Last November, a 71-year-old Morrisville woman died from gangrenous bedsores at University of Vermont Medical Center. Now, the married couple who took federal money to provide her with home care — one of whom is a former Stowe Middle School employee — face felony charges of neglect and Medicaid fraud.
Joshua Jones, 32, and Brittany Spaulding, 32, both of Morrisville, were arraigned May 19 on felony charges of neglect of a vulnerable adult with serious bodily injury and Medicaid fraud by the Vermont Attorney General’s Medicaid Fraud and Residential Abuse Unit, a branch of the office that deals specifically with abuse, neglect and financial exploitation of people living in Vermont care facilities and that investigates fraud in the state’s Medicaid program.
The couple received payment through the Choices for Care waiver program to pay for caring for a woman who suffered from dementia, developmental delays and had difficulty with mobility, particularly toward the end of her life.
She lived with the couple in their home.
After her death, a report to Adult Protective Services triggered an investigation from the attorney general’s office and Morristown Police Department. Another patient receiving care in the same home was removed after the investigation began.
Jones and Spaulding pleaded not guilty at arraignment in Vermont Superior Court.
They face up to 15 years in jail and a fine of $10,000 on the charge of neglect and another 10 years for the alleged Medicaid fraud. The fraud could mean fines equal to twice the amount of payments the couple wrongfully obtained, accourding to the attorney general’s office. Jones received around $21,000 and a monthly room and board payment from Medicaid and Spaulding received around $14,700.
A long decline
According to a probable cause affidavit prepared by Det. Virginia Merriam of the residential abuse unit, Jones and Spaulding oversaw the care of the woman beginning in 2019.
Despite a fall that rendered her nearly immobile just over a month before her death, Jones and Spaulding insisted on keeping the woman in their home even though Spaulding, the primary caregiver, was working a full-time job as a speech language aide at Stowe Middle School.
Jones and Spaulding took over care of the woman from Spaulding’s father, David Spaulding, who owned and operated a care facility, following his retirement and the death of his wife, Barbara Spaulding.
The woman had been a resident at David Spaulding’s operation for eight years before moving into Jones and Brittany Spaulding’s home.
David Spaulding was listed as the primary employer on Medicaid paperwork, with Brittany Spaulding and Jones as the primary caregivers.
The woman was totally dependent on caregivers for dressing, bathing, hygiene and using the toilet for many years, even before she entered Jones’ and Spaulding’s full-time care. She also required extensive assistance for mobility in bed and for transfers.
The couple claimed they did not receive enough support from Lamoille County Home Health & Hospice or in compensatory Medicaid funding, though they received 1,440 hours of respite.
The home health agency declined to comment on the charges.
Around Oct. 10, the woman fell in the night, fracturing her back, and was admitted to Copley Hospital. She was rendered nearly immobile and subsequently required a hydraulic lift for any kind of movement outside of bed.
A recommendation made by the hospital that the woman be discharged to a skilled nursing facility for rehabilitation services was ignored, and the couple requested she be discharged to their home.
In two subsequent visits by an occupational therapist, Jones said he was desperate for a hydraulic lift, saying that he was “feeling this in his back” when he had to move the woman. Jones was provided with a hydraulic lift on Nov. 6.
Three weeks later, Jones told the occupational therapist that the woman in his care was fine and that sponge baths were going well. Five days later, she was dead.
A rapid deterioration
Two days before the woman died, Jones called Lamoille County Home Health & Hospice requesting that a registered nurse come to their home after she noticed sores on the woman’s body.
The nurse discovered several wounds with a strong odor, some of them black in coloration, as well as an adult diaper and bed sheets soaked in urine. She recommended the woman be immediately taken to the ER.
Spaulding and Jones then claimed, according to a court documents, that in the last two weeks of her life, the woman made a miraculous recovery. The couple claimed the woman had been “more independent in her room, including toileting (herself) and dressing (herself),” which Jones and Spaulding claimed caused caregivers not to worry about bathing her or examining her skin.
The nurse found this claim “difficult to accept,” as the woman was entirely dependent on a hydraulic lift for movement. It was also in direct conflict with what Jones told the occupational therapist just a few days earlier.
At Copley Hospital, a doctor said Jones seemed shocked by the severe bedsores and Adult Protective Services was called after a doctor noted the conflict between Jones’ statement about the woman’s sudden independence in the last two weeks of her life and the fatal nature of her bed sores.
A doctor at the University of Vermont Medical Center, where the woman was taken after a surgical evaluation at Copley, said the wounds indicated she had been lying on a hard surface, possibly the floor, for two to three days or possibly a week.
Doctors said the smell from the wounds was so bad it would’ve been difficult not to notice them developing. A CAT scan revealed the bed sores were gangrenous and tissue rot had already occurred to the bone. Surgery was attempted, but the bed sores were too severe and the woman died.
After an autopsy, the official cause of death was ruled as “septic shock due to necrotizing soft tissue infection due to prolonged immobility and neglect of care.”
The death was listed as a homicide due to neglect of care.
An audit of timesheet records by the Medicaid Fraud and Residential Abuse Unit uncovered that Spaulding had claimed she was providing care for the woman, as well as the other man in her care, while she was also allegedly working at Stowe Middle School. Her timesheets were approved by her supervisor and husband, Jones.
In a statement, Lamoille South Unified Union superintendent Tracy Wrend said Spaulding had not worked at the school since April 1. She had no other comment.