## Facts

- Community Alternatives Missouri, Inc. operated licensed group homes for developmentally disabled residents, including Turtle Creek Group Home in Bolivar, Missouri.
- Resident Gary Oheim was developmentally disabled, immobile, and at high risk for pressure sores.
- The State alleged that, between November 28, 2001, and January 10, 2002, Turtle Creek staff failed to provide reasonable and necessary services to maintain Oheim’s physical and mental health, creating imminent danger to his health, safety, or welfare.
- Mary Collura served as “lead staff” for Turtle Creek (a management position) and was responsible for resident care, staff supervision, and operational needs, including access to a company credit card for supplies.
- Evidence showed Oheim developed serious pressure sores during the charged period and that preventive and responsive care (including monitoring, repositioning, and follow-up) was not adequately provided under Collura’s oversight.
- At a clinic visit, when a physician attempted to examine Oheim for bedsores, Collura declined to reposition him as requested, leaving him seated and clothed during the examination.
- Oheim later died from complications related to pressure sores.
- A jury convicted the corporation of felony resident neglect; the trial court entered judgment and denied post-trial relief.

## Issues

1. Whether the evidence was sufficient to establish corporate criminal liability by proving that a “high managerial agent” engaged in or knowingly tolerated the neglectful conduct within the scope of employment and on behalf of the corporation.
2. Whether the evidence was sufficient to prove that the failure to provide reasonable and necessary services presented an “imminent danger” to the resident’s health, safety, or welfare.
3. Whether alleged instructional or other trial errors required reversal.

## Decision

- The Missouri Court of Appeals affirmed the conviction.
- The court held the evidence permitted a reasonable jury to find Collura was a “high managerial agent” and that she engaged in or knowingly tolerated the neglectful conduct on the corporation’s behalf.
- The court held the evidence permitted a reasonable jury to find the care failures created “imminent danger” to Oheim, given his known vulnerability and the seriousness of untreated pressure sores.
- The court rejected remaining claims of error and found no basis for reversal.

## Legal Principles

- A corporation may be held criminally liable when a high managerial agent, acting within the scope of employment and on behalf of the corporation, engages in or knowingly tolerates conduct constituting an offense.  
- “High managerial agent” may be shown by functional authority and responsibility for operations and resident care, not solely by formal corporate title.
- Resident neglect is established by proof of failure to provide services reasonable and necessary to maintain a resident’s physical and mental health, when that failure presents imminent danger to the resident’s health, safety, or welfare.
- “Imminent danger” focuses on whether conditions posed a substantial and immediate threat, and does not require that the threatened harm already have occurred.
- On sufficiency review, the evidence is viewed in the light most favorable to the verdict to determine whether a rational juror could find each element beyond a reasonable doubt.

## Conclusion

The court upheld a felony resident-neglect conviction against a residential care corporation, concluding that evidence of a lead staff manager’s operational authority and tolerated care failures supported corporate criminal liability and that the neglect created imminent danger to a highly vulnerable resident.


State v. Cmty. Alternatives Mo., Inc., 267 S.W.3d 735 (Mo. Ct. App. S.D. 2008)