Bruises on an elderly woman's chest. Falls that go unreported. Medications not given. And now an allegation that a nurse raped a patient helpless to report the abuse or protect himself.
"It hurts my heart," said Olivia Burns, who has been a nursing assistant at Concord Care and Rehabilitation Center for nearly 24 years. She resigned Tuesday after hearing about nurse John R. Riems' arrest on charges of sexually abusing a patient.
"I have cried about it ... prayed about it," the 56-year-old said before breaking down into sobs. "I've had it. I'm done. I'm done."
The 620 W. Strub Road nursing home has a record of providing substandard care that has escalated since November.
In the past three months, investigators with the Ohio Department of Health have received 11 complaints containing at least 22 allegations of wrongdoing at the facility.
After four visits to Concord Care, investigators were unable to find enough evidence to support two of the allegations, but continue to review 20 allegations.
*Two allegations of resident abuse -- the sexual abuse reported Tuesday morning to the state and an earlier report of physical abuse of a resident.
*Two allegations of violation of resident rights.
*Eight allegations of failure to provide quality care and properly treat residents.
*Two allegations of injuries of unknown origins -- one of which is a report about a resident with bruising and shoulder injuries.
*Two allegations of lack of infection control.
*Two allegations that the physical environment at the facility is lacking.
*One allegation that the residents' quality of life is diminished.
*One allegation that rehabilitation services are deficient.
Moriah Needham, spokeswoman for the Ohio Department of Health, said details on the current allegations are not available, but an investigation into the facility is ongoing.
"We take all complaints seriously," she said, declining to compare Concord Care to other nursing homes, but pointing to such rankings provided by the Ohio Department of Aging.
On that department's Web site, Concord Care residents and family members of residents scored the 50-bed facility below the state average in all categories.
Residents gave the home a 66.8 percent score -- a D grade -- on the question, "Overall are you satisfied with care?" whereas the state average is 86.6 percent.
Burns, who said she cares for the residents at Concord Care as though they were her family members, was pained to admit the facility has gone downhill in the time she's been there.
"All the years I've been over there, this is the worst I've ever seen it," she said. "I don't want them hurt any more."
Though she never witnessed physical or sexual abuse of residents, she said she was appalled at how Reims interacted with residents. She recalled he had a temper, often swore at patients and slammed his fist on the counter when residents sought nursing assistance by flipping on their lights.
"It was terrible," she said. "Patients have complained, 'I don't want him in my room.' They didn't say why. They said they didn't like him."
Burns was especially frustrated because she said she reported this verbal abuse to her supervisors and advised them Reims needed counseling.
"They never followed up on it," she guessed.
Concord Care declined comment.
Needham said it could take some time for the state to wrap up its investigation. Once a report is finalized, the facility has 10 days to respond or dispute the findings. If Concord Care then does not come into compliance, the state could recommend punitive actions ranging from banning the facility from admitting new residents to closure of the nursing home.
"That is a very worst-case scenario," she said.