Amy Greene
01/21/2000
A Choctaw home for mentally handicapped adults where a death went unnoticed for six days was fined $10,000 in 1998 for pulling the teeth of 11 residents without proper proof of consent.
The Choctaw Living Center, 2707 N Harper, has a history of run-ins with the state Health Department and could face fines over the death of one of its residents, Victoria Pepiakitah, this month.
In 1998, the teeth of 11 mentally handicapped residents were pulled to reduce problems with biting and not because of health problems, a lawsuit filed by a resident's guardian alleges.
The civil lawsuit was filed in Oklahoma County District Court by the guardian for resident Glenna Dockery against the center and its past operators. The suit is one of four that seek money on claims that the living center failed to protect residents' safety and rights.
Oklahoma City dentist Stephen Parker, a defendant in one of the lawsuits, contends that he had the proper consent and that the teeth removed were affected by periodontal disease. Periodontal disease occurs when teeth rot from lack of proper care.
"There were records" of consent, Parker said Thursday.
The patients "were all treated in the hospital, weren't they?" he said.
He refused to provide copies of those records, saying they're a part of the litigation.
Choctaw Living Center officials have not responded to questions from The Oklahoman.
Administrator Treva Millarr referred questions to Randy Goodman, the living center's court-appointed receiver.
Goodman, a Midwest City attorney, did not return telephone calls. Goodman receives between $17,000 and $19,000 per month from the center for acting as receiver.
Parker has not been disciplined by the state Dentistry Board for the extractions or any other actions, board director Linda Campbell said Thursday.
The state Health Department fined the center $10,000 over the incident. Staff members were required to attend a 6-hour seminar about resident rights and care.
That is the only time the living center has been fined in the past three years despite recurring deficiencies found by health department inspectors.
The center has been on a roller coaster with state regulators since it opened in 1987, said Brent VanMeter, health department deputy commissioner.
In 1996, the center went into receivership after the owner failed to pay off bonds issued to build the building. There have been three receivers in the past four years and as many administrators.
The constant financial turmoil and disruption of staff have contributed significantly to problems with resident care, VanMeter said.
"The things that go on out there, while they are not excusable, they are somewhat tolerable because of the alternative," VanMeter said. "What are you going to do with these people if you don't keep them there and hope that that facility is doing the best that it can?"
The center is in danger of losing Medicaid and Medicare reimbursements because of deficiencies cited in a report released last week, VanMeter said.
The report alleged 10 deficiencies found during a three-day investigation. Those deficiencies ranged from Pepiakitah's death to resident abuse by staff and a lack of privacy for the residents.
The state health department regulates compliance with guidelines for Medicaid and Medicare funding for facilities for the state's nearly 40,000 residents in intermediate care for the mentally retarded and aging.
The center must show that it can correct the problems before Feb. 5 or it will lose Medicaid and Medicare funding, which is its major source of income.
On Jan. 7, a cleaning person went to Pepiakitah's room and saw what appeared to be a pile of clothes between the bed and the dresser. The worker moved a blanket and uncovered Pepiakitah's body.
She had last been seen Jan. 2 when she told staff she was going to stay with family.
Pepiakitah apparently returned to her room, had a seizure and died, VanMeter said.
Although VanMeter doesn't expect any criminal actions against the staff, the health department's inspection division has referred the matter to its legal staff. The center could be fined $10,000 a day for each day Pepiakitah's death went unnoticed.
Because of recurring problems, the health department conducts regular inspections in Choctaw every six months instead of at 9- or 12-month intervals, VanMeter said.
This month's inspection was a follow-up to an inspection in November where 18 deficiencies were found. The deficiencies ranged from inadequate and unqualified staff to failing to protect residents' rights to privacy and safety.
One resident was allowed to eat trash, which made him incontinent. Staff members found cigarette butts, plastic cigar mouthpieces and pieces of potato chip bags in his stool.
Inspectors saw residents hitting other residents without any staff intervention. Inspectors also found that staff members were not acting on goals to improve resident behavior and skills.
One resident, whose goal was to learn to take care of her eyeglasses, was never seen wearing glasses during the inspection. After inspectors asked about the glasses, staff couldn't find them and the resident told inspectors she had broken them.
Most of the deficiencies cited this month also were found in November. Administrator Millarr had asked for another inspection because she said the center had corrected the problems cited in November, records show.
After the unattended death was reported Jan. 2, health department officials decided to conduct an unannounced survey.
Although VanMeter said the unattended death is atypical, he said the other offenses are customary when working with the mentally retarded - even cases of resident-on-resident violence and sex among residents.
Compared with other similar facilities, the Choctaw Living Center is not unique, he said.
He said after news reports last week about Pepiakitah's death, he received many calls from residents' families and guardians asking him to make sure the center remains open.
The center will only be closed if it is found not to be financially viable, VanMeter said.
In October, the health department investigated claims that one resident had unexplained black eyes and other injuries. The injured person had been found in the center's gym by another resident.
The complaints were verified, and the living center was cited for failing to report unusual circumstances in accordance with state law.
VanMeter said it is very uncommon for such facilities to fail to report incidents to the health department.
Before October, state officials had been hopeful that the 110-bed facility was turning its back on its tumultuous history, assistant deputy director Becky Moore said.
No deficiencies were cited after an inspection in May 1999.
That was one month after the facility responded to deficiencies found in a February 1999 inspection.
In 1998, the year of the teeth extractions, the health department heard 13 complaints against the living center and found nine deficiencies.
Other deficiencies during that year included insufficient staff and training and failure to maintain appropriate resident records, among others that reappeared on later reports.
In 1997, similar deficiencies were cited during complaint investigations and regular surveys and follow-up visits, including the sexual assault of a female resident by a male resident.
CONTRIBUTING: Staff writer Nolan Clay
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