Care home
unaware of murder
in patient’s past

The care resident, accused of
killing her nurse, was acquitted
of murder in another case
due to insanity

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By B.J. Reyes
breyes@starbulletin.com

Despite a history of mental illness that included acquittal on a murder charge by reason of insanity, the background of a woman charged with killing her care home operator never was revealed to the home, the slain woman's husband said.

"If we only knew that she is like that, we'd never take that lady," said Bart Alcaraz, whose wife was stabbed to death Sunday in the Waipahu care home they ran.

Emelie Rauschenburg, a 55-year-old resident of the home, has been charged with second-degree murder. She faced similar charges 17 years ago after setting fire to a Makiki boarding house with 10 people inside, killing one, according to police reports. She subsequently was acquitted of all charges by reason of insanity.

Alcaraz said he only learned of his client's past through media reports of his wife's death.

"With this lady, we never had any background," Alcaraz said. "We had her for months and nobody has come to my humble home to tell us any of this. There was no disclosure at all."

It wasn't immediately known how Rauschenburg was referred to Alcaraz's care home, where she'd lived since March. State health officials said privacy laws keep them from discussing Rauschenburg's case.

Although social workers and case workers are required to divulge certain information if asked, it ultimately is the care home operator's responsibility to find out about a potential client's background, a state health official said.

First and foremost, an operator must make inquiries to determine if the care home has the facilities and staff to meet the needs of the client, said Helen Yoshimi, chief of the Department of Health's Office of Health Care Assurance, which licenses care home operators.

If that research turns up anything questionable, the operator can then request the full patient history from doctors and social workers before deciding whether to accept the client, Yoshimi said.

Hypothetically, a social worker would not be obligated to disclose someone's past treatment for mental illness if that person had since been deemed mentally fit by a physician, Yoshimi said.

After her acquittal in 1984, Rauschenburg was admitted to the State Hospital and was released to the adult probation office in 1988, according to court documents.

In 1994, Rauschenburg went to St. Francis West Medical Center in a coma, and then about six months later went to a care home, according to the court. Doctors said Rauschenburg had suffered partial paralysis due to a stroke.

In 1997, one doctor stated that Rauschenburg "poses no threat of danger to herself or to the persons or property of others" and that her diagnosed paranoid schizophrenia was in "remission." Though the doctor said Rauschenburg still suffered from dementia, it was a "mild to moderate" case, according to the court. Rauschenburg was kept on probation with orders to continue reporting to state health officials.

Maria Etrata, president of Primary Caregivers of Hawaii, an association of care home operators, said it's not uncommon for social workers to provide a patient's partial history.

"We should have the information of what this person is capable of," she said. "If those are not disclosed, sometimes the operator will just think that they're all right and she'll take the client."