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Abuse
case alarms families of elderly
By
Matt Leingang
Democrat and Chronicle, June 8, 2003
Every day that Deedie Littrell visited her 75-year-old mother
at an adult home in suburban Rochester, she passed through the halls of a
beautifully appointed facility designed to look like a New England
cottage.
Everything about Clare Bridge of Perinton, a state-licensed adult home for
people with Alzheimer’s disease and other memory disorders, seemed
top-notch. From private bedrooms to an outdoor courtyard, the place looked
immaculate. A 24-hour staff was there to help Littrell’s mother overcome
declining skills that left her unable to eat, dress and bathe herself.
But that feeling of trust shattered on April 10 when police arrested a
21-year-old employee, Jesus Gonzalez, for attempted sexual abuse of an
elderly Alzheimer’s patient so feeble that she couldn’t speak or move
without assistance.
That was just the beginning. The state Health Department, which swooped in
days after the arrest, then issued in a scathing report outlining how
Clare Bridge had hidden previous abuse allegations involving Gonzalez,
some of which were documented by his supervisors last year.
’’The more that comes out about this place, the more horrifying it
becomes,’’ said Littrell, who moved her mother to a new home after
Gonzalez’s arrest.
Two months later, Littrell and other family members still seek to learn
why Clare Bridge kept Gonzalez around when his supervisors allegedly knew
there were warning signs about his behavior that jeopardized the safety of
all 52 residents.
The results of an investigation by the Democrat and Chronicle,
encompassing interviews with more than a dozen clients and former
employees at Clare Bridge, show that favoritism and a culture of hands-off
management may have played a role.
Clare Bridge, which is owned by Milwaukee-based Alterra Health Care Corp.,
caught Gonzalez making calls to ‘’900’’ numbers -- believed to be
sex lines and psychic services -- from residents’ bedrooms last year,
according to the state.
Instead of firing Gonzalez, who has ties to management, Alterra paid the
$1,750 bill and kept Gonzalez on the payroll, perhaps to garnish his wages
as payback, former employees tell the Democrat and Chronicle.
The unfolding story may only get worse. The state Health Department
continues to investigate the matter, and Gonzalez -- who is charged with
attempted first-degree sexual abuse, a class E felony -- may face
additional charges, said Leanne Moser, assistant district attorney for
Monroe County.
About 44 residents remain at Clare Bridge; at least six others, including
Littrell’s mother, have been moved to new adult homes by their
guardians, who wait for answers to some crucial questions: How many more
dementia residents -- many of whom either cannot talk or lack the
cognitive skills to speak intelligibly -- may have been abused? What
motivated management to protect this allegedly dangerous employee? Did the
parent company know about the situation? And moreover, how was the state
Health Department, the agency in charge of regulating patient safety at
adult homes, so easily misled?
Money troubles
Alterra Health Care Corp. is one of the largest operators of
assisted-living facilities and memory care homes in the nation. But it has
a checkered past.
In the late 1990s, many companies like Alterra made big profits as elderly
people and their families, eager to avoid nursing homes, flocked to
assisted-living centers and memory care facilities. Alterra charges
between $4,800 and $5,200 a month for room and board -- all of it private
pay.
But according to industry observers, Alterra’s expansion exceeded
demand, leaving it with mounting debt and tumbling stock prices. The
company filed for Chapter 11 bankruptcy protection in January.
As part of its bankruptcy recovery plan, Alterra has been selling off
adult homes across the country, including a memory care home in the
Rochester suburb of Greece. Alterra now operates 379 homes in 24 states,
down from about 490 last year.
Fifteen Alterra-owned homes remain in New York; Clare Bridge of Perinton
is the only one in the Rochester area.
Although the company has received high marks from patient advocates in
many states, questionable practices have been documented in at least five
others.
Many of these problems, such as medication errors and constant staff
turnover, may be emblematic of a broader industry issue -- labor turmoil
in an industry that prizes low-paid, unskilled workers -- but others are
extreme.
A trial is expected to begin this month in suburban Philadelphia, where
four former employees at an Alterra facility there are charged in the
beating death of an 83-year-old Alzheimer’s resident.
Industry observers question whether for-profit companies such as Alterra,
which pay between $8.50 and $10 an hour for unskilled workers, always act
in the best interest of patient care.
’’Clearly, there is a cultural problem with publicly traded companies
that operate adult homes,’’ said Marvin LeRoy Jr., director of the
Coalition of New York State Alzheimer’s Association Chapters. ‘’The
corporate culture is always money. That is your only concern at the board
table.’’
