Hearing on facility continues
By COLLEEN JENKINS, Times Staff Writer
INVERNESS -- The fate of the River Oaks Assisted Living facility remained in limbo Thursday evening after Circuit Judge Patricia Thomas continued the hearing being held to determine whether the facility should remain open.
Attorneys for the Agency for Health Care Administration and those for River Oaks presented extensive cases Thursday afternoon, bringing forth more than a dozen witnesses who offered a dichotomous portrait of the assisted living facility in Crystal River. The hearing is scheduled to resume April 21.
The state agency, which has asked the court to immediately and permanently close the facility, argued that the facility had violated state law by continually using restraining belts on residents.
Also, the state says River Oaks has violated patients' rights by locking them out of their rooms, restricting their diet and leading them to believe that owner-operator Dan Ward was a doctor.
But Ward's attorney, Jerome Hoffman, said the state agency could offer no evidence of an immediate or ongoing threat to residents. He asked why the licensing agency had not exhausted its administrative options before seeking court action.
"I don't understand what transpired all of a sudden that made these violations more egregious," he said.
William R. Dear, a former nurse's aide at the facility, offered recent experiences to bolster the state's argument. Between December 1999 and March 29 -- the time he worked at River Oaks -- Dear said he fractured bones in four different residents while stretching out their limbs.
Dear said residents endured fractured hips and shoulders as he administered the "range of motion" exercises Ward taught him. Dear, who says he is an alcoholic, also said he had come to work drunk on at least two occasions and still had contact with patients.
Over the phone, Ward asked him to resign in late March after a woman's hip was injured, Dear said.
"He told me on the phone what to write . . . that I performed rotation on her that I wasn't supposed to," he said. Ward said that if he didn't, he would "report him to the state for neglect and abuse."
Other witnesses said they saw Ward and his director of nurses, Orinthia King, alter prescriptions, throw out patients' prescribed medications and force residents to remain at the meal table for hours until they consumed a drink ordered by Ward.
Joann Roberts, whose mother lived at River Oaks for 14 months, said Ward had charged her between $500 and $600 a month for medications he ordered. He threw out $400 worth of thyroid medication Roberts had initially taken to the facility, she said.
"Every time I went in there, I said, 'I'm so happy there's a doctor here,' and he never told me he wasn't," she said, adding that Ward gave her mother "extreme doses of fish oil, which gave her extreme diarrhea."
Gifts of food from families were thrown out, former staff members said. Hoffman suggested that was because of insect problems at the facility.
On the other hand, Charlotte Beck, who has lived at River Oaks with her husband since January, said she continued to refer to Ward as a doctor even though she'd learned he didn't have a doctorate degree.
"He's the best doctor that I've ever had," she said.
She said the diet administered to residents was curing her husband of his diabetes. She said she had lost 30 pounds and he'd lost 20 pounds while living at River Oaks. Also, Ward had helped the couple cope better with each other's illnesses, she said. Her husband had been verbally abusive toward her since his paralyzing stroke seven years ago, she said.
Ward had helped him improve his attitude, she said.
"He's the only person who's been able to do that," Beck said.
Other residents and family members of residents praised the food at River Oaks and said they'd never been concerned about the level of care there.
William Dorey said he had allowed the facility to use a restraint belt on his wife, who has dementia and Alzheimer's disease. Ward, whom he believed to be a doctor, had told him the state did not allow assisted living facilities to use such restraints and left the decision up to Dorey, he said.
Dorey said they used the belt only until she recovered from a broken hip.
"If she didn't have the belt on, she was going to get up and fall," he said. "It was for her own protection. I felt she was getting proper care there and still do."
Richard J. Saliba, AHCA's attorney, said residents were belted into chairs for seven to eight hours at a time, even after the facility was warned by agency officials over many months that this was not permitted.
Both sides still have multiple witnesses to present. Ward and King are expected to testify at the hearing April 21.
The Department of Children and Families, in a separate action, removed nine residents on March 28 and placed them at Crystal River Health and Rehabilitation Center. Those residentswill likely remain there until the matter of whether River Oaks can operate is resolved.
Thomas delayed a ruling on the removals at a hearing on Monday.
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