By ALYSSA LENHOFF
and TIM FRANCISCO
At 7:30 a.m. Jan. 30, there was a commotion at Stow Glen Health Care Center, a nursing home for about 100 residents on Kent Road in Stow. Forty minutes later, a 90-year-old woman was taken to the hospital with bloody head injuries, a nurse’s aide was fired and police were investigating a case of abuse.
Police had collected bloody wash rags, a blood-soaked gown and a broken clothes hanger.
Ruth Nelson died Feb. 28, less than one month after the attack. About 10 months later, Stow Police Detective Edie Gaffney is still investigating and can’t talk about the case, which leaves Ruth’s daughter and son-in-law, Joan and Greg Shreve, wondering if the incident hastened Ruth’s death and if they could have done anything differently to have prevented this from happening.
Seated in a restaurant in Kent, the Shreves scroll through pictures on an iPad. The images show Ruth at her 90th birthday party in May 2011. In some, she is wearing a necklace from her father’s home country of Norway. In others, she is seated in a wheelchair and smiling directly at the camera.
“She was cute and sweet, and the night before the incident, she was talking about going back to Norway where her father was from,” said Joan.
The Shreves are educated, well-spoken and firmly upper middle class. Greg is a retired professor of modern and classical languages and linguistics from Kent State University. Joan was a librarian at the University of Pittsburgh and Kent State University and a professor of computer technology at several Kent State campuses.
Their story begins in 2005, when Ruth and her husband, Donald Theodore Nelson, wanted to move closer to their daughter.
They had lived most of their lives in Pittsburgh, where Ruth had been active at the Good Shepherd Lutheran Church of Bower Hill, Pa., and sang in its church choir. Donald was a World War II veteran who worked as a cost analyst for U.S. Steel for 40 years before he retired in 1983.
“They were solidly Lutheran middle class, and we chose Stow-Glen because it seemed like a fit for them,” Greg said. “There were school teachers and professors, and it just seemed suitable.”
Donald was suffering from Alzheimer’s, and his condition had worsened.
Before choosing Stow Glen, the Shreves conducted research and weighed their options. They liked that the facility was an eight-minute drive from their home in Kent and that it was employee-owned. They didn’t find any serious problems in their research.
The Nelsons moved to the facility in July 2005. When Donald died three months later, Greg and Joan agonized over whether to bring Ruth home to live with them. At the time, she was in the independent living section of the facility, where she had friends and played bingo regularly.
“She was happy so she stayed there,” Greg said, explaining that as her health deteriorated, she was transferred to the assisted-living part of the facility and eventually to the skilled-care complex, where the beating incident happened.
The Shreves don’t plan to file a lawsuit against the nursing home, but they do want to see charges brought against the nurse’s aide who is accused of attacking Ruth. Mostly, they just want to understand why anyone would beat a frail woman suffering from dementia.
All they know about the incident is what is in a report by the Ohio Department of Health. That report, complete with graphic details, is written in inspector jargon. The residents, nurse’s aides and licensed practical nurses are identified by number, not by name.
The state inspection report, written Feb. 23, describes what inspectors say happened to Ruth, who is identified in the report as Resident 55, and her roommate, Resident 70, when a nurse’s aide arrived to work angry.
The state report says the incident began after a state tested nurse’s aide (STNA 6) began her shift and found that the night shift hadn’t gotten residents up for the day. Another staffer, identified as STNA 8, went to help STNA 6 after she heard her yelling profanities. She said STNA 6 told her that she had been “drinking wine.”
STNA 6 began to help Ruth’s roommate out of bed using a mechanical lift. During the transfer, “STNA 6 let go of the mechanical lift and Resident 70 hit her leg on the device … STNA 6 turned and punched the wall of (the) room and yelled, F---, F---, F---.”
STNA 8 had to respond to a call light and left STNA 6 alone in the room with Ruth and her roommate.
When the other nurse’s aide left the room, Ruth’s roommate said, “STNA 6 went behind the curtain to (Ruth’s) side of the room. She heard three slaps. She could not see STNA 6 but she could hear [Ruth] cry out each time,” the state report reads.
