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Monday, April 16, 2012

Another terrible 'Illinois Nursing Home' story

Beleaguered nursing home manages to expel 2 state monitors
Court sides with South Side facility, which has been beset by allegations of violence
By David Jackson and Gary Marx, Chicago Tribune | April 16, 2012

Two years into the state's fight to close a troubled South Side nursing home, the facility remains open and even has successfully booted out two state-appointed monitors who were installed to ensure patient safety.

Police reports and state health department inspections allege a pattern of patient-on-patient violence at the Rainbow Beach Care Center, a 200-bed facility that houses and treats indigent adults with mental illness.

{photo: Rainbow Beach Nursing Center - 7325 South Exchange Avenue Chicago, IL 60649}

In the most serious episode in July, two male residents were accused of pinning down a 45-year-old female patient and raping her. When police arrived at Rainbow Beach to investigate that allegation, they learned that the two men had allegedly attempted to sexually assault a second seriously disabled female resident just weeks before.

The state, which had moved to revoke the facility's license in April 2010, placed monitors at Rainbow Beach in the wake of those attacks. But earlier this year, an attorney for the facility persuaded a Cook County judge to issue a temporary restraining order barring them from the premises.

State authorities say the push-back from Rainbow Beach underscores how vigorously some nursing home operators are using the courts to contest enforcement efforts, even as the industry presses for legislation that patient advocates say could water down nascent state reforms.

The Illinois Department of Public Health won new powers to ramp up inspections, fines and license revocations of nursing homes through a sweeping reform law enacted in 2010 in response to a Tribune investigation. The stories documented patient-on-patient rapes, assaults and even slayings inside a subset of understaffed facilities.

The placement of two monitors at Rainbow Beach was part of an effort by the department to step up safety and quality enforcement in nursing homes that house large numbers of younger adults with disabilities, including thousands with felony records.

Teresa Garate, assistant director of the Public Health Department, called the ongoing court battle to reinstate the monitors "very important. The fact that the court put a restraining order on our monitor shocked me completely."

"We have definitely sent a message to the nursing home industry that we mean business, that we're increasing our presence in the homes," Garate said. "If it wasn't making a difference, then I don't think we would be getting that push-back."

Holly Turner, an attorney for Rainbow Beach, said she could not comment on many of the pending violence allegations, but said "Rainbow Beach cares for all of its residents."

Many nursing home operators feel besieged by the stepped-up enforcement and other mandates while the state has been slow to pay them and slow to implement a new bed tax that will provide badly needed additional Medicaid revenue, according to an industry leader who asked not be identified.

Rainbow Beach had seven allegations of criminal sexual assault or abuse since 2008, more than any other Chicago nursing home, according to preliminary Chicago police data. Although police discounted at least one of those reports, Rainbow Beach was the only Chicago facility where such allegations resulted in criminal charges.

The facility also had among the highest number of assault and battery allegations for city nursing homes during that period, the preliminary Chicago police reports show.

Health inspectors have filed five "immediate jeopardy" citations against Rainbow Beach since 2009, while state inspectors asserted that the facility has failed to properly evaluate or treat violent and sexually aggressive residents.

In one case, the facility failed to monitor and periodically reassess an "aggressive and violent" male resident who repeatedly punched others and finally smashed a woman's face for no apparent reason, breaking her nose and eyeglasses, state inspectors wrote.

In addition to the facility's handling of alleged violence, Garate said she was concerned about whether residents with mental illnesses receive effective therapy and treatment that could move them to independence.

Turner said the allegations of patient-on-patient violence involved only a handful of residents, and few resulted in criminal prosecution. She said the facility had corrected or successfully contested all health department citations and was found in its most recent inspection to be offering appropriate rehabilitation services.

In an unprecedented legal action, Turner successfully argued in court in January that the state's two monitors should be barred because they were behaving offensively toward residents and staff, overreaching their authority and had no legal right to be there. Turner told the judge that the monitors were part of "larger conspiratory efforts to shut Rainbow Beach down," according to a transcript of the hearing.

Lawyers for state attorney general's office were caught flat-footed at the January hearing, the transcript shows, but recently came back with a lengthy court brief defending the health department's right and need to install the monitors to ensure patient safety.

"This is a nursing home with a track record of serious violations and a poor track record of fixing problems," said Ann Spillane, chief of staff of the Illinois attorney general's office, which represents the health department in the case.

Eric Rothner, who is listed as the facility's majority owner on the most recently available government cost reports, which cover 2006 through 2010, declined to comment for this article. His staff members in the past have told the Tribune that they work hard to assure the highest quality of care for often-troubled residents.

Turner said Rothner had no ownership of Rainbow Beach since early last year. The facility's ownership company is now managed by two of Rothner's relatives for the benefit of a private trust, according to Turner and separate records, and Turner said she did not know who was behind the trust.

In partnership with close relatives, Rothner has had an ownership stake or administrative role in more than a dozen Illinois nursing facilities, including Somerset Place in Uptown — one of Illinois' largest facilities until the state shuttered it in 2010. The Tribune had reported on allegations of sexual assault, violence and drug use there, as well as the slaying of one resident who had been trading sex for cash and using cocaine only blocks from the nursing home.

At Rainbow Beach, the vast majority of residents are African-American, according to the state health department's website. The for-profit facility received roughly $8 million per year from Medicaid during the five years from 2006 through 2010 and reported profits totaling $2 million during those years, while paying $3.8 million in dividends or distributions to owners, according to cost reports filed with the state.

The home additionally paid companies associated with Rothner or his family for services ranging from clerical work to consulting, as well as more than $1.5 million in annual rent to a land company managed by Rothner, land records and facility costs reports show. Such related-party transactions are common in the Illinois nursing home industry, often to increase efficiencies.

Residents include 44 patients with felony convictions, records from February show.

It was in the wake of the July rape allegation that state health inspectors placed the first of the two monitors in Rainbow Beach. Suspects Marvin Palm and JaJuan Rice have pleaded not guilty in both cases and are in Cook County Jail awaiting trial.

This was not Palm's first arrest in connection with violence inside the facility.

In 2007, Palm was charged with robbery and aggravated battery for mugging another patient. In that case, Palm's accomplice, a 29-year-old resident and gang member named Melvin Lewis, held a 64-year-old fellow resident while Palm punched him in the eye. Lewis then took the victim's wallet from his back pocket and stole the $5 he had. Both men pleaded guilty to felony charges, and Palm spent 139 days in jail before completing mental health probation in 2010.

The court dispute over the monitors is scheduled for a hearing next month. Turner will not be there representing Rainbow Beach; the judge disqualified her last month because she had recently worked as a staff lawyer at the Public Health Department and taken part in the state's effort to revoke Rainbow Beach's license.

The Illinois Supreme Court's professional conduct rules for lawyers prohibit those who served in government agencies from then representing a private client in connection with a matter in which the lawyer participated personally and substantially as a government employee, unless the appropriate government agency gives its consent.

Turner told the Tribune that the effort to remove the monitors had nothing to do with her previous government work on the revocation case. "I know I didn't do anything unethical," she said.

Copyright © 2012, Chicago Tribune
# http://www.chicagotribune.com/news/local/ct-met-rainbow-beach-20120416,0,1121038.story

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