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Close care facility now, state asks judge
By COLLEEN JENKINS, Times Staff Writer
CRYSTAL RIVER -- The state has asked a judge to immediately shut down the River Oaks assisted living facility, which is accused of restraining residents illegally, providing negligent care and violating residents' dignity. The Agency for Health Care Administration filed its complaint Friday in Circuit Court, according to agency spokeswoman Kim Reed. The state argued that River Oaks repeatedly had violated Florida laws and should not be allowed to continue operation. The health, safety and welfare of residents are in jeopardy, the complaint stated. The request for a temporary and permanent injunction was accompanied by extensive paperwork: records from state inspections completed this month, plus sworn statements and letters from past River Oaks employees and residents' family members. The action underscores years of troubles between River Oaks and the agency, which monitors assisted living facilities and nursing homes. In 2000, after being accused of a variety of deficiencies, owner and operator Dan Ward was allowed to keep his licenses after paying a $1,500 fine. Last year, regulators refused to renew the facility's license after issuing two negative report cards. Ward requested an administrative hearing, which is set to begin April 14. The state apparently decided it couldn't wait that long. No court hearing had been scheduled as of Friday afternoon. On Thursday, Jerome Hoffman, River Oaks' attorney in Tallahassee, dubbed many of the allegations "highly suspect." The facility and the state agency long have had different opinions about what care was best for some residents, he said. "They don't see eye to eye on certain things, and as a result, the agency has taken, I think, an overly aggressive attitude with trying to shut this facility down and moving the residents somewhere else," the lawyer said. During the most recent inspections, called surveys in industry circles, regulators did not raise any warning flags that would suggest that River Oaks needed to be shut down, Hoffman said. "Certainly, if these things were going on, nobody on the survey team mentioned them while they were there," he said. "I frankly don't know what has changed." Indeed, findings recorded during the surveys taken two weeks ago sound similar to those previously cited. Restraint belts tied some residents to their dining room seats, surveyors observed. A staff member revealed that residents were unable to remove the restraints themselves, contrary to state resident care standards. Surveyors were told the belts were used to prevent residents from falling, reports noted. Also, state inspectors said Ward had spoken in a "chastising sounding tone" to two residents. However, one report noted that one of these residents didn't seem bothered by the harsh approach and praised the facility. Statements from seven past employees or family members, which the state filed in support of its court complaint, provided other scenarios: -- Several said residents were locked out of their own rooms during the day, even if they wanted to take a nap. "He (Ward) told me that they were like babies and that they would be up all night," said Karolyn Otlewski, a certified nursing assistant. -- Workers refused to send residents to the hospital for medical needs. In one instance, the facility's director of nursing suspected that a woman had internal bleeding but would not send her to the hospital as requested by her family. Instead, the woman's daughter drove 150 miles, found her mother motionless on her bed and rushed her to the hospital. Hospital staff said the woman was "full of feces and urine." -- Orinthia King, director of nursing, changed residents' charts, according to Teresa Stayler, a licensed nurse who worked at River Oaks between May 21 and July 12, 2001. "This happened on numerous occasions, even with incident reports," Stayler wrote in a letter. -- Former employee Maxine Carlson witnessed residents being underfed, gifts and treats mailed from families being discarded and elderly residents being forced to pick up trash along Gem Street for nearly two hours in extreme heat, according to her statement. -- Both employees and family members said Ward referred to himself as a doctor or a psychologist. In some cases, the motion stated, he changed, modified or destroyed prescriptions. He replaced some residents' medications with fish oil, a major component of the Zone Diet he advocates, and vitamins he deemed appropriate, reports said. "Each resident is required to drink three glasses of liquid with fish oil prior to eating each meal," the complaint said. Hoffman said Ward was not a medical doctor. He has taken some courses toward a doctoral degree, the attorney said, but had not earned the advanced degree. "I've never heard anybody refer to him as Dr. Ward," Hoffman said. "He certainly does not represent himself as a medical doctor." After past disputes between the state and River Oaks, many families have voiced their support for Ward and his techniques. One man who suffered from dementia told his daughter that his time at River Oaks had been the "best days of my life," according to a past Citrus Times article. "We believe that most of the residents get good care and the families of most of the residents are happy," Hoffman said Friday. Such loyalty hasn't allayed the unease recent evidence has stirred among disability advocates. The Advocacy Center for Persons with Disabilities might send its own inspection team to check out River Oaks next week, deputy director Pat Wear said Thursday. The assisted living facility only recently appeared on the center's radar screen, but he said the allegations of locked doors, seized personal possessions and diet raised concerns. "If all of those things are true, all of those things are a real problem," Wear said in a phone interview from Tallahassee. "We continue to be very concerned about what's happening down there." -- Colleen Jenkins can be reached at 860-7303 or cjenkins@sptimes.com.
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