For much of the 1990s, Richmond psychiatrist Nazir A. Chaudhary thrived in Virginia's assisted living industry, aided by the state.
He built up a sizable business of 15 facilities. He was embraced by state leaders, including former governor James S. Gilmore III. But behind the facade of a successful business and caregiving enterprise was a very different reality -- one in which state officials approved new licenses and sent taxpayer dollars to an owner who had serious problems caring for residents at his homes.
In 1998, Chaudhary was asked to step down from a state mental health advisory board because of serious violations in some of his facilities. By then, the state had catalogued a long list of problems. But on 30 other occasions after his resignation, the state granted new licenses or renewed licenses for his homes.
Chaudhary, known as a well-dressed, soft-spoken and stubborn man, came to Virginia in the late 1970s. He was born and studied medicine in Pakistan, then received his medical license in Virginia. He began to treat adult home residents, eventually opening his own homes and taking on some of the residents as patients, according to court documents and Medicaid records. That allowed him two sources of income: the patients' room and board as well as medical billings.
Within a few years, complaints began to come in to state offices. By the end of 2001, homes licensed to Chaudhary's company accumulated hundreds of violations of state regulations, including neglecting the residents, understaffing and allowing dirty, run-down conditions, records show.
A resident was tethered to a wheelchair and forgotten in a bathroom for more than 16 hours, inspectors reported. One resident died from choking on food. And two residents died after suffering hypothermia: One wandered undetected from a facility, and another, Theresa Buford, 75, collapsed in a home that had faulty heating. In each case, the homes were reprimanded for improper care.
Chaudhary declined repeated requests to be interviewed. But in legal depositions, he has said that though he controlled the finances at the facilities, daily operations were in the hands of his administrators.
Chaudhary ordered employees to run the homes as cheaply as possible, using skeleton crews, according to interviews and public records. Employees were without funds to pay the bills, and one administrator told licensing inspectors that she was budgeted just $2.40 a day to feed each resident.
Angela Codynah, administrator at a Chaudhary facility in Fredericksburg, said in an interview that she used her own money to buy food for the residents. And she said Chaudhary ordered her to hide problems from inspectors.
"It was absolutely pitiful, the whole picture," said Codynah, who quit after 11/2 years.
Chaudhary collected enviable revenue. In one court filing, he reported that his company, Dogwood Realty, received $282,000 a month from just five of his homes. At one home, he reported $696,000 a year in state subsidies for low-income residents.
A decade earlier, he had built a sprawling, eight-bedroom brick mansion for his family in Henrico County near the James River.
State inspectors warned Chaudhary in April 1997 that chronic problems at Kenmore Forest, a facility in Richmond, were threatening his license there. One month later, emergency personnel called to the home found an ailing male resident with severe bedsores, wearing nothing but a wet shirt in a filthy, soaked bed. Inspectors said the home neglected the man, but within months it was granted a full license.
When problems resurfaced, Chaudhary subleased the facility to another operator, which removed all violations from its record. He did the same at another facility in Suffolk, transferring official responsibility but continuing to earn money from the operation as its landlord.
It was in 2001, after Buford's death, that state regulators began to deny or revoke his licenses.
He complained to federal officials and Gilmore about state inspectors and sued the state claiming discrimination, saying it was unfairly harsh on minority owners. Federal and state officials investigated Chaudhary's claims, and countered that the accusations had no merit.
Chaudhary's attorney, Harold E. Lucas of North Carolina, argued that after his client filed claims of discrimination, state inspectors retaliated and conspired to drive him out of business. "It's easy to pick on people that are doing a complicated operation," said Lucas, referring to the challenge of running assisted living facilities.
He said that his client has spent more than $25 million on his facilities over the years and that Chaudhary is in financial straits as a result of state actions against him.
Chaudhary's company continues to operate a facility in Richmond. He sold or closed several other homes. But Chaudhary has remained the landlord on others, where leases show that management has been turned over to new operators.
Staff researcher Bobbye Pratt contributed to this report.