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McAllen Nursing Center photo by Dave Mann deterioration was due to an unhealthy diet at the nursing homes and the cocktail of medications they gave him. “All the medications poisoned his blood,” Noe Jr. says. “He slumped all the time. They had to brace him to his wheelchair.” In most respects, McAllen Nursing Center is unremarkable. According to state records, it certainly doesn’t provide exceptional care, but sadly, neither is it the state’s most neglectful nursing home. State regulators score McAllen Nursing Center’s quality of care at 50 out of 100, according to state records. That’s below the state average score of 59, though other facilities consistently score in the 20s and 30s. Still, it’s clear from agency documents, obtained by the Observer, that plenty of abuse has been alleged against McAllen Nursing Center. In the three months preceding Noe Sr.’s death, the state received 29 complaints of abuse and neglect at the facility from residents and their families, according to internal agency documents. The complaints included accusations that residents waited for 45 minutes before an attendant responded to calls for aid; that staffers were belligerent with residents; and that the facility smelled of urine and feces. State regulators investigated all 29 complaints and concluded that all but one of them were “unsubstantiated.” Usually, by the time state investigators arrived several days, or in some cases weeks, after the complaint was filed, the alleged problems had been cleaned up. \(The one complaint that investigators did verify was a minor finding that the facility “failed to address patient grievances.” That didn’t prompt a violation McAllen Nursing Center were accused of improperly and roughly handling a patient. The resident sustained bruises and a broken leg bone. When a state investigator arrived, the aides had been suspended, and the inspector couldn’t locate them for an interview. The complaint was filed as “unsubstantiated.” \(After Noe Sr.’s death, however, state investigators found plenty of flaws with McAllen Nursing Center’s quality of care. Regulators thoroughly investigated the death, substantiating neglect and abuse by the nursing home. Regulators tagged the facility with three of its most severe code violations and fined it $2,000, offering a $700 discount if the In the immediate aftermath of their father’s death, the Martinez family had no idea that he had been the victim of neglect. They say nursing home and hospital officials simply told them that their father had choked and suffered a heart attack. The nursing home had fired the nurse who fed him the peanut butter sandwich. No one from the nursing home would explain why their father had choked. Noe Jr. says they couldn’t even obtain their father’s medical records. The manager of McAllen Nursing Center at the time of Noe Sr.’s death has since left the facility. The new manager, Hari Namboodiri, referred all questions about the Martinez case to the facility’s corporate owners. McAllen Nursing Center is operated by an outof-state management company, according to Secretary of State records. You need a flowchart and a business degree to discern who actually owns it. Many for-profit nursing homes use such complex corporate structures to protect their investors and owners from litigation. The facility is owned by McAllen Nursing Center LP, according to state records, which is owned by McAllen Nursing Center LLC \(a holding comrun by a third entity that’s owned by two men, Peter Licari and Michael D’Arcangelo of Horsham, Pennsylvania. Licari and D’Arcangelo own a management outfit that runs nursing homes in a handful of Northeastern states. They also operate 61 facilities in Texas, according to state records. An aide for Licari and D’Arcangelo referred all questions to Dallas attorney Nicole Bunn, who was vacationing in early September and couldn’t be reached for comment. The Martinez family might never have known what happened to Noe Sr. if not for a McAllen police detective, who investigated the death. No charges were ever filed in the case. When the investigation was complete, the McAllen detective invited the family into the station house to read the police report. Leticia’s husband, Mario Millan, recalls, “He said, ‘This is gross negligence. Between you and me, if I were you, I would get an attorney.'” So the Martinez family set out to find a lawyer. Like so much else in the tort reform debate, whether Texas’ damage cap is having a positive or negative impact on nursing homes depends on who’s talking. To David Thomason, tort reform in Texas has been a success. Thomason is a lobbyist for the Texas Association of Homes and Services for the Aging, the Austin-based trade group for non 28 THE TEXAS OBSERVER SEPTEMBER 23, 2005