Stephanie Black

Stephanie Black's 12-year-old son, Derrick, died last year after he was left unmonitored because his night nurse left work early and his day nurse showed up late, records show. (José M. Osorio, Chicago Tribune / June 30, 2010)

A 4-year-old boy with severe developmental disabilities died in his nursing facility when he had difficulty breathing and no one heard the alarm on his monitor. Three weeks later, a 4-year-old girldied at the home in an almost identical way.

When state regulators investigated, records show, they found that numerous alarms at the Chicago facility had not been set correctly or the volume had been turned down so low that the sound could not be heard.

Such failures of care have repeatedly jeopardized the lives of fragile children at the facility now known as Alden Village North, a Tribune investigation has found. Records show the problems have persisted for a decade, through various owners, sometimes with deadly consequences.

Illnesses have been ignored, life-support alarms have gone unanswered and residents with complex medical problems have been left unattended. Even basic hygiene, such as bathing children and changing diapers, has been neglected.

Instead of cracking down, regulators and lawmakers have allowed problems to worsen.

Fines have been dropped or reduced, and deaths at the facility haven't been fully investigated. Illinois' rules are so weak, inconsistent and reliant on industry self-reporting that the state cannot gauge the true scope of problems at Alden and the 300 other facilities caring for people with developmental disabilities.

And earlier this year, when state lawmakers had a rare chance to boost oversight of these homes, they did not.

Deaths of children living at Alden have occurred with alarming regularity. Last year, records show, 12-year-old Derrick Black died when he was left unmonitored because his night nurse left work early and his day nurse showed up late. In 2008, five children and young adults died within threemonths of each other, yet the facility did not thoroughly investigate any of the deaths.

In all, 13 children and young adults have died at the facility since 2000in cases that resulted in state citations for neglect or for failure to investigate adequately in order to rule out neglect, the Tribune found.

The newspaper's investigation was based on state and court records as well as interviews with former employees and parents of Alden children. Although state records typically do not disclose identities of children who have died at nursing facilities, the Tribune tracked down names by cross-checking public inspection reports with other government documents.

Five parents of children who died at the facility said they did not know until they were informed by the newspaper that regulators had cited the home in the deaths. "Wow. I had no idea," said Esmeralda Alvarado, whose 1-year-old son, Gabriel Melgar, died in 2008.

Although the Illinois Department of Public Health has levied $190,000 in fines against the home in the past decade, the facility has not paid the full amount of any penalty, records show. Instead, it has negotiated reduced fines, is currently challenging others and, in one case, simply never paid.

Since 2000 the facility has paid just $21,450 in fines.

In the case of the two 4-year-oldswho died in 2004 when no one heard their alarms, the state fined the home $50,000 but never collected because the facility changed owners. The state usually denies a license to new owners until an outstanding fine is paid, but a state employee erred and allowed Alden to take over without paying, said Melaney Arnold, spokeswoman for the Illinois Department of Public Health.

Arnold said the state had hoped that Alden would improve care at the facility. New owners, she said, often straighten out troubled homes.

"In this case," she said, "it didn't happen."

The state has found 10 serious violations at Alden since 2009, far more than at any other Illinois facility that cares primarily for children with developmental disabilities, records show.

The vast majority of residents at Alden Village North, a for-profit facility at 7464 N. Sheridan Road, have severe or profound cognitive disabilities. Some cannot walk, talk or call for help. Many are in wheelchairs and diapers. Some breathe and eat through tubes. More than half have epilepsy or cerebral palsy. Several have impaired vision.

Their parents, in some cases, are extremely indigent and seldom visit or advocate on their children's behalf. In trying to reach the parents of the 13 children who died, the Tribune found that four of them were in jail or prison.