State inspectors handed a restraining order to Corliss Ford, operator of the Autumn Rest adult-care home in west Phoenix. The order, signed earlier that day by a Maricopa County judge, instructed Ford to remove the eight elderly residents from the residence.
Steve Tseffos, the public relations spokesman for Attorney General Grant Woods, tipped off the Phoenix media about the supposed house of horrors. The reporters quickly gathered outside the home at 3447 West Redfield, near Thunderbird.
After registered nurse Ford invited everyone in to observe the goings-on, it got so chaotic that resident Gertrude Harper fell and gashed her forehead, requiring hospitalization.
The raid topped the news on local television, and the next morning was the lead local story in the Arizona Republic: "State Closing Valley Care Home. Conditions Spur Criminal Investigation."
Autumn Rest appeared to be a sadly vivid example of why Governor Fife Symington in 1991 had signed a law requiring adult-care homes to undergo a state licensing process.
The Ford case also allowed Attorney General Woods to follow through on a campaign vow to crack down on those caught abusing the elderly.
"When Grant Woods saw the photos yesterday, he said, 'Go shut this thing down,'" said spokesman Tseffos.
The photos, taken by Department of Health Services inspectors, depicted gaping bedsores that plagued three of Ford's past and present residents. The pictures seemed to prove the rest home was the stuff of nightmares.
Though the AG's Office didn't file criminal charges against Corliss Ford, it sought in a civil lawsuit to keep her from ever operating an adult-care home in the state of Arizona.
But the media that had trumpeted Grant Woods' swift action in closing Autumn Rest weren't present during Corliss Ford's extraordinary civil trial last month.
The proceeding laid bare a health-care system yet to come to grips with Arizona's vast aging population.
Ford didn't argue that she'd operated an unlicensed "health-care institution" and an unregistered adult-care home. But she steadfastly refuted the most serious of the three counts against her--that she'd committed "abuse and neglect of vulnerable adults" under Arizona law.
In a stunning turn of events, the family members of those allegedly abused and neglected--including a veteran Phoenix police officer--testified on behalf of Ford.
And, as it turns out, criminal investigators at the AG's Office agreed with them. Documents uncovered after the trial reveal how the AG's Office failed to release key evidence that could have exculpated Ford.
The recently uncovered AG's documents show that months before the trial, AG's criminal investigators concluded in writing that Corliss Ford hadn't abused or neglected anyone.
"No neglect can be charged," agent Nancy Paine wrote in a report last April. "The residents could have received more and/or better food, they could have lived in cleaner conditions. But the conditions they lived in were not criminal."
On June 23, assistant AG Gail Greeley sent a memo to Paine which summarized the Ford case: "Your investigation concluded that there was no neglect of patients. . . ."
That's as straightforward as it gets.
This wasn't another dreadful case of an evil person harming senior citizens in her care. In truth, there's no evidence Corliss Ford or her employees ever intentionally injured anyone at her care homes.
The evidence shows Ford kept many of her elderly residents because they had nowhere else to go. A Phoenix hospital kept sending one very ill 90-year-old resident back to Autumn Rest. Another aged woman returned after her son told Ford he couldn't take care of her anymore.
"This is a look at the other side of the system," Ford calmly told Judge Stanley Goodfarb during her trial. "One you may not have heard about before."
Ford's lawyer, Tim Evens, came unglued when he first saw the AG's previously unreleased documents December 16, a day after Ford allowed New Times to sift through papers mistakenly supplied her by an assistant AG not involved in the case.
Evens has asked Goodfarb to dismiss the AG's lawsuit against Ford and to impose sanctions against those responsible for what he calls an "egregious violation."
Assistant AG Helen Baldino--who presented the case against Ford at trial--says her office did nothing improper by not releasing the criminal investigation. Reports stemming from the criminal investigation were "work product," Baldino argues, and not legally applicable to the civil case against Ford. To Corliss Ford, however, the newly uncovered reports are vindication.
