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11/09/06
By Linda
Strowbridge
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Editor's
Note: This is the first of a two-part story about the
Rosewood
Center
in Owings Mills. The second part will appear next week.
Disabled-rights
organizations are demanding the state close
Rosewood
Center
in the wake of a monitor's report detailing numerous episodes of violence
and neglect at the Owings Mills facility.
Investigators
for the state's Office of Health Care Quality uncovered so many incidents
of residents hurting themselves and each other in September that they
concluded residents faced "immediate jeopardy." Investigators
issued a citation to Rosewood threatening to terminate the facility's
Medicaid funds.
Rosewood
addressed the state's "immediate jeopardy" concerns before a
late-October deadline and retained its Medicaid support.
Acting
director Joanne Knapp said Rosewood staff members have developed new care
plans for eight residents who were identified as facing immediate
jeopardy.
The
facility enacted a seven-step process to protect victims of abuse, Knapp
said, and adopted a 24-hour deadline for getting additional psychiatric
care for any resident who has a violent episode.
Staff
members are receiving new training, she said, and the facility is making
greater use of contract psychologists.
"Essentially,
the fire is out, but we still have concerns," said Wendy Kronmiller,
director of the Offfice of Health Care Quality. She plans to send
inspectors back to Rosewood for a second, extensive review in the near
future.
On
Nov. 6, Kronmiller's office rejected Rosewood's proposal to correct
systemic problems, saying Rosewood lacked "credible evidence" of
enhanced staff training, safety procedures and psychology services.
Rosewood must produce an acceptable plan by Nov. 16 or face financial
penalties.
Disabled-rights
activists say the state's report highlights long-standing patterns of
violence, neglect and civil rights violations at Rosewood that likely
can't be changed.
They
say Rosewood residents would receive superior and cheaper care, greater
freedom and improved quality of life if the state closed the facility and
moved residents to community-based facilities.
"This
is not a facility you are going to turn around," said Lauren Young,
director of litigation for the
Maryland
Disability
Law
Center
, which has tracked problems at Rosewood since the 1980s.
"They've
had several different directors and brought in different consultants over
the years. But there are chronic problems in that environment that concern
us greatly," Young said.
Broken
ribs, death threats
Established
in the 1800s as an "asylum and training school for the
feeble-minded," Rosewood currently houses 203 adults and children
with serious developmental disabilities and psychiatric disorders.
The
resident population includes individuals who have been deemed mentally
incompetent to stand trial.
In
the Sept. 26 citation letter to Rosewood, the Office of Health Care
Quality stated that investigators "determined that the facility
failed to ensure that individuals are free from abuse, neglect and
mistreatment and that the potential for harm existed."
Investigators
focused on incidents involving eight residents. They included:
*A
man, with a history of physical assaults, self-inflicted injuries and
suicidal gestures, broke through two locked doors at Rosewood, then ran
full-speed, head-first into a trash receptacle, colliding with sufficient
force to move it off its foundation. He hit his head twice more on the
receptacle, then stuck his arm inside it and repeatedly closed the door on
the limb. Staff did not attempt to restrain him.
*A
man who was admitted to Rosewood as a 6-year-old in 1958 and readmitted
several times, suffered from mental retardation, pedophilia and substance
abuse and often made racially offensive comments. Within a three-month
period this summer, he was the victim of three physical assaults resulting
in several broken ribs and other injuries, one act of sexual harassment
and one death threat by other residents. Rosewood staff, investigators
concluded, not only failed to safeguard the man but allowed him and his
main attacker to live in the same cottage.
*A
45-year-old woman with profound mental retardation and a history of
self-injury attacked herself or others 10 times within a two-month period.
In one instance, she repeatedly hit her head on a radiator and required
sutures to close the wounds. The staff's efforts to calm her regularly
failed, and Rosewood's psychiatric staff failed to produce a requested
plan to better manage the woman's behavior.
In
about half the incidents cited in the report, investigators concluded that
Rosewood officials failed to complete thorough investigations and failed
to protect the injured resident from further abuse.
Unfixable
Members
of the
Disability
Law
Center
say that incidents of abuse and other forms of mistreatment or neglect at
Rosewood have gone unreported for years.
Rosewood
workers produced few reports of injury or abuse, even though the reports
are required by law, until they received training in the procedure a few
years ago, Young said.
"But
the numbers are pretty staggering still on incidents that they do not
report," said Rachel London, an attorney with the law center who has
represented Rosewood residents for the past two years.
Meanwhile,
investigators for the Office of Health Care Quality gave Rosewood
virtually spotless reports in recent years, Young said.
"That
raised lots of red flags for us," Young said, suggesting that the
reports were incomplete.
Kronmiller,
who became director of the Office of Health Care Quality in April, said
she couldn't comment on how investigations were completed in the past.
She
said she has added investigators to a department that was severely
understaffed and made some management changes that affected the
investigations.
Conditions
at Rosewood, Young said, "didn't just suddenly get to be an immediate
jeopardy situation."
"It's
not that things changed drastically there," she said. "It's that
the people doing the reviews changed, and they were looking more
carefully."
The
Office of Health Care Quality reports confirm that these conditions exist
and that residents are in jeopardy,
London
said.
"The
state was failing to protect them," she added.
Brian
Cox, executive director of
Maryland
's Developmental Disabilities Council, said the state monitor's report is
the latest in a long line of reasons to close Rosewood.
In
an October letter, Cox and the leaders of four other disabled rights
organizations called on Gov. Robert Ehrlich to develop a plan by Dec. 31
to close Rosewood and implement that plan within two years.
"There
has been rights violations and noncompliance with federal standards for
decades at Rosewood," the letter stated. "We do not believe the
broken facility can be fixed."
Next
week: Rosewood's habits of dealing with behavior problems, psychiatric
care, education and physical restraint/isolation have subjected residents
to rights violations, advocates for the disabled say.
Maryland
, they insist, could provide higher-quality and lower-cost care through
community-based services.
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