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Nursing a Grudge

Jerry Ritchie is dying. He has emphysema, and as he moves around his small Arvada apartment, he carefully steps over the plastic tubes that link him to an oxygen tank. For the last several years, Ritchie has been in and out of hospitals and nursing homes, recovering from surgery and bouts with pneumonia. He knows his lungs may not hold out much longer.

"I've almost died twice," says Ritchie. "I can't hardly do anything anymore."

But he can still talk, even if his voice is raspy and he gasps for breaths between words. And he has plenty to say. The 67-year-old activist ticks off the names of the nursing homes he's endured--"They served food that inmates in a cell block would have rioted over," he says of one--and he loves regaling visitors with the tale of how he called police from another nursing home's bed to report the facility for substandard care.

Ritchie's best story of all, though, has yet to be concluded. While hospitalized with pneumonia in 1995, he was served with papers informing him that he'd been sued for slander and conspiracy by the Denver-based Meridian chain of retirement homes, a company that operates four centers in the metro area. In the lawsuit, owners Ralph and Trish Nagel accused Ritchie of telling lies about Meridian to people who called a "Renter's Hotline" service that he operated.

"I wouldn't move onto their property with a tent," Ritchie told one caller--who happened to be a private investigator working for Meridian.

As the lawsuit dragged on and Ritchie's health worsened, Trish Nagel's position only improved. Already influential at the Colorado legislature, where she lobbied against nursing-home reforms, in November she was appointed by Governor-elect Bill Owens to co-chair his transition team on health and welfare. That's the committee charged with helping to select Owens's nominee for director of the Colorado Department of Public Health and Environment, the agency that regulates nursing homes in Colorado.

Colorado's enforcement efforts against nursing-home abuse are the most lax in the region, according to data compiled by the federal Health Care Financing Administration. While Colorado substantiated only 10 percent of the complaints against nursing homes that it received from July 1995 to August 1998, several neighboring states substantiated nearly half of their complaints. Nationally, 30 percent of such complaints were verified. Colorado health-department surveyors also found fewer deficiencies in their surveys than did their regional and national counterparts ("Dying for Dollars," October 15, 1998).

Nagel's role in choosing the state's new health director outrages Ritchie and other health-care activists. "For Owens to put her in charge," Ritchie says, "a woman who has done everything she can to stop the progress of better care and stood in the way of anything that would impede her power to earn money--to me that's a slap in the face to the people of Colorado."

Initially, Jerry Ritchie's interest in nursing-home abuses came not from personal experience, but from his work as a tenants'-rights activist. In the early Eighties, Ritchie realized that compared with landlords, tenants had very little power in this state, and he set out to balance the scales. Since Ritchie's illness restricted his ability to work outside the home, he and his wife set up a tenants' hotline that operated out of their apartment. While Ritchie kept the project afloat by reviewing leases for a small fee, to anyone who called he'd offer free advice about tenants' rights and how they might deal with certain situations. In the process, he also compiled files on problem landlords and companies.

Ritchie frequently called consumer advocate Tom Martino's radio show to discuss tenant issues. During one such appearance, he talked about the complaints he'd collected against Meridian.

On the air, Ritchie said he'd heard from several people who lived in Meridian communities or had relatives who did. Their complaints usually concerned disputes over security deposits and futile efforts to get their money back.

In November 1994, private investigator John Corsentino, working on behalf of Meridian, called Ritchie's hotline claiming to be a son looking for a long-term care facility for his elderly mother. According to a transcript of the telephone call, which Corsentino secretly taped, the private eye began by telling Ritchie, "I got your name from some referral agency somewhere." When Corsentino said he'd been looking at long-term-care facilities on the west side of town, Ritchie replied that the only such facilities he knew anything about were Meridian's.

"The last contracts of theirs that I saw on independent living take your rights away," Ritchie told Corsentino, adding that many independent-living facility contracts place extensive restrictions on their residents. Ritchie then talked about calls he'd received from Meridian residents or their relatives who were mad at the company, including one man who said his parents had died and the company was demanding three months' rent because no advance notice had been given.  

"Meridian doesn't give a damn," Ritchie said. He talked about the company's political influence and the campaign the Nagels waged to prevent extended-care facilities from being regulated by the state health department.

