In a cinderblock nursing home, cradled in the Blue Ridge Mountains surrounding the twin cities of Bristol, Tenn., and Bristol, Va., workers say a predator stalked the elderly in its halls.
They say that for nearly a decade, he fondled, groped and may have even sodomized patients—some of whom couldn't walk, speak or see.
Affidavits, an investigator's memo and other documents obtained by the Scene identify the man as James W. Wright, a nurses' aide. Wright declined to comment when the Scene contacted him at his Bristol, Va., home.
But despite repeated complaints from fellow employees, managers at the National HealthCare Corp. (NHC) Bristol facility allowed him to stay on the job.
Wright's co-workers were bewildered by what they describe as management's lackadaisical attitude toward their allegations. Many left in disgust. Wright only resigned in 2007, several months after a Bristol police investigation of the home. Det. DeeDra Branson, the officer in charge, refused to say what that inquiry revealed.
As the complaints threatened to become public, however, pressure was applied to NHC on the victims' behalf. It is not known how much NHC has paid to keep the allegations against Wright quiet. But sources say several cases were settled before they ever went to court. Parke Morris, an attorney for the victims' families, declined comment.
But now the nursing home industry is moving to restrict lawsuits in situations such as this. State Sen. Jim Tracy of Murfreesboro, home to NHC, wants to restrict punitive damages in abuse cases to $300,000—if the home can prove it was fully staffed at the time of an incident.
The industry—and NHC in particular—are pleading poverty as their cause. In their PR campaign, nursing homes have argued that frivolous suits by out-of-state lawyers are diverting money from patient care and employee wages.
If the industry has fallen on hard times, though, it isn't showing. The health-care lobby has given Tracy $23,000 in campaign contributions. According to the Center for Responsive Politics, NHC's political action committee spent $10,000 on Congressman Bart Gordon of Murfreesboro, and gave $84,000 in political contributions during 2008 to push its interests.
Moreover, NHC's ledgers look downright hearty. It's one of the 15 largest nursing home chains in the country, with about 60 facilities in Tennessee and others spread from Arizona to Florida. Since 2000, according to the corporation's own 10-k and the Tennessee Association for Justice, its net income has climbed to $43 million—a whopping 326-percent rise.
The company's part of an estimated $125 billion industry, with taxpayers picking up roughly 70 percent of that tab. Homes have become so lucrative that independents have been gobbled up by investors and corporations. And that, says the Health Researchers and Educational Trust, has caused a corresponding decline in care. The ratcheting-up of profit margins, they argue, has often caused short-staffing. A separate AARP-funded study also found that for-profit nursing homes can generally be associated with lesser care.
But the serial problems at NHC Bristol show how bad nursing care can be—and how even civil liability cases involving rape of the elderly may soon be restricted under Tennessee law.
Those who've worked with James Wright, 35, describe him as stocky, short, maybe 5-foot-5 with curly, thinning hair. He is particular about his scrubs, arriving cleaned and pressed before work each day.
The first complaint against him came in early 2000, according to a memo written by private investigator Lloyd Emmons, a former DeKalb County Sheriff and Tennessee trooper. The daughter of a resident we'll call Emma—to maintain the privacy of alleged victims, the Scene has changed their names—noticed her mother became agitated whenever Wright was around. Emma was suffering from the early stages of dementia, but was reportedly still lucid.
Emma would swat defensively at Wright, according to her daughter. She also complained that Wright "fingered me and he hurt me." The daughter reported her concerns to Charge Nurse Helen Roberts, but said the nurse defended Wright and persuaded her not to ban him from Emma's room. Through her husband, Roberts declined to comment for this article.
After seeking counsel from her pastor and Emma's private sitter, the daughter resolved to have Wright banned from the room. Emma's complaints stopped.
Co-workers say Charge Nurse Roberts remained Wright's steadiest defender, invariably taking his side as the allegations began to mount. Roberts was a religious woman, says former NHC patient-care coordinator Amy Edwards, and Wright's professed piety curried favor in her eyes.
"James played that card with her," Edwards claims. "He was wearing a wedding band, and when asked who it was, he said he was married to Jesus. I think that kinda blinded her eyes."
Not long after he was removed from Emma's care chart, two aides came forward with more accusations against Wright. As they were folding bibs at a desk, they said, they saw Wright pushing a resident, "Delores," in a wheelchair to the dayroom. Delores had limited speaking abilities and could not walk on her own. The aides claim Wright's arms and hands were draped over her breasts as he pushed her down the hall.
