“Orange Grove takes very seriously any allegations of abuse, neglect or exploitation of the individuals we serve. We report those allegations to the State and to Adult Protective Services, and also to law enforcement authorities where that is indicated”
On March 3, 22-year-old Brandon Hardy was arrested for allegedly punching a man in the face.
He was fired as a caretaker at Orange Grove Center because the man he punched was a deaf, autistic client of the center who has microcephaly, a speech impairment, and a seizure disorder, among other conditions.
Hardy was at the victim's home, where the punch was caught on video. Court records don't reveal a motive, and his coworkers failed to report the incident, according to a report by the Tennessee Department of Intellectual and Developmental Disabilities.
Hardy's case is one of 210 allegations of abuse, neglect or exploitation of Orange Grove clients investigated by the DIDD since January 2012. Of those, 79 were substantiated by evidence, including 17 within the last year. DIDD investigates all allegations and complaints relating to Orange Grove.
› Abuse: The knowing infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain, or mental anguish
› Neglect: Failure to provide goods or services necessary to avoid physical harm, mental anguish or mental illness, which results in injury or probable risk of serious harm
› Exploitation: The deliberate misplacement, misappropriation or wrongful, temporary, or permanent use of belongings or money with or without consent
Although more than a third of the DIDD investigations into Orange Grove employees over the last five years have been substantiated, that's still a low rate by Tennessee standards — half the average of other providers of services and programs for individuals with intellectual and developmental disabilities statewide.
Matthew Parriott, DIDD spokesman, said of roughly 450 providers in Tennessee, 150 offer residential and day services similar to those offered by Orange Grove, which is a private, nonprofit organization that serves adults and children.
The center serves about 1,000 people with educational programs, job training and health services. Its residential service options include around-the-clock care for some adults living in Orange Grove homes in the city.
DIDD has substantiated findings at the center ranging from carelessness, such as patients falling out of bed because their caretakers failed to lock their bed rails properly, to more egregious incidents like the case involving Hardy. The agency and Chattanooga police also are investigating an April incident where a longtime client was found dead in an Orange Grove van.
In every confirmed case of abuse or exploitation, the workers have been terminated under Orange Grove policy, and spokeswoman Heidi Hoffecker said all allegations of abuse or neglect are examined closely.
"Orange Grove takes very seriously any allegations of abuse, neglect or exploitation of the individuals we serve. We report those allegations to the State and to Adult Protective Services, and also to law enforcement authorities where that is indicated," she wrote in an email.
"No allegation, to say nothing of substantiations, is insignificant ... We use every investigation, regardless of the final determination by DIDD, as an opportunity to do better, to learn more, and to better serve."
A month after Hardy was charged, another staff member referred to as "Dexter J." also punched a client, a DIDD investigation report states.
The report says the client became difficult with staff and began pushing people. The worker physically abused him by "punching him in the lower back and by grabbing the [client] by the back of the shirt."
› 2012: 11
› 2013: 14
› 2014: 21
› 2015: 14
› 2016: 12
› 2017 (to date): 7
› Physical or emotional abuse: 22
› Neglect: 53
› Exploitation: 4
Several cases of neglect also were substantiated over the last year, including multiple occasions in which people who are not supposed to be left alone were abandoned by their caretakers.
On the morning of March 1, Orange Grove employee Philesheon Crutcher neglected a woman by dropping her off at First Centenary United Methodist Church without any supervision, according to records.
"Everyone from [Orange Grove] had left due to the expected bad weather and the [client] was by herself," the case report states. "Reportedly, the [client] was upset and afraid, and one of the pastors took her home."
On Sept. 24, 2016, a client was found in the front yard of her neighbor's home. It was reported the woman was an "elopement risk" who might hurt herself or be aggressive, but the caretaker was in a vehicle apart from the woman.
Reports also showed multiple substantiated cases of verbal and emotional abuse and instances in which workers failed to report alleged abuse.
Last year a staff member named Cathey Stamps emotionally or psychologically abused a client by yelling or screaming at him and threatening to hit him if the he hit her, according to the DIDD records.
She reportedly told the man, "I wish you would hit me so I could hit you back."
In another case, Kimberly Spivey failed to report allegations that another staff member hit a client on the neck. The incident proved to be unfounded, but Spivey was faulted for waiting four days to report the allegations — DIDD policy mandates that staff report alleged abuse, neglect or exploitation of patients within four hours.