"There are people who do hurt the elderly and I hate them," she says. "But I loved my people and they loved me in return. I'd rather die than abuse or neglect someone, period."
@rule:
@body:It is a sunny December morning at Corliss Ford's rented north Phoenix townhouse, but for her the holiday season has not been festive. She's lost a car to repossession and a house to foreclosure, and her financial future remains murky.
With the legal cloud hanging over her, Ford says she can't find work as a nurse. A Valley investment firm hired her late last year as a financial planner, but she lost that job after the Arizona Department of Insurance denied her a license because of the allegations.
Ford says she and her husband, Johnny, are unemployed and are surviving on welfare. He's been out of work more often than not over the years--a source of strain between the off-and-on couple. But she's long been the family breadwinner, and her current unemployed status rankles and embarrasses her.
While she awaits the disposition of her case, Ford busies herself with a baby granddaughter and two of her five children who live at home. Watching her interact so easily with the children, it's apparent how she won over the many families who placed loved ones with her.
But Ford's pleasant demeanor sours instantly when talk turns to her troubles with the government.
"I can see how I got under their skin," says Ford, a trim black woman in her mid-40s. "I mean, I was a pain in the butt because they'd say 'Do this!' and sometimes I'd do the opposite. But they haven't proved I'm wrong on the most important thing."
That, of course, is the allegation that she abused and neglected her elderly residents.
Ford and her family moved to Arizona from her native Illinois shortly after the big Midwest blizzard of 1976. Though she'd long worked as a registered nurse, Ford first tried selling real estate in Phoenix.
After an up-and-down stretch financially, Ford reentered the nursing field in 1981. She worked at several Valley hospitals, including a stint as a home-health nurse, treating residents at homes similar to Autumn Rest.
Visiting those care homes inspired Ford to try her own luck at running one. And many, many people who placed family members with Ford continue to sing her praises, despite what's happened.
"I think the state really thinks Corliss was preying on Mom," says Jeanette Harper, whose mother-in-law, Gertrude Harper, was an alleged victim of Ford's. "She did nothing of the sort. She was good to Mom, to all of them."
Dennis Alfeltis, a son of alleged victim John Alfeltis, concurred with that line of thinking in a sworn affidavit presented at Ford's trial.
"I had an opportunity to frequently visit [Dad] and observe his physical condition and the environment in which he was residing," wrote Alfeltis, a 24-year veteran of the Phoenix Police Department.
"I was always happy with the care, attention and treatment my father received while at [Corliss] Ford's home."
And the court file contains a letter from James Willoughby, former coordinator of the Maricopa County Attorney's victim-witness program.
"I do not believe that my mother could have spent the last months of her life in a more caring and loving environment than she had at Autumn Rest," wrote Willoughby, whose mother, Agnes, died at Autumn Rest in January 1989.
The ex-cop said he and his wife--a nurse--made unannounced visits to Ford's care home during his mother's stay there. They did so, Willoughby wrote, because "we are well aware of the potential of exploitation and abuse in a caretaking situation."
What they saw at Autumn Rest, he added, was "a homelike atmosphere. Mom died in her own bed, in her own home, regardless of the name it bore."
These testimonials do not appear to spring from feelings of guilt family members often suffer after moving loved ones into a care home. The comments are especially remarkable in light of the AG's Office's descriptions of Ford's residence following the June 1992 raid:
"Pressure sores all the way through the skin to the bone. . . . Sores infected with staph. . . . Hands bruised and covered with areas of blood under the skin. . . . A resident found lying in urine. . . . An empty refrigerator. . . ."
@rule:
@body:Until 1986, few laws and regulations governed how operators ran such residential adult-care homes in Arizona. That year, the state started to require registration of the homes, which may house up to ten people not in need of round-the-clock nursing care.
Once a home was registered, state Department of Health Services inspectors wouldn't visit it again unless someone filed a complaint. If DHS saw the complaint as valid, it would monitor the home until things improved. If merited, the agency also could order a home's operator to remove residents.
