frustration, they’ll declare their hatred of drama and make you feel bad for reacting to their horrible behavior (instead of addressing the behavior itself).

3. "You're so sensitive."

Psychopaths manufacture emotions in others—it’s what they do. After once showering you with 24/7 praise and flattery, they’ll ignore you for days on end and wait for you to react. When you finally do, they’ll accuse you of being sensitive or needy. They’ll insult, belittle, and criticize you (usually in a teasing/joking demeanor), pushing your boundaries until you finally speak up. Then they use your manufactured reactions to make you seem crazy. Within weeks, psychopaths can turn an exceptionally easy-going person into an unrecognizable mess of insecurities and self-doubt.

4. "You misunderstood me."

Sure, healthy couples have misunderstandings and miscommunications all the time. But with psychopaths, they’ll intentionally say things they know will provoke you. Then when you react, they’ll turn it around on you and blame you for misunderstanding. Oftentimes, they’ll even deny that they ever said it. This is called gaslighting—blatantly doing or saying something, and then blaming you for misinterpreting it (or denying that it even took place). The fact is, you understood what they said perfectly fine. They’re just trying to make you doubt your sanity.

5. "You're crazy / bipolar / jealous / bitter / in love with me."

The name-calling usually starts when things are going downhill fast. According to a psychopath, all of their ex lovers, colleagues, and friends are crazy, bipolar, jealous, bitter, or in love with them. This becomes very confusing when they start reaching out to those very same people they once denounced to you, using them to triangulate and cause chaos (making the psychopath appear in high-demand at all times). Then they toss you in that very same "crazy" bucket, continuing their never-ending cycle of idealizing and devaluing anyone unfortunate enough to cross their path.

The only way out is to go No Contact. This means no texts, calls, emails, or even Facebook friendships. Otherwise you can be guaranteed that they’ll do anything and everything in their power to make you feel crazy. The good news is, when a psychopath tries to make you doubt your intuition, it means your intuition was causing them trouble. Psychopaths seek to psychologically destroy anyone who might threaten their illusion of normalcy to the world. So when they begin playing mind games with you, it’s actually a strange indirect tribute to your ability to notice that something was “off” about them.

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5 Things Sociopaths and Narcissists Say to Make You Feel Crazy

Mentally ill people trapped in nursing homes because Louisiana lacks support programs, DOJ investigation finds

Thousands of Louisiana residents with mental illnesses are being unnecessarily housed in nursing homes, deprived of independent living and cut off from their friends and families, because the state has failed to provide them with more humane options, according to an investigation by the U.S. Department of Justice.

The Justice Department's investigation, which spanned more than two years and was detailed in a letter to Gov. John Bel Edwards this month, found that some 4,000 people with serious mental illnesses are cooped up in costly nursing homes in Louisiana. These people are often much younger and physically healthier than the typical elderly nursing home resident and have no clear path to regaining independence. They also receive minimal mental health services at the nursing facility, the report said.

The report concluded that Louisiana is in violation of state and federal laws, such as the Americans with Disabilities Act, that require states to provide options other than institutionalization to people with disabilities. Chiefly, the state should be improving access to "community-based services," which allow people to be treated in their own homes, often at a lower cost than nursing homes. The Justice Department estimated that the state is spending as much as $7,000 more per person, per year, to treat a mentally ill person in a nursing home instead of in his or her community.

"Louisiana's unnecessary reliance on nursing facilities violates the civil rights of people with serious mental illness," the report said. "By contrast, community integration will permit the State to support these individuals in settings appropriate to their needs and in a cost-effective manner."

The reason so many mentally ill people end up in nursing homes is because the state lacks an adequate supply of community-based services to treat people in their own homes. Louisiana also does not identify people with mental illnesses, once they're in the facilities, to inform them of their options and plan for a transition back to their homes, the report stated.

The Justice Department reported that 14.5 percent of people in Louisiana nursing homes have a serious mental illness, which is among the highest percentages in the nation. At least eight unnamed nursing homes in Louisiana had such high populations of mentally ill patients that people in the community identified them as psychiatric facilities instead of nursing homes, the report said.

Many of the patients interviewed over the course of the investigation told the Justice Department they hoped to be able to leave, and at least two people said they felt like "prisoners."

Remarkably, the report found that some of the people staying at the nursing homes were fairly healthy mentally and physically.

"One woman with serious mental illness experienced a crisis after the death of a family member, leading to her nursing facility admission. Four years later and still in her fifties, she remained in the nursing facility, despite needing minimal physical and psychiatric care," the report said. "She longed to go home saying, 'I would like to be normal, complete, whole again -- like I used to be.'"

In a emailed statement, Louisiana Nursing Home Association executive director Mark Berger said he had not yet fully reviewed the data to support the Justice Department's findings, which made responding to the allegations difficult. But he said the association would be working with the state to improve mental health outcomes.

"The report mentions hundreds of instances where Louisiana's nursing facilities successfully discharged residents into the community," he said. "It is important to note that nursing facility residents are voluntarily admitted and are free to leave the facility except in the rare case of a court order."

Louisiana currently offers a variety of community-based programs for the mentally ill, such as housing assistance, crisis intervention services and at-home primary health care services. But the report said there aren't enough of these resources available.

Many of the people with mental illnesses who end up at the nursing homes come from private psychiatric hospitals, where they are admitted for acute care after a crisis. State hospitals were another source, discharging 153 people with serious mental illnesses directly into nursing homes, between 2010 and 2014.

"One man's journey into the nursing facility began when he had a mental health crisis a few years ago and repeatedly called 911 about his blood pressure. Instead of connecting him to community treatment services, he was charged with abusing 911, sent to jail, and then admitted to a State hospital," the report said, adding that the man was eventually discharged to a nursing home.

"Six years later, the man, who is in his sixties, remains in the same nursing facility, even though he wants to return to the community and could do so with proper physical and psychiatric supports. This man's story is not unique."

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Mentally ill people trapped in nursing homes because Louisiana lacks support programs, DOJ investigation finds