"If the allegation had been true, Spivey would have allowed a person to be subjected to continued abuse by not reporting in a timely manner, placing them at risk of harm," the report read.
More recently, the DIDD investigated a March incident in which a client's leg was broken. It was reported that an unknown staff member forgot to put on the client's seat belt in an agency van during transport, causing him to slip out and fall.
Evidence did not substantiate neglect allegations, but the investigation did find evidence for staff misconduct "against an unknown staff for conducting personal business on duty by transporting a mattress in an agency van while [name redacted] is being supported/transported."
Experts say finding the right people to work can be a huge challenge, given the work required and the state pay scale. Employees often feed, clothe and clean clients with unique care challenges for $8.73 an hour, the minimum rate set by the state.
Both hurdles are some of the largest the industry has to deal with, said George Liacopoulos, chief evaluation and planning officer for St. John's Community Services. St. John's is based in Washington, D.C., but supports people with intellectual and developmental disabilities in Tennessee, Virginia, Pennsylvania and Delaware.
"It's difficult when you're making not a lot more than minimum wage to be able to meet all your bills and such," Liacopoulos said. "You often find that direct support personnel work multiple jobs.
"It's also a very demanding job because you are tasked with supporting individuals that sometimes have very complex medical conditions, as well as the challenges presented by an intellectual disability."
Employee wages at facilities like Orange Grove are funded primarily with Medicaid dollars, but the House passage last week of a health care bill repealing and revising portions of the Affordable Care Act has Liacopoulos worried the situation could become even more challenging.
"Clearly, nationally, we're going in a different direction," he said. "You're looking at about an $800 billion cut in Medicaid spending over time."
Orange Grove said job applicants are carefully vetted and trained in a rigorous and continual process. The center does background checks through multiple databases including Tennessee's abuse and sexual offender registries, among others.
"We take about 30 days between someone expressing interest and being engaged in a training program," said Kyle Hauth, Orange Grove's executive director.
Once hired, employees are subjected to random drug screenings and must complete annual additional training.
"Training is not just a one-and-done issue," he said. "Every aspect of what we're doing is constantly changing."
The realities of employment in the industry partially explain its high turnover rate — Orange Grove employs more than 800 people, but has hired 200 people in the last year alone to replace workers who left.
"We view what we do as a ministry," Hauth said. "It's a different type of employee than someone who's just looking for a paycheck."
In an internal email sent Friday, Hauth encouraged Orange Grove staff to remember the center's overall mission and the services it offers to community members.
"Orange Grove is a strong provider in this State because we don't hide our mistakes," he wrote. "We report, study and revise based upon what we have learned. Please remember that every day you are helping to make people's lives better."
"You are getting them to and from their homes and to their jobs and training opportunities. You help them succeed and you often save their lives Thank you for your devotion to the people we serve."
Over the last 17 years, the Department of Intellectual and Developmental Disabilities also investigated nine client deaths at Orange Grove, two of which were substantiated for employee neglect.
In 2001, a patient was found dead in his room. The investigation report states it was unclear whether the death "was due to staff not giving him his medications," but an allegation of neglect was substantiated against the staff for failing to provide the client's medication as ordered.
In 2011, an 83-year-old man choked to death while eating a peanut butter sandwich. Allegations of neglect were substantiated against the staff members who did not properly monitor him while he was eating.
Chattanooga police and the department now are investigating the death of Carrie Lee Parkey, 60, a longtime client who died in an Orange Grove transport van on April 18.
Parkey was picked up at approximately 8 a.m. to be driven to a day facility he attended, but he never arrived, according to police. At 3 p.m., Orange Grove staff found Parkey unresponsive in the vehicle, called 911 and attempted to render aid.
Although Parkey's body bore no visible signs of trauma, members of the violent crimes bureau and crime scene investigators were called to gather evidence. An autopsy was ordered to determine how Parkey died and the findings will inform whether criminal charges are filed.
Following the death, the center posted multiple statements on Facebook to update their followers and others on the situation.
"For more than six decades, Chattanoogans and the surrounding areas have entrusted us to care for and celebrate people with intellectual disabilities. This is a trust we take very seriously," one post read.
"We cannot emphasize how important it is for the community to know how much we value and care for each individual who comes through our doors on a daily basis."
Contact staff writer Emmett Gienapp at firstname.lastname@example.org or 423-757-6731. Follow him on Twitter @emmettgienapp.