Licensing of adult-care homes didn't become law in Arizona until mid-1992. By last July, DHS had licensed only 144 homes, with a few hundred applications on file. Many sources tell New Times that untold numbers of "underground" homes continue to operate secretly in Arizona.
The reason for adult-care homes--legal and illegal--is simple:
Nursing homes on average charge patients more than $3,000 a month. That's often far too much for those whose income through Social Security, retirement pensions and the like is too great to qualify for government assistance, but too little to afford skilled care.
Licensed adult-care homes generally charge residents about $1,000 a month, "underground" homes often even less.
Corliss Ford opened her first care home in October 1988, on West Libby in Phoenix. She didn't live there or at any of the three other homes she operated before the state's June 1992 raid. Instead, she would hire live-in "care givers," usually people with little or no medical training, to tend to the residents.
In March 1989, Ford registered the Libby facility with DHS--the only one of her four homes in which she did so. The registration allowed her only to provide "personal assistance" to residents, a level far below nursing care.
Ford says her three residents came to her through the reference of a former colleague at Good Samaritan Hospital. But it didn't take her long to go to war with the State of Arizona.
In the summer of 1989, someone--it's not certain who--complained to DHS that Ford herself was providing "health-related services" to residents at the Libby house.
Undaunted, Ford opened a second home, on Echo Lane in Glendale. One of her residents there, then at Libby, was a woman named Eula Archuleta.
The State of Arizona's war with Corliss Ford escalated because of Mrs. Archuleta's situation. Granny, as everyone calls her, is a legally blind octogenarian who suffers from incontinence, arthritis and other maladies common to the elderly.
Ford says a Humana Hospital nurse recommended the Libby care home to the Archuleta family. Records show Granny had broken her ankle, and Adult Protective Services didn't want her home alone while her son and granddaughter were working.
A nursing home was out of the question, as Granny's Social Security income was too much to qualify her for aid through the state's long-term-care program.
A residential adult-care home seemed the best, possibly the only, alternative. Ford says she told Granny's son, Laddy Archuleta, that she couldn't provide medical services herself, but that a doctor and home-health nurses would monitor and treat his mother at the care home.
Such arrangements are commonplace in Arizona, even though many Arizona elderly might be better served by a higher level of day-to-day care.
By late 1989, however, the State of Arizona didn't want Eula Archuleta at Ford's care home because of her medical needs. That December, the Department of Health Services ordered Ford through its first of many cease-and-desist orders to relocate Granny.
Ford says she sought help from Adult Protective Services and the Phoenix-based Foundation for Senior Living. She got some telephone numbers for Maricopa County adult-care homes--which operate under some different regulations from the state--but Ford says they didn't want Granny and her medical problems.
The Archuletas shopped around for a nursing home, but Ford says they told her the cheapest one they could find was $2,700 a month--almost three times more than the $1,000 a month she was charging them.
(Laddy Archuleta declined to discuss his mother's case with New Times.)
Records show Ford ignored more DHS cease-and-desist orders. Finally, in February 1991, the Archuletas moved Granny to a new adult-care home operated by Reggie Wilson, Ford's former manager.
At that time, DHS officials asked a state hearing officer to fine the intransigent Ford $130,500 in the Archuleta case. On May 29, 1991, the hearing officer fined her $14,000, $1,000 for each month Granny had resided at Ford's care homes.
The night she was fined, Ford says, she learned that care-home operator Reggie Wilson had died suddenly. The death forced Laddy Archuleta to take his mother home with him. A few days later, Ford says, Archuleta called her in desperation.
"Laddy said he couldn't sleep and he couldn't go to work with Granny there," Ford recalls. "He asked me, 'Can you help?' I said, 'I'll take her.'"
And so, just three days after the hearing officer had nailed Ford in the Archuleta case, the aged woman was back in her care.
Eula Archuleta lived at Autumn Rest until the state's June 1992 raid.
