Key Takeaways:
- George Marks’ death happened after documented safety concerns at a Charlotte nursing home, including concerns about his awareness, decision-making and repeated unsafe behavior.
- State inspectors found that the facility failed to safeguard Marks.
- The Marks case is part of a broader accountability question about nursing homes and private equity ownership.
By Ashley Fredde
The morning of Oct. 17, 2023, was dawning in Charlotte when George Marks rolled out of The Citadel at Myers Park in his electric wheelchair. First light was creeping into the sky when, just feet from the facility’s entrance, according to a police report, Marks rolled into Providence Road as a municipal garbage truck traveled west through the intersection.
There was no crosswalk. A witness later told police they saw a “shadow” roll into the street.
The garbage truck’s driver told police he attempted to stop but it was too late. The front bumper slammed into Marks, and the report details how Marks was catapulted five feet in the air. That account noted he smashed into the pavement, on his face.
While the immediate cause of Marks’ death eight days later was nearly 8 tons of steel striking his wheelchair in a dimly lit roadway, lawsuits filed on behalf of his family allege the outcome represented a failure of the system that was supposed to provide him with care and safety.
An account pieced together by state nursing home inspectors found that Marks had gotten up about 5:20 a.m. As he rolled past the front desk of the skilled nursing home facility where he lived, he said he was going to a family member’s house, staff told state inspectors. The facility’s record obtained by those inspectors does show that he had signed out on the morning he was struck, but no time was recorded.
NC Health News reached out several times for comment from the facility, its managing operator and parent company but received no response. The managing operator and parent company phone lines lead to full inboxes with no opportunity to leave a message. Separate emails were sent to the attorney representing the facility and affiliated corporations in the lawsuit and to one of the parent company’s founders.
Doctors found fractures throughout Marks’ body, including every rib on his right side, his sternum and multiple vertebrae. The medical record showed he had fractures to the sides and the middle of his face, as well as facial lacerations and a large hematoma on his forehead. Clear fluid — likely cerebrospinal fluid — leaked from his nose and around his eyes.
Despite all this trauma, Marks did not die at the accident site. He was rushed to Atrium’s Carolinas Medical Center, where he was admitted in stable condition.
For a day and a half, Marks lay in an intensive care unit alive, awake and mostly alone — aside from the doctors and nurses treating his many injuries. Outside the hospital, his family alleges, only a few people knew what had happened to him: the nursing home staff, residents in the surrounding neighborhood, and the garbage truck driver who struck him.
His family had no idea.
His daughter, who lived out of state, said she began to worry after she hadn’t heard from her dad. She called her cousin Joseph Marks who lived nearby — the nephew George Marks would often visit — and asked him to stop by the facility and see what was going on.
The morning of the crash, Marks had left his nephew a voicemail saying he was planning on visiting him that day, but he never arrived.
“They were very nonchalant about things, time and time again,” his daughter, Angela Marko, alleged in a recorded statement that was used in an arbitration proceeding.
“[The nursing home] dropped the ball of communication. It was horrible. They didn’t even have the decency to tell me that my dad was struck.”
Joseph, his nephew, was the first member of Marks’ family to learn what had happened. He immediately went to see him at the hospital.
“I was the first one to see him, but wish I hadn’t been,” he told NC Health News. “Especially like that.”
Joseph Marks said he still has pictures of his uncle in the hospital on his phone.
“I don’t know why they’re in my phone. I was going to erase some, but I think one of the lawyers [for the estate] said hold on to them for certain reasons,” Joseph said. “He was pretty messed up.”
The Marks family are suing, horrified by what happened to George — and horrified by the chain of what they call failures leading to his death that they allege occurred at The Citadel at Myers Park. In the lawsuit, they also blame North Carolina regulators, who they allege allowed Myers Park to continue operating and “to engage in a sustained course of noncompliance: ignoring regulatory mandates, disregarding inspection findings, and failing to implement necessary reforms.”
Three years later, they are still pursuing justice, something that’s unusual. By this time, most families in this type of situation have settled, with lawsuit documents sealed, shielding defendants from public scrutiny.