"Meridian I wouldn't do business with," Ritchie concluded.
"You wouldn't?" responded Corsentino. "Well, see, we were really leaning towards this Lakewood Meridian."

"No, absolutely not," Ritchie replied. He'd been talking with people in the state health department and the office of the state ombudsman for long-term care, he added, and they said they had received complaints about Meridian as well.

"From my point of view, as far as I'm concerned, and any records and anything that I've seen, and the track record that I know about Meridian, I wouldn't wish it on my worst enemy," Ritchie concluded.

"That's good to know," Corsentino said. "I'm glad I placed this call."
This conversation was intrinsic to the suit Meridian filed against Ritchie in early 1995, claiming that he had defamed the company as part of a "conspiracy." Meridian accused Ritchie of slander, interference with contractual relations and civil conspiracy and asked for an injunction that would prevent him from "communicating to any third person any false and inaccurate statements" about the company.

The lawsuit also asked for an unspecified amount of damages because of the "irreparable harm" Meridian had suffered as a result of Ritchie's comments.

One day in 1996, a lawyer arrived at Ritchie's apartment to take his deposition in the case. She introduced herself as an attorney with Moye, Giles, O'Keefe, Vermeire & Gorrell, the firm that represented Meridian. Her name was Trish Nagel.

"At that time, she in no way identified herself as an owner or party to Meridian nursing homes," says Ritchie.

Meridian's attorneys also subpoenaed several staffers in the ombudsman's office and even tried unsuccessfully to obtain copies of the confidential complaints against the company that had been filed with that office.

"To come to court and say I set out to destroy somebody is ridiculous," says Ritchie. "I was just one individual. They chased this horse all over the state and discovered there weren't any other horses."

Ritchie didn't hire a lawyer to fight the suit. Nor did he show up in court to defend himself. Because he failed to appear, Meridian was granted a default judgment in 1997 by Adams County District Court Judge Harlan Bockman, who also issued an injunction prohibiting Ritchie from making "false and inaccurate" statements about Meridian.

Trish Nagel says that the company was justified in filing a suit against Ritchie. "While Meridian respects the right of individuals to voice opinions, Meridian also believes in the right to conduct its business without unjustified interference," she wrote in response to inquiries from Westword.

Jeffrey Pond, Meridian's attorney, says the company is satisfied with the injunction and has no plans to demand money from Ritchie.

Not that Meridian would be able to collect anything if it tried. "What are they going to take?" asks Ritchie, who has no assets. "They can't attach my government check. If they'd done their homework, they'd know I was living on disability."

"I have no knowledge of his financial circumstances," says Pond, who accompanied Nagel to Ritchie's apartment to conduct the deposition. "By all appearances, he's not a person of means."

Judging from the size of the Nagels' political campaign donations, they are definitely people of means.

In 1996 the Nagels donated a whopping $340,000 to the national Republican Party and Republican candidates. Trish Nagel sent a personal check for $100,000 to the Republican National Committee in October of that year.

Here in Colorado, the Nagels are among the biggest funders of Republican political campaigns; their generosity is almost legendary at the Colorado legislature.

They certainly did their bit for Colorado's governor-elect. After voters passed Amendment 15 in 1996, limiting campaign contributions from individuals to $1,000 per election year, Bill Owens moved quickly to stock his campaign chest before the law took effect on January 1, 1997. He set up a new fundraising committee that collected $64,584 between Christmas and New Year's Eve 1996, with Ralph and Trish Nagel contributing over a third of that. Each of the Nagels donated $10,000 to the fund, and their company, Legan Inc. --the name for Meridian's parent firm is Nagel spelled backward--gave another $3,200 to the Owens campaign.

Owens returned the favor after the 1998 election, when he appointed a transition team that included heavy representation from the nursing-home industry. Besides Nagel, the transition committee for health and welfare included Arlene Miles, director of the Colorado Health Care Association, which represents Colorado nursing homes.  

The committee eventually recommended the appointment of longtime Republican activist Jane Norton as director of the state health department, a recommendation that Owens followed. Norton, the wife of former U.S. Attorney Mike Norton, was Jack Kemp's state presidential campaign director in 1988 and served as regional director of the U.S. Department of Health and Human Services under the Reagan and Bush administrations.