But what happened to Granny after that speaks volumes about how Arizona's system of caring for its elderly operates: Her family moved her to a care home in Peoria--one registered with the State of Arizona at exactly the same "personal assistance" level as Ford's.
Tommie Sanders, the Peoria home's owner, says DHS inspectors never bothered her about Granny in the months the woman stayed with her until her son moved her into a county-licensed home.
"I told them up front, 'I'm not Corliss,'" recalls Sanders, referring to Ford's habit of taking sickly residents back into her care over the government's objections. "I'd say, 'Don't you hassle me or I'll wheel her to DHS and drop her off.'"
@rule:
@body:Corliss Ford's three alleged victims--John Alfeltis, Gertrude Harper and Tommie Smith--definitely should have been situated at a higher level of care, medically and legally. Financial and other roadblocks kept that from happening.
But even with the passage of time, the residents' family members have no beef with how Ford treated their loved ones.
"The home was clean and neat when I was there," says Fern Alfeltis, a licensed practical nurse whose late husband, John, lived at Ford's homes from late 1988 to May 1992.
"Truth is, John had tissue-paper skin and constant diarrhea and he was dehydrated because of his bowel problems. But he thought so much of Corliss. And if someone treated my husband the wrong way, he would become very hostile."
Fern Alfeltis brought her retired bus-driver husband to Ford in 1988 with severe bedsores, caused by his constant diarrhea and other problems.
"He was in bad shape when Corliss took him in," she says. "The state tried to say how much he improved after they made him leave Corliss, but he really didn't. He was very sick in his last years."
Tommie Smith's story isn't much different. The 90-year-old moved into the Libby house after a hospital referral in May 1990. Once a vibrant, fun-loving person, according to her niece, Elizabeth Swain, Smith now was nearing the end of her days.
In December 1991, Mrs. Smith developed a staph infection which led to lesions. That month, her physician, Charles Bell, authorized her release from Community Hospital Medical Center after a ten-day stay. Bell wrote of Mrs. Smith's condition at the time:
"Multiple [bedsores] which require intensive dressing. . . . All wounds infected and draining. Total Care required. . . . The major concern [is] getting her placed appropriately for continued antibiotic therapy and continued care post-discharge. . . . The patient's condition at the time of her discharge was fair and her prognosis is fair-poor."
Though Bell had released Tommie Smith back to Autumn Rest, Corliss Ford says it was obvious to her that the woman needed skilled nursing care. In late January 1992, Community Hospital records say, Heather Glen Nursing Home accepted Mrs. Smith as a patient.
But the nursing home suddenly changed its mind, because of financial reasons and Mrs. Smith's possibly contagious staph infection.
Apparently at a loss, the hospital again shipped this obviously very ill woman back to Autumn Rest.
"They just dropped her off in an ambulance," Corliss Ford says. "I had no idea she was coming back. At that point, I really didn't have a choice. I didn't know what the legal ramifications were for me to just stick Tommie out in the driveway, and I wouldn't do something like that, anyway."
The hospital papered its dubious actions in a January 21 memo: "Patient [Smith] now resides in group home. Environment clean and nurturing."
Ford kept Tommie Smith at Autumn Rest for only a few more weeks. On February 4, 1992, Ford returned Mrs. Smith to Community Hospital after the woman complained of great pain and wouldn't eat.
The hospital noted Tommie Smith's multiple oozing bedsores--some of them enormous--dehydration and malnutrition. But she apparently wasn't sick enough in the hospital's estimation to keep her there.
But Dr. Bell and his staff again were frustrated in their attempts to find a nursing home that would admit Mrs. Smith.
"I am thoroughly open to suggestion as to how to manage the bureaucratic aspects of this case," Bell wrote in a February 5 memo.
A few days later, Heather Glen accepted Tommie Smith as a patient--this time for real.
Despite a higher level of treatment there, Mrs. Smith's health kept slipping. New bedsores emerged. The nagging sores looked and smelled terrible. Her kidneys and gastrointestinal system were failing.
