Care provider charged in death at nursing home
Julia McCauley , a resident at Life Care Center in Acton since 1996, tended to roam the nursing home in her wheelchair. Worried about her safety, doctors fitted her with a tan plastic bracelet that set off an alarm and locked the doors if she got too close to the exits.
But one morning in April 2004 the woman described as a "loved and welcomed resident" at the home by her family and care providers was found dead at the bottom of the center's front stairs. The 74-year-old had a 3-inch gash in her forehead, her wheelchair overturned. McCauley's bracelet was nowhere to be found, and several nurses and aides told state investigators they did not know she was supposed to wear it at all times.
Yesterday, a Middlesex grand jury indicted the Tennessee-based Life Care Centers of America Inc. on charges of manslaughter and abuse and neglect of a long-term facility resident. It is the first time in Massachusetts that a national corporation has faced criminal manslaughter charges, said Attorney General Martha Coakley .
Investigators found that for 2 1/2 months before her death, McCauley hadn't worn the protective bracelet because the doctor's orders were not written on her charts. Those orders required that the device, called the WanderGuard , be checked once a day to ensure that it was on the patient and fully operating.
The company, which operates 260 nursing homes and other long-term care facilities around the country, including 15 in Massachusetts, vigorously denied the allegations and suggested that it was being unfairly prosecuted.
"Life Care's 21-year record of service in Massachusetts speaks of its demonstrated professionalism and compassion for the people of this Commonwealth that it has served," the company said in a statement. "The Attorney General's decision to seek prosecution in a case that involved an accident of a valued patient of more than seven years at Life Care Center of Acton puts every healthcare provider -- physician, hospital, nursing center or home health -- at risk of criminal indictment."
No individuals have been charged in the case. Coakley emphasized yesterday that the company as a whole is responsible for the hiring and training of its staff.
"Had Julia McCauley had that WanderGuard on that day, we allege that she would not have gone through that door and she would not have tumbled to her death," Coakley said at a news conference, announcing the charges.
If convicted, the company faces a fine of up to $1,000 on the manslaughter charge, $5,000 on the abuse and neglect charge, and $10,000 on a charge of making a false Medicaid claim. The latter charge alleges that the center was collecting Medicaid payments for McCauley's care, which was supposed to include making sure she wore the safety bracelet.
Federal officials would not say whether a conviction would also lead to penalties on Medicaid and Medicare reimbursements that are a major source of funding for nursing homes.
Despite having a state inspection record that puts it in the bottom 11 percent of nursing homes in Massachusetts, on a wide range of measures including the quality of nursing care, food service, and housekeeping, Acton Life Care Center has never faced a criminal lawsuit or criminal charges before and has had only a "minor number of complaints," Coakley said.
"We have no reason to believe today that any other patient is in any urgent danger," she said.
A 2006 annual state report on the facility cited a number of problems, including not properly caring for residents who had a history of falling. Some of those patients suffered broken bones and cuts, the report said. It also said the center failed to notify physicians of the need to change a patient's treatment and did not adequately address complaints from patients and families of improper medical care and other grievances.
According to Roseanne Pawelec, spokeswoman for the Boston regional office for the federal Centers for Medicare & Medicaid Services , the nursing home corrected the underlying problems in December 2006 and paid a fine of $11,147.50.
Life Care centers elsewhere in the country have also been charged with abuse and neglect.
In 2005, the owners of a Lawrenceville, Ga., nursing facility paid a $2.5 million civil settlement to the state and federal governments after an investigation into the deaths of three patients. A Life Care facility in Denver was sued in 2003 after a family alleged that a relative died because the staff withheld insulin from the diabetic man.
Still, some who visited relatives at the Acton home yesterday said they had nothing but positive experiences.
Ranjan Patel , 37, of Nashua, was visiting her mother, Jashoda , 66, who has been in the center for eight months after suffering a stroke in March 2006.
"The care has been very good," Patel said. "They treat her like their own mother."
Alice Dembner of the Globe staff and Globe correspondent Claire Cummings contributed to this report. Megan Tench can be reached at mtench@globe.com. 
