Tears, protests and burnout: End-of-life care gets more restrictive

Weeks after Greg McGarity and Wendy S. Roberts were moved to a South Carolina psychiatric hospital, they were each booked on an attempted murder charge by a suspect who testified that McGarity shot him…

Tears, protests and burnout: End-of-life care gets more restrictive

Weeks after Greg McGarity and Wendy S. Roberts were moved to a South Carolina psychiatric hospital, they were each booked on an attempted murder charge by a suspect who testified that McGarity shot him while Roberts held a knife to his throat. That incident did not require a doctor’s evaluation, according to people with knowledge of the investigation.

The removal of the couple and the related charges amounted to extraordinary intervention by the state Department of Mental Health in Maryland. To experts, it also could set a precedent that could lengthen vulnerable, elderly residents of nursing homes, secure hospitals and treatment centers who require care but do not meet the medical standards of inclusion in the Medicaid system. The action was not limited to mental health facilities. On Jan. 3, the Maryland Department of Licensing and Regulation also began removing dozens of patients at Roland Park Place, a residential facility for seniors in Baltimore that has become a focus of political tumult.

The rule change, adopted by state officials in February, followed reports that a January 2018 move of the couple to an assisted living facility resulted in Schon Melchert, a 6-year-old resident, tripping over the couple’s feces on Jan. 6, suffering a broken leg and falling unconscious. She was transported by ambulance to nearby Sinai Hospital and spent two weeks hospitalized.

Melchert’s attorneys argue that the boy was wrongfully placed in the home after developing several medical problems from his trip over the feces, including a fractured femur. But two doctors who evaluated the boy concluded that he was healthy and appropriately placed in the home.

“They were turning over someone to the governor who is not licensed,” the boy’s mother, Rona Kielman, told The Washington Post.

“How in the world could you do that?” the family said in a statement after the pending revocation of Melchert’s license was announced on Jan. 16.

Schon’s story gained wide attention in August 2018 when Melchert’s mother, 41-year-old Hope Meyer, posted a video of her pleading with the governor to return her son.

“Is there anything more vulnerable than a 6-year-old child? That is criminal and it should not have happened,” Meyer says. “You’re here, Rony, which is an old Hebrew word meaning son. … You must think that a family has to be scared every day.”

The narrative of Schon’s injury and its aftermath quickly became a political flashpoint. State lawmakers saw it as a test of the integrity of the Maryland Department of Health and Mental Hygiene, which oversees the agency that keeps vulnerable people safe and provides care to those who are seriously mentally ill and need help.

In August, Gov. Larry Hogan, R, signed legislation sending the Department of Health and Mental Hygiene to review the transfer of Melchert from the hospital and to recommend corrective measures.

At a Dec. 20 hearing, a public information officer for the health department, Ricardo Santana, testified that his office reviewed the case and concluded that the case was typical, and legally, compliant. Santana confirmed that the department had made the decision to place the couple in supervised living situations.

At an April hearing, Del. Gordon Helsel, R-Anne Arundel, asked Santana that if they were considered normal patients, how could his agency determine when people have dementia. At one point, Helsel called the actions “massaging the facts.”

“They just make it out to be not good for somebody. They even want to impose $500 fines on people who are currently being evaluated and supervised,” said Jen Gouch, a spokeswoman for Schon’s mother.

Although the Schon case attracted the spotlight, officials in Maryland report that the agency has transferred similar cases, while working to prevent the removal of potentially vulnerable patients from mental health and substance abuse facilities. On Dec. 7, the agency reassigned 57 residents from a South Carolina facility to another facility.

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