Jane Pauley: They're among the nation's most vulnerable people, but lucky to be living in these enlightened times. In most of history to be mentally stable was subject to unimaginable horrors. Even the state hospitals of our parents' generation were rife with abuse. Today there are group homes where people can get personalized care. But wait until you see what that can mean. Here's Chris Hansen.

Reporter: This woman is about to commit a cruel crime against a defenseless victim, a man who is mentally disabled. What makes matters worse is that she is paid $1,600 a month to care for him. And this is her idea of a bath on a 40-degree day. But perhaps most troubling is how this video from a group home for developmentally disabled adults resembles these shocking images from years past, images that exposed as "snakepits" the state hospitals that warehoused many of america's profoundly retarded citizens a generation ago. Indeed, it was these pictures
and others that sparked the drive to shutter those institutions. And across the country, most state hospital beds have been eliminated, replaced by a far-flung collection of tens of thousands of small community based facilities like this one, where the developmentally disabled are cared for, typically, by nonprofit organizations, not the government.


Hall: Probably as much money has been spent on building the system of community based treatment care for the whole range of disabilities as has been spent on the building of the interstate highway system. We're talking billions.
Reporter: Professor Peter Dobson Hall of Harvard University, is one of the nation's leading experts on nonprofit organizations. He says that while most people who run group homes are undoubtedly well-intentioned, less scrupulous operators are also attracted by those taxpayer billions. And who's monitoring how all the money is being spent?
Hall: Nobody.

Reporter: That was also the conclusion of a 1993 investigation by the U.S. Congress, which found widespread abuse, neglect and fiscal mismanagement in a care system where, in most places, "virtually anyone can open a home," background checks are often "procedural and cursory" and staffers are sometimes "poorly trained and abusive." On top of that, the investigation found many states inspected group homes too infrequently, usually with "prior notice," and "rarely or never penalized" home operators for providing poor care. Surprisingly, these findings never led to any comprehensive federal reform, and, as you'll see later, a number of subsequent reports on the state level, most notably in California, where this video was shot, suggest too little has changed since that congressional investigation. Underscoring it all, a steady trickle of group home horror stories from around the country that have critics asking just how safe group homes are and if someone's asleep at the switch. Are these things isolated occurrences?

Hall: They're occurrences -- they're occurrences that, because there's no adequate system of oversight monitoring, are all too likely to happen.
Reporter: Does that frighten you?
Hall: Scares me.

Reporter: And it scares this man, who says he's haunted by nightmares about a brother he moved from an institution into a group home.

Cavalo: He's screaming for you to help him, and i want to help him, and I can't help him.
Reporter: Chuck Cavolo was best friend and guardian angel to his brother Jack, born 59 years ago with down syndrome. Chuck says the family tried to care for Jack at home, but when Jack reached his 20s, Chuck made the agonizing decision to move Jack into the nearby state hospital called the Western Center.

Cavalo: Three days out of the week, I had him home. When I'd get done working, I'd go up on the weekend, and I'd bring him home. I had him home more than when he was in an institution.
Reporter: And so it went for years, until Chuck Cavolo learned about a new option. In 1992, he moved Jack into this group home now operated by a subsidiary of the Arc of Allegheny County, near Pittsburgh, a nonprofit advocacy group for retarded citizens.

Cavalo: He loved people.
Reporter: In the beginning, Chuck says he was impressed but that over time, he sensed Jack was increasingly agitated, that he seemed frightened. That's why Chuck feared the worst last year when, he says, he got a phone call from a home worker.
Cavalo: She called me on the phone and said, "Mr. Cavolo, Jack is in the hospital."

Reporter: In the hospital?
Cavalo: And I said, "What do you mean, 'in the hospital'?" She said, "He had a little problem breathing, and they gave him a little bit of oxygen," but it was nothing to be concerned about. And inside me, I felt that there's something wrong here, and I'm going down to the hospital. So I got down to the hospital, and I went into that emergency room. I couldn't believe what I saw.

Reporter: What he saw was Jack's blackened eye, bruises on his legs and stomach, and a broken collar bone. Chuck took these pictures himself, he says, because nobody seemed interested in how Jack got hurt.
Cavalo: It was just all closed-mouth. I said, "Didn't you notice the black eye?" He said he never noticed it. Nobody noticed anything at the time.

Reporter: Meanwhile, Jack began suffering one complication after another. After 12 days, he died of an infection, which the coroner would conclude was "directly related" to his injuries.
Cavalo: An inquest was conducted.
Reporter: Chuck pushed for an investigation, and a coroner's inquest focused on a group home supervisor who was working alone over the weekend Jack was injured. Police say, that supervisor, Ed Hall, initially told them he didn't know how Jack got hurt. Then he changed his story, claiming he accidentally fell on Jack while trying to dress him. Did you buy that story when you first heard it?
Cavalo: I didn't buy it at all.
Reporter: The county coroner had his doubts, as well.
Cavalo: The weight of the evidence leans more toward nonaccidental injury.

