White Fawn Family Care Home, which serves mentally ill adults in Asheville, is owned by a company that incorporated itself as Nutz R Us. Frank Taylor/Carolina Public Press

ASHEVILLE, N.C. — Nutz R Us, a Buncombe County company that incorporated under that name in 2008, operates assisted living facilities catering to mentally ill adults.

Multiple officials with state and local public health agencies have told Carolina Public Press that they find the name Nutz R Us appalling.

But they also said they lack the statutory authority to do anything about it.

The parent of a mentally ill adult, whom a court-ordered guardian placed in a Nutz R Us facility, recently contacted CPP with grave concerns about the quality of care there. Some of her concerns appear supported by deficiencies recorded on the facilities’ inspections.

Even so, the homes that Nutz R Us operates are officially licensed and operating according to state law. The inspection deficiencies have led to penalties and a requirement for corrections, rather than an outright threat of more serious state intervention.

But there’s that name.

Why would someone operating a facility serving the needs of mentally ill adults incorporate their business with a name that is widely viewed as demeaning its clients?

CPP attempted to ask that very question of Forrestene “Tina” Muckelvene of Asheville, who founded Nutz R Us and continues to be listed the corporation’s registered agent. But she did not respond to a request for an interview prior to this report’s publication.

Incorporation of Nutz R Us

Other companies across the United States are incorporated in different states as “Nutz R Us” or similar variations. As far as CPP could determine, the rest of them are involved in the food industry.

A spokesperson for the North Carolina Secretary of State’s Office told CPP recently that nothing about the name violated North Carolina statutes for incorporated companies, despite its obvious offensiveness, given the type of services that the Asheville company provides.

The Secretary of State’s incorporation division doesn’t have the staff to probe too deeply about those seeking to incorporate, even if the law gave it that authority, which it doesn’t.

No criminal background checks are required. There’s not even an effort to ensure those registering as the principle agents of a company are using their real names.

So while Nutz R Us did what was required to operate under that name, this doesn’t mean anyone with the state has vetted the company to see how legitimate its operations as a corporation are. The name may have raised red flags for state officials, but there was nothing they could do about it.

In fact, CPP found that Nutz R Us briefly underwent dissolution by the state two years ago for failing to file updated paperwork on its corporate status. The dissolution was revoked a few months later once the appropriate documents had been filed.

The Secretary of State’s Office told CPP that the corporation is already in jeopardy of dissolution again for repeatedly falling behind on its filings.

Getting its business license back so quickly in 2014 may have helped the company to fly under the radar from state health officials who oversee its right to operate as a service provider.

“(The Division of Health Service Regulation) checks a company’s status with the Secretary of State on an annual basis at license renewal,” said Alexandra Lefevbre of the North Carolina Department of Health and Human Services, the parent agency of DHSR, in an email to CPP.

“If DHSR was to obtain knowledge of the dissolution of a company that was licensed, we would contact the licensee and take necessary action to ensure the facility is appropriately licensed and required care and services are provided to residents.”

Placements

Lefevbre also told CPP that even though DHHS screens and inspects facilities like those operated by Nutz R Us, the agency isn’t directing making placements there and hopes those who do place people in such homes will be careful when they see something like a company name that could lead to concerns.

“Residents and families have choices when it comes to placing a loved one into a licensed facility,” Lefevbre wrote. “We strongly encourage residents and their families to gather as much information about potential placement facilities as possible.”

But family members have no say in many placements.

Instead, privately owned guardian companies can be appointed by the courts to handle an individual’s case. Sometimes they work closely with family, but sometimes they don’t. Family members who contacted CPP about Nutz R Us had their son placed by a guardian. They have described a situation in which the guardian was uncooperative with them and either disputed or misrepresented the facts in the case as they understood them.

While they are Henderson County residents, the clerk of court there assigned their son to a Buncombe County guardian who in turn made the Nutz R Us placement.

The guardian in the case works for Weaverville-based Hope for the Future, a private guardianship company. The organization’s director, Cindy Barisa Wolff, is well-known in the guardianship industry in North Carolina, serving as the immediate past president of the North Carolina Guardianship Association. She is currently the NCGA’s only board member from Western North Carolina.

Wolff talked with CPP this week about Nutz R Us. She said her organization knew in advance that the homes in which clients were being placed was owned by a company named Nutz R Us, a name that she agrees is offensive.

But Wolff said the facilities owned by Nutz R Us provide good care and few other facilities in the region are offering that kind of care.

CPP found that about 85 facilities in Buncombe County are listed on the DHHS website as family care homes, including the three run by Nutz R Us.

This list includes facilities with at least six beds. It’s not immediately clear how many of them offer precisely the same sort of care. Some may focus more on elderly adults or those with various physical disabilities.

Quality of care

Despite Wolff’s approval, inspection reports from DHSR raise questions about the quality of care being provided at Nutz R Us’ three facilities.

