Lax rules, missing information put nursing home residents at risk

Safeguards designed to protect residents from sex offenders are failing.


The residents of Roselawn Gardens knew another registered sex offender was being admitted to their small, one-story nursing home of roughly 40 beds.

They were informed that his care plan, like the other six offenders in the Stark County home, would require checks every hour around the clock.

What they didn’t know — what even the operators of the home say they didn’t know — was that Scott Russell Cook’s previous victim was a 92-year-old woman he attempted to rape while he was housed in a Cleveland nursing home.

Around 2 a.m. on March 15, seven days into his stay at Roselawn, a resident spotted Cook in the room of an 85-year-old woman and called for help, telling a nurse the man was reaching to touch her. When the nurse arrived, she saw the paraplegic Cook wheeling himself out of the room, according to an Ohio Department of Health investigation report.

Three days later, Cook admitted to a parole officer that he digitally penetrated the woman. He pleaded guilty Oct. 5 to one count of rape in Stark County Common Pleas Court and was sentenced to 25 years in prison.

>> RELATED: Convicted rapist says his care hurt by his offender status

>> RELATED: Sex offenders in Ohio nursing homes: 5 things to know

>> MAP: Searchable database shows which nursing homes have sex offenders

Ohio has a duty to protect its most vulnerable citizens, many of them frail or disabled. But safeguards enacted to keep sex offenders in check are more difficult to enforce when the predator is down the hall. A Dayton Daily News investigation found 136 sex offenders are living in 43 nursing homes in Ohio, where an intricate safety net is supposed to balance the needs of all patients with a responsibility to shield them from danger.

But as more offenders enter nursing homes as residents, often needing long-term care themselves, that safety net is failing.

The Daily News investigation found:

  • The state sex offender registry that should provide critical information to nursing homes about potential risks is unreliable, with even the most basic facts — including the nature of the crime itself in some cases — missing for many offenders.
  • An aversion to taking on sex offenders at most homes has led to a concentration in a small number of facilities, some with citations for failing to stop abuse. A Columbus home where 18 of 136 residents are registered sex offenders was cited by the health department last year for failing to prevent an attempted rape by a resident who was then left alone long enough to wash himself before police arrived. He was convicted of the lesser charge of gross sexual imposition.
  • Cook isn’t the only nursing home resident who was sent to a new home after attacking a resident or staff member in a previous home. Fresh from a prison stint after he was convicted of gross sexual imposition of a child under the age of 13, Marvin Chandler was sent to a home in Fayette County, where he attempted to rape a nurse. He was convicted, served four years in prison and is now living in another nursing home — this one next door to a middle school.
  • Some of the homes with the highest number of offenders are also those with the most serious staffing needs. Of the five homes with the most sex offenders, two are rated by the federal government as “much below” average for staffing, one is below average and two are average.
  • Nursing homes are responsible for investigating the backgrounds of sex offenders, but critics say there is a disincentive among some homes to reject residents who bring in money from Medicaid, the federal program that provides health care for the poor. “They know they’re going to get their money, so they don’t care,” said former state Rep. Courtney Combs, R-Hamilton.
  • State law requires that sex offenders live no closer than 1,000 feet from a school, yet at least six nursing homes currently housing sex offenders are either inside that boundary or very close. The state registry shows that a Mercer County home that is across the street from Parkway High School has two sex offenders living there, including a 62-year-old man who was convicted in 1995 of sexual battery against a juvenile girl.

 

Parkway Superintendent Greg Puthoff said there have been no issues at the school involving residents in the home but also said students don’t participate in programs at the home.

The Daily News’ findings illustrate how difficult it is to provide care to all those who need it while keeping potentially dangerous residents from doing harm.

“It speaks volumes to us when we have so little regard for the safety and well-being of our people with disabilities and our elders that we would warehouse them with violent sexual offenders with no locked door between,” said Wes Bledsoe, who has advocated for better nursing home oversight for more than a decade through his Oklahoma-based group, A Perfect Cause.