Reporter: Nonaccidental injury. Possibly even homicide, the coroner concluded. He referred the case to the district attorney, but Hall, who refused to testify at the coroner's inquest, has not been criminally charged. Hall wouldn't talk to "Dateline," nor would the Arc of Allegheny County, citing an expected lawsuit by the Cavolo family. Chuck says he just wants to know what happened in that group home. If this could happen to your brother, given how devoted you were to him, what's happening to people who live in these groups homes who don't have a relative?
Cavalo: God help them.
Reporter: God -- or a neighbor with a camcorder. That's who shot this disturbing video we showed you earlier. The man getting hosed down on this chilly day last April was one of four residents in a group home in Suisun City, California, near the Napa Valley Wine Country. The home's owner, Clara Mroz, didn't realize she was being videotaped. The neighbor shot this shaky footage through a backyard fence.

Mroz: Get over here!
Reporter: The man suffers from cerebral palsy. He's unable to speak. He's lived in Mroz's home for 14 years. Drenched, the man shivers for almost an hour in the wind and cold while Mroz hoses down the patio. Then the camera catches a shocking scene -- Mroz kicks once, then once again, at the man's groin. After viewing this tape, authorities quickly arrested Mroz and shut down this home and another one she operated. She pleaded guilty to abuse of a dependent, a felony, and was sentenced to six months in jail and five years probation.

Mroz: I'm very, very sad. Very, very sad.
Reporter: But the most disturbing thing about this video may be what it reveals about oversight of group homes in California, for it would not be the first time someone questioned that state's ability to monitor and protect group home residents. Indeed, between 1996 and 1998, a series of scathing studies by university researchers, state investigators and federal auditors uncovered alarming deficiencies -- poor oversight, questionable deaths and even higher mortality rates in group homes than in the institutions they were supposed to replace. While state officials disputed many of these findings, they also promised "new and expanded oversight" for group homes. So could it be, still, that nobody was watching Clara Mroz's home closely enough? "Impossible," says the person ultimately responsible for the residents in Mroz's care. How did you react when you first saw the video in the Clara Mroz case?

Gardner: It made me sick to my stomach. It was shattering. It's appalling that anybody could treat another human being that way.
Reporter: Nancy Gardner is the executive director of the North Bay Regional Center in Napa, a nonprofit company paid by the State of California to monitor some of its group homes. One of those was Clara Mroz's home, which Gardner says was inspected 26 times in the last year, several times without notice. She says the Mroz case shows the system working, not breaking down.

Gardner:  We were able to provide immediate response in a dangerous situation.
Reporter: What would have happened if this man didn't have a camcorder or his camcorder battery was dead that day?
Gardner:  It's hard to say what would have happened, but I would have hoped that he would have immediately called the police or the regional center to intervene at that moment.

Reporter: Wouldn't one of your earlier interactions with her have detected her propensity for this kind of thing?
Gardner:  We do the best we can to monitor and to minimize risk. But unfortunately, in our society, we face risks every day.

Reporter: That, by the way, is more than anyone in Pennsylvania would tell us about the death of Jack Cavolo. In a letter citing confidentiality laws, the state's deputy secretary for mental retardation turned down our request for an interview, at the same time insisting that pennsylvania's system of oversight ensures "that people receive appropriate care, and they are safe." But don't tell that to Jack's brother Chuck, who's still looking for answers.
Cavalo:  Where is it going wrong? Why is this happening? There has to be a reason for it. Somebody had to know. Somebody had to know about this.

Jane Pauley: You may be wondering how many people actually live in these homes. One university study estimates that approximately 160,000 developmently disabled americans now reside in small group homes across the country.
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  Peter Dobkin Hall, Leonard Bacon Research Fellow and former Director of the Program on Non-Profit Organizations (PONPO), has been connected with Yale University since 1973. As of January 2000, he joined the faculty of the Kennedy School of Government at Harvard University. A graduate of Reed College, Hall received advanced degrees in history from the State University of New York, Stony Brook. Hall's published work includes: The Organization of American Culture, 1700-1900: Institutions, Elites and the Origins of American Nationality (NYU Press, 1982). Inventing the Nonprofit Sector and Other Essays on Philanthropy, Voluntarism, and Nonprofit Organizations (John Hopkins, 1992), and (with George E. Marcus) Lives in Trust: The Fortunes of Dynastic Families in Late Twentieth Century America (Westview Press, 1992). He is also the co-editor of an anthology (Oxford University Press, 1997), Sacred Companies: Organizational Aspects of Religion and Religious Aspects of Organizations. Hall serves as the Book Review Editor of the Nonprofit and Voluntary Sector Quarterly, the leading scholarly journal in the field.