RALEIGH -- A month after entering Wake Forest Care Center, Harry O. Rake had to spend three weeks in the hospital to recover from an infected bedsore he developed at the assisted living home, state records show.
For allowing that and other serious problems among its residents, Wake Forest Care Center should pay $22,000 in fines, a state advisory panel recommended Thursday.
Wendy Lee, Rake's daughter, told members of the state Penalty Review Committee that his stay at the 80-bed Wake Forest home was characterized by "complete neglect" that led to the infected bedsore. Even though records showed the staff had known about the sore for two weeks, Lee said she had to urge them to take Rake, then 63, to a hospital emergency department on Nov. 7, 2008.
"It had not been dressed, it had not been cleaned, and it smelled to the heavens," Lee said during the committee's review of a proposed top-level penalty against the center.
Wake Forest Care Center's violations have earned it azero rating since March on the state's four-star scale, but it remains licensed and open.
"That's the question of the year: At what point does the state take action?" said Gail Holden, director of senior and adult services for Wake County Human Services. "How long can someone get zero stars?"
The state Department of Human Services oversees adult-care homes such as the Wake Forest Care Center with help from county officials such as Holden. A state spokesman said Thursday that the center had made significant enough progress and that its full license was restored after almost six months of operating under a provisional license.
The star-rating and licensing processes are separate and do not affect each other, state spokesman Jim Jones said in an e-mail message. "Naturally we hope that any facility with less than a perfect score would strive to do better," Jones said.
State Rep. Jennifer Weiss, a Cary Democrat, said the star-rating law was designed so that centers that get a bad rating are stuck with it until the next annual inspection by the DHHS.
"If somebody does something wrong, you still need to let the public know there are issues," Weiss said.
Legislators passed the star-rating system into law in 2007, saying it would allow families to make better decisions about adult-care homes across North Carolina. The ratings are based on recent violations and on how well centers perform on meeting minimum standards in staffing, giving out medication, security staff training and sanitation. Consumers started getting star-ratings information about how well adult-care homes look after residents early this year.
State licensing officials suspended admissions at Wake Forest Care Center and downgraded its license to provisional status in March, then extended it provisionally for another three months last summer before restoring it fully in September.
At the meeting Thursday, Richard Cresenzo, the center's owner and administrator, said a doctor who saw Rake at the assisted living home in October 2008 did not think the sore required hospitalization.
In addition, Cresenzo described Rake, a former bus driver who had a stroke in 2001, as a combative resident who was difficult to treat.
"I cannot explain why the resident care coordinator was not more diligent," he said, referring to a manager at the center, whom he did not name. "She was fired."
Joan Miller, Rake's former wife, told committee members that she visited Rake at Wake Forest Care Center and found him unable to communicate and dressed in dirty clothes and diapers.
"They had him doped up to keep him quiet," Miller said.
Another 2008 incident, in which a resident went for weeks without treatment for painful dental problems, was included under the $18,000 penalty for Rake's poor care. Advisory panel members also said the center should pay an additional $4,000 for poor monitoring of smoking residents, one of whom twice set himself on fire.
