State regulators at the Vermont Department of Disabilities, Aging and Independent Living stepped in last month following what court filings describe as a spate of “troubling events” at Our House homes in the last year that showed a pattern of understaffing and inadequate training.
A judge approved the temporary receivership on June 4. The order places an outside manager in charge of the business at the owner’s expense.
For years, Our House has participated in a state program that allows it to admit elderly residents whose needs are intensive enough that they qualify for a traditional nursing home. About half of the 40 or so residents at Our House, which caters to people with dementia, live there through the state program.
Our House’s unlicensed caregivers and licensed aides have struggled to manage their complex behaviors. They’ve resorted to mechanical and chemical restraints and physical abuse, the state found.
Officials banned the homes from accepting new residents in early May, then two weeks later revoked Our House’s ability to continue caring for those with high needs.
Hoping to avoid the “trauma” of relocating more than 20 residents, DAIL and the Vermont Attorney General’s office proposed the receivership as an alternative, interim DAIL Commissioner Monica White said. Our House co-owner Paula Patorti agreed to the idea, leading to the first voluntary takeover of a poorly performing eldercare home in Vermont.
The goal, Patorti and White said, is to improve the homes and then return them to Patorti and her husband. For now, Patorti will continue to work alongside receiver Mark Stickney of Spinglass Management, who oversaw an earlier receivership in Vermont involving the Pillsbury eldercare homes.
“We’re hopeful and optimistic that the receiver will put in place systems and processes that the facilities will be able to maintain long-term,” White said.
In August, a caregiver at Our House Too was charged with assault for hitting a resident with dementia and grabbing his genitals during an altercation at the home. The 83-year-old was bleeding when another caregiver found him, Seven Days and VPR previously reported.
Six months later, in late January, an agitated resident at Our House Outback charged a caregiver from behind, according to a recently released DAIL licensing survey. The worker turned a shoulder into the resident, who lost balance and fell over. The resident was knocked out, and hours later was taken to the hospital by ambulance. The resident was diagnosed with a subdural hematoma and died two days later, according to the report.
DAIL surveyors found that Our House’s caregivers weren’t trained to manage difficult behaviors, nor did the home have the staffing levels it described in its applications to operate a dementia unit. One frustrated staffer punched through a wall in a resident’s room, according to the state surveys.
Employees restrained residents through medication, belts and physical force. One resident was routinely strapped into a wheelchair using a lap belt. Another was prescribed the antipsychotic medication Risperidone “as needed,” but was given it daily. Two caregivers tried to calm a third resident by hooking their arms through the resident’s armpits.
Our House has a history of such problems. A pending civil lawsuit filed by the family of deceased resident Marilyn Kelly accuses the home of inappropriately using powerful antipsychotics. Kelly died in early 2016 within weeks of being physically assaulted by an Our House caregiver. The state cited the home for nearly 20 violations at the time but did not impose any penalties.
The state’s recent petition for receivership cites regulatory violations at Our House dating back to Kelly’s death, but focused on the problems discovered during investigations in February, April and May of this year.
Patorti said her homes, like many others, have had trouble finding and keeping enough caregivers. The pandemic, she said, added extra pressure on her homes.
A few people at one of Patorti’s homes were infected with COVID-19 in late spring. The residents didn’t get sick, she said.
During a May inspection, a state surveyor cited Our House for its COVID-19 precautions after observing Patorti walking into an infected resident’s room wearing no protective equipment beyond a surgical mask. Four employees did not even wear masks while working, claiming their doctors had advised against it, Patorti told surveyors.
“I can’t let them go,” she said, according to the report.
Patorti opened Our House more than 20 years ago. She and her husband started the business in memory of her mother-in-law’s experience with dementia. “Our residents need us, and that hasn’t changed,” she said.
Of the receivership, she added: “We’re just looking at it as a positive situation, hoping that it will wrap up quickly and fairly painlessly.”
Read the state's application for receivership here:
About the Series
To report and write the Worse for Care series, Seven Days and Vermont Public Radio joined forces to analyze five years worth of state inspection reports and complaints involving Vermont’s 133 residential care and assisted living facilities.
Seven Days data editor Andrea Suozzo created the Vermont Eldercare Navigator, a searchable online database that details what state inspectors found at these homes.
Audio stories are available at vpr.org.