Later, he and Delores left the dayroom for her own quarters, ostensibly to clean up. In an affidavit, an aide who asked not to be identified because of her current employment testified that she heard Delores "screamin' and hollerin' " from her room. She entered to find Delores sitting on the toilet, pointing at her genitals and saying over and over, "He hurt. He hurt." Wright was standing over her.
"I was trying to calm her down," he explained.
Addison says she filed a report with Charge Nurse Roberts, and Wright was banned from caring for Delores by management. But Addison claims there was never an investigation of the incident, even though Virginia law requires reporting of elder abuse to the state Department of Health. She left NHC soon after.
The next incident came in 2003. Aide Diane Lewis was working the first shift; Wright was her second-shift relief. They walked together down the hall, checking in on patients and exchanging information. That's when a male resident called Lewis into his room.
"He called me in and said, 'I don't want that boy taking care of me,' " Lewis claimed in an affidavit. "And I said, 'Why?' And he said, 'Because he sticks his finger up my butt.' I went straight up and wrote a report on it."
Lewis filed the report with director of nursing Evelyn Nunez, but it did little good. "Nunez told me it was no findings," she says. "I said, 'Well, what do you mean no findings?' "
The man was now refusing to talk to nursing home officials. "Some stranger went in his room and talked to him and he had no idea who that was," Lewis says. "They ain't going to talk to strangers. It's embarrassing enough."
It is not known to what extent Wright was questioned about the allegations. Nunez no longer works for NHC Bristol, and she did not respond by press time. Lewis herself left NHC Bristol in 2005. Aides were overstretched, she believed, and patients weren't getting the attention they deserved. She had begun to bring that anxiety home with her.
This theme recurs in interviews with former NHC Bristol employees. Most aides say they can only effectively care for eight patients at a time. Bristol, Lewis says, would push that number to 12.
Lewis says the home circumvented rules by keeping a call log. If the facility was short-staffed, it would dial up an employee on the log. But if that employee couldn't come in, she says, the home had still satisfied state regulations just by making the call.
Nor were state-mandated inspections much of a threat. In an affidavit, Lewis claims NHC Bristol knew when state inspectors would arrive. Suddenly, employees were offered time-and-a-half and even double-time to ensure full staffing.
That did nothing to stem the complaints coming from Wright's charges. The next incident involving Wright occurred in 2004. According to Emmons' memo, patient-care coordinator Amy Edwards was alerted to a suspicious bruise on a female resident: a perfectly round ring around her anus.
Edwards in turn notified the new director of nursing, Ann Franklin. But she says Franklin merely examined the injury and shrugged. (Franklin refused to discuss the matter with the Scene.)
Edwards launched her own inquiry, interviewing aides who cared for the woman on various shifts. That led her to Wright. He told her the resident was severely constipated, so he took care of it manually.
But Edwards remained suspicious. She later resigned in frustration, galled by the facility's chronic short-staffing and management's failure to investigate Wright.
It wasn't long before another aide—an NHC employee who requested to remain anonymous for fear of retaliation—walked in on Wright and a female patient. In an interview with the Scene, the aide alleges that Wright had the curtain pulled closed, obscuring the view from outside the room. One arm was wrapped around the woman's shoulder; the other was between her legs.
"She had her hands on his and she was sweatin' and hollerin'," the aide says. "I said, 'What are you doing?' And he said, 'She won't turn loose of me.' She said, 'You devil, you. You won't turn loose of me. Get him outta here. Give him to the devil.' "
When the nurse aide examined the woman, she claims she found a hole in the patient's diaper directly over her genitals, about the size of a 50-cent piece.
"I knew something was going on," the aide says. "But it was my word against his."
The complaints, once sporadic, had become a chorus by 2007. In April that year, Bristol police investigated claims that yet another female resident had been molested. No arrests were made or charges filed, and Detective DeeDra Branson refuses to comment on her inquiry. According to investigator Emmons, though, Branson told him Wright's name was never mentioned during her probe.
At around the same time, Patty Davenport, then a new aide at NHC, says she saw Wright molest a patient during her first month on the job in April 2007. According to an affidavit and a videotaped interview, she says she heard grunting coming from across the hall. She had worked with this particular patient before, and knew that grunting generally signaled distress.
When she entered the room, she says, she saw Wright fondling the woman's breasts.
"She was in her chair and he had her bra up, her shirt open and he was just like this," Davenport claims, working her hands over a pair of imaginary breasts. "Right in front of her, and she's in her chair, just shakin' and shakin', making all these sounds. I said 'Get your fucking hands off her. I'll finish dressing her.' "
Davenport reported what she saw to a nurse, who was disbelieving. "She said, 'Well, maybe you saw it wrong,' " alleges Davenport. Since NHC has a strict chain of command, she's unsure if her report ever made it to top administrators. But she says Wright was effectively banned from caring for the woman.