“They can’t physically defend themselves, and for a host of reasons cannot report what’s happened to them.”

‘National disgrace’

The Daily News identified the 136 registered sex offenders by matching the addresses listed in the state registry with the addresses of licensed nursing facilities, and then reached out to each home in an attempt to verify that a sex offender was living there. The actual number of sex offenders living in Ohio nursing homes is likely greater than 136 because anyone who was released from prison in the state prior to 1997 is not required to register. Ohio’s registry also includes 172 offenders who are listed as “non-compliant,” meaning they have failed to notify law enforcement of their whereabouts.

The earliest date of a crime committed by a known offender now living in an Ohio nursing home is 1978. Other crimes are much more recent. At least 14 residents have convictions during the past five years.

All but three are men and the median age is 67. The youngest, a 27-year-old Tier II offender in Logan, was convicted of gross sexual imposition of a victim under 13.

The oldest, a 95-year-old in Harrison County, was convicted of the same crime. He was 90 at the time.

Offenders were convicted of a range of crimes, including child molestation, sexual battery and rape.

But the list also includes octogenarians with advanced Alzheimer’s and people with severe disabilities who have limited choices for quality care based on a registration status that stems from crimes as long as 35 years ago. Identifying the risks they pose is a vexing problem for the homes that open their doors to those rejected by society.

Sex offenders make up a small fraction of the estimated 84,000 nursing home residents in 940 homes in Ohio. But as their numbers grow, the challenges become greater because the number of facilities willing to take them remains small.

“We’re moving really into new territory in the sense that 20 years ago there wasn’t reporting and registry and so forth,” said Doug McGarry, executive director of the Area Agency on Aging. “Now as these previously adjudicated offenders are aging and in need of care it’s opening up a whole new challenge for homes and residents alike.”

For years advocates have pushed for better notification to inform communities about sex offenders in their midst.

In the 1990s every state enacted a version of Megan’s Law that called for the creation of public registries. The national 2006 Adam Walsh Act established a more uniform, tiered system for classifying offenders with the most serious level given a designation of Tier III.

Ohio has strengthened its law numerous times. A 2003 state law said sex offenders can’t live within 1,000 feet of a school or day care, but there was no requirement that residents in nursing homes or their families be notified when a resident moves into a facility, or even in the room next door.

That changed in 2014. State Senator Capri Cafaro, D-Hubbard, pushed for the legislation out of a concern that homes were seeking out sex offenders to fill empty beds and not informing other residents.

“You and your loved ones need to know the circumstances,” she said.

But some question whether those laws have gone too far, labeling for life elderly people who no longer pose a threat to the community.

“Some of these laws, they had good intentions, but to sentence someone to a life of registration … there is a point when these people are not able to even care for themselves, let alone come down and register,” Clark County Sheriff Gene Kelly said.

Kelly said one of his deputies visits two nursing homes in Springfield once a year to take photos of the three offenders living there and help them update their registrations.

Bledsoe, who founded A Perfect Cause to raise awareness about safety and neglect issues in nursing homes, said sex offenders have no business living in homes where other residents may not know or understand the potential risk.

“This is just an absolute national disgrace,” he said. “If it’s absurd to put (offenders) in a daycare center, what makes it less absurd to put them in a nursing home?”

His group conducted one of the first national surveys to identify how many sex offenders were in nursing homes. In 2005 — as many states were just starting online registries — A Perfect Cause identified 800 in 36 states, including Ohio.

Some of the horror stories the group uncovered involved Ohio nursing homes. In a Cincinnati home, a disabled woman was raped by a 43-year-old registered sex offender, according to the group’s report, and in a now-closed Washington Court House nursing home a 65-year-old resident stomped his roommate to death after an argument over a TV set.

Oversight needed

The Daily News investigation found at least two registered sex offenders — Cook and Chandler — whose histories alone would seem to call for more intensive oversight and protective measures. In Cook’s case, the nursing home did change its policies after he attacked a resident.

