WARRENSVILLE HEIGHTS, Ohio — A grand jury has indicted a nurse on involuntary manslaughter and related charges following the hypothermia death of an 84-year-old wheelchair-bound woman who was left outside a Cleveland-area nursing home overnight on Christmas Eve 2024, according to the Cuyahoga County Prosecutor's Office.
Amber Henderson, 32, who worked at Avenue Care and Rehabilitation Center in Warrensville Heights, faces one count of involuntary manslaughter, one count of tampering with records, and one count of patient neglect in the death of resident Alvera Meuti, as reported by the Cuyahoga County Prosecutor's Office in a March 2025 announcement.
What Happened
According to the prosecutor's office, Henderson began her overnight shift at approximately 9:15 p.m. on December 23, 2024, and discovered Meuti was not in her room by 9:30 p.m. Rather than immediately alerting supervisors or initiating a search, Henderson reportedly assumed the elderly resident had departed with family members, according to News 5 Cleveland.
Investigators determined that Henderson attempted to reach Meuti's family by phone at 12:36 a.m. but received no answer, as reported by News 5 Cleveland. Despite this failed contact, Henderson did not formally report the resident missing until approximately 6:30 a.m. on December 24, when staff initiated an emergency "Code Purple" search protocol — roughly nine hours after she first noticed Meuti's absence.
Meuti's body was discovered at approximately 8 a.m. on the facility's outdoor patio, according to the prosecutor's office. Investigators determined that Meuti had exited through an unlocked door that locked from the outside, which prevented the 84-year-old from re-entering the building. The Cuyahoga County Medical Examiner ruled the cause of death as environmental exposure with hypothermia, as reported by Cleveland 19.
The investigation also revealed that Henderson allegedly falsified facility records to indicate she had completed required care checks on Meuti throughout her shift, according to the prosecutor's office. Henderson was initially arrested on January 16, 2025, and has pleaded not guilty. Her pretrial hearing was scheduled for late January, as reported by Law & Crime.
Meuti's family has separately filed a civil lawsuit in Cuyahoga County alleging that an unsecured exit door allowed the wheelchair-bound resident to leave the building unnoticed, according to Law & Crime.
CMS Inspection History
Federal inspection records paint a troubling picture of the facility where Meuti spent her final days. Avenue Care and Rehabilitation Center holds the lowest possible overall rating from the Centers for Medicare & Medicaid Services — just 1 out of 5 stars. The facility's health inspection rating and staffing rating each stand at 1 out of 5 stars as well, according to CMS data. Only its quality measures rating, at 4 out of 5 stars, rises above the bottom tier.
The 97-bed for-profit facility has accumulated 66 deficiencies across 26 inspections documented in CMS records, with the most recent inspection occurring on October 29, 2025.
Deficiencies cited during that October 2025 inspection include failures to promptly notify residents, physicians, and family members of situations affecting residents, as well as inadequate assistance with daily living activities. Inspectors also cited the facility for failing to provide sufficient nursing staff to meet resident needs on every shift and for deficiencies in infection prevention and control protocols, according to CMS records.
Notably, an inspection conducted on October 6, 2025 — less than a year after Meuti's death — cited the facility for failing to protect residents from all types of abuse, including physical abuse, mental abuse, and neglect. Federal regulations require nursing facilities to ensure the safety and well-being of every resident and to maintain adequate staffing levels around the clock.
The pattern of deficiencies documented in federal records raises serious questions about whether systemic operational failures at the facility contributed to the conditions that led to Meuti's death.
Ownership & Operations
Avenue Care and Rehabilitation Center operates as a for-profit corporation, according to CMS records. The facility's consistently low federal ratings across both health inspections and staffing suggest ongoing operational challenges that predate the December 2024 incident. The combination of a 1-star staffing rating and documented failures to provide adequate nursing coverage is particularly relevant given that the criminal charges against Henderson center on her failure to follow proper protocols for a missing resident during an overnight shift.
Resources for Families
Families who have concerns about the care of a loved one in an Ohio nursing home have several avenues for reporting and assistance:
- Ohio Long-Term Care Ombudsman Program: 1-800-282-1206 — The ombudsman program advocates for the rights of nursing home residents and can investigate complaints about care quality, neglect, or abuse. - National Elder Abuse Hotline: 1-800-677-1116 — Available for reporting suspected elder abuse or neglect at any facility nationwide. - Long-Term Care Ombudsman Resource Center: [ltcombudsman.org](https://ltcombudsman.org) — Provides information on resident rights and how to file complaints in any state.
Families are encouraged to document concerns in writing, request copies of care plans and inspection reports, and contact their local ombudsman office if they believe a loved one is receiving inadequate care.
💬 Join the Discussion
Comments are moderated. Please keep discussions respectful and relevant to nursing home care quality.