But they are also registered sex offenders.
More than 100 men and women currently living in Ohio's nursing homes are on the state's sex offender list, and they are not required to inform other residents of their presence because of a gap in state law.
A comparison of state records of long-term-care facilities with the state's offender list shows that 110 nursing-home residents and six employees are registered sex offenders, an analysis by The Columbus Dispatch found.
A gap in state law requiring notification of anyone who lives within 1,000 feet of a sex offender does not require nursing-home owners to inform residents.
About two-thirds of the sex offenders in nursing homes are from the most serious category, including offenders who have committed rape and kidnapping a minor. The number of registered sex offenders living in Ohio nursing homes has nearly tripled since 2004, according to the Perfect Cause, an Oklahoma-based nonprofit group that has been tracking sex offenders in nursing homes for five years.
"What we're seeing is a truly disturbing and horrifying trend," said Wes Bledsoe, head of the Perfect Cause. "We're seeing a system that's getting worse instead of better. We're seeing more assaults in facilities. Many times the assailants are never charged."
The organization has found at least 60 murders, rapes and serious assaults in nursing homes across the country by residents who are sex offenders. An 18-year-old mentally retarded woman was raped in a Cincinnati nursing home early in the morning of Aug. 21, 2005, by Rickey Smith, a registered sex offender living in the home.
Smith was convicted, served two years in prison, and now lives in a Cincinnati group home.
"I think he should have been chemically castrated," said the woman's father, Ray McDaniel, of Fairfield. He has become an advocate for stronger notification proposals at both the state and national levels.
Beverley Laubert, Ohio's long-term care ombudsman, urged state lawmakers in an annual report released last week to approve legislation that would close the gap for sex offender notification in nursing homes.
"Nursing-home residents have the right to be notified just like anyone else," Laubert said.
But the administrator at the Ohio nursing home with by far the biggest concentration of sex offenders disagrees.
Carlton Manor differs from the usual nursing home because it mixes in elements of a correctional facility, Andrews said. Security restrictions, full-time psychologists, social workers and a behavioral-care nurse protect the residents, he said.
Pete VanRunkle, executive director of the Ohio Health Care Association, said he is concerned about the lack of notification but also feels requiring nursing homes to notify residents would put them in a difficult position.
"There's no provision in the law that says you can kick a person out for being a sex offender," VanRunkle said.
The Buckeye State Sheriffs Association supports changing the law to require nursing home operators to notify residents and, in cases when residents have health problems such as Alzheimer's disease, their families as well.
Bills have already been introduced in the Ohio House and Senate, and lawmakers are expected to take them up this fall.