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Although Heritage Sam Houston shaped up in a month, by January inspectors found violations again. In February DHS again fined Heritage Sam Houston and suspended its Medicaid and Medicare payments. This time, it referred the case to the attorney general's office for a possible civil suit.
Heritage Healthcare Management, which operates Heritage Sam Houston, recently closed its Fort Worth-area location after similar problems plagued it. Chief Operating Officer Chris Callahan says the company has made changes at Sam Houston, which has been hit with more than $60,000 in fines. "We've switched administrators and reviewed our policies," he says. Sam Houston has seen five different administrators in 15 months.
While many families have moved relatives from Heritage Sam Houston, some feel they can't because very few nursing homes maintain Alzheimer's units andaccept Medicaid. Those were the same reasons Ellis cited for placing Van Rysseghem there.
"There are not many places in the city of Houston, in the state of Texas, what they call a lockdown facility," says Bruce, who witnessed the pushing incident against Van Rysseghem. "It's like a jail; the people can't get out unless they're escorted out by a visitor or family member, which is the only way you can have it for their own safety. I don't like it, but there's no other way if you're not able to take care of a loved one at home."
In a darkened hospital room, Van Rysseghem lies motionless with her arms to her side, asleep, breathing heavily through her mouth. Her gray hair falls back from her face, matted with blood at two spots on the top of her head. Bruises discolor her left arm, right hand and left knee.
On March 26 Van Rysseghem was taken to the Spring Branch Medical Center emergency room. "It was an emergency, something about getting hurt, that she fell down," Salazar says. "But they're always telling you they fell down." Micki Krchnak, a case manager at the hospital, says Van Rysseghem was brought in for "confusion" and "altered mental state."
That same week Salazar called the police again during a visit. He says Van Rysseghem seemed heavily drugged, could barely open her eyes and hadn't walked in days, so he massaged her limbs and released restraints across her abdomen. Krchnak and nurse Redia Thomas say he was fondling Van Rysseghem and that they asked Salazar to leave. He called the police, but when an officer arrived, he told Salazar to leave or he'd arrest him for trespassing.
At a hearing earlier this month, Wood signed a restraining order prohibiting Salazar and his family from seeing Van Rysseghem. Salazar constantly interfered with her care, he said; no facility will take her if he continues to behave like that. "You can call the police every day, every hour, but it's not helping her," Wood said from the bench. Without money or an attorney, Salazar made a futile effort to show the judge snapshots of her condition at the nursing home.
Wood also ordered the Press not to publish photos or comments that may have been obtained from Van Rysseghem during a visit to Spring Branch Medical Center with Salazar.
Because Van Rysseghem now has no money, her case is being turned over to the Harris County Guardianship Program, which assigns caseworkers to manage the affairs of incapacitated indigents. Once again, Salazar has put in an application for guardian. Wood is skeptical. "I have a feeling that Mr. Salazar will lose interest when he finds out he won't get paid," he says. But Salazar points out that he voluntarily signed off the joint bank accounts without claiming any funds from them. He says he doesn't care about money, he just wants his wife back.
That prospect looks doubtful. Without money, Van Rysseghem depends on the very system that rendered her penniless. She remains in the hospital, sleeping in a sedated haze, probably not even aware that she has no more visits to look forward to.
E-mail Melissa Hung at firstname.lastname@example.org.