Angelite Nurses

Rape allegations were reported in a quarter of city's 119 nursing homes in those two and a half years, records show

Authorities have investigated at least 86 cases of sexual violence against elderly and disabled residents of Chicago nursing homes since July 2007, but only one of those cases resulted in an arrest, a Tribune investigation has found.

Allegations of criminal sexual assault, or rape, were reported in a quarter of Chicago's 119 nursing homes during those 2 1/2 years, government records show.

State law requires nursing homes to notify police immediately when they receive an allegation of sexual violence or abuse. However, no police reports were filed in connection with at least nine alleged sexual attacks reported by the state Department of Public Health, according to Chicago police records released to the Tribune. In a 10th case, the allegation was reported to police months after the incident.

Police and state investigative reports depict the terror endured by elderly and disabled women in some city nursing facilities where predatory males troll through common areas and unlocked bedrooms with little supervision.

Almost all of the 86 cases the Tribune examined involved residents attacking other residents. Only a handful of the alleged attackers were employees or visitors; the lone successful prosecution was of an orderly.

The frightening atmosphere is another consequence of Illinois' unusual reliance on nursing homes to house younger psychiatric patients with sometimes violent criminal records. Many understaffed facilities are ill-equipped to treat these residents or monitor their behavior.

Government records show that the 30 Chicago facilities where rapes were reported were roughly twice as likely to house convicted felons and mentally ill patients as the 89 city nursing homes without a sexual assault allegation.

At Rainbow Beach Care Center on the South Side, a 61-year-old woman said she was afraid to fight or scream and could only say, "No, no, no, please," as she was allegedly raped by a schizophrenic 47-year-old man with a "history of inappropriate sexual behavior toward females," according to a state health department report. When a police report was filed months later, it said the woman had called the sex "consensual."

A physician had previously ordered that the alleged attacker be given periodic shots of the drug Depo-Provera, a form of chemical castration used on male sex offenders. But state health inspectors found no medical record indicating those shots were given. State investigators also said the facility failed to conduct a "thorough investigation" to determine whether the same man had raped a second woman.

A few miles away at All Faith Pavilion, a female resident was hospitalized in a "catatonic state" with a swollen black eye, broken nose and human bite marks, state records show. She told authorities she was raped by a schizophrenic48-year-old male resident in the facility. The woman remained hospitalized for at least a month, a state report said.

No charges were brought in the Rainbow Beach and All Faith cases.

The owners and administrator of All Faith declined interview requests. Eric Rothner, a co-owner of Rainbow Beach, issued a written statement saying: "Every day, we confront a unique set of challenges and we deal with them realizing that if it were not for our facilities, our residents would be living on the streets. All of us caring for this population are keenly aware of these issues and work to overcome them 24 hours a day, seven days a week."

'Something hidden'

Most of the 30 city homes with alleged attacks had substandard staffing levels, which experts call a key indicator of patient safety. Of the 23 homes that federal authorities have rated on a ratio of nursing staff to residents, 21 were rated "below" or "well below" average on staffing levels, while two others were deemed average, the Tribune found.

In addition to 48 reports of criminal sexual assault, which is a felony, Chicago police records show 28 allegations of criminal sexual abuse at city nursing facilities since July 2007. Those sexual abuse cases, which include charges of molestation and groping, can be misdemeanors under some circumstances.

One of the nine alleged attacks that did not turn up in police records released to the Tribune came to light in May 2008 during a state inspection of Rothner's Sheridan Shores Care & Rehabilitation Center on the North Side. Three "alert and oriented" women described "the fear they were experiencing at night time" when they awoke to find strange men in their rooms, sometimes standing over their beds, according to the state inspection report.

One woman said: "It scared me to death!" Another recounted staving off "2 attempted rapes during the night when male residents entered her room using the stairwell," the state report said. A facility investigation confirmed one woman's allegation about a male intruder standing over her bed, but Sheridan Shores' administrator denied to state investigators knowledge of any attempted rape.

Although both police and state health inspectors investigate allegations of sexual violence in nursing homes, the Tribune found that the two agencies rarely communicate with each other about the incidents and do not typically share reports on violent incidents or pool their expertise and resources.

The extent of the violence in Chicago nursing homes was unknown to the state ombudsman's office, which fields abuse complaints from nursing home residents and their families. That agency investigated only two sexual abuse allegations in Chicago homes during a recent 12-month period, according to its records, while police listed 27 reports of sexual assault at city nursing homes during that time.

