Published: August 22, 2007 11:52 am            

River Crest recriminations

San Marcos — Vicki Davis said she should have known something wasn't right when River Crest Nursing and Rehabilitation was eager to admit her ailing, elderly mother when other facilities had flatly turned her away.

Ever since she came home from work one Friday about two and a half years ago and fell severely ill overnight, 73-year-old Ruth Lucille Biggs has been bed-ridden with a drug-resistant gastrointestinal bacterial infection and the resulting batteries of prescription antibiotics caused her kidneys to fail.

Isolated and lonely, her mind began to slip too, a condition aggravated by the stress of frequent emergency room visits and weeks-long hospital stays. Eventually, the nursing home in Houston where she was staying told Davis she would have to find somewhere else for her mother to live.

"Because she had so many problems, I was told (River Crest) was the only place that would take her. In hindsight, I can see that I should have understood that they were willing to take patients that they knew they couldn't care for. They weren't turning anyone away," said Davis, a San Marcos resident who works as a dispatcher for the Hays County Sheriff's Office.

But River Crest was close to home, making frequent visits possible and, Davis said, the home's management assured her that they would take good care of her mother.

At first, Biggs seemed to be adjusting well after moving to River Crest in November 2005, Davis said. Eventually, Davis started noticing that she rarely saw nurses or orderlies or even janitors in the hallways and at times the bell at the nurses station across from her mother's room would ring continuously without being answered. Sometimes her mother appeared to have gone unbathed. One day she found a column of fire ants trailing across her mom's bedspread.

"They told me the reason she had ants was because ate in her bed. Well, she's bedridden so she has to eat in the bed and she can't clean it up herself," Davis said.

On March 17, Biggs was rushed to the Central Texas Medical Center emergency room with pneumonia, and it turns out, complications including breathing difficulty that her kept her on a respirator for a week. For days, her mother seemed disoriented, didn't recognize her family and didn't speak.

Davis said she had noticed that her mother was losing weight but chalked it up to age and inactivity. At the hospital, however, Davis said she was told for the first time that her mother had not been eating for weeks.

An emergency room doctor "stood at the foot of her bed and said she was severely malnourished and severely dehydrated. She was down to right at or a little under 100 pounds," from Biggs healthy adulthood weight of 140-150, Davis said.

"I tried to get him to document the conditions he described but he wouldn't do it and wanted to know why I was asking. He said it won't do any good, that (elder care workers) who see these people who won't eat kind of get used to it. I said, that's my mother. If someone had thought to tell me that she couldn't get mother to eat, I wouldn't have blamed them but I wouldn't have let her nearly starve to death," she said.

Biggs never returned to River Crest and Davis thinks her family's complaints to the state's Department of Aging and Disabilities "brought the heat down" on River Crest, which at the time was licensed to the wife of a Bedford nursing home executive, Stephen Michael Ewing, under a 29-count federal indictment accused of Medicare, Medicaid and tax fraud.

A February River Crest inspection report, when the home was under Ewing’s management, found pressure sores on some residents and soiled and torn wheelchairs. Ceiling tiles fell on an employee’s head during the inspection.

Employees told the Daily Record that the company wasn’t paying bills and that air mattresses designed for residents with skin problems were repossessed. Payroll checks occasionally bounced, former employees said. In April, another inspection found problems had not been corrected and Medicare and Medicaid funding were shut off.

Since terminating Ewing's contract to operate the nursing home, the facility's owner, Donald A. Karchmer of Oklahoma City, said he put it under new management with the goal of regaining certification and staying opened.

Two weeks ago, he abruptly shut the home – forcing residents and their families to find new accommodations often several hours drive away – because bringing it up to compliance would be too expensive. Residents had 30 days to move out as required by state law.

The most recent state inspection June 29 cited the facility for 33 violations of state licenser standards including failure to provide adequate food, hygiene, facilities and medical care.

The indictment against Ewing and two associates alleges that starting in 1999, the three defendants knowingly and intentionally devised a scheme to defraud the U.S. Health and Human Services department and the Internal Revenue Service and the IRS obtained control of 70 nursing homes in the name of sham corporate entities.

All told, the homes, including River Crest, were responsible for $200 million in Medicare and Medicaid payments to the nursing homes tens of millions of which, the indictment alleges, Ewing and his associates laundered through banks in Europe and kept for themselves.

To swing the operation, the defendants created more than 150 sham staffing/payroll entities, some of which were little more than mailboxes in England and Austria, to avoid paying federal taxes on 4,500 nursing home employees, according to the indictment.

The defendants did not file corporate tax returns for the sham corporate entities, as required by law. During a five year period, Ewing is accused of withholding $34 million in employees‚ income, social security and Medicare taxes but did not report or pay the withholdings to the IRS. At one point, one of them flew to London to mail back to the U.S. false withholding tax returns, records indicate.

Ewing's lawyer, William H. Ray of Fort Worth, has not returned phone calls seeking comment.



bradrollins@yahoo.com

        

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