By NATE JENKINS Associated Press Writer

LINCOLN, Neb. (AP) -- A man who helped turn around a troubled center for the developmentally disabled in Kentucky has recommended a similar center in Nebraska remain open, but predicts the state will have to spend millions more to do so.

Joseph Toy, the former CEO of a Kentucky organization that took control of a center in that state and is credited for improving care provided to residents, told Gov. Dave Heineman in a report last week that the Beatrice State Developmental Center should remain open.

The Beatrice center has repeatedly failed federal inspections and a U.S. Justice Department investigation uncovered about 200 cases of alleged neglect and abuse at the hospital from late 2006 to late 2007. Earlier this week, Nebraska's chief medical officer declared it too dangerous to hold medically fragile people after the sloppy handling of a resident while she had a seizure late on Jan. 15. The resident died a few hours after her seizure began.

On Wednesday, the state Department of Health and Human Services announced it would not appeal the decision by the medical officer, Dr. Joann Schaefer.

The resident whose death prompted the order from Schaefer was Olivia Manes, 18.

On Wednesday, her father repeatedly praised the center for the care staff provided to her daughter over the years, saying they treated her like loving parents and "went above and beyond" for her. But David Manes, of Steinauer, blamed the state for staff shortages and other problems he said undermined the center and is convinced that "if the appropriate nursing staff had been there, she wouldn't have died."

He said state officials haven't told him about the circumstances that preceded his daughter's death. Instead, he learned about details by watching the television news, including that her seizure medication was discontinued without his permission.

"No one has sent us anything. It's horrific, we're just destroyed," he said.

The state Department of Health and Human Services issued a statement: "Olivia was a member of the BSDC family and we are sorry Mr. Manes learned the results of the licensing investigation through the media. BSDC and the Department of Justice Mortality Review Committee have not yet completed their internal reviews."

A state investigatory report revealed that center staffers waited 15 minutes before seeking medical help after Olivia Manes' seizure began, weren't aware of her medical history and were not all trained to handle seizures - even though 17 of the 18 residents in the unit had a history of them, according to the state investigatory report.

Not all staff were aware of the facility's procedures on handling an emergency, and the nurse who finally arrived broke off a syringe needle in one of Olivia Manes' legs when trying to provide medicine, then she left to get more medicine.

After properly administering it, the nurse reportedly left the other staffers with no instructions on how to care for the person.

Olivia Manes died about three hours after her seizure began.

Thirty-five to 40 of the center's approximately 240 residents, most of whom are mentally retarded, must be moved to hospitals by Friday evening following the declaration by Schaefer, the chief medical officer. Twelve residents were admitted to hospitals on Wednesday. A couple parents have objected to the admissions.

Heineman says he prefers to keep the center open but that care provided to residents there must improve. He is not ruling out shutting down the center should the state lose its appeal of the federal government's decision last year to yank its certification and the more than $29 million in annual, federal funding that goes along with it.

Toy predicts in his report, which was addressed to Heineman directly, that the state will lose its appeal and the Medicaid funding. A ruling is expected late this spring, or during the summer.

"Given the pressure that such an event will place upon the state budget, particularly at such difficult and troubling financial times, there will likely be an outcry by some parties to close the facility," Toy wrote.

"It is my strong belief that such action will be ill advised."

While confident the center will lose the federal funding, Toy said that based on his experience it would take between one and two years for the center to get into compliance with federal requirements and regain its certification.

Continuing to operate the center should it lose federal dollars would cost the state an amount roughly equal to what it is expected to lose: The $29 million in federal funding makes up about half the center's annual budget.

Heineman's proposed budget sets aside state dollars to keep the center running should it lose federal support as expected.

Toy's report is based on what he observed during a weeklong visit to the Beatrice center last month. State officials, who invited him, have said Toy was to be paid roughly $50,000 for his work.

His findings include: a lack of strong leadership at the center; a shortage of nurses, doctors and other staff; excessive use of mechanical and physical restraints on residents; a lack of formal communication between divisions; and a lack of awareness of the problems facing the center.

"The long term eroding of leadership and relative resources has contributed to the culture accepting marginal or minimal work product and calling it good or excellent," Toy wrote in his report.