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Health company failed to protect slain Dade City caseworker, witnesses say

Published May 7, 2014

TAMPA — The health care management company facing fines and a civil lawsuit after the fatal stabbing of a case manager in Dade City failed to report her death and lacked policies that could have prevented the tragedy, federal officials said Tuesday.

Workers at Integra Health Management, who were recruited from the ranks of recent college grads to cut costs, weren't told about clients' criminal records or severe mental illnesses before having to visit them in person, witnesses said in an Occupational Safety and Health Administration hearing.

Integra is the Maryland-based company that employed 25-year-old Stephanie Nicole Ross. The recent USF graduate was chased and stabbed to death outside a Dade City home on Dec. 10, 2012, while visiting Lucious Smith, a man even Dade City police officers dealt with carefully due to his history of violence.

Ross was assigned to Smith and about 34 other clients who were on Medicaid. Her job was to visit the clients, complete health assessments and make sure they were completing doctor visits and taking medicines. Smith, whose record includes aggravated battery with a deadly weapon, is charged with first-degree murder in Ross' death. After nearly two years, he remains hospitalized and unfit for trial. Ross' family recently filed a wrongful-death lawsuit against Integra and several other parties with ties to the case.

After the stabbing, OSHA fined the company after an investigation showed Integra lacked a workplace violence prevention policy. The company also was cited with failing to report her death to the agency. Integra is contesting the $10,500 fine. Federal Administrative Law Judge Dennis L. Phillips is expected to rule later.

The hearing opened with the U.S. Department of Labor making its case for the fine. Investigator Jason Prymmer testified that the company did not have any written safety rules. The caseworkers, who were expected to make face-to-face contact with clients and sometimes drive them in their private vehicles, weren't told about criminal histories even though executives admitted that most of them had histories of violence.

"The service coordinators had to fend for themselves," Prymmer said.

Interviews with workers revealed a "saddle up and get out there" mentality, he said. Workers who felt unsafe could ask a colleague to accompany them on visits, but that was often difficult given the large geographic areas they served. Company executives didn't get involved, saying that was the job of workers or lower-level supervisors.

Prymmer said Ross had said in case notes that she felt uncomfortable meeting with Smith alone. Prymmer said that Smith once made reference to the Last Supper painting and said Jesus was his father and that he and others he knew were in the painting. Another time, he pretended to be a twin brother.

During another visit, he made remarks that Ross described as "flirtatious," and those made her uncomfortable.

Integra's attorney Kevin McCormick pounced on that remark, pointing out that Ross didn't use the term "unsafe."

"She was just uncomfortable," he said.

Prymmer also said that the company's 40 hours of training it claimed to provide was all online and barely addressed safety.

Prymmer said OSHA learned of Ross' death through an anonymous phone call. When he reached Integra, he said a company representative told him she didn't realize the death had to be reported to OSHA.

"She said they had reported it to workers' comp," he said.

The hearing is expected to conclude Friday.

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