Two more facilities that primarily house the mentally ill had their personal-care Medicaid funds cut off Monday after surprise visits last week by auditors from the Arkansas Department of Human Services.
The agency also is investigating whether health and safety violations at the centers warrant fines or license revocations.
Officials took similar action last week against four other centers and began license revocation procedures against three of them.
Human Services Department officials refused to release the names of the residential-care facilities or their owners, saying state law shields inspection information.
However, the Arkansas Democrat-Gazette has learned that one of the two latest centers under investigation is Rest Avenue Residential of England. Claude Sutterfield, who owns 50 percent of Rest Avenue, is a member of the Arkansas Residential Assisted Living Association board of directors. That group is made up of residential-care owners.
Sutterfield of Mountain View is also a member of the Health Services Commission, which approves permits to run these types of facilities. He was appointed by Gov. Mike Huckabee. The commission determines whether there is a need for a proposed facility and, if so, issues permits of approval. The state Human Services Department licenses the centers.
"I have just received notification, and it's my understanding that it's under investigation. So I better not comment," Sutterfield said.
The other owners of Rest Avenue are J.T. Compton of Morrilton and Kris Compton, Kevin Compton and Ken Compton. Each of the Comptons owns 12.5 percent, according to state records.
Photographs taken at Rest Avenue by Medicaid auditors show an open trash can sitting beside a stove caked with thick deposits of dried food, ceiling panels dangling down and a laundry room where the floor and walls have rotted.
Rest Avenue Residential is licensed for 64 residents.
"There wasn't one roll of toilet paper in that facility or any towels, either paper or cloth," an inspector said.
Sutterfield and the Comptons also own Westwynne Place in Wynne, state records show. There is no indication that that facility is being investigated, however.
Residential-care facilities house residents who are elderly, mentally ill or mentally retarded but who are not so impaired as to require nursing home care. Rest Avenue and the other residential center in question primarily house the mentally ill.
For disabled residents with little or no income, monthly fees often come from a $500 Social Security check. In those cases the resident signs over the check to the facility and is given back about $30 for personal items.
In 1991, the Human Services Department decided to reimburse residential-care facilities for personal care, such as helping a resident bathe, groom, eat and take medications.
Facilities receive $12.35 an hour for up to 64 hours a month -- up to $790.40 per resident to perform personal care for those who qualify.
Rest Avenue received $212,000 in state and federal Medicaid funds for personal-care services during the last fiscal year, which ended June 30.
The other facility received $133,372 in Medicaid funds during that same time.
Medicaid auditors took pictures at the centers during their inspections last week.
"Based on pictures taken by the field auditors, we have sent two residential inspectors to those two facilities today to decide what should be done," Mark Hemingway said Monday. Hemingway is director of the Department of Human Services Office of Long Term Care, which supervises these facilities.
Rose Tabor, assistant chief program administrator, is leading that inspection. Hemingway will use Tabor's reports to determine whether more severe penalties are needed.
The surprise inspections are part of a crackdown on residential-care facilities.
In December, the Disability Rights Center, a private advocacy group, took pictures of Alternatives Plus in DeWitt to the Office of Long Term Care.
That DeWitt center is owned by Joe Alexander and his mother, Avanell Looney. Disturbed by what he had seen, Ray Hanley, director of the department's Medical Services Division, sent Medicaid field auditors to DeWitt and to three other residential-care facilities owned by either Alexander or Looney.
Those centers include Camden Family Inn in Camden, De Queen Residential Care Facility in De Queen and Sparkman Care Center in Sparkman.
The state notified Alexander and Looney last week that it will revoke three of the four licenses by March 19. The fourth facility has until Friday to comply with state standards.
Photographs of those centers show uncovered electrical outlets, roaches, unheated rooms and commodes covered with feces.
Dr. Ray Nelson, commissioner of the state Developmental Disabilities Services Division from 1981-84, has been hired by Alexander and Looney to bring those facilities to code. He said the owners will appeal the license revocations.
The Office of Long Term Care also cut off Medicaid funds to those four facilities, fined them $14,500 and demanded repayment of $220,000 in state and federal funds.
The agency also is investigating its own residential-care inspectors for failure to aggressively enforce the law.
The state attorney general's office became involved last week when it seized records from the DeWitt, De Queen and Sparkman facilities involving Medicaid funds.
Hanley said he was concerned that problems at other centers might have been ignored or overlooked by his inspectors, and he sent Medicaid field auditors to 20 other centers last week based on tips and complaints.
"We are continuing to check into these facilities and will aggressively revoke licenses if we need to," Hanley said.