Chandler, 45, had a known history. He spent four years in prison for gross sexual imposition on a victim under age 13. Upon his release in 2005 he was labeled a registered sex offender and had that label when he was moved into Carlton Manor in Washington Court House.

Until its closing in 2014 following multiple failed inspections, Carlton Manor had more sex offenders than any other home in Ohio. It is also the same home where the resident killed his roommate in 2005.

In 2008, Chandler knocked to the ground and attempted to rape a female nurse at the Washington Court House home. He was sent to prison for four years, released and given the most serious designation in the sex offender registry: Tier III. But despite Chandler’s history, he ended up at Wayside Farm in Summit County, a 95-bed nursing home that is next door to Woodridge Middle School, which has 473 students in grades 6 through 8.

Woodridge Superintendent Walter Davis said school officials have been assured by the sheriff’s office that Wayside is a locked facility and that no resident would pose a harm to the students or staff. Davis, however, said he did not know that one of the residents — Chandler — is a Tier III-designated sex offender.

Multiple attempts to reach the administrator of Wayside, which has two sex offenders living there, were unsuccessful.

>> RELATED: Despite law, sex offenders live near schools

>> RELATED: Ohio’s sex offender registry missing critical information

Cook, 48, was admitted to Roselawn four months after his release from prison. In 2010 he was convicted of the attempted rape of a resident at the former Larchwood Village nursing home in Cleveland after he was found on top of a 92-year-old partially clothed woman. A rape exam revealed bruising and a laceration on the woman that was consistent with sexual assault, according to court records.

Although Cook was indicted for rape and assault, he was convicted of the lesser charge of attempted rape, sentenced to five years in prison and ordered to register as a Tier III offender.

Matt Dapore, COO of Hillstone Healthcare, which owns Roselawn and other nursing homes in the state, said Cook came to the facility in March to be treated for severe ulcers on his body that had become infected. He was receiving IV antibiotics twice a day and was “very sick,” Dapore said.

But a week after being admitted Cook was back in jail following the assault on the 85-year-old woman.

The nursing home acknowledged it would have handled Cook’s care differently had it known the full details of his history.

“When you check the sex offender registry in the state of Ohio you would believe that the information is current, but in this situation the offense and charge did not appear on the registry when we did our initial search,” Dapore said.

A Roselawn staff member later told a health department investigator she may have overlooked a note that appeared on Cook’s offender registration page that reads, “Victim was a 92-year-old female,” in all caps.

As a result of the crime, Roselawn has changed its policy to do more frequent checks on residents who are in the registry and will no longer admit sex offenders whose crimes were against those 55 or older, Dapore said.

Registry incomplete

The Daily News’ examination of the nursing home residents on Ohio’s sex offender registry shows it is missing critical information on some offenders, including the type of crime committed.

State law requires the public registry to include: name, photo, address, offense, date of conviction, tier or classification, supervision status, address of any school attended or place of employment, and license plate number of any vehicle.

Information about a victim’s age is not required, though that information could be useful in determining whether certain offenders pose a risk to other nursing home residents. Although most of the records list whether the victim was a juvenile, few indicate the age of adult victims.

Most also contain little or no information about an offender’s actual crime, and virtually none listed the county where the offender was convicted.

The actual tier designation — I, II, or III — was omitted in 21 of the 136 registrations, or about one in six. The newspaper investigation found 58 nursing home residents who are required to register as sex offenders for the rest of their lives.

Responsibility for enforcing the sex offender law and ensuring that offenders provide accurate information to the registry, including their addresses, rests with individual sheriff’s departments.

But nursing homes should do their part, too, said Gene Fischer, Greene County sheriff and past president of the Buckeye Sheriffs’ Association. Fischer said the transient nature of many offenders makes it difficult to track down some of them. Instead of relying solely on the registry to determine an offender’s history, nursing homes should conduct their own investigations, he said.

