Rarely mentioned is, the MAJORITY of nursing home residents are TEMPORARY, there to rehabilitate following some sort of surgery. Most people erroneously think nursing homes house LONG TERM residents only. No matter who the person is, or what the person's background is, there are times when they need the services of a nursing home. Politicians ignore such circumstances as does the media in its reporting.12-1-2009 Illinois:
Crimes frustrate Uptown and Edgewater, where a cluster of nursing homes admit mentally ill felons
She was a beautiful woman with broad cheekbones and an easy smile. But drug addiction dragged Maratta Walker into a life of prostitution and violence.
By last year the 45-year-old had been arrested more than 35 times for crimes ranging from crack cocaine possession to slashing three people with a razor blade.
Still, because she was diagnosed with schizophrenia and suffered debilitating seizures, Walker qualified for Medicaid-funded housing in the Somerset Place nursing home in Uptown.
Before she was admitted to the massive, 450-bed facility on North Sheridan Road last year, a probation officer noted hopefully that "her mental and physical conditions can be monitored at all times."
But instead of getting close supervision, Walker soon was trading sex for cash and using cocaine only blocks from the nursing home, government records and interviews show.
Cases like hers fill the crime blotters of the Uptown and Edgewater communities, where a cluster of large nursing homes admit hundreds of felons who have severe psychiatric disorders.
Illinois is unique among states in relying on nursing homes to house younger adults with mental illness, including several thousand felons. A recent Tribune investigation documented reports that violent psychiatric patients who were not receiving proper treatment assaulted, raped and even murdered their elderly and disabled housemates.
But stories like Walker's show how the chaotic and harmful behavior also can spill outside the nursing home walls.
Nowhere is that more true than the lakefront communities of Uptown and Edgewater, which contain the state's densest concentration of mentally ill and criminal nursing home residents, a Tribune analysis of recent data from the Illinois Department of Public Health found.
Among the nursing homes in a 2-square-mile section of those neighborhoods, 11 facilities last month housed 318 convicted felons and 1,350 people with mental illness -- roughly 10 percent of the felons in all Illinois nursing homes and more than 9 percent of the psychiatric patients in state facilities.
Here, Maratta Walker joined a ragged underclass of dope dealers, prostitutes, panhandlers and petty thieves who sometimes ply the streets while living in government-funded homes.
Many facility residents wind up becoming both criminal and victim. The pattern frustrates many in these neighborhoods who recoil at their destructive behavior, yet see that it stems from lifelong addictions and disabilities.
"People are suffering in these homes, and because of them," said Ald. Mary Ann Smith, 48th, who recently met with officials from the U.S. Justice Department and other agencies to address what she calls the deplorable conditions at some facilities.
Though nursing home staffing levels are considered the cornerstone of patient safety and quality care, most of the 11 Uptown-Edgewater homes that currently house felons have substandard nurse staffing levels, a Tribune analysis found.
Of the seven facilities recently rated by the federal government on nursing staff-to-patient ratios, five were "well below average," while another was below average and only one was average.
"If you provided adequate psychiatric services in these nursing homes, then you wouldn't be so nervous about people walking out the door," said University of Chicago Law School clinical professor Mark Heyrman, who has worked with mentally ill nursing home residents in Uptown-Edgewater.
At the All American Nursing Home at 5448 N. Broadway, state investigators reported last month that the facility often lacked care and discharge plans for psychiatric residents. One suicidal felon, who fought with peers and tested positive for drugs, signed himself out of the home despite a physician's restrictions against leaving the facility, that report said.
State inspectors also reported this year that the nearby Sheridan Shores Care & Rehabilitation Center, 5838 N. Sheridan., failed to provide services to the mentally ill.
The owners and administrators of those two facilities declined interview requests, as did Eric Rothner, who through companies and family trusts has an ownership stake or consulting role in Somerset and more than a dozen Illinois facilities. Rothner told the Tribune in a one-page letter that "the real issue is that no one wants these facilities in their respective neighborhoods."
"We are working," he added, "to assure that residents in our facilities have the best quality of life possible. We also work closely with the community to address any issues that may arise."
