Ohio's secret shame
Abuse and neglect

By Debra Jasper and Spencer Hunt
Photos by Michael E. Keating
The Cincinnati Enquirer

Troubled homes

The state threatened to close these 65 institutions for the mentally retarded between January 1999 and August 2001. These 72 institutions and nursing homes passed at least three annual Health Department inspections since January 1999 without a single citation.   Inside the Report Failing the fragile Ohio is supposed to care for 63,000 people with mental retardation — but the system is failing. Twelve who died Our investigation found a dozen questionable deaths — and there could be more. Unequal system The kind of care mentally retarded people get depends largely on where they live. Who is accountable? The agencies and departments charged with enforcing minimum standards of care. Slow reform The agencies and departments charged with enforcing minimum standards of care. Take control How to make sure a person with mental retardation is well cared for and safe. Photographer's album A visual journey into the lives of Ohio's mentally retarded. Ohio's Secret Shame Part 1 • Part 2 • Part 3

Those facilities were cited 1,301 times for more than 2,900 incidents related to poor care, an Enquirer database compiled from Health Department inspection records shows.

The database shows 524 incidents of abuse and neglect ranging from cruel language to sodomy. There were 590 injuries, from minor bruises to skull fractures, and 205 incidents in which people either weren't given their medicine or were given the wrong doses.

Two of the most troubled nursing homes were in Greater Cincinnati.

Inspectors found so many problems at Fairfield Center in Butler County that they threatened three times since 1997 to decertify the 119-bed facility, one of the largest private nursing homes for the mentally retarded in Ohio.

Inspectors repeatedly cited Fairfield Center for giving people nothing to do, inadequate medical care and insufficient staff and training.

One inspection found that workers didn't know a resident had pneumonia. Despite the resident's "cracked, dry lips," workers didn't offer the person anything to drink for more than five hours.

Nor did workers respect people's dignity or privacy - a problem cited in case after case across Ohio. At Fairfield Center, some people didn't have toothbrushes. They bathed in rusted showers and lived in rooms with soiled walls, torn bedding and broken furniture.

Officials responded by retraining staff, buying new furniture and painting walls.

At Brookside Extended Care Center in neighboring Warren County, inspectors found that a staff person left a woman upside down, alone in a tub, where she was discovered choking and gagging.

Another inspection found that workers bathed 18 people and then put them in a hallway with wet hair near open doors in 30-45 degree weather.

Workers at the same facility had been told that during fire drills they should attach red ribbons to rooms once they were evacuated. After one fire drill, workers had attached red ribbons to nine rooms with 27 people inside.

Brookside officials assured the state they conducted more fire drills and trained staff to better monitor people, dry their hair and dress them more appropriately.

Fairfield Center and Brookside are run by ViaQuest Inc., which also operates seven other nursing homes for the mentally retarded in Ohio. Five of the company's homes were threatened with loss of funding seven times in the past three years. During that time, the government paid ViaQuest $86 million to care for about 375 people.

Janet Pell, vice president of operations for ViaQuest, acknowledges that things were so bad at some facilities in the late '90s that "we were unfortunately relying on feedback from regulators, so we were moving from fire to fire."

She and Richard Johnson, president of ViaQuest, say conditions have vastly improved in the past year.

The company has added layers of management, raised staff salaries from $7 to more than $10 an hour and reduced turnover at Fairfield Center from as high as 100 percent to less than 40 percent a year.

"Clearly we're not where we want to be. But we recognize the issues, and we're working very hard," Mr. Johnson says.

Helen Rothert, 77, knows first-hand about the problems inside Fairfield Center. Her 51-year-old son Dale, who is severely mentally retarded and has never spoken or even cried, has lived there for 16 years.

A few months ago, Ms. Rothert found cuts on Dale's knees when she took him home to her Green Township condo for the weekend. Another time, she bought him a quilt to brighten his room and somone took it off his bed.

When she found it later, the quilt was covered with feces.

"It's unbelievable," she says. "They can't seem to train the staff."

Last month, Ms. Rothert went to pick up Dale and found him curled up in a corner recliner while other residents wandered the halls alone or sat slumped in their wheelchairs, staring down an empty corridor. She stopped by Dale's bedroom, picked up a pad off his urine-soaked, unmade bed and shook her head in frustration.

Ms. Rothert and her husband cared for Dale at home for more than 30 years. But after her husband's open-heart surgery, they felt they could no longer take the strain and reluctantly agreed to allow their son to move. It was a heartbreaking decision.

"I just worry about him all the time," she says.

Despite the problems, Ms. Rothert believes Fairfield Center is better for her son than a less-regulated group home or apartment. At least she can keep close watch over him there.

She kisses her son and pats his face. "As long as I'm around," she says, "I'm going to keep fighting."