A former nurse at Mount Joseph at 7 Highwood St. in Waterville is accused of endangering the welfare of a man with disabilities who was under his care. The man died two days after an incident in 2021 at the nursing home and rehabilitation center. Michael G. Seamans/Morning Sentinel file

AUGUSTA — A former nurse at Mount Joseph at Waterville is being charged following the death of a man with disabilities who was being treated at the nursing home and rehabilitation center in 2021.

Marius Ramirez, 62, of Ellsworth pleaded no contest Thursday to a misdemeanor count of endangering the welfare of a dependent person as part of an agreement with prosecutors, after initially facing felony-level charges.

Ramierz is expected to be sentenced to 30 days in jail for failing to give Daniel H. Crommett seizure medication when he said he did. Ramirez must also surrender his nursing license, but could be allowed to reapply a year after his release.

Crommett’s family said Thursday at the Capital Judicial Center in Augusta that the decision is not sufficient to reflect the treatment their loved one endured, with some initially calling for Ramierz to be charged with homicide.

A TROUBLING PATTERN, BUT NOT ENOUGH EVIDENCE

Crommett, a 48-year-old man with mental and physical disabilities, arrived at Mount Joseph at 7 Highwood St. in 2021, after moving from the Gardiner group home at which he lived to recover from a broken hip. His sisters testified in court that his health deteriorated rapidly while at the Waterville facility, which at the time was called Mount Saint Joseph.

He also sustained bruises and other injuries, which his sisters said were discovered after Ramirez had worked the overnight shift and been responsible for their brother’s care.

Daniel H. Crommett Courtesy of the Crommett family

While Crommett was at the Waterville facility in December 2021, a worker reported seeing Ramierz allegedly get on top of Crommett and hold him down while he was overseeing his care during a night shift, according to prosecutor Patricia Poulin. Ramierz later said he was trying to give Crommett his medication.

Crommett had been deemed a fall risk, and the door to his room was supposed to remain open. The morning after Ramierz allegedly held him down, workers found Crommett’s door closed. And when they entered the room, Crommett was on the floor with injuries, including handprint bruises on both his wrists and a purple-blackish finger, his family said.

The normally social and talkative man was slumped over in his chair, drooling when he attempted to speak.

His twin sister, Krista Crommett, said he was in such poor condition she called 911. He died at a hospital two days later.

A grand jury indicted Ramierz on a felony-level charge of endangering the welfare of a dependent person, and a misdemeanor-level assault charge in the December 2021 incident.

Ramierz was also indicted on two felony-level counts of endangering the welfare of a dependent person, and two misdemeanor-level charges of falsifying a health care record and unlawful possession of scheduled drugs, for failing to give Crommett medication in August and September of 2021.

Under questioning Thursday from Superior Court Justice Michaela Murphy, Poulin, an assistant state attorney general, said the state had concerns it might not be able to prove the felony-level charges against Ramirez if the case were to go to trial.

A medical examiner listed Crommett’s cause of death as a blockage in his heart, Poulin said. The report did not cite any signs of abuse on his body.

It could not be determined whether the injuries Crommett sustained resulted from a fall or from Ramirez, Poulin said. And there were other health care workers on duty who were also responsible for Crommett’s care.

Ramirez’s lawyer, Joseph Baldacci, said the charges against Ramirez had significant gaps, and there was no proof the allegations happened.

The result was a plea agreement that lessened a felony-level charge against Ramierz to a misdemeanor-level offense and dismissed all others.

“No way were we going to plea to the felonies because there were so many holes in the case,” Baldacci said. “This is not easy for Mr. Ramirez. He has no criminal record. He has a love of nursing. But he has agreed to plea to this charge, and his wish is to go forward.”

CONCERNS AT MOUNT JOSEPH

Krista Crommett, who moved to Pittsfield from New York so she could visit Daniel Crommett daily at the facility, said the family received frequent telephone calls reporting that nurses would find her brother on the floor — with bruises and lacerations — on mornings after Ramirez had worked the night shift.

Daniel Crommett also had his medications go missing, including those used to treat his seizures, which he suffered increasingly while at Mount Joseph, according to his family.

The drug for which Ramirez was indicted on unlawful possession of scheduled drugs charges, according to court records, was divalproex sodium, which is used to treat seizures. That charge was dismissed as part of the plea agreement.

“As Dan’s twin, the instinct to care for him and protect him from harm is embedded in my DNA,” Krista Crommett said in court at a hearing to take Ramirez’s plea in the case. “A CNA (certified nursing assistant at Mount Joseph) told me, ‘Marius is not your brother’s friend.’

“The atrocities Marius Ramirez inflicted on my vulnerable brother are beyond the pale. Please do not allow Marius Ramirez to ever work in health care again.”

Daniel Crommett’s other sister, Carrie Francis, said he was neat, affectionate, social, funny and demonstrative, but over the last few months of his life — at Mount Saint Joseph — he experienced trauma, abuse and neglect that sent his physical and emotional health into a downward spiral.

“We initially believed Dan was in good hands,” she said. “We observed his condition deteriorate before our very eyes. The defendant betrayed Dan and our family’s trust. I urge the state to revoke his nursing license permanently, to ensure he never has the opportunity to abuse his power in a similar manner again. We want to make sure other patients are protected.”

The concerns raised by the Crommett family come against a troubling backdrop for the Waterville nursing home and rehabilitation center.

Since 2019, it has been cited for 70 deficiencies, according to data from the Centers for Medicare & Medicaid Services. It that period, Mount Joseph was fined a total of $38,100, including a $30,000 fine in September 2022. Most recently, it was cited for 14 deficiencies in January 2023.

The facility, referred to as Waterville Center for Health and Rehabilitation, is not rated at Medicare.gov because it has a history of serious quality issues. A notice on the government site reads, “This nursing home is subject to more frequent inspections, escalating penalties and potential termination from Medicare and Medicaid as part of the Special Focus Facility program.”

Officials at Mount Joseph could not be reached Tuesday for comment.

Murphy said Thursday she understood the family is angry and hurt about the loss of their brother and lack of a harsher sentence for Ramirez, but said the state has to be able to prove the charges before a jury, and it was clear the state had concerns about being able to do that with the felony-level charges.

Ramirez did not speak in court, but his lawyer said he “wishes to express his sorrow and respect for what (Crommett’s) family went through.”

As part of the plea agreement, Ramirez, who is to be sentenced Nov. 15, must make a $2,000 donation to charity.