Resident 70 told the aide to stop hitting her roommate or she would tell the nurse. She “came around the curtain and threw a dirty gown at Resident 70,” the report said.
Ten minutes later, STNA 6 came out of the room and told a licensed practical nurse, identified as “LPN 12,” that Ruth’s head was bleeding.
That nurse told state inspectors that she entered the room and “saw several washcloths full of blood on the counter.”
She also said Ruth had “multiple cuts, bruises, swelling and bleeding about the scalp, eyes, nose, lips and ear.” LPN 12 said Ruth, who was “seated in her wheelchair with her eyes closed and her arms folded over her chest, “was visibly shaking.”
STNA 6 returned to the room and told the nurse she didn’t know why Nelson was bleeding. “Maybe [she] hit her head during the night,” the report said.
Later, Ruth’s roommate told the nurse “that one there is a liar; she is a mean one,” and began to talk about what she had seen and heard.
Eventually, Ruth was admitted to the hospital where doctors diagnosed a bruise to her brain, and documented and treated other more superficial wounds and injuries.
Tammy Denton, chief executive officer of Stow-Glen, said the nurse’s aide was fired immediately and that facility officials conducted an investigation and notified police and the Ohio Department of Health.
In a written statement prepared in response to questions from The NewsOutlet, Denton said the incident was “an isolated situation that did not uphold the quality of care that this facility expects from all [its employees].”
The Shreves, who credit Denton with notifying them immediately about the incident and being candid about it, agree that the incident was out of character for the quality of care they had come to expect from the facility.
Stow-Glen, however, has a spotty record of providing service, according to Medicare.gov, the federal website that compares nursing homes. For example, its overall rating is “much below average” with one of five possible stars. The overall rating is compiled with data from health-inspection reports from the Ohio Department of Health, staffing levels and various other quality measures.
Medicare.gov gave Stow-Glen two stars for its staffing levels, scoring less than the state average in all categories. The facility told the state that it offers its residents three and a half hours of staff time each day. The state average is four and a half hours a day. There is no federal or state standard for optimal staffing levels, however.
“Stow-Glen screens its employees prior to employment through interviews, reference checks, criminal background checks, fingerprinting and verifying active and good standing licenses, as appropriate,” Denton wrote.
“In addition, Stow-Glen provides ongoing training and education for its staff regarding the appropriate care and treatment of its residents.”
The state health department cited the facility for failing to protect a resident from abuse. Statewide there were 46 similar citations in 2011 and 45 so far this year.
The state found that Stow Glen corrected the problem by giving staff members training on “elder abuse and stress,” and how to identify and report it. The state also interviewed residents and staff in an attempt to determine if there were other instances of abuse, and it reported that no other problems were found.
So, for the state, the matter is finished.
Gaffney said the case is not over as far as the police are concerned.
The Shreves, too, have issues that linger. The incident with their mother has motivated them to talk about how to be good family members to those living in nursing homes.
“You need to be there a lot,” Joan said. “We were there three times a week or more.” But even this, she said, didn’t help avoid what happened to her mother.
“People think that when you put someone in a nursing home that you have abdicated your responsibilities. That’s just not true. You still have so much that you do and that you need to do,” she said.
For much of Ruth’s time at Stow-Glen, Joan and Greg were still managing her medicines, taking her to the dentist and to various other appointments, including for hearing aids and cataract surgery.
But there’s a glaring irony that is not lost on the two. They did everything right — they researched, they were vigilant and they were involved in Ruth’s care. Looking back at their six years of experience with the facility, Greg and Joan do not think that there is much that they would have done differently.
Although they are certain that the attack hastened her death, they recognize that she was 90 and already had health issues.
They still don’t know which nurse’s aide assaulted Ruth. “We rarely visited early in the morning or in the evening so we didn’t know the caregivers who worked during those times,” Joan said. “I don’t blame Stow-Glen necessarily unless we find out that they didn’t check the background of the person who did this.”
The couple said they may find out more if police file charges.
TheNewsOutlet.org is a collaborative effort among the Youngstown State University journalism program, Kent State University, University of Akron and professional media outlets including, WYSU-FM Radio and The Vindicator, The Beacon Journal and Rubber City Radio, both of Akron.