By Spencer Hunt and Debra Jasper
The Cincinnati Enquirer

Raymond Stahl was on a strict low-calorie, dairy-free diet that called for ground foods on the day a Columbus nursing home worker gave him a grilled cheese sandwich.

Mr. Stahl, 46, choked to death. In an autopsy, a coroner removed a "golf ball-sized wad" of bread and cheese from his throat. The coroner's report also showed high levels of an anti-depressant drug in Mr. Stahl's blood. While the drug did not kill Mr. Stahl, it could have hindered his ability to swallow food, says James Ferguson, the Franklin County Coroner's chief toxicologist.

ResCare Inc.'s Karl Road nursing home, where Mr. Stahl lived, was cited last May for inadequate staff training. The state Mental Retardation Department also faulted the home for allowing the worker, who gave Mr. Stahl the sandwich, to continue caring for people while the death was investigated.

The department said the worker was the only staffer available to supervise and bathe four people, including Mr. Stahl, on Dec. 3, 2000, the day he died. The worker was fired three months later.

ResCare officials won't discuss specifics of Mr. Stahl's death.

But David Rastoka, operations director for ResCare of Ohio, says workers are given picture books that display how ground and pureed food looks to help prepare meals for residents on special diets.

Residents who have digestive and swallowing problems and require special diets pose a constant training issue for homes and staff, says another ResCare official, Nell Taylor.

"You can put in every system in the world. Sometimes, something will happen," she says.

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