In her statement to Westword, Nagel said she was chosen for the health-care transition team because of her years of experience. "I was chosen to serve on this committee because of my more than twenty years as a professional working with doctors, hospitals, regulators, lawmakers, administrators, nursing homes and other health- care businesses," Nagel wrote. "Over that time, I have been asked by Democrats and Republicans, at the state and federal level, to share my perspective. Therefore there would be no reason to question my appointment or that of other members of the committee to share our expertise."

But many inside the state's health-care system did question Nagel's appointment. "It's an outrageous conflict of interest," says one health-department worker who monitors nursing homes.

Nagel has made her interest in nursing-home policy very clear in the past. In 1997 she successfully lobbied the legislature's legal-services committee to approve a measure that removed the health department's authority to require detailed reports from nursing homes and hospitals where patients had been abused, neglected or died unexpectedly and to release those reports to the public. Several of the legislators who voted for that bill had received campaign contributions from Nagel.

After health-care activists complained, the legislation was changed to permit the health department to continue requiring such reports from nursing homes.

Nagel's ongoing influence at the legislature, as well as her expanded role with the new administration, concerns critics. "This clearly indicates the influence of big money on politics," says Jon Goldin-Dubois, director of Colorado Common Cause. "The Nagels have a history of giving a lot of money. The fact that the new head of the health department will have some regulatory power over an industry the Nagels are involved in is certainly a concern."

But Dick Wadhams, who ran Owens's campaign and is now his press secretary, says that Trish Nagel is just one of hundreds of people who will have the ear of Colorado's new governor.

"Trish and Ralph were very good supporters of Bill Owens," says Wadhams. "I would hasten to add that if you took a look at all our transition committees, we had a lot of people who didn't even support Bill during the campaign." Besides, he adds, Owens wasn't bound by any of the committees' recommendations--even if he did agree to make Jane Norton the new director of the health department.

"Trish and her husband are involved in the nursing-home business," says Wadhams. "They deal with the regulations and the changing demographics every day. Did she come from a particular point of view? Probably."

In fact, the very first recommendation made by the committee that Nagel co-chaired calls for the health department to avoid or terminate programs that are not part of the department's basic statutes. That was exactly the request Nagel made of the legislature when she was trying to kill the health department's required investigations of abuse and death in Colorado nursing homes.

In a 1997 letter to the Rocky Mountain News, Nagel wrote: "What was before the legal services committee was whether the state health department issued regulations beyond its legal authority. The committee decided that's exactly what the department did. By responsibly carrying out its job, the committee protected Colorado citizens and private enterprise from unauthorized actions by state agencies."

Nagel has also successfully lobbied the legislature to prevent regulation of extended-care facilities such as Meridian's. Although Meridian operates two nursing homes on its property, the company has evaded regulation by refusing to take Medicare or Medicaid patients: Federal and state laws mandate inspections only of facilities that take public funds.

While many involved in nursing-home regulation worry that the health department isn't doing enough now to protect nursing-home patients, Ritchie is concerned that the situation will only get worse. And he knows from personal experience that nursing homes can turn a person's final days into hell on earth. "I've seen enough to curl your toes," says Ritchie.

He was so outraged by the care he encountered in one nursing home that he borrowed a typewriter to compose a nine-count complaint, then had someone drive him to the state health department so he could deliver it personally. "It was the first time a nursing-home resident had done that," he says. "Everyone told me I wouldn't live to see the next day."  

But Ritchie lived to fight again--and he says there's plenty out there to battle. Since he closed the Renter's Hotline in 1996, he's focused most of his attention on nursing-home complaints. He knows the opposition to any reforms is formidable. But when he recalls the inhuman care he's seen in nursing homes--people tied to their beds, patients dropped on the floor, aides threatening great-grandmothers--he says he will not be intimidated. Despite lawsuits, despite injunctions, he will continue to speak his mind.

"It's bad enough we have to get old and suffer," says Ritchie. "But when people take advantage of us and try to get rich off our problems, that pisses the hell out of me."

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