Investigators have issued a scathing report criticizing a state-run Baltimore County residential center for the mentally disabled, recommending that federal funding be cut off if the center's staff does not stop patients from hurting themselves and abusing others.
Wendy Kronmiller, director of the Office of Health Care Quality at the Maryland Department of Health and Mental Hygiene, wrote the citation letter to Rosewood Center in Owings Mills this week. The pattern of violations was so serious that investigators stopped their annual review in midstream to put Rosewood on notice, according to Kronmiller.
"Conditions at your facility pose an immediate jeopardy to the individuals," Kronmiller wrote to center director James Anzalone.
Investigators noted a woman who hit her head repeatedly on a radiator, requiring sutures to close her wounds, and another man who "broke through locked doors of the residence and ran full speed, head first into the metal Dumpster." Incidents of residents harming others include a man who was pushed off gym bleachers by two residents and a mentally ill robbery suspect who had three fights within a month of his admission.
"The facility staff had knowledge of clients who physically abused other clients and/or were self-injurious," the report issued Tuesday found. "The facility did not thoroughly investigate incidents and had not implemented effective preventative measures to protect the individuals from actual and potential physical abuse or self-injury."
If Rosewood officials do not correct the center's deficiencies by Oct. 18, state officials said they will recommend suspension of its Medicaid funding, which is almost half of the center's annual budget.
According to state inspectors, Rosewood officials said they are trying to correct the problems identified. A message left for Anzalone was not returned yesterday.
Several advocate groups for the disabled applauded the internal report, saying its critical findings were long overdue.
"It's been a pretty huge deal for us dealing with the problems there. The violations are horrific and illegal," said Lauren Young, director of litigation at the Maryland Disability Law Center, whose organization has called for Rosewood's closure.
Rosewood was founded in 1888 as the Asylum and Training School for the Feeble Minded. In 1970, Rosewood housed 2,744 people with mental retardation and other developmental disabilities.
Today, only 206 remain, about 50 of whom are committed to Rosewood by the courts because they are incompetent to stand trial. Of its $41 million annual budget, about $17 million comes from federal funds.
For years, nearby residents and some advocates for the developmentally disabled have called for Rosewood's closure. The state legislature also tried to close Rosewood.
Rosewood's supporters, who include the parents of adult residents who have lived there for decades, say that many of the residents could not survive in a different environment such as a group home.
A plan to move other Rosewood residents who have been accused of crimes and committed by judges ran into problems as well. New cost projections for moving those residents to the state's maximum-security psychiatric hospital in Jessup skyrocketed.
Officials added that the option - building a new facility on the grounds of the Clifton T. Perkins Hospital Center - would not be completed for years.
"There are no plans to close" Rosewood, state health department spokesman John Hammond said yesterday.
Maryland has four institutions similar to Rosewood. But in annual evaluations this year, none had the kind of violations Rosewood experienced, according to Kronmiller.
"Rosewood stands apart," Kronmiller said in an interview yesterday.
Rosewood's mixed population - about 150 long-term residents who are developmentally disabled living with some 50 mentally incompetent defendants who have been committed to the center by the courts - is at the heart of the problem, she said.
When asked about additional complaints of staffing shortage at Rosewood, Kronmiller said her department's inspection was not yet complete. A full report on the center should be available about 10 days after inspectors finish their review, she said.
Rachel London, a staff attorney for Maryland Disability Law Center, said she has seen repeated violations involving illegal restraints and forced isolation at Rosewood over the last two years.
In one case, she said, a man was confined to his room for 20 hours a day, outfitted only with a bed and table. There was no plan to incorporate him into outside life at Rosewood, she said.
London complained on his behalf and now he has a job on Rosewood's campus, enjoys friends and attends baseball games.
"It goes to show that you get good things done with good programs," the attorney said.
But good programs may not have helped the son of Arbutus Lloyd.
Her 35-year-old son was a victim of sexual assault at Rosewood, she said, an attack substantiated by center officials. The Sun is withholding the name of her son, who has a different last name, because the newspaper does not identify victims of sexual assaults.
The state's attorney declined to prosecute the case, but a judge initially would not remove Arbutus' son from Rosewood.
"I wouldn't even send a dog down there," Lloyd said.
Sun reporter Sara Neufeld contributed to this article