On March 5, 1992, DHS inspectors took photos of Tommie Smith's bedsores. Around that time, Adult Protective Services officials and a Phoenix police detective dropped by to see her. She was barely conscious by this time.
Two weeks later, Smith was taken by ambulance to Arrowhead Community Hospital in Glendale, where she died March 20, 1992.
Corliss Ford's third alleged victim, Gertrude Harper, came to Autumn Rest from a skilled nursing home in January 1992. Mrs. Harper's son and daughter-in-law placed her at Desert Valley Rehabilitation Center in June 1991, after they couldn't properly care for the retired bookkeeper anymore.
If Mrs. Harper had made just $3 less per month in Social Security, she could have qualified for Arizona's long-term-care aid. But her $1,269 check put her over the top, and her family had to come up with about half of Desert Valley's $2,800 monthly charge.
In papers filed with Judge Goodfarb, the AG's Office painted a grim portrait of Gertrude Harper's treatment at Autumn Rest.
Assistant attorney general Eric Bryant wrote of Mrs. Harper: "In August 1991, before she became a resident of [Ford's] facility, she was in good health, was ambulatory without any assistance and was continent. . . . On May 21, 1992, [she] had deteriorated so much so that she required total assistance with activities of daily living."
Records from Desert Valley, Autumn Rest and even DHS show Bryant's allegations to be inaccurate.
Desert Valley's files show Mrs. Harper's condition deteriorated during her stay there, which immediately predated her move to Autumn Rest. It wasn't necessarily the nursing home's fault: Her body and mind simply were wearing down.
On January 23, 1992, Desert Valley registered nurse Shirley Pendley noted Mrs. Harper's "tendency to develop pressure sores."
Like John Alfeltis and Tommie Smith, Gertrude Harper was very ill before she ever got to Autumn Rest. "Rehab potential poor," a nurse wrote of Harper a few days before the elderly woman left Desert Valley. "Resident requires intensive care in long-term-care facility. Family unable to provide care. . . ."
By this time, the cost of Desert Valley had become too much for the Harpers to bear. A referral service recommended Corliss Ford's care home.
"That was confusing to me, how she went from a nursing home to Corliss' home," says Dr. William Maguire, a Maricopa Medical Center physician who testified for the state at Ford's trial.
The reason again came down to money. Autumn Rest's price of $1,000 per month, plus $80 for diapers and medication, fit the Harpers' shrinking budget. And Corliss Ford's reputation still was sound, despite her many run-ins with DHS.
Mrs. Harper's January 1992 admission papers to Autumn Rest refer to a large bedsore on her right hip. The home-health nurses couldn't do much at first to heal the sore, and records show Ford sent Mrs. Harper twice to hospitals for bedsore treatment in the spring of 1992.
No one contends Gertrude Harper's health improved during her six months at Autumn Rest. The woman was wheelchair-bound--DHS claims Ford illegally "restrained" her in the chair--and she developed new bedsores.
On one of many unannounced visits, the inspectors took the photos of Mrs. Harper and others that convinced Grant Woods to "shut this thing down."
But DHS officials never contacted Dr. Charles Bell--the physician for Mrs. Harper and Ford's other alleged victims--before they raided Autumn Rest. Bell testified at Ford's trial that he would have told DHS of his "medical opinion that the residents of that home were being cared for in a proper fashion. . . . And I would have been the first to report [abuse]."
Although the state's own medical witness, Dr. Maguire, testified to the residents' "substandard care" at Autumn Rest, even he conceded that the state erred by not interviewing Dr. Bell or having an independent physician examine the residents before the June 1992 raid.
Concluded Maguire, after viewing the photographs of the alleged victims and reading their medical charts: "I did not see any willful abuse. I think it's bad judgment or neglect."
But Maguire admitted he couldn't specifically pin the residents' medical woes on Corliss Ford.
DHS inspectors also testified they never obtained full medical histories of the residents, nor did they question family members before the raid.