A North Carolina Health News investigation found that the facility was one of multiple nursing homes owned by private equity company Portopiccolo Group that received a notice from CMS of substantial failure “to comply with Medicare and Medicaid health and safety requirements.”
Despite repeated federal sanctions, the loss of Medicare and Medicaid certification at several facilities and years of documented resident harm, Portopiccolo has continued operating in North Carolina — often under different management, but with the same founders. While “Portopiccolo Group” does not ever appear in the federal database, owners of these and other facilities are usually identified by the two founders’ names — Simcha Hyman and Nafatali Zanziper — as a chain. Portopiccolo and affiliated chains in North Carolina now own more than 100 nursing facilities. That includes The Citadel at Myers Park, which now operates under a different name. The facility can no longer bill Medicare or Medicaid because it is under CMS sanction, even though it is still licensed by the state of North Carolina.
Portopiccolo and affiliated chains’ North Carolina facilities had an average Medicare quality rating of 2.1 stars out of 5 in 2025, with the highest rating being 2.2 stars. LinkedIn indicates that the two, Simcha Hyman and Nafatali Zanziper, have since organized a new company, 980 Investments, but CMS ownership data continues to link the facilities under the two founders’ names.
The company and its affiliates, as well as the City of Charlotte are all named as defendants in the lawsuit filed by the Estate of George Marks in May 2025.
A mandatory arbitration agreement signed by Marks as he entered the facility — even as he had a diagnosed brain injury — requires the estate’s claims against the facility to be resolved through arbitration rather than in civil court. To date, the arbitration has not been resolved, holding up the civil case. The City of Charlotte is proceeding in civil court and has asked the court to compel the nursing home to participate in the case.
Signs of risk and opportunities to intervene
According to inspection records, Marks was admitted to The Citadel at Myers Park, now renamed Myers Park Nursing Center, in April 2022 with diagnoses that included a traumatic brain injury from a motorcycle crash when he was younger, anxiety and depression. Marks had lived with his father for some time after the crash.
After his father died, Marks moved around, living with other family members. He admitted himself into the facility.
State inspection reports show a complicated picture of Marks’ cognitive functioning. A July 2023 assessment that was included in the inspection reports described him as alert and aware, while an August 2023 wandering-risk assessment included a diagnosis of dementia or cognitive impairment. His falls-risk assessment also noted that he “overestimates or forgets limits” and classified him as being at high risk for falls.
His daughter said that Marks and his family had chosen the facility for the advertised dementia care.
“They had marketed themselves as helping people with dementia, paying real close attention to their needs,” Marko said through tears. “It wasn’t what it was supposed to be. I didn’t know that it was as bad as it was until all this came out. And come to find out, it was bad.”
The facility’s records obtained by state inspectors show that Marks had demonstrated behaviors that raised concerns about his ability to safely leave on his own. His care plan, revised in May 2023, documented repeated behaviors that included refusing care and medication, and leaving the facility without signing out. The plan called for staff to discuss those behaviors with him and explain the potential consequences of not following care or treatment recommendations.
After the crash, the facility’s nurse practitioner told state investigators that Marks was “cognitively alert and felt like the resident was safe to leave the facility because he did so daily.” She also told state investigators she believed he had poor decision-making skills. She said that in the past she had observed him crossing the road where there was no crosswalk, traveling at a fast speed in his motorized wheelchair and doing so without safety precautions on the chair.
She said she had reported those concerns to nursing staff.
A nurse from the facility told investigators that Marks left The Citadel at Myers Park daily and had frequently refused to sign out when staff could not immediately provide the sign-out sheet. That nurse said he had not personally seen Marks outside but said he had heard from other staff that he crossed the road unsafely and traveled into town. A nursing assistant told state investigators that she had seen Marks riding his motorized wheelchair down the middle of the four-lane road, with traffic honking and braking because he was not paying attention.
more COVERAGE of AGING ISSUES
After the accident, state investigators inspected the area of the accident and found that Providence Road, several yards from where the nursing home sat, had a 35 mph speed limit, heavy traffic and no safe crossing at the location where Marks was hit. The sidewalks on either side also lacked accessible ways to get onto them, according to the inspection report.