Even nursing home advocates acknowledge that’s not happening. Most nursing homes don’t run background checks on incoming patients beyond the required sex offender registry check, said Peter Van Runkle, executive director of the Ohio Health Care Association, a nursing home industry advocate. He said staff likely wouldn’t have time to track down details that aren’t included.

Critics say the incomplete registry is just part of the problem.

Combs, the former Ohio House member from Hamilton, said the nursing home lobby has resisted stronger laws, hoping to protect guaranteed Medicaid payments for qualified residents.

But Van Runkle disputed that homes are profiting off sex offenders.

“Medicaid doesn’t pay us the amount it costs to care for a Medicaid patient,” he said, adding that those who do accept offenders have a calling to provide care.

Combs said full histories on sex offenders are publicly available if the homes care to look.

“There’s public record,” he said. “You can contact your local sheriff.”

In some cases, operators may not even know there is a sex offender in their home. When this newspaper called the administrator at Covington Care Center in Miami County about a resident who is on the registry, he said he wasn’t aware of anyone on the offender list living there. The administrator said he would look into it, but at last check the resident — who was convicted of sexual battery — is now living in Bryden Place in Columbus. Covington no longer has any residents listed on the sex offender registry.

Under the 2014 state law, homes must check the registry, notify other patients if a sex offender moves in, and create and share the care plan they’ll use to monitor that person.

No homes have been cited for failure to comply with the notification law, Ohio Department of Health spokeswoman Melanie Amato said.

False sense of security

Whatever their crimes, most sex offenders are in nursing homes because they need medical care. There are numerous men on the public registry whose photos show them hooked up to oxygen or lying in bed. One man’s registry page lists that he is paralyzed from the waist down and has multiple sclerosis.

But determining whether someone is a threat is not an exact science, both critics and advocates say.

“There isn’t something that happens to someone when they turn 50, 60 or 70 that they become this perfect grandparent,” said McGarry with the Area Agency on Aging. “If someone had deviancy when they were younger, it doesn’t necessarily go away because they’ve had a birthday.”

Bledsoe’s 2005 study found numerous examples of crimes by people with severe physical limitations.

“We even found amputees, including one double amputee in New York who raped and assaulted another resident,” he said.

Bledsoe says there is a false sense of security when someone is labeled as “no longer a threat” based on little evidence.

Mercer County Sheriff’s Deputy Douglas Wuebker says there is plenty of evidence that Donald Heitmeyer no longer poses a threat.

Heitmeyer, 84, who was convicted in 2005 for gross sexual imposition, lives in the Colonial Nursing Center of Rockford — directly across the street from Parkway High School.

Heitmeyer will soon be off the registry, according to Wuebker. He uses a wheelchair and can’t get around without the help of two nurses, the deputy said.

“His threat level was assessed, and I guess his threat level is considered to be pretty much non-existent,” Wuebker said.

Sheriff Kelly in Clark County said common-sense exceptions are needed for some offenders.

An 81-year-old resident of Good Shepherd Village Nursing Home in Springfield, who recently came off the registry, has advanced Alzheimer’s, Kelly said. Another Good Shepherd resident who is on the registry has suffered a stroke and is paralyzed on one side of his body, according to sheriff’s records.

“These individuals are not physically capable of getting out of their rooms or their beds,” Kelly said.

A nursing home resident doesn’t have to be on the registry to pose a threat. Cuyahoga Falls police were called to Wayside Farm twice in 2014 to investigate alleged sex offenses by a man living there, including that he paid a developmentally disabled woman 75 cents to touch his penis. Both times police took a report but did not make an arrest.

According to police and state inspection reports, the same man was arrested in 2010 for disseminating matter harmful to juveniles but was found incompetent to stand trial.

Rather than being ordered into a state mental health facility, a probate judge ordered that he live at the nursing home. He is not required to register as a sex offender and remains in the home.

Joshua Garis, the man’s court-ordered guardian, disputes the claims made in the police and state reports: “I’m not at all concerned about his behavior at this point,” Garis said.

Unpopular label

Some homes said they accept offenders because caring for everyone, regardless of background, is their mission.