"Why didn't the state come out and ask us what we thought?" asks a still-bitter Jeanette Harper. "It wasn't an out-of-sight, out-of-mind situation. We loved Mom. Instead, they gave us a whole hour to find another place for her."
@rule:
@body:Judge Stanley Goodfarb tried to get to the heart of things during Corliss Ford's trial last month. The judge raised more sobering questions than anyone could possibly answer about how this society treats its elderly.
The sole legal issue before Goodfarb was to rule whether Ford had committed "abuse and neglect of vulnerable adults." Arizona law defines neglect as "a pattern of conduct . . . resulting in deprivation of food, water, medication, medical services, shelter, cooling, heating or other services necessary to maintain minimum physical or mental health."
The judge often spoke extemporaneously from the bench, on subjects that ranged from the recent local death of Michael Jackson's grandfather to his own mortality. He seemed deeply troubled by much of what he was hearing.
"What I got is a very clear picture of a very muddled system," Goodfarb said at trial's end. "It sounds like a world turned upside down."
The world seemed far clearer to assistant attorney general Helen Baldino. "It is easy to conjecture," she argued, "that the defendant's motivation in continuing to maintain these residents in the home was simply greed."
Goodfarb's task was to square the awful photos of the residents' bedsores against medical records that showed they had been admitted to Autumn Rest with the wounds and other ailments.
"What you have done in this case," the judge told the lawyers, "is expose a very, very raw aspect of the supposed golden years and most people don't want to look at it. . . . What do we do? Just kind of dump these people out on the street in a garbage can? Maybe they are too old for that.
"We've extended life and now we have a big aging population. For someone who just made 63, it's not a great prospect. . . . I just wish I had shipped this case somewhere else."
The opposing lawyers prepared well for the three-day trial. Both made their points: The state paraded articulate DHS inspectors to the stand, as well as Dr. Maguire; the defense relied on the residents' family members, Dr. Bell and Corliss Ford.
But defense attorney Tim Evens was working at an unfair disadvantage during the proceeding and he didn't even know it. Evens didn't have access to the AG's "no neglect" reports that likely could have gutted the state's case against Corliss Ford.
Assistant AG Helen Baldino said in a sworn affidavit signed Monday that she wasn't aware until she read defense attorney Tim Evens' motion to dismiss the case last week of the 36-page "final report" on the Ford criminal investigation. And even if she had known about the report, Baldino added, it falls under the blanket of "work product" and didn't have to be turned over to Ford's attorney. The documents also show that AG Grant Woods remained involved in the Ford case long after he viewed the unnerving photographs. A June 25 memo to agent Paine indicates Woods wanted to be briefed on "the neglect (or non-neglect) aspects" of the case. Several attorneys--prosecutors and defense lawyers--contacted by New Times say Baldino's "work product" argument might fly concerning the memorandums. But each of the sources concludes that Paine's "final report" should have been released to Corliss Ford.
Baldino points out that her burden of proof in the civil case is far less than the "reasonable doubt" standard in criminal proceedings.
But it's hard to imagine that the case against Corliss Ford would have passed muster with any legal standard if lawyer Evens had put AG agent Paine on the stand to explain the April 1 report's pivotal conclusion:
"There is no indication that Ford's residents did not get at least the minimum and sometimes more care to maintain their health."
Judge Goodfarb tells New Times he probably won't turn his attention to the Ford case until after the holidays.
@rule:
@body:It's been 18 months since Grant Woods' media bust at Autumn Rest. Corliss Ford says that even if Goodfarb does rule in her favor, she has no plans to get back into the adult-care-home business.
"I love the people, love the work, but life is just too short," she says. "I'm going to have to find another line of work, if the government will let me."
Meanwhile, folks such as John Alfeltis' 74-year-old widow will continue to worry what's going to happen to them when and if their health fails.
"I put myself in John's place sometimes," Fern Alfeltis says, rubbing her hands together slowly. "At least he had a wife to take care of him, and then Corliss and them did their best. But who's going to take care of me?