"We believe the reports are less frequent than they should be — we think there is something hidden here," said Karen Roberto, a Virginia Tech professor who studies sexual assaults against the elderly in nursing facilities.

The small number of arrests related to recent rape allegations in Chicago nursing homes — 48 rape reports, one arrest — sharply contrasts with figures on sexual assault allegations citywide, official figures show.

Last year, Chicago police investigated 1,446 criminal sexual assault reports and made 450 arrests. Though some rapes can involve multiple defendants and some arrests can be linked to reports from the previous year, that amounts to roughly one arrest for every three reports.

Similarly, the FBI estimates that nationally there were 89,000 rape reports to law enforcement agencies in 2008 and 22,584 arrests.

Prosecution pitfalls

Experts say a variety of factors can interfere with investigating or prosecuting sexual assault reports in nursing homes. Often the victims suffer from dementia or appear delusional and can't describe the attacks in enough detail to assist investigators.

In December 2008, for example, a health care worker found evidence of sexual trauma on an elderly female resident of Warren Park Health & Living Center on the Northwest Side. The woman, who was hospitalized after the alleged attack, said a man came into her room and sexually assaulted her, but she "was unable to provide any further (information)," according to a Chicago police report.

Some facility residents are afraid to speak out because they live alongside their alleged attackers, others are anxious about alienating their caregivers or being moved from the only homes they have, and many simply feel too weak to face the ordeal of police questioning and forensic examinations.

"When they're at the end of their life, a lot of times people give up. It takes a lot of strength to go to police," said Karla Vierthaler, outreach coordinator at the Pennsylvania Coalition Against Rape.

Some cases become compromised because residents delay reporting the alleged attacks until they are visited by a relative or trusted caretaker. By then, any DNA or forensic evidence can be lost.

A Tribune review of police and state health reports found that although many facility operators responded immediately to rape allegations, some unwittingly cleaned up crime scenes rather than properly preserving evidence.

Others downplayed the incidents as consensual sex. They "act in their own self-interest rather than the interests of the residents," said Holly Ramsey-Klawsnik, a Massachusetts-based sociologist and mental health clinician.

For their part, police sometimes drop their investigations too quickly when faced with the host of obstacles from both victims and facility employees, said Ronald Costen, a former criminal prosecutor who directs Temple University's Protective Services Institute.

"You have to treat these cases of sexual assault in a long-term care setting like coming across a dead body on the side of the road — you have to look for hard, forensic evidence," Costen said.

In addition, experts said, police sometimes decide that mentally ill perpetrators lack the intent needed for successful prosecution and may have a better shot at treatment in nursing facilities rather than prison.

Only one of the 48 Chicago cases involving the most serious allegation, criminal sexual assault, was referred to the Cook County state's attorney's office for felony review, according to a records search done for the Tribune by prosecutors.

Chicago police say they vigorously pursue every sexual assault allegation. "We're not real quick to drop investigations ... that's not the case," said Thomas Byrne, chief of detectives for the department. "Sexual assaults are something we take very seriously."

In April 2008, police were summoned after midnight to Somerset Place on the North Side after a mentally ill 28-year-old resident told staff that he had beaten, then raped a schizophrenic 53-year-old woman after forcing his way into her fourth-floor bedroom, records and interviews show.

The man told police "he wanted to make a confession," and a police report said he sexually assaulted his female housemate "without the victim's consent." Sent to the emergency room with a blood-filled and swollen black eye, the woman told police and Somerset employees she had been sexually assaulted.

The victim's mother, Dorothy Foster, of Bolingbrook, saw her daughter at the facility the next day. "I just broke down," Foster said. "It was so bad."

But in the end, no arrest was made in the case. According to a police detective's report, the victim refused to cooperate with officers. She and the male resident now live in different facilities.

Somerset, another Rothner nursing home, sent a description of the incident to the state Department of Public Health as required by law, and the facility has not been accused of wrongdoing in the case.

Somerset has had seven reports of alleged sexual violence since July 2007, more than any other Chicago nursing home, records show. Federal and state authorities this month moved to revoke its state nursing home license and cut off its federal funding because of citations for abuse, safety breaches and other problems. The facility is contesting those actions.

Tribune reporter Anne Sweeney contributed to this report.

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