An article in the ChilicotheGazette rightly questions a nursing home’s decision to accept a potentially dangerous incompetent resident.   Competing public policy decisions arise in these situations:  The right of the incompetent resident to receive care versus the right of other residents to be protected,

The article references the tragic case of 53 year old John Stroud who was arrested after shooting at Scioto County deputies in 2011.  After being found not competent to stand trial, he was placed at the Health Nursing Care Center at the request of his family.   He escaped confinement forcing nearby schools to lockdown and placed nursing home residents at risk.  The care facility consists of a locked unit for patients requiring a secure environment.  However, even under lock down in this setting, patients have the right to sign out or be signed out by a family member. These units are hardly the place for dangerous and deranged residents.

The Health Nursing Care Center admits it does not contain a psychiatric ward suitable for dangerous residents such as Stroud.  Individualized care plans, specialized personnel and increased security is needed before such a patient can be accommodated. According to Dustin Ellinger, chief of the Bureau of Long Term Care Quality at the Ohio Department of Health, if a facility lacks any of these necessary accommodations, it may and should turn down accepting residents such as John Stroud.

The Health Nursing Care Center is one among many nursing homes ill-equipped to handle the mentally impaired yet is forced to make up for the lack of state resources needed for such individuals.  Locked units are common across the states but often have become a dumping ground for the mentally ill.  These facilities take on dangerous residents suffering mental illness as there is no requirement of a special license.  Also missing are laws regarding the housing of residents with a criminal history.

Stroud was not the facility’s first mentally ill resident facing felonious charges. The home took on a federal prisoner several years ago who assaulted three residents before being removed by U.S. Marshalls. Nursing home facilities have locked units for patients suffering from dementia or late stage cognitive impairment.  If a resident strays from the area, they are treated as a missing person rather than a fugitive.  Further, these special units have been described as lonely hopeless environments. 

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