Opinion: Following Another Incident, We Still Have Questions About Cayce’s Twilite Manor


Cayce’s Twilite Manor assisted living continues to be — and has never stopped being — allowed to operate by the state Department of Health and Environmental Control. 

And while the situation continues to be handled in seeming accordance with department regulations governing assisted living facilities, the details surrounding the death of a resident earlier this year and an 81-year-old with dementia who went missing for a few hours last week leave us wondering if it should be this way.

Consider these details reported by the Chronicle:

  • On Feb. 19, 69-year-old Timothy Frank Catalano was found dead at the rest home, not by staff, but by his roommate who called 911.
  • While the official cause of death is still pending, Lexington County Coroner Margarter Fisher said, “Preliminary [autopsy] results did show that Mr. Catalano had severe pneumonia with Abscess formation in both lungs.”
    She continued, “As most know, pneumonia is an infection of the air sacs in one or both lungs. Symptoms include but are not limited to severe cough with phlegm, fever, chills, and difficulty breathing. Healthcare providers usually recommend urgent medical attention.”
  • When Cayce police arrived at Twilite Manor they found, in addition to the deceased Mr. Catalano, another elderly resident requiring immediate transport to the hospital.
  • The Cayce police department noted, “The remaining 13 patients at the facility had not eaten or received any of their medications since the night before.“
  • Cayce police noted, ”We found a facility with no medical staff on site that could handle a medical emergency and unfortunately a medical emergency occurred.”
  • Deeming the living conditions to be unsafe, Cayce police relocated the residents to other facilities as they are empowered to do in such cases.
  • DHEC staff was notified and that agency’s staff went to Twilite Manor at about noon that day.  DHEC reports it “did not observe any conditions or practices that pose an immediate threat to the health, safety and welfare of the residents.”
  • DHEC documents show the department found 18 violations of its regulations governing such facilities at Twilite Manor between November 2019 and April 2021.

    Violations included failure to administer medications in accordance with physician orders, failure to have enough staff for the number of residents, leaving unsecured medications in the room of a patient not allowed to self-administer medications, failure to have a licensed administrator, lack of documentation of staff members’ annual medication management training, failure to maintain accurate records of controlled substances, and failure to maintain a two-day supply of staple and perishable foods.
  • On March 11, DHEC confirmed that all of Twilite Manor’s plans of correction had been approved and that residents could return, although it had not corrected all the violations cited in previous inspections. 

    It had retained its license since Feb. 19 and  was never forced to close, DEHC said.

    Twilite Manor didn’t reopen before March 15 when DHEC said it had submitted and has plans of correction approved for all pending violations. The state agency said the facility had worked through the issues with them before reopening, though it was not required to do so.
  • On May 5, an 81-year-old resident of Twilite Manor diagnosed with dementia went missing for multiple hours before being found after staff reported him missing to the Cayce Police Department.

    DHEC told the Chronicle it is investigating the incident.

We are confused why DHEC regulations would allow a facility that had not yet been cleared of some seemingly extreme violations the freedom to operate if it chose to do so, especially when Cayce Police deemed residents to be in imminent danger. 

We wonder if the circumstances that violated DHEC regulations — and led Cayce Police to temporarily remove all residents — have contributed to the health and safety problems that have taken place this year at Twilite Manor.  

And we wonder if DHEC regulations for assisted living facilities are strong enough to safeguard the vulnerable population they are designed to protect.

This article is the opinion of the Chronicle editorial board. To comment, email opinion@lexingtonchronicle.com.

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