Few nursing home employees are ever convicted of crimes when a resident is hurt or dies because of abuse or neglect. Fewer still go to jail.
The cases are difficult to prove, prosecutors say, because victims often can't testify, so those charged frequently plea bargain and typically receive probated sentences.
The Herald-Leader examined 107 cases in which nursing homes received serious citations, also known as Type A citations, over a three-year period. Of those, seven cases were pursued by local or state prosecutors.
Shelley Johnson, a spokeswoman for the Kentucky attorney general's office, said the most important thing is that the defendants surrender their professional licenses.
"The plea agreements accomplished multiple goals, the most important of which was to ensure that these people never again work in a care facility," Johnson said.
But the light sentences "speak to the lack of regard for people who are older and vulnerable," said Jan Scherrer, president of Kentuckians for Nursing Home Reform.
The most likely cases to be prosecuted are those involving sexual violence. Three of the seven cases prosecuted over three years involved sexual assault.
In July 2008, Bradford Heights Nursing Home in Hopkinsville was issued a Type A citation, the most serious the state can levy. A female resident repeatedly told staff members that she had been "raped and hit" by a male nurse's aide. Four supervisors ignored her.
Ultimately, a staff member walked into a resident's room and found the nurse's aide on top of the resident, according to the citation.
Rodriguez Durr, the nurse's aide, was charged with two counts of sexual abuse. He pleaded guilty to reduced charges and was given a three-year probated sentence. If he does not get into trouble, the plea will be removed from his record.
Durr's sentence was diverted because he was mildly mentally disabled and did not have a criminal history, according to Lynn Pryor, Christian County commonwealth's attorney. In addition, without his cooperation and admissions "we wouldn't have had a case at all," she said.
"Oftentimes, what has happened to them is terrible," said Pryor, but when there is no physical evidence, juries that have been exposed to television shows like CSI "expect DNA and fingerprint evidence."
Bradford Heights is now under new leadership, said administrator Selina Beck, who said she was not employed there when the incident occurred.Other cases that were prosecuted include:■ In June 2009, James F. "Chum" Tackett, former administrator of Golden Years Rest Home in Letcher County, was charged with knowing abuse of an adult, a felony.
Tackett pleaded guilty to misdemeanor reckless abuse of an adult. He received a 12-month sentence for the 2007 assault of a resident, and was put on probation for two years on the condition he not have any contact with the facility.
According to a Type A citation issued by the Cabinet for Health and Family Services, a resident told investigators he had been smacked and hit in the head with a rubber hammer.
Tackett's legal problems were not over, however.
In April, a 74-count indictment alleged he stole nearly $500,000 in federal and state funds meant to be used for disabled residents of Golden Years.
Tackett has pleaded not guilty in Letcher Circuit Court.
■ In October 2007 at Pimlico Manor, now called Bluegrass Care and Rehabilitation Center, in Lexington, the family of an 89-year-old woman repeatedly asked the nursing home to protect her from a 44-year-old male resident with a head injury.
The man had a "history of sexually inappropriate behavior" and the family had seen him touch her breasts and buttocks, according to the citation. The staff allowed the resident to continue to have "close contact" with the woman, the citation said.
Finally, the man took the woman to his room and pulled the curtain around his bed. His roommate, alarmed, tried to contact nurses, but it took them seven or eight minutes to answer his call, the citation said.
The staff found the man on top of the woman, both undressed from the waist down. An exam showed that the woman had vaginal tears consistent with penetration, according to the citation.
State investigators found that the facility failed to protect the woman. The 44-year-old resident was charged, but found mentally incompetent to stand trial.
Carl Young, the center's administrator, said it is under new management and is in compliance with state and federal guidelines.
■ Mills Health and Rehabilitation in Graves County was cited in February 2008. Barbara Tate, a nurse's aide who is sometimes referred to in documents as Barbara Moss, later pleaded guilty to one count of reckless neglect after she tried to move a resident alone. The resident's chart said she should always be moved by two people.
The resident fell and broke both legs. Tate was sentenced to one year in jail, but was given two years' probation. She agreed not to seek employment in the health care industry.
■ In October 2008, a citation was issued to Richmond Health and Rehabilitation, also known as Madison Manor. Three nurse's aides pleaded guilty to abuse of an adult after being caught on hidden video camera abusing an elderly resident. All three initially received diverted sentences.
Johnson said that for the aides' cooperation in an ongoing investigation, they were offered probation.
Jaclyn VanWinkle and Valerie Lamb were each sentenced to 12 months in the Madison County jail. Lamb's case was discharged for two years on conditions of good behavior and cooperation.
On June 14, VanWinkle was ordered to serve 12 months in prison for violating probation after she was convicted of public intoxication and rape and sodomy of an underage boy. She has been in the Madison County jail for nearly a year, Assistant Commonwealth's Attorney Jennifer Smith said.
Amanda Sallee, a former nurse's aide, pleaded guilty to wanton abuse and neglect and received a one-year sentence, which was diverted for five years on conditions of good behavior and not working with vulnerable adults. She must also cooperate in pending cases against other former employees.
"We commend the attorney general's office for investigating this situation and bringing charges against these former employees," said Cindi Simpson, regional director of operations at Extendicare, which owns the nursing home. "We cooperated fully with their investigation and terminated any individuals who behaved inappropriately."
■ In April 2009, NHC Healthcare in Barren County failed to protect a resident from sexual abuse by a visitor, according to a state citation. Ronald McKinnis, 61, a visitor, was charged with first-degree sexual abuse after a nurse caught him with his hand in a female resident's pants. A Glasgow police citation said that McKinnis admitted touching the woman's vagina. A pre-trial conference is set in the case for July 12.
NHC Healthcare Administrator Emogene Stephens declined to comment.
■ Elizabeth Elaine Royse, a former nurse at a Frankfort nursing home was indicted June 30 on charges that she neglected a patient at Golden LivingCenter in December 2007.
According to a release from Attorney General Jack Conway's office, Royse knew the resident was at risk for dehydration and knowingly neglected to monitor the patient's intake of liquids. The patient had to be taken to a hospital for dehydration, according to the citation. Royse's arraignment is set for July 23.
Robb Durham, executive director of the center, said the nursing home has corrected the issues for which it was cited.