Somerset staff and a representative of two other area nursing homes said in interviews that they provide excellent care to a difficult population and cannot stop mentally ill residents from leaving the facilities or follow them onto city streets. State and federal nursing home regulations emphasize resident rights, including access to the community.
When residents like Walker commit crimes or endanger themselves, the homes say they can only offer behavior contracts, impose curfews and restrict pass privileges. The facilities' last option is involuntary discharge, a legal process that can take months.
Somerset, 5009 N. Sheridan, placed Walker on a "pass restriction," meaning she was not supposed to leave without being accompanied by staff or a family member, a state report said. But shortly after 9 p.m. on May 8, 2008, she strolled onto the streets alone.
Twelve days later, her decomposed body was found in a nearby motel room. Police say a paroled bank robber beat Walker to death after the two met on the streets and launched a days-long binge of drinking, sex and crack-smoking and heroin use.
"I was so angry and hurt -- I was outraged," said Walker's sister Caroline. "All they had to do is keep her on restriction. ... I don't know how they let her get out. There needs to be something done about it."
'Public safety hazard'It took decades for parts of Uptown and Edgewater to become what one federal report called "a psychiatric ghetto."
High-rise apartment-hotels were constructed here in a more glamorous time -- the 1920s and '30s, when Broadway shimmered with dance halls and speak-easies.
But as the club scene shifted elsewhere, the streets of Uptown and Edgewater got rougher. Then, starting in the 1960s, Illinois joined a nationwide de-institutionalization movement and began to empty the state-run psychiatric hospitals that once housed more than 50,000 patients but now hold only about 1,500.
Many of the old hotels were converted into transient rooming houses and nursing homes as Broadway became a squalid mosaic of taverns, day labor agencies and methadone clinics.
Though pockets of the West and South Sides of Chicago were similarly affected, the unique concentration of large facilities packed with the mentally ill in Uptown and Edgewater strained a part of the city already struggling with poverty and crime.
Somerset alone generated 6,698 police calls for service in the 20 months from January 2008 through August 2009, according to data compiled by Smith. Although many of the calls are frivolous, Smith noted that they represent a drain on resources.
In an April letter to local officials, the Carmen-Winona Neighborhood Association said Somerset created a "public safety hazard," adding: "There are numerous complaints from neighbors about being accosted by Somerset residents as they walk by the building. ... Some neighbors have been followed home and threatened."
Somerset administrators recently met with police and community groups to address allegations of drug sales and loitering in front of the building.
Among the nursing home residents who engaged in chronic street crime is former Gangster Disciple Rodney Williams, 43, who has been arrested at least 14 times since 2004 during stays at the Wilson Care and Grasmere Place homes, police records show.
Diagnosed with schizophrenia, Williams was charged with punching a bicycle rider to the ground during a 2007 Uptown robbery attempt. This year, he was arrested for selling crack cocaine on the street and jailed for shoplifting. Efforts to reach him for comment were unsuccessful.
At the One Stop Convenience grocery at 4601 N. Sheridan, between Grasmere Place and Wilson Care, manager Waleed "Wally" Alsilwadi said he catches several shoplifters from nursing homes each day, but "I just take the stuff and let them go because I know the police won't do nothing."
Just up the street from the Bryn Mawr Care nursing home -- an aging facility at 5547 N. Kenmore Ave. that recently housed 20 felons among its 169 mentally ill adults -- Reza Minaey traces a long crack in the front door of his tidy deli.
A nursing home resident kicked the door last year after being told to leave because he was belligerently demanding free food, Minaey said.
"They walk down the street kicking over garbage cans. They scream and talk to themselves," he said. "A lot of people are leaving the neighborhood because they bother people."
A downward spiralAs a teenager in Maywood, Maratta Walker dropped out of high school in 10th grade to care for her ailing mother and her siblings.
But Walker was soon struck by paralyzing seizures as well as overwhelming mood disorders. She developed a cocaine addiction and a growing criminal record, court documents and interviews show.
In recent years, Walker lived on and off in Somerset, a grim, century-old former hotel with narrow, antiseptic corridors. Since 2000, the facility has reported profits of $21.4 million on revenues of $132.8 million, much of it from the Medicaid health program for the poor.
