A Midtown nursing home agreed this month to pay the state $17,500 in civil penalties for more than two dozen violations, including failing to protect its elderly residents from sexual abuse.

Other problems at the Santa Rosa Care Center, 1650 N. Santa Rosa Ave., included failing to report injuries to the state as required, including falls with cuts or broken bones.

Since state inspectors discovered the problems in April, the 144-bed care center has corrected all the deficiencies and continues to operate, state officials said Friday.

Santa Rosa administrator Kim Arndt did not return calls seeking comment.

Among violations that state inspectors noted when they visited:

● The facility waited 10 days to tell a resident's medical provider that the resident had suffered a seizure, fallen to the floor and was unconscious for about 10 minutes. The resident's condition deteriorated after the seizure, state records show. He became increasingly confused and needed assistance to walk and eat. Doctors later determined he had intracranial bleeding from the fall.

● A resident's "do not resuscitate" directive was not correctly documented by staff.

● One woman fell in the bathroom and was given Tylenol for ankle pain. It wasn't until almost a full week later that the care center determined she had fractured her ankle, even though the woman said she told staffers that her pain was at least an 8 on a 10-point scale even with the Tylenol.

● A nursing note indicated a man was discovered giving oral sex to a resident with a documented history of dementia on March 16. There was no notation that the second resident's physician or family member was notified. The perpetrating resident had a history of "sexually inappropriate behaviors," state records say.

● One staff member said that if residents' don't object or resist, staffers consider sexual activity between two residents to be consensual. When asked if the resident's ability to consent was assessed, the staff member said no.

● Multiple, alert residents from four or five sections of the facility complained of urine odors at all times of the day; visitors to the facility also complained about an odor.

● A staff member who was helping to put a resident into a wheelchair made an unkind remark about the resident's leg being heavy. State rules say residents in licensed facilities "have the right to be treated with respect and dignity."

● Earlier this year, the Centers for Medicare and Medicaid agreed with state health inspectors that a "substandard quality of care" was being provided at Santa Rosa and suspended Medicare payments until Santa Rosa made the corrections. The federal government also required the care center to pay fines of $7,000.

State records show that corrective steps the facility took included putting a new policy in place on sexually expressive behavior between or among residents. The new policy included training for staff.

On StarNet: See the Star's April 2008 special investigation and database of enforcement actions, "State fails to protect nursing home residents," at go.azstarnet.com/nursinghomes