Still, the overall quality of care at adult homes largely comes down to
having good local management, LeRoy said. Good local managers, even if
their facilities are short-staffed, can make the best of tough situations.
Who was in charge?
At Clare Bridge of Perinton, that job fell to building administrator
Charlene Englerth, who was promoted to that position in late 2001.
Previously, Englerth had been the home’s activities director, scheduling
in-house concerts and various programs for the residents.
Some clients say that Englerth, 50, was in over her head -- that she
wasn’t qualified for the job and that she couldn’t control her staff,
allowing them to go unpunished for medication errors and for not showing
up for work.
’’People were shocked that she ended up being the director,’’ said
Jennifer Merlo of North Chili, a former aide at Clare Bridge who left in
2002 because of what she called an unprofessional atmosphere. ‘’I
think it just happened because she was there and no one else was around to
fill the position.’’
The state Health Department, however, certified Englerth in February 2002,
saying she met the requirements: A high school diploma, or an equivalent;
at least two years of supervisory experience; and the completion of
state-credited training courses.
’’Charlene always impressed me as a caring person. That’s why it’s
so hard to believe that she was involved with this coverup,’’ said
Littrell, who added that she does not suspect that her mother was abused
at Clare Bridge.
Englerth did not return calls seeking comment.
As for Gonzalez, he is described by Littrell and others as polite,
charming and mostly soft-spoken. He had endear-ed himself to many family
members.
Gonzalez, who declined to be interviewed for this article, lives in
Rochester with his girlfriend and their two young children. Until his
arrest, he had been assigned to work the daytime shift at Clare Bridge.
’’I made a huge effort to be there every week and to get to know the
people who were taking care of my mother,’’ said Littrell, whose
mother lived there two years. ‘’I felt I knew the place, but clearly I
did not.’’
According to the state Health Department’s unfolding investigation,
Englerth and case manager Geri Thurston knew that Gonzalez posed a threat
to residents in 2002 and did everything they could to prevent others from
knowing about it.
At the start of that year, Gonzalez was caught calling the 900 phone
numbers.
In June, a co-worker found Gonzalez in the bedroom of an elderly woman,
his pants undone and the woman half-naked. Englerth and Thurston
documented the incident, but never reported it to the state. They also
threatened to fire any employee who might reveal this information to
inspectors, according to the state.
’’Charlene said to us: ‘The subject is dropped,’ ‘’ said a
former employee who was there last year and spoke to the Democrat and
Chronicle on the condition that her name not be used.
Then in November, the state Health Department received an anonymous tip
that Gonzalez was abusing a resident. Investigators immediately swarmed
the facility, but Gonzalez and Englerth were nowhere to be found, the
state says. When investigators turned to Thurston, she denied any
knowledge of the allegation. Other rank-and-file employees -- mindful of
management’s threat -- told the same lie.
’’If this is true, then this is one of the most outrageous things
I’ve ever heard,’’ said Cynthia Rudder, executive director of the
Nursing Home Community Coalition of New York State.
Thurston could not be reached for comment.
What Alterra knew
It is unclear from the state’s report whether Englerth and Thurston also
kept Alterra in the dark. From its headquarters in Milwaukee, the company
has not publicly stated whether it had prior knowledge of Gonzalez’s
behavior.
Alterra is also silent about its handling of the three key players:
Gonzalez has been fired, but Englerth and Thurston have only been
suspended and the company won’t say for how long. Jane Kirby, a regional
manager for Alterra, is temporarily in charge.
A bigger mystery is what may have motivated these two high-level managers
to keep Gonzalez on the payroll and protect him from outside scrutiny.
Former employees told the Democrat and Chronicle that favoritism may have
been a factor. Gonzalez’s live-in girlfriend also worked at Clare
Bridge, along with her mother and other family members. All were said to
be good friends with Englerth and Thurston. The group formed a tight
circle.
Officials at Alterra declined to be interviewed for this article. Instead,
the company issued a short statement.
’’It is Alterra’s practice and desire to keep our families informed
of matters as it relates to their loved ones,’’ the statement says.
‘’We continually balance this communication process with the
requirement of resident confidentiality. Likewise, it is our practice not
to discuss confidential employment-related matters.
’’We can assure you, however, that when we learned of the incident, we
immediately notified the police, the state Health Department and the
family of the resident involved. We cooperated fully with the authorities
and continue to do so.’’
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© 2002 Global Action on Aging
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