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'Like I Was In Prison': Assisted Living Facility Shut Down For Allegedly Neglecting, Humiliating, And Punishing Residents

GALETON, Colo. (CBS4) - In a rare move, the Colorado Department of Public Health and Environment has shut down the Triangle Cross Ranch assisted living facility in Weld County. Inspectors for the CDPHE say the facility intentionally humiliated, neglected, and punished its residents, who are adults with special needs.

Triangle Cross Ranch
Triangle Cross Ranch in Galeton (credit: Kati Weis, CBS4)

According to the order suspending the facility's license, residents were underfed and underweight. Inspectors even saw residents licking dirty plates and going through the trash for scraps.

Randy Kuykendall, Director of the Health Facilities and Emergency Medical Services Division of the CDPHE, signed off on the suspension order. He said the facility purposefully imposed restrictive diets on the residents.

"Food had been withheld from them as a form of punishment, as well as a form of forced weight loss," said Kukendall. "We did observe, on one occasion, residents scavenging food from the disposal area."

Karen Peterson, 53, had been a resident at the ranch since 2014. Peterson has Asperger's, a syndrome on the autism spectrum. She says everything was fine at the ranch until last year, when staff changed and pandemic restrictions prevented family members from visiting.

Peterson says she was subjected to diet punishments at the facility. In 11 months, Peterson lost 51 pounds.

Karen Peterson and Kristin Linton (credit: Kristin Linton)

"They would blend my food into shakes, and I would have to drink my food from a glass while everybody else got to eat solid food," Peterson said. "I had to eat in the living room while everyone else sat at the kitchen table."

Peterson's sister, Kristin Linton, said she was devastated when she first saw how much weight her sister had lost.

"I wanted to cry, she was so thin, so bony," Linton said. "She was shrunken when I got to her in March (2021), she was walking bent over, wringing her hands, and just seemed to be very withdrawn and within herself."

According to the CDPHE, when inspectors asked the facility about the diet restrictions, a staff member said, "we cannot let them eat a dozen donuts," and they were just following families' directions and practitioner's orders.

'They Were Listening In': CDPHE Says Facility Violated Residents' Privacy, Among Other Violations

The CDPHE also claimed the facility humiliated and punished residents in other ways. In one instance, the CDPHE says the facility made a resident pick up alpaca feces for refusing to play corn hole. In another instance, a staff member allegedly made a resident cry for talking about a video game.

Inspectors also said the facility failed to give residents privacy, saying staff tried to prevent inspectors from privately interviewing residents.

Peterson said the facility opened her incoming mail, and wouldn't send her letters out.

"It made me angry, and I was not allowed to talk to Kristin on the phone in private... there was a lot I wanted to tell Kristin that I couldn't, because they were listening in," Peterson said. "I did feel like I was in prison."

Kuykendall also said the facility blocked the state ombudsman from entering the property.

"In addition to the ombudsman not being allowed into the facility, our teams were stalled every single time we went out there at the front gate by having to make phone calls and wait for someone to come, unlock the gate, even to the extent at one point that our team found an alternative way into the facility to get into it at that time," Kuykendall said. "The rules and regulations are very clear, that we are entitled to access under the law, and we are entitled to private interviews with any resident of any licensed health care facility, but there were significant efforts to prevent us from having those conversations with the residents of the facility on a number of occasions during any number of visits."

(credit: CBS)

In the suspension order, the health department writes that when inspectors first visited, residents were "friendly and spoke openly and willingly," and "residents appeared jovial."

But when inspectors returned eight days later, the order says residents "avoided eye contact, appeared fearful, uncomfortable, and upset," and "the residents told the department they were not allowed to speak with the department."

"No matter their abilities, their disabilities, intellectual levels, respect and dignity is the most important, and treat people the way you want to be treated; the way Karen was treated, those staff members would never tolerate if they were being treated that way," Linton said.

In addition, the CDPHE also found the facility failed to follow proper COVID-19 requirements, including not offering the vaccine to residents, and staff not wearing personal protective equipment around residents. Inspectors also said the facility "failed to ensure hot water did not measure more than 120 degrees Fahrenheit at taps that we accessible to residents."

"We continued to find excessively hot water, water that could scald people in the facility," Kuykendall said. "That obviously becomes quite a danger, particularly in a facility of this nature, where the residents are developmentally disabled individuals requiring assistance."

What's Next

Kuykendall said the CDPHE first discovered the facility's actions when the department received a complaint in April 2020. Kuykendall said the facility was first fined the maximum amount - $2,000 - for its violations, but the facility refused to pay the fine, and the facility did not submit proper plans to correct the issues.

"There was less cooperation as time went on," Kuykendall said. "We certainly began to feel that there was a threat to the health, safety, and welfare of the residents."

The license suspension order against the facility was signed on April 7.

An action by the state of this kind doesn't happen often in Colorado. Since 2013, the CDPHE has shut down 27 assisted living facilities. That's about three closures a year.

Now, the Triangle Cross Ranch has the option to fight the order in court. The CDPHE says an administrative hearing on the matter could take up to eight months to take place. The facility will remain shut down until a judge deems it can reopen.

Staff members declined an interview with CBS4 Investigates about the allegations, but an attorney representing the ranch sent a written statement, that reads, "it is the policy of Triangle Cross Ranch to not comment on pending litigation; however, as their attorneys, we can say that the board and staff members of Triangle Cross Ranch have done nothing wrong."

The attorney also provided this document, saying the facility has "grave concerns that medical records or medical information of some of the residents of Triangle Cross Ranch may have been copied or removed without the proper, written authorization having been given by the residents or their guardians."


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