All Sue Harang ever wanted, she says, was to ensure decent care for nursing-home patients. For her troubles, she suspects, someone crept up to the bunkhouse on her rural property near New Orleans last May and set it ablaze. Her 17-year-old daughter Laurie and a girlfriend were sleeping inside. They narrowly escaped. Lost in the flames were the case records, court documents and computer files that have helped make Harang a formidable crusader against abuse and neglect in nursing homes across the nation.
Sue Harang started working in nursing homes when she was a 14-year-old volunteer and so enjoyed the work that she made it her career. She was a director of nurses at a Louisiana home in 1979 when she says she learned about the darker side of patient care. Harang says residents showed her their bruises and told her they were being handled roughly at night. When she complained to her boss, she says she was told that such treatment was a fact of life in nursing homes. She quit her job and vowed never to work in the industry again.
She did return a few years later, when her husband, Jack, a maritime and personal-injury lawyer, asked her advice on a fellow lawyer's case. The client alleged that her mother had been beaten, oversedated and restrained unnecessarily at a McComb, Miss., nursing home owned by Beverly Enterprises, the nation's largest chain. Intrigued, Sue Harang reviewed the records and helped amass evidence that resulted in 19 separate suits against Beverly Enterprises, two of which went to trial in 1990. The initial awards were small-including $50,000 for leaving one woman in her own excrement and $15,000 for not bathing another patient-and they were later settled on appeal. (Beverly has consistently denied any wrongdoing.) Still, the awards helped establish the principle that even simple neglect can be a form of abuse and punishable by damages. Since then, Sue and Jack Harang have helped file suits on behalf of 75 families alleging similar incidents. Many of the cases have settled, but the Harangs won all four that have gone to trial. They have taken on some of the industry giants and, evidently, made a dangerous enemy along the way.
No arrests have been made in the fire. But an FBI spokesman in New Orleans says its office in Boston asked them to investigate the blaze. Harang says that when agents interviewed her, their questions centered on her knowledge of the New Medico Healthcare System, a Massachusetts-based chain specializing in neurologic rehabilitation. The FBI and federal prosecutors in Boston won't confirm or deny that New Medico is the target of investigations. But former employees say they were questioned by the FBI and a federal grand jury about alleged improprieties at the chain. Charles Stillman, a New Medico attorney, said he had no knowledge of the probes. He also said, "The notion that New Medico could have anything to do with anything as crazy as [the fire] is totally insane."
Sue Harang began looking into New Medico when Duane and Mary Ann Paraday sought her help for their daughter, Felicia, who needed round-the-clock nursing care after a car accident in 1988. The Paradays say Felicia was initially given the daily therapy she required at New Medico's Northampton, Mass., nursing home, but that after two weeks, she was left unattended and unclean. Harang helped the Paradays get care for Felicia at home, and Duane filed suit charging New Medico with negligence, breach of contract and violating consumer-protection laws. Stillman denied the accusations and dismissed Sue and her husband as "harass and Harang."
Sue Harang is not a lawyer herself and she has never testified as an expert witness. Instead, she works behind the scenes to help her husband build cases, poring over patient charts, sitting in on depositions and analyzing the testimony. "No one is going to write in a chart that someone was beaten," she says. "But if you look closely you can tell there was a broken ankle that wasn't treated for a week or overmedication or too much weight loss, and you can begin to put together a picture." Harang says such patterns of neglect are common in the industry, partly because of chronic underfunding and understaffing. A landmark nursing-home reform law passed in 1987 was designed to help ensure better care. But regulations under the law have been repeatedly delayed.
Some nursing-home administrators regard Harang as a troublemaker and allege that she is out to make money. (She doesn't accept payment for her services, but Jack does get a share of awards and settlements, in all about $300,000 in the last six years.) "I think she goes too far-it's not fair to accuse a whole industry because of a few bad apples," says Rose Boritzer, executive director of the respected Kingsbridge Heights Health Care Facilities in the Bronx, N.Y. But nursing-home reformers applaud her work. "She's not just trying to get damages. She wants to change the system," says Barbara Frank of the National Citizen's Coalition for Nursing Home Reform, a Washington group.
For all her tenacity, Harang admits she was frightened by the fire and nearly gave up her crusade. "It made me stop, think and reassess my career and family goals," she says. Her three daughters pressed her to continue. "Why should she stop what she started?" says Laurie. "Our elderly are not being treated right and that's not fair." Nursing-home officials may not agree, but for now, they will continue to have Sue Harang watching over their care.