Fatal neck injury in Shoreline leads to adult-home charges

Dalton Anderson doesn't know for sure how his wife broke her neck.

But he knows it happened at the adult family home in Shoreline where she began living after developing Alzheimer's symptoms — a home that proclaimed itself to specialize in dementia patients but employed help who had little clue how to care for them. One caregiver didn't even recognize the term "dementia," an investigator later found.

Wednesday, in an unusual case, King County prosecutors filed second-degree criminal mistreatment charges against Anna and Celso Balagot, the adult-family-home owners.

Prosecutors don't often file charges against adult-family-home owners. But the most unusual part of the case is this: the Balagots aren't charged with intentionally harming 75-year-old Jean Anderson. Instead, they're charged because of what they didn't do.

"Putting employees that aren't trained and aren't equipped in a dementia specialty home is a recipe for disaster," said Tim Leary, the prosecutor in charge of the case. "All of the things they failed to do put her at risk."

The hired caregivers were not charged because prosecutors believe the Balagots should never have put them in charge of fragile, elderly residents in the first place. The Balagots could not be reached for comment Wednesday.

Anderson broke her neck in 2004 and died as a result. That it took so long to file criminal charges shows just how difficult these cases can be, Leary added.

Nonetheless, the case should send a message to other adult-family-home owners, said Louise Ryan, the state Long Term Care Ombudsman. "I think what's important about these charges is they say adult-family-home owners are responsible for the people they hire and the residents they agree to take care of," she said. "The buck stops with them. "

Dalton Anderson said he was attracted to the Balagots' home, known as the Richmond Beach House, because they said they specialized in dementia and only hired "state-trained" caregivers. Plus, the Balagots lived in the house, and Anna Balagot was a registered nurse, so he initially felt things would be all right.

He placed his wife there in August 2003, after he grew unable to care for her himself. And things went all right for a while. But by the summer of 2004, the Balagots moved into another home, and the care at Richmond Beach started to go downhill as they relied more on hired help, Dalton Anderson said.

For example, in August 2004, the Balagots hired a man in his 20s whose prior experience was washing dishes and working at McDonald's, according to charging papers. He was paid $7.16 an hour, Leary said.

Dalton Anderson, meanwhile, paid $2,700 a month to the Balagots. At that time, there were four other clients in the home. They owned two more homes with an additional 12 beds, Leary noted.

"These things are cash cows if you're taking the shortcuts that they were," he said.

On Aug. 23, 2004, Dalton Anderson filed a complaint with the Department of Social and Health Services (DSHS), saying his wife wasn't getting proper care and the current caregiver was "a young man that doesn't seem to have much training," charging documents state.

DSHS spokesman Abel Hewitt said complaints are prioritized based on seriousness and placed on timetables ranging from two to 45 days. Dalton Anderson's complaint was serious enough to warrant an investigation within 20 working days, Hewitt said, and the agency met that deadline when it sent someone to the home Sept. 20.

That day, the Balagots couldn't produce evidence that caregivers were trained, according to charging documents. Or that they passed criminal background checks. Or that they all had tuberculosis tests — except for those who had tests that came back positive.

"There were issues with every single one of those employees," Leary said.

The day after the investigator's visit, Jean Anderson was discovered listless in her bed. Doctors diagnosed a broken neck and discovered she was rendered quadriplegic. Jean Anderson underwent surgery and died eight days later.

After her death, investigators became convinced the Balagots knew her condition had been deteriorating in recent months. Yet they didn't reassess her or transfer her to another facility better equipped to handle her issues.

In addition, they learned she had suffered a series of injuries in the months before her death. Several times, she fell forward, and her face hit a table hard enough to bruise. At least once, she fell when caregivers improperly transferred her from her wheelchair.

To Leary, that was significant: The Balagots knew that Jean Anderson had been hurt during transfers and that she couldn't hold her head up, yet they still didn't properly train caregivers how to keep her safe.

Leary said he still doesn't know exactly what happened the night Jean Anderson was injured. But one thing is certain: Given the nature of the break, it couldn't have been a simple fall out of bed. And because she was unable to stand, much less get out of bed herself, she couldn't have caused it on her own.

But filing charges against the couple wasn't easy, he noted. His office considered the issues for more than two years, finally deciding that their knowing failure to follow the rules was so egregious that criminal charges were warranted.

Meanwhile, in 2005 an administrative-law judge found the Balagots violated more than a dozen rules governing adult family homes, some of them repeat violations from previous years. Their license for the Richmond Beach home was revoked.

However, Hewitt said state regulations prohibited them from revoking licenses for their two other adult family homes, which are also in King County.

Recently, Dalton Anderson won a civil settlement of $300,000 from the Balagots' insurance company, his lawyer said. But he will never stop being angry over his wife's care and how DSHS didn't investigate his allegations more quickly.

"But the good part," he said, "is we had 57 beautiful years together."

Maureen O'Hagan: 206-464-2562 or mohagan@seattletimes.com