Care aide doing time for death adds plea

A former home healthcare aide who by neglect caused the death of his mentally disabled client promised on Thursday to pay more than $31,000 in fines and restitution for cheating Medicaid, which funded his services as a fulltime caretaker.

Shawn Edward Howard is already serving a 20-year prison sentence for second-degree murder for the February 2015 death of Jimmy Don Abner.

The 57-year-old Fort Smith man had the mental capacity of a 5-year-old due to early onset dementia. Abner’s body was found in woods near Cedarville two days after Howard reported him missing.

The 5-foot-tall Abner weighed 92 pounds when his body was found, naked except for socks. Medical examiners attributed Abner’s death to dehydration and infections from bedsores brought on by starvation. He had weighed 125 pounds five months earlier.

Doctors reported he had bedsores that had developed over the last six months of his life. One sore was 2 inches wide and more than 5 inches long.

State Assistant Attorney General Emily Abbott, who prosecuted the fraud case, told Pulaski County Circuit Judge Leon Johnson that Howard fraudulently billed Medicaid for $23,980 in services he did not perform or insufficiently performed between August 2014 and Feb. 10, 2015, the day Howard reported Abner missing.

Pleading guilty to Medicaid fraud and theft, Howard, who was represented by attorneys Bill Simpson and Will Ogles, accepted a five-year extension to his current prison sentence.

The arrangement also requires that he serve a 15-year suspended sentence conditioned on him paying a $7,500 fine and repaying Medicaid or going back to prison.

Howard pleaded guilty to the murder charge in January 2016. Attorney General Leslie Rutledge charged him with Medicaid fraud the next month.

The charges arose from the discovery by investigators in the attorney general’s Medicaid fraud division that Howard had billed the program for 196 days of round-the-clock work, about six months.

But records from the Choctaw Casino show that his player’s card was used 151 days over that same time at the gambling hall in in Pocola, Okla., and that he collected winnings on 14 days.

Howard reported that he had been earning $8 per hour to look after Abner while working for Bost Human Development Services in Fort Smith.

When he reported Abner missing, Howard told authorities that Abner had left the apartment, while Howard was taking a shower, with a man Howard knew only as Eugene.

At one point, police received a letter purportedly from Abner, saying that he and Eugene had gone to Joplin, Mo., to be “gay married” and that he would kill Eugene and himself unless police stopped trying to find him.

Police said the letter was mailed from Oklahoma, where Howard kept a home, and that the handwriting was identical to Howard’s.

Howard told police that Abner was wearing shoes when he left the home, but the man’s only pair of shoes were still in his closet.

Howard also reported that he regularly took Abner to lunch at restaurants and bathed the man daily. He never sought medical care for Abner, according to police reports.

Abner had become susceptible to the infection from his sores because he was starving, according to the autopsy report.

“The only reasonable conclusion is that he did not receive adequate nutrition during that six-month interval,” the autopsy report said. “When the malnourishment reached a point where lethargy and abandonment of normal activities had taken place, a reasonable response would have been to seek medical attention.”

The symptoms of starvation and festering sores would have been apparent to whoever was caring for Abner and clearly demonstrated the need for medical care, the report said.

“The pressure sores, particularly the one on the hip, would have taken days to develop, and would have been readily visible to a caretaker. The appearance of a bed sore should have provided further interest to seek medical attention.”

At one point, police received a letter purportedly from Abner, saying that he and Eugene had gone to Joplin, Mo., to be “gay married” and that he would kill Eugene and himself unless police stopped trying to find him.