The Traverse City Record Eagle had a story about  a pattern of abuses uncovered at Tendercare Health Center-Birchwood resulting in fines and prompting an ongoing criminal investigation by the Michigan Attorney General’s office.   Several residents suffered repeated physical and sexual abuse at the hands of their fellow residents in 2006-07, a pattern of violence that nursing home management failed to stem or report.   Victims included both male and female residents at Birchwood, which in November was named to a federal government list of the nation’s most troubled nursing homes.

Ellen Miller lived at Birchwood for just more than a year, until November 2007, and knew several residents who were harassed and assaulted.   Miller moved into Birchwood in November 2006 while she underwent rehabilitation and physical therapy following a leg amputation. She warned a male resident who sexually assaulted her neighbors that he’d have to pick himself off the floor if he laid a hand on her.  "I wouldn’t send a dog there," said Miller, 68, of Bear Lake.  Nursing home employees didn’t prevent aggressive patients from striking time and again, she said, an allegation backed up by state reports.

More recently, state regulators cited Birchwood for problems with patient confidentiality, incomplete medication records, improper care for bedsores and not preventing residents from falling. The nursing home was fined less than $38,000 in 2007-08 for all the violations.  Birchwood is owned by Milwaukee, Wis.-based Extendicare Health Services Inc.

Michigan Department of Community Health personnel inspected Birchwood in July 2007 and found an extensive history of physical and sexual assaults dating to 2006. Nursing home staff didn’t investigate the incidents as abuse or report them to the state. Inspectors said Birchwood employees neglected to protect the residents, often leaving them to fend for themselves.

Some men groped and grabbed women who couldn’t physically defend themselves. One man exposed his genitals; another touched women’s legs while he sat next to them playing bingo.  State officials found that nine female residents were sexually harassed and/or assaulted by five male residents. One of the repeat sexual assault victims also was physically attacked multiple times, state documents show. At least three other residents, including men, were physically assaulted by fellow residents.

Nursing home staff recorded most of the incidents on residents’ personal history charts, but did not report them to state regulators or local law enforcement.

"Despite the facility’s knowledge of residents with a history of sexually aggressive behaviors and of ongoing sexual and physical assault of several facility residents, they neglected to investigate and report these incidents and to intervene to protect facility residents from the pervasive and continuous abuse/assaults being perpetrated on a regular basis," the Department of Community Health report stated.

The report detailed several attacks from a 71-year-old male resident with dementia, behavior disturbance and "high-risk sexual behavior." A female resident told inspectors the man grabbed her breast while she was in the hallway.  She said the facility’s social worker told her she needed to watch how she spoke to men, "because some of them might consider it an invitation." "That’s like telling me if I’m a little girl in a pretty dress that I’m asking to be raped," the woman told state inspectors. "I’m not stupid. They should have stepped in and protected me. They should have stood up for me. Do I have no rights? Do I matter to anyone?"

The man also targeted a 52-year-old woman with Huntington’s disease, a neurological disorder. The woman’s chart indicated the man molested her five times.  One time, the man was found in bed with the woman. He was clothed, but the woman’s pants and underwear were around her thighs. She said "He hurt me," according to the woman’s chart.

The man lived in the section of the nursing home reserved for residents who require additional care and supervision. Employees later moved him to a different wing because residents there were more alert and could better defend themselves. "They thought residents would handle themselves, and that’s really not the residents’ role. They’re there to protect the residents," said Alice Turner, director of nursing home monitoring for the Department of Community Health.

A 70-year-old male resident with schizoaffective disorder committed at least 13 physical assaults over a three-month span in 2007, nursing home records show. Most attacks were violent, unprovoked and involved repeated punches to the face or head.

State inspectors asked Birchwood Administrator Kim Kloeckner if she investigated those incidents.  Kloeckner, the report stated, told state officials she didn’t think incidents involving a man with dementia needed to be investigated or reported as abuse.  Birchwood may have had "more behavior problems than they could manage," Alice Turner said.  Probably because of understaffing and the inability to supervise all the residents.

Nursing homes are required to notify residents’ families of significant incidents, but Birchwood didn’t do so in the assault cases. 


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