More about residential care facilities

November 18, 2008 

THE DEATHS

Three deaths in Midlands residential care facilities in the past two years are in the spotlight:

• October 2006. DONALD BASS, 56, a disabled resident at Peachtree Manor Residential Care Facility in Fairfield County, left the facility with the help of another resident and was struck and killed by a car. Authorities said Bass, in a wheelchair, was being pushed along a road by another resident. Peachtree Manor was closed earlier this year. Officials cited numerous threatening conditions.

• October 2007. This insulin overdose death happened at a Columbia facility. Richland County Coroner Gary Watts declined to release identifying details as the probe continues.

• April. WILLIAM SEELEY, 59, a resident of Prosperity’s Southside Residential Care Facility in Newberry County, died at Newberry Hospital on April 12.

A diagnosed schizophrenic, he suffered from leg injuries, malnourishment, bed bugs and a rotten toenail, and his skin peeled off when his sock was removed, said Prosperity Police Chief Craig Nelson. He said Seeley’s normal weight was 160 pounds, but he weighed 94 pounds when he died.

Southside operator Roy Lee Bowers, 64, was indicted Oct. 24 by a grand jury on a charge of felony neglect of a vulnerable adult resulting in death. He will be tried next year, said 8th Circuit Solicitor Jerry Peace.

Bowers’ lawyer, Richard Breibart, said Seeley had been transferred several weeks earlier from Peachtree. “There’s clearly another side to this story, and the facts are not what they appear to be.”

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WHO DOES WHAT

The state Department of Health and Environmental Control is responsible for licensing and overseeing the homes for those who are mentally and physically disabled, but not seriously enough to be in a nursing home.

The state Department of Labor Licensing and Regulation is responsible for licensing and disciplining residential care operators.

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COST

Quality — and cost — vary greatly at the homes.

HIGHER COST. The best facilities are for people who can afford high monthly payments. Their money buys quality, food, cleanliness, safety and numerous highly trained staff. Streams of family and friends visit. Costs may range from $2,500 to $5,000 a month. People in a well-protected, highly staffed Alzheimer’s unit may pay the $5,000.

LOWER COST. Many of the facilities are in rural areas, away from family and friends. Costs may be around $1,000 a month, which might barely pay for food, heating, cleaning and the minimal 24/7 staffing required by law. Living in close proximity may be Alzheimer’s patients, mentally ill residents with violent tendencies and relatively healthy people who simply need help getting around.

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STATE IS LOSING BEDS

Many of the poorer residents of the homes pay for their care by giving the operators the state and federal checks they get for disabilities and support.

In an unknown number of cases, this amounts to little more than $1,000 a month — so little that many low-cost homes, unable to meet expenses, have gone out of business in recent years.

A Legislative study group concluded this summer that “there is currently an inadequate number of ... beds for publicly funded residents with behavior disorders,” according to an Oct. 3 state Mental Health Department internal memo.

“Since 2005, there has been a net loss ... of 687 beds,” the memo said.

The memo was written by Vicki McGahee, coordinator of residential care for the state Department of Mental Health and an expert on care quality.

The shortage has “had an adverse effect on clients served by Mental Health,” she wrote, as well as on hospitals.

People with behavior disorders go to hospitals “to the detriment of those hospital Emergency Departments and the persons who depend on them by increasing their costs and diverting their resources,” McGahee wrote.

The beds are important, said Jim Head, senior vice president of the S.C. Hospital Association.

With no psychiatric services available at many hospitals, doctors need to have somewhere to send those patients, Head said.

Many of the mentally ill people now in lower-cost homes have “challenging behaviors,” according to the Mental Health internal memo. “Many residents are extremely difficult to place. They have multiple needs,” agreed Gloria Prevost, one of the state’s leading advocates for better care.

John Monk

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