“If we admit anybody that unfortunately has this label or tag, first and foremost we have to be able to meet their health needs. And if we can do that we feel that’s our call to humanity,” said Roselawn’s Dapore. “I took an oath as a licensed nursing home administrator that I will take care of people, and that’s what we plan to do.”

William Johnson, the administrator for Bryden Place, said his home “firmly believes that all individuals in our society have the right to be provided needed nursing care and services in a dignified manner in a safe and secure environment. This includes those individuals who may have a prior conviction of a sexual-related offense.”

Bryden Place houses 18 sex offenders — more than any other facility in Ohio — and like many of the homes that take in offenders, it is not highly rated.

Nearly half of the homes that currently house sex offenders, including Bryden, have a 1 rating (on a 5-point scale) on the Medicare.gov nursing home comparison tool. Only one has the highest 5-star rating.

Lower ratings indicate repeated health and safety citations on state inspections and can indicate inadequate staffing levels.

Bryden Place was recently cited for failing to protect a resident from sexual abuse.

Anthony Jerome Carson was not a registered sex offender, but state records indicate staff members had concerns about his behavior and even suggested discharging him prior to January 2015, when he was caught attempting to rape a female resident in her bed.

Carson was convicted of gross sexual imposition and is back in jail on a probation violation.

The Daily News examination of the registry list found 12 sex offenders living in the Scenic Pointe Nursing and Rehabilitation Center in Millersburg, 11 in the Edgewood Manor of Lucasville and 10 each in Pine Kirk Nursing Home in Kirkersville and Eastbrook Health Care Center in Cleveland. Calls to each home were not returned.

The five homes house about 44 percent of the known sex offenders living in Ohio’s nursing homes. The other homes on the list typically house just one or two sex offenders.

No home is required to accept sex offenders, the health department’s Amato said.

The administrator at Autumn Court in Ottawa wouldn’t confirm if a sex offender lives there, but said the home no longer accepts individuals on the registry.

“It’s just a label that is unpopular,” he said.

Several other administrators said they follow all regulations when it comes to notifying other residents that a sex offender is being admitted, and make admission decisions on a case-by-case basis.

“Right now it’s basically the nursing home’s decision if they accept a referral — if they are willing to admit a sex offender or not,” said Marianna Kiser, a social worker at Sapphire Health and Rehab in Summit County.

“We are not taking any sex offenders at this point,” she said.

The vast majority of skilled nursing centers don’t accept sex offenders, Van Runkle said.

“Most skilled nursing facility operators are going to look at it as more of a risk than it is something they want to take on,” he said.

Homes that do admit those on the registry can’t just kick them out without a valid reason, but advocates say there are ways to get around the rule.

“What they will say is we can’t meet your needs,” said Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care. “In some instances that may be true, (but) at other times what they may be feeling is, we don’t want to.”

The state ombudsman who advocates for long-term care patients said it’s rare when a bed can’t be found for someone on the sex offender registry.

Next to schools

Registered sex offenders in Ohio aren’t supposed to live within 1,000 feet of a school or daycare center, but this newspaper found six nursing homes currently housing offenders that are next door, across the street or around the corner from school properties.

That includes a Springfield nursing home resident who has legally lived near Lagonda Elementary School for two years despite convictions for touching young girls, including a 10-year-old.

George Pistner, 72, is allowed to live in close proximity to a school because his crime occurred in 1999, prior to the state’s 2003 law that included a residency restriction.

Pistner, who lives at Springfield Manor, was convicted in Florida of multiple counts of lewd or lascivious contact with a victim under 16, and must register as a sex offender for life. There is no indication in his file that he is not able to get around.

Springfield Manor declined comment.

Neighbors say it’s concerning to have offenders living so close to schools.

“At the end of the day, if they’re going to let him live that close, they need to be keeping a really close eye on him,” said Dominic Maddalena, who lives across the street from Springfield Manor. “Every morning there’s tons of kids walking to school.”



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