BUFFALO, N.Y. (WIVB) — Short of closing the facility, the New York State Department of Health could not penalize Emerald South Nursing and Rehabilitation Center any more severely.

After the death of nursing home resident Ruth Murray, who was severely beaten by another dementia patient, the state leveled the stiffest fine allowed by law.

Despite this, it still took the nursing home months to come into compliance with the state.

The 82-year-old Murray had just finished breakfast on Aug. 26 when she wandered into the room of another resident on the dementia floor of Emerald South.

Moments later she would be found unconscious, after a brutal beating at the hands of an elderly male resident.

A News 4 investigation in August and September, which included an analysis of medical documents and nursing home staff notes, showed the staff knew the male resident had violent tendencies.

In fact, he was supposed to be checked on every 15 minutes, according to the Department of Health.

That’s just one of the many reasons why the agency fined the nursing home $10,000 “based on the seriousness of this matter.”

“The DOH findings pretty much are that the assailant resident, his care plan was violated, in addition to our client’s,” said Don Chiari, of Brown Chiari Law Firm, which among other areas, specializes in nursing home abuse. “And that both violations caused this to come about.”

He says any fine, especially the highest allowed by law, is rare.

“This is very unusual that No. 1, they would even be fined,” he said. “We’ve had cases in the past where there have been 50 deficiencies, and there was no fine. So, the fact that there’s a fine tells you something. And the fact that it’s the largest that they can fine, I think, is significant in the case.”

The department of health also says it took Emerald South multiple attempts, and multiple failures, for them to finally come into compliance.

The facility submitted a plan of correction in early September, and again in late September. Both failed. It submitted another plan of correction on Oct. 4.

It was approved by the department of health following an on-site survey on Oct. 20.

“The time that it took to come into compliance doesn’t shock me at all because they had a lot to do,” Chiari said. “This was an egregious, deplorable situation in this facility, one that took a lot of investigation.

“The health and safety of every resident was at risk in this facility,” he added. “And I’m sure that’s why the DOH took this so seriously.”

The DOH released a statement to News 4 this week.

“The New York State Department of Health is committed to protecting the health and safety of New York’s nursing home residents,” the statement read. “The Department required the facility to submit a revised plan of correction for review and approval. Based the seriousness of this matter, the Department fined Emerald South $10,000 and conducted a post-survey visit at Emerald South Nursing and Rehabilitation to make sure all of the corrections were made.”

In addition to their failure of comply with state regulations, Emerald South also failed to notify the appropriate staff in a timely manner after Murray’s beating, according to the DOH.

They also failed to notify the state until two days later.

It was another instance of the facility downplaying the violent incident.

As the News 4 investigation showed, Emerald South staff said Murray’s injuries were far less severe than they actually were. They said Murray sustained only lacerations to her head, scratches to her nose and a bruise on her backside.

The department of health, however, said Murray had a collapsed lung, five fractured ribs, a fractured neck and vertebrae and broken bones in her face.

“Nothing surprises me about Emerald South, I have to say,” Chiari said. “We have several cases against them. I think they’re a deplorable facility.”

Chiari said the report generated by the DOH that resulted in the fine gives them the information they need to move forward with a lawsuit. That process will begin next week, Chiari said.

Representatives from the law firm representing Emerald South, Harris Beach, did not return calls seeking comment.