A home health care company is being fined over $163,000 after an investigation found that the company did not provide adequate safeguards to protect a Connecticut visiting nurse who was killed during an appointment with a convicted sex offender last October, federal workplace safety officials said Wednesday.

The Department of Labor's Occupational Safety and Health Administration found that Elara Caring, one of the nation’s largest home-based care providers, failed to protect Joyce Grayson, a behavioral health nurse who was killed on Oct. 28, 2023, during a home visit in Willimantic, Connecticut. The Dallas, Texas-based company has over 200 branches in 17 states, including five branches in Connecticut, according to OSHA.

OSHA found that the company "exposed home healthcare employees to workplace violence from patients who exhibited aggressive behavior and were known to pose a risk to others," on Oct. 28 and at times prior, the agency said in a statement Wednesday.

Willimantic police found Grayson, 63, strangled in the basement of a halfway house for sex offenders after her daughter called police to request a well-being check, according to an arrest warrant. Michael Reese, 39, who had an appointment with Grayson at the halfway house, was accused of attacking and killing Grayson.

Reese was on probation at the time, according to the warrant, and was living in the halfway house after serving about 14 years in prison for sexually assaulting and stabbing a woman in 2006 in New Haven, the Hartford Courant reported. Reese was arrested on April 19 and has been charged with murder, felony murder, and criminal attempt to commit sexual assault in connection to Grayson’s death, Connecticut State Police said.

"Elara Caring failed its legal duty to protect employees from workplace injury by not having effective measures in place to protect employees against a known hazard and it cost a worker her life," Charles McGrevy, an OSHA area director in Hartford, Connecticut, said in the statement. "For its employees’ well-being, Elara must develop, implement, and maintain required safeguards such as a comprehensive workplace violence prevention program. Workplace safety is not a privilege; it is every worker’s right."

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What happened to Joyce Grayson?

On Oct. 28, 2023, Grayson's daughter requested a well-being check on her mother after she was unable to get in contact with her. She discovered that Grayson had missed several later appointments, according to the warrant.

Earlier that day, Grayson had an appointment at Reese’s halfway house.

At 7:37 a.m., a surveillance camera captured a red vehicle that matched Grayson's Hyundai Sonata driving near Reese's halfway house, the warrant said. About 20 minutes later, the vehicle was located at a convenience store and cameras showed Reese entering the store and using an ATM, according to the warrant. Police later found that Reese had stolen over $200 from Grayson’s account bank account.

Reese then drove around the area before stopping at a bank and again withdrew more than $200 from Grayson's account, according to the warrant. Police, who were searching for Grayson and Reese, tracked Reese’s movements through his ankle monitor and matched his activity with surveillance footage.

Grayson's daughter also reported to police that she had tracked her mother's phone through the Apple "Find My iPhone" app, which showed that Grayson was still at the halfway house, the warrant said. Officers were later notified that Reese's ankle monitor was alerting to signs of tampering and an officer caught Reese leaving the halfway house through the back.

The officer advised Reese that he was not free to leave at the time and discovered Reese had a knife, a crack pipe, Grayson’s credit and debit cards, and her vehicle's key fob in his possession, according to the warrant.

Officers then searched the halfway house in an attempt to locate Grayson and discovered her in the basement, the warrant said. Grayson's body was covered with a blanket and pillow.

An autopsy later revealed that Grayson had blunt-force injuries to her head, torso, and extremities. There were also signs of attempted sexual assault and Reese's DNA was found on Grayson's body.

She died of asphyxia due to neck compression, the warrant added. The death of Grayson sparked calls for better safety measures and new legislation for health care workers.

"The hard-working women and men who provide care in the home need and deserve to feel safe while doing their jobs," National Association for Home Care & Hospice President William Dombi said in a statement last November. “NAHC and our members will continue to do everything in our power to improve the safety and well-being of home care workers."

Elara Caring disputes OSHA's findings

Elara Caring faces $163,627 in proposed penalties, according to OSHA. The agency said Elara Caring could have reduced the hazard of workplace violence in numerous ways, including providing clinicians with comprehensive background information on patients, giving clinicians emergency panic alert buttons, and developing procedures for the use of safety escorts for patients with high-risk behaviors. 

Elara Caring said in a statement emailed to USA TODAY that the citation OSHA "issued to the company is unwarranted, and we intend to contest it vigorously." 

The company added that Connecticut authorities, including the state Department of Corrections, had determined that Reese was safe to re-enter the community.

"Post-release, state authorities were responsible for monitoring and managing the patient's activities," Elara Caring said. "The death of Joyce Grayson was a tragedy, and we continue to grieve with the family."