"When the first time it happened, I thought, 'OK, maybe I did see it wrong,' " Davenport says. But a month later, she caught Wright in another compromising situation. This time, she had no doubts. "Oh, hell no," she says. "Uh-uh. There wasn't no misunderstanding or none of that."
Davenport walked into the room of a patient who was blind and could not speak. As she rounded the corner, she saw Wright sitting next to the woman on her bed. Her gown was up and Wright, she claims, was rubbing her genitals while stimulating himself.
"I said, 'What the fuck are you doing?' " Davenport says.
She left the room and had an employee call director of nursing Franklin. Davenport says she told Franklin what she had seen and wrote her own statement. She told the head nurse that Wright's license needed to be revoked and his actions reported to the state.
But Franklin insisted they follow the chain of command, she says. That would have led to NHC Bristol administrator Charlotte Wilson, who refused to comment for this story.
The next morning, Davenport called in sick. She was told that someone would cover for her: James Wright. She decided to quit on the spot.
"This has been going on for years," Davenport alleges. "[Other aides] said this. And I said, 'Well, ain't nobody said anything about this?' And they say, 'Well, it's not going to do anything.' There were over eight rooms he couldn't go in—couldn't take a tray. He couldn't do nothin'."
Still, Wright retained his job—even though Davenport's claims wouldn't be the last brought to Franklin's attention.
According to a videotaped interview, Cynthia Aldridge was caring for a resident on a morning in July 2007. She asked the woman if she was ready for her morning bath. The patient said she'd prefer a shower, which struck Aldridge as strange. The resident normally didn't like showers. Aldridge put on gloves to examine the woman's diaper. "And when I put the gloves on she went crazy and started crying and screaming, 'What're you gonna do? You gonna finger me like that boy did last night?' " Aldridge alleges.
She later spoke with the woman's daughter, curious to see if the mother was prone to talking like that. The daughter was stunned. Both reported the situation to the nearest nurse. The next day, Aldridge was asked to file a written report and submit it to the charge nurse.
"I had went to [Ann Franklin] and told her, 'Look, if you need to talk to me about this, then I'm more than willing to talk about this,' " Aldridge claims. "[Franklin] just kind of blew it off."
Less than a week later, Aldridge says the resident's family pulled the woman from NHC Bristol. Not long after, a meeting was held during which the medical director pointed out that aides needed to show more respect to the nurses, Aldridge says. She could not hold her tongue.
"I said, 'How can you respect somebody that lets people get molested, lets people eat the patients' food?' " Aldridge says.
She says several aides spoke up as well about Wright's alleged misdeeds—that they'd caught him eating patients' food (a firing offense) and with his hands beneath their blankets.
Sometime in August or September 2007, Wright resigned. The medical director did not respond to repeated interview requests, but aides say Franklin gave the accusation-plagued aide an ultimatum—leave or be fired.
He left NHC and began working for another nearby senior-living facility, Grand Court Bristol. During an initial visit to Grand Court, executive director Libby Bailey was unavailable. But when a reporter returned later that day, Bailey was expecting the visit. She read from a prepared statement and refused to answer questions.
"I have just become aware of some allegations of a legal situation involving one of our associates from his previous place of employment and he's going to be terminated" pending the outcome of an investigation, she said. "During the person's employment here, there've been no negative reports or issues related to his work."
This is not the first time Murfreesboro-based National HealthCare Corp. has raised questions about the quality of care in one of its facilities. Still smoldering in memory is the deadly 2003 fire that killed 16 residents at an NHC nursing home in Nashville. Widely reported at the time were the lack of a sprinkler system (which the state did not require), the scarcity of smoke detectors, and allegations of insufficient staffing.
If you believe the current allegations, an NHC employee was able to prey sexually on patients over a seven-year period. Now lawmakers will decide if $300,000 is enough to compensate the people left in his hands.
Sen. Jim Tracy apparently thinks so. He is, after all, the bill's main sponsor and a beneficiary of nursing-home contributions. When asked about the incidents at NHC Bristol, he deflects the inquiries with noncommittal rhetoric.
"You know, you've done a question...those are some of the questions that are discussed when the bill moves through the general assembly," is all he'll say.
But that's understandable. He wouldn't be the first person in power who didn't want to look too closely behind those curtains.
(Note: This story has been corrected to say that Virginia law, not Tennessee's, required the facility to report elder abuse.)
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