Marks’ daughter had also worried about the wheelchair that carried him into the intersection. In her statement, she claims she had called the facility multiple times and asked staff to prevent him from using the motorized wheelchair. She alleges they assured her they would.
“He had no reflectors, no flags, no type of emergency anything on his motorized wheelchair,” Marko said.
Despite what Marko said were repeated pleas and staff observations, state inspectors found nothing in his patient record such as a documented safety assessment for Marks to operate his motorized wheelchair outside the facility. Inspectors also noted a lack of documentation that he had been educated about the risks of operating the wheelchair in the community.
According to documents signed when Marks admitted himself to The Citadel at Myers Park, the facility considered him his “own responsible party.” That was also the case when he signed an arbitration agreement upon admission. These types of agreements, which generally require disputes with the facility to be resolved through a private arbitration process rather than in court, are often tucked into a pile of paperwork. Many times families are unaware of what they or their loved one are signing.
State inspectors classified the facility’s failure to stop Marks at the door that morning as an “immediate jeopardy” situation — the highest level of regulatory concern — because they found the facility had failed to complete a safety assessment for Marks’ use of his electric wheelchair and departure of the facility despite his history of traumatic brain injury and what the facility identified in his patient record as poor decision-making.
When someone makes a complaint about a nursing home, state inspectors work in coordination with the federal Centers for Medicare & Medicaid Services, which can issue sanctions and levy fines. Those inspectors cited The Citadel at Myers Park for its failure to supervise Marks and for failing “to altogether attempt safeguards.”
George Marks died at 68 years old on Oct. 25, 2023, just eight days after he was hit in the roadway. In the days before his death, his daughter said she sat vigilantly at his bedside.
She recounts being horrified when she first arrived, saying she’d never seen anything like the state her dad was in. His face was incredibly swollen, she said, bruised black and blue, with one fractured eye socket. When he tried to open his eyes, one would remain shut.
Angela Marko said she reassured her dad repeatedly that she was there and loved him as she held his hands. She recalled kissing his battered head softly and watching a tear leak out of the corner of his eye.
He could recognize the voices of those in the room, like his estranged wife. Marko said he would occasionally move his hands or his head, but his movement was limited. He couldn’t wrap his arms around his daughter.
Throughout Marko’s life, she said, “when he would wrap his arms around me it just felt like everything would be okay, no matter what. That security of knowing that when he was with us, I was wrapped in this blanket. Now, that was just gone. It was taken away.”
Before the motorcycle crash that left George Marks with a traumatic brain injury, he worked as a car salesman and enjoyed fishing, often taking his nephew out on the river in South Carolina. He loved to sing, with Tom Jones and Whitney Houston among his favorite artists. His faith was important to him, and he taught the children in his family the Lord’s Prayer.
The family was incredibly close. His nephew remembers parties at his grandfather’s house when Marks lived with him when they put whole hogs on the barbecue pit for gatherings of 30 people or more, along with cooking whole lambs and deep-frying turkeys and ducks.
Marks’ daughter said her father’s death was a reminder that nursing homes are entrusted with people’s lives, not just their care.
“If people are not capable of wanting to take care of people’s loved ones, and being there and being really on top of it, then don’t take the job,” Marko said in her statement. “These are not toys, these are our family members, these are people we love dearly and can’t get back. My father died at 68 years old. He had a lot more life left in him — whether it would have been good, bad, or indifferent, that doesn’t matter. He still had it left in him, but it was torn away from him by people that neglected their job.”
George Marks’ death cannot be undone. Neither can the years of life his family alleges were taken from him as a result of the accident. But the records surrounding his death raise a broader question: If a nursing home fails to protect a vulnerable resident, how many warnings can accumulate before someone is held accountable?
That question extends beyond the nursing home where Marks lived.
This is the first in a series of stories about nursing homes owned by private equity firms in North Carolina. The next story takes a closer look at the facility’s record before and after the crash — and the regulatory decisions that have allowed it to remain open.
This story was published with the assistance of the Journalism & Women Symposium Health Journalism Fellowship, supported by The Commonwealth Fund.
KEEP UP WITH THE LATEST
Republish our articles for free, online or in print, under a Creative Commons license.