Deficiencies at Deaverview Heights Family Care Home, a Nutz R Us-own home at 290 Deaverview Road in Asheville, led in 2015 to a decline in its rating on the state’s four-star system from three stars to two.

“Based on observation and interview, the facility failed to assure ceilings, walls, and floor coverings were clean and in good repair for (both) of the two bathrooms used by residents, the dining room and the hallway,” the inspector wrote.

Specific findings included loose sheetrock tape in several locations, cracks or holes in the walls and ceiling and stains on the floors.

The inspector also found defective furniture, a failure to screen all employees for tuberculosis and serious concerns with the quality of the food being provided to clients and the proper handling of their medication.

A follow-up inspection four months later cited the Deaverview facility for many of the same deficiencies.

Haywood Heights Family Care Home on Euclid Avenue in West Asheville is owned by the Nutz R Us company and serves mentally ill adults. Frank Taylor / Carolina Public Press

Problems at Haywood Heights Family Care Home on 17 Euclid Boulevard in Asheville led to a rating decline from four stars to three in January 2016.

“Based on observations and interviews, the facility failed to assure the facility’s living room furniture and dining room chairs were kept clean,” the inspector wrote. He described dining room chairs that were heavily soiled with spills and food debris, along with heavy dust on cushions and back rests. Furniture in the living room was also heavily soiled.

The Deaverview facility’s relief supervisor reportedly told the inspector that the soiled furniture had been cleaned thoroughly by hand, but not for two months. Other filthy furniture had only been vacuumed.

The inspector also described “heavy accumulation of soap scum coating the shower walls and black mildewed soap scum around the built-in grab bar” in several bathrooms. Kitchen offenses included heavy coating “with a sticky yellow residue” on the carafe of the coffee pot, heavy soiling with “spills and loose food particles” on the towel near the kitchen sink, and “a large spill of dried brown substance” on the bottom inside of the oven.

In addition to the physical problems at the Euclid site, the inspector found no documentation for state-mandated personal-care training for some staff or of a licensed health professional support evaluation for a staff member administering medication.

Perhaps most serious for a facility serving mental health clients, a patient suffering from multiple diagnoses including schizophrenia had not had timely administration of medication because a staff member “forgot” to order his monthly injection.

The White Fawn Family Care Home, located on 96 White Fawn Drive, just east of downtown Asheville, also dropped from four stars to three following an inspection.

A DHSR inspector in December 2015 wrote, “The facility failed to monitor and correct electrical hazards, improper oxygen tank storage and cockroach infestation.” In the kitchen he reported several apparent sanitary violations including greasy surfaces, a “dried, brown splattered substance” covering a wall near the stove; dirt built up on the side of the refrigerator adjacent to the stove, improperly sealed food containers, expired food, moldy food and unlabeled containers of food.

The inspector also found fixtures that were either in disrepair or not clean, cracks in the walls, broken or loose floor tiles, several blown light bulbs, a dust-covered grille on a window air conditioning unit, dusty floors and ceiling fans, a dirty box fan, a damaged baseboard heater, cobwebs hanging from the ceiling, pealing drywall tape, protruding rusty nails, loose seat and arm supports on a toilet, peeling paint in the bathroom, missing or broken towel bars, a black substance dotting a shower curtain, dirty grout around a tub and dark staining on the floor around a toilet.

The inspection report indicated that the facility administrator knew of some of these problems but explained that she had “not had the chance to do some things.”

In addition to the physical issues at White Fawn, the inspector also reported that the home was not properly complying with the dietary needs of a client who needed his beverages thickened according to a physician’s orders.

A follow-up inspection at White Fawn in March found additional concerns, including a non-client child who was improperly living at the house. The March inspection also found unresolved issues with many of the cleanliness and maintenance issues identified in the previous inspection. An administrator offered the excuse that her maintenance person did not live in the same state and could not travel to make repairs due to the weather.

Not unnoticed

The name Nutz R Us in association with a mental health services provider hasn’t gone unnoticed by the larger mental-health care community in Western North Carolina.

A February 2015 article in the Asheville Citizen-Times indicated that a psychiatrist with the state-run mental-treatment facility for the western region, Broughton Hospital in Morganton, had contacted the newspaper with concerns about the existence of Nutz R Us.

According to the article, Dr. Suzannah McCuen hoped that public exposure would lead to a change in the company’s name. That hasn’t happened.

John Boyle, the “Answer Man” columnist for the Citizen-Times, wrote that he and McCuen were both unsuccessful at getting anyone from the company to return their calls.

Boyle reported that McCuen was reaching out to advocacy organizations for the mentally ill to press for a change in the company’s name. His article ends, “We’ll keep you posted.”

CPP was unable to find any follow-up reporting the newspaper has done on the subject.

CPP attempted to contact McCuen about her opposition to Nutz R Us, but because she is an employee of the state mental hospital, DHHS has to give clearance for her to talk with CPP. A request for that clearance has not yet been met with a response as of publication.