CHARLESTON, W.Va. -- Workers in an understaffed Charleston nursing home failed to properly care for an 87-year-old woman who had stayed there for about three weeks before dying of dehydration, lawyers for the woman's son said during the first day of a civil trial Tuesday in Kanawha County Circuit Court.

Too few nurses were on staff in Heartland of Charleston to make sure Dorothy Douglas, who suffered from dementia and Alzheimer's, was eating food and drinking water, lawyers for her son Tom told a jury.

In September 2009, Tom Douglas checked his mother into the Heartland home temporarily until a bed opened up at Heritage Center, a Huntington nursing home that is better suited for caring for Alzheimer's patients, Douglas' lawyer Amy Quezan told jurors Tuesday afternoon.

Dorothy Douglas died at Hospice of Huntington on Oct. 11.

When she arrived at Heritage Center after three weeks at Heartland, she was covered in bruises, sores and scars in various stages of healing, Quezan said. Crud caked the elderly woman's mouth and she did not respond to her name, sounds or pain.

"You will find that the reason," Quezan said, "is that she was literally dying of thirst."

Before she was admitted to Heartland, the elderly woman could walk, talk and recognize family members, Quezan said. When she was living with her son, her condition had actually improved from previous low points.

Quezan claimed that Heartland, which operates under the umbrella of a hierarchy of corporations, intentionally keeps the home understaffed to increase the revenue generated by its residents.

Heartland is owned by ManorCare Inc., which in 2007 agreed to a multibillion-dollar buyout from the equity firm giant Carlyle Group.

The way ManorCare makes money, Quezan said, is to keep the number of staff members low and the number of residents high.

"[Witnesses] will tell you that there is simply not enough staff to take care of the residents," Quezan told jurors during her opening statement.

Heartland lawyer Charlie Johns said that nurses at the home actually spend more time with each resident per day than the state requires.

Nurses at Heartland spend an average of 3.14 hours with each resident every day, Johns said. The state requires that nurses in federally funded homes spend at least 2.25 hours per day with patients.

The nursing home budgets more than 100 hours per day for the approximately 150 residents in the home, Johns said.

Johns also pointed out that Douglas' death certificate states that she died of dementia, not dehydration, and that staff at the Heritage Center documented that the woman had not consumed any food or drink for a full 21 hours after she had been admitted to the new facility.

Johns flashed document after document on a projector screen that detailed treatment that staff at Heartland had given Douglas, including evidence that the home made a concerted effort to have the woman transferred to the Huntington facility.

Douglas had multiple skin issues when she was admitted to Heartland, and records from previous facilities had already labeled the woman as failing to thrive and noted that her Alzheimer's and dementia were worsening, Johns said.

"The important thing for us is that [Douglas' death] was not anything that was done, any neglect, that was caused by Heartland of Charleston," he said.

Reach Zac Taylor at Zachary.Tay...@wvgazette.com or 304-348-5189.