State finds flaws in training at facility

A man accused of murder at the North Side group home had refused to take antipsychotic medicine.
By PATRICIA MEADE
VINDICATOR CRIME REPORTER
YOUNGSTOWN -- Other than calling police and an ambulance, the staff at a North Side adult care facility where a resident was choked to death wasn't told what else to do in an emergency or crisis, a state health surveyor discovered.
An unannounced inspection at Illinois Manor, a home for mentally ill men, was conducted by the Ohio Department of Health on March 12 and 13, after the death of Stephen A. Lawson, 34. A caregiver at the group home at 135 Illinois Ave. told police that Lawson and another resident, 50-year-old James R. DiCioccio, had been fighting and Lawson was choked around 5:30 p.m. March 11.
DiCioccio was charged with murder and his lawyer entered pleas of not guilty and not guilty by reason of insanity. He remains in the Mahoning County Jail in lieu of 1 million bond. A pretrial in Mahoning County Common Pleas Court is set for May 3.
Group homes are licensed by the state and city health departments. State inspectors are called surveyors.
The Illinois Manor policy for crisis intervention fails to provide instructions for the staff during an emergency or crisis other than to notify the director of care and police and call for an ambulance, the surveyor discovered.
In enforcement phase
Now that the survey is complete, the case is in the enforcement process, said Sara Morman, ODH public information officer in Columbus. Without offering specifics, she said ODH is working through the Illinois Manor case to determine what enforcement actions will be taken against the facility. The process should take a few weeks.
DiCioccio's most current mental health care plan, dated Oct. 28, 2006, determined he has a history of drug and alcohol abuse, aggression with the staff and residents and hates to follow rules, according to the surveyor's report obtained by The Vindicator.
Employees interviewed at Illinois Manor during the inspection last month had the same impression of DiCioccio, saying that he would consistently break the rules by smoking and drinking coffee in his room, could be periodically loud, aggressive and threatening to other residents but that no one considered him dangerous or violent. Several staff members even reported that he was "sweet," the surveyor said in his report.
The employee on duty during the fight in March reportedly screamed at DiCioccio to let Lawson go, called next door to another adult care facility for help and then ran there "in hysterics," the surveyor said. The report shows it wasn't clear from interviews whether police were called before or after the caregiver enlisted the help of the employee next door.
Victim unconscious
When the employee from Illinois Manor, joined by the employee from next door, entered Illinois Manor, they found DiCioccio with his arm still around Lawson's neck, and one of the women pulled DiCioccio off, according to the state report. By then, Lawson was unconscious and an ambulance was called. He was pronounced dead at 6:18 p.m. at a hospital.
The state inspector said the Illinois Manor policy for crisis intervention requires that a member of management be brought in to control the situation.
"In this case, which happened to be on a weekend, even though the employee followed [Illinois Manor] policy and called the police, the situation was too volatile for her to wait for a member of management to return to the facility to control the situation," the report states. "The director of personnel admitted the employee running next door to obtain additional assistance would not be consistent with policy."
Told not to intervene
The state inspector learned that the staff had been instructed to not put themselves in harm's way by physically intervening during a fight. When asked why she pulled DiCioccio off Lawson, the caregiver told the state inspector she didn't think about it, she just did it.
Charlene Crissman, administrator for Illinois Manor, did not respond to messages seeking comment.
The state inspector reviewed DiCioccio's medication record and found that the man, diagnosed as schizophrenic, had refused his Prolixin, an antipsychotic drug, on the mornings of March 10 and 11. The care facility's policy is to notify doctors, guardians and case managers after three missed doses, the report states.
"In this case, a missed third dose would not have occurred until the day after the [choking] incident," the state inspector said.
meade@vindy.com