In 2007, while living there, Walker was arrested for crack cocaine possession and sent briefly to prison. A month after being paroled, she checked herself back into the facility.
Caroline Walker said she phoned her sister most mornings, sometimes taking Maratta to Maywood to visit family or to a beauty salon to get her nails painted.
One mental health worker later told state investigators that Walker was not supposed to leave the facility without such supervision to "protect her from her substance abuse and prostitution."
But nursing home employees, including the facility administrator, knew Walker was slipping out to use drugs and work as a prostitute, according to police and state public health reports. Between March and May 2008, Walker failed at least five drug tests, a state report shows.
When Walker returned to Somerset bloodied one spring evening last year, she told staff a man gave her $20 for sex in an alley, then took back the money and pummeled her, cutting and bruising her eye, a state report shows.
On the night of May 8, Walker signed out at the facility's front desk and hooked up with Edward Gibson, a violent and mentally unstable vagrant who was on probation after a federal prison stint for a series of Chicago bank robberies, police and court records show. She never returned to Somerset.
Holed up in the Chicago Lodge, a now-shuttered motel on Foster Avenue, Gibson and Walker smoked cocaine, snorted heroin and drank Crown Royal whiskey, according to statements Gibson made to police.
On their third or fourth day together, Gibson said he became enraged and began punching Walker -- flattening her nose and knocking out her teeth, according to police and medical records. She fell backward, Gibson later told police, smashing her head against the mini-refrigerator.
Gibson told police he put a newspaper over Walker's bloody face and continued his drug binge. When her corpse began to smell, Gibson said, he dragged it into a closet, then kept getting high for two or three more days.
Meanwhile, Walker's sister was in a panic. On May 9, she telephoned for Walker but was told by Somerset staff that she wasn't around. "Nobody had an answer for me," Caroline Walker said.
Eventually, she said, Somerset administrator Jeremy Boshes called to say Maratta Walker had been discharged May 12. Caroline Walker said she was incredulous because her sister wasn't supposed to leave without notifying family.
Days later, Caroline Walker was summoned to the Cook County medical examiner's office. "There were a lot of people there trying to identify somebody," she said, breaking down in tears. "It was us that caught the bad luck."
Boshes told police investigators that Somerset filed a missing person's report the day Maratta Walker disappeared. But Chicago police told the Tribune they could not find such a report on Walker, and state public health investigators reported that Somerset failed to notify police or file a missing person's report. Boshes declined interview requests.
State investigators interviewed Walker's parole officer and determined that facility staff had not told the officer she was living at the facility, let alone that she was testing positive for cocaine. Had the parole officer known about her drug abuse, Walker could have been placed in a treatment program or in prison, the state report said.
State public health investigators cited Somerset with failing to prevent Walker from "leaving the facility unsupervised" and fined the facility $7,000.
Somerset administrators said they couldn't discuss Walker's case, but said that among several corrective actions, they have improved their process for reviewing which residents have access to the community and placed an enforcement monitor at the front desk. Somerset employs a cadre of professional counselors and therapists, the administrators said, and has successfully treated and moved many residents back into the community.
Still, problems have persisted. An April 2009 state inspection found several residents repeatedly skipped out despite pass and curfew restrictions, including a 36-year-old schizophrenic woman who was "soliciting outside the facility for sex" and tested positive for cocaine. And an October report said the facility failed to monitor and treat numerous mentally ill patients.
Since Walker's death, state and federal agencies have levied an additional $80,000 in fines against the facility for other alleged infractions, public health spokeswoman Melaney Arnold said. And Somerset's insurance company settled a civil lawsuit by Walker's family for $245,000, according to Walker family attorney Mark McKenna.
In an interview at Cook County Jail, Gibson, 58, denied the unresolved charges that he murdered Walker, telling a Tribune reporter that police promised to release him if "I told them what they wanted."
Caroline Walker said she attends each one of Gibson's court hearings, hoping that someday justice will be delivered.
"Somebody got to stand up," she said. "Somebody loved her." ..Source.. Gary Marx and David Jackson Tribune reporters
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