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Adult Home Operator Pleads Guilty In Death Of Resident

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MARCH 27, 2000 VOLUME 7, NUMBER 39

Although nursing homes are more familiar to most Americans, nearly half of all elderly residents of institutions live in adult care homes. Often housed in converted residences, adult care homes usually provide personal care, supervision and activities for a small group of residents. Care in such facilities is often excellent, and may be more personal and comfortable than a larger, medically-oriented nursing home. Sometimes, though, the care can be horrific—as Chiyeko Tanouye’s case attests.

Ms. Tanouye was placed in an adult care home operated by Raquel Bermisa in mid-1999. At age 79, the Pearl City, Hawaii resident was completely unable to provide for her own care, and was confined to her bed.

One common problem experienced by bedridden patients is the development of bedsores—more properly referred to as pressure sores or decubitus ulcers. Ms. Tanouye began to suffer from such sores within a short period of her placement.

Treatment for pressure sores is normally straightforward. Patients must be turned regularly to relieve the pressure on affected areas, and the sores must be cleaned, protected and treated with salves. Regular nursing and medical review is essential to help in the reduction of pressure sores.

Unfortunately for Ms. Tanouye, her caretakers did not follow up with the prescribed medical care. By the time Ms. Bermisa took her to the emergency room last August, she was beyond treatment. Ms. Tanouye died shortly thereafter.

Hospital personnel reported the death to prosecutors, who ultimately charged Bermisa with manslaughter. As operator of the care home, Bermisa was responsible for seeing to the care of Ms. Tanouye, and she failed in that duty, prosecutors argued. Ms. Tanouye’s death from sepsis caused by inflammation of her open wounds could have been avoided, and Bermisa had a duty to provide the care necessary to prevent that death.

Last month Bermisa plead guilty to manslaughter, and she is awaiting sentencing. She is facing a one-year jail term for her failure. Prosecutors believe that hers may be the first such conviction in the country.

Most adult care homes provide good care. Despite that, neglect is unfortunately all too common. Such total disregard for patient care is not common, but it is difficult to estimate how frequently such incidents occur.

Under Arizona law a person can be charged with manslaughter for “recklessly” causing the death of another. That standard is met when the defendant is aware of the risk of injury and consciously disregards that risk. An Arizona conviction for manslaughter will lead to imprisonment for 6 to 18.5 years.

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Robert B. Fleming


Robert Fleming is a Fellow of both the American College of Trust and Estate Counsel and the National Academy of Elder Law Attorneys. He has been certified as a Specialist in Estate and Trust Law by the State Bar of Arizona‘s Board of Legal Specialization, and he is also a Certified Elder Law Attorney by the National Elder Law Foundation. Robert has a long history of involvement in local, state and national organizations. He is most proud of his instrumental involvement in the Special Needs Alliance, the premier national organization for lawyers dealing with special needs trusts and planning.

Robert has two adult children, two young grandchildren and a wife of over fifty years. He is devoted to all of them. He is also very fond of Rosalind Franklin (his office companion corgi), and his homebound cat Muninn. He just likes people, their pets and their stories.

Elizabeth N.R. Friman


Elizabeth Noble Rollings Friman is a principal and licensed fiduciary at Fleming & Curti, PLC. Elizabeth enjoys estate planning and helping families navigate trust and probate administrations. She is passionate about the fiduciary work that she performs as a trustee, personal representative, guardian, and conservator. Elizabeth works with CPAs, financial professionals, case managers, and medical providers to tailor solutions to complex family challenges. Elizabeth is often called upon to serve as a neutral party so that families can avoid protracted legal conflict. Elizabeth relies on the expertise of her team at Fleming & Curti, and as the Firm approaches its third decade, she is proud of the culture of care and consideration that the Firm embodies. Finding workable solutions to sensitive and complex family challenges is something that Elizabeth and the Fleming & Curti team do well.

Amy F. Matheson


Amy Farrell Matheson has worked as an attorney at Fleming & Curti since 2006. A member of the Southern Arizona Estate Planning Council, she is primarily responsible for estate planning and probate matters.

Amy graduated from Wellesley College with a double major in political science and English. She is an honors graduate of Suffolk University Law School and has been admitted to practice in Arizona, Massachusetts, New York, and the District of Columbia.

Prior to joining Fleming & Curti, Amy worked for American Public Television in Boston, and with the international trade group at White & Case, LLP, in Washington, D.C.

Amy’s husband, Tom, is an astronomer at NOIRLab and the Head of Time Domain Services, whose main project is ANTARES. Sadly, this does not involve actual time travel. Amy’s twin daughters are high school students; Finn, her Irish Red and White Setter, remains a puppy at heart.

Famous people's wills

Matthew M. Mansour


Matthew is a law clerk who recently earned his law degree from the University of Arizona James E. Rogers College of Law. His undergraduate degree is in psychology from the University of California, Santa Barbara. Matthew has had a passion for advocacy in the Tucson community since his time as a law student representative in the Workers’ Rights Clinic. He also has worked in both the Pima County Attorney’s Office and the Pima County Public Defender’s Office. He enjoys playing basketball, caring for his cat, and listening to audiobooks narrated by the authors.