Prosecutors said William Neff, 83, of Philadelphia, had an 18-inch long bruise on his side and had suffered broken ribs, internal bleeding and a collapsed lung when he died in 2000 at the Alterra Clair Bridge assisted living facility in Lower Makefield.

The facility is owned by the Alterra Healthcare Corporation, a for-profit firm based in Milwaukee, Wis.

After an 18-month investigation, a grand jury last month indicted Heidi Tenzer, a former aide at the home, on homicide charges.

The indictment was unsealed Monday after Tenzer, 33, was arrested at her mother's home in Bristol Township. She was being held on $2 million bail.

The grand jury also indicted the facility's director, a second staff aide, a registered nurse and a hospice worker from another agency on felony charges of neglecting a care dependent person as well as failure to report suspected abuse.

In a detailed report spanning several hundred pages, the grand jury said Tenzer attacked and kicked Neff at 2 a. m. on Sept. 11, 2000. The assault was allegedly overheard by a privately employed health care worker, who reported it to another staff worker, but prosecutors said nothing was done.

Neff, who had Alzheimer's disease, died on Sept. 17. The facility reported that Neff had died from natural causes, authorities said.

"The facility, despite seeing the injury and knowing he was in pain, failed to report it," District Attorney Diane Gibbons said. "He never received treatment. He received no pain medication. He died in agony after suffering for six days. "

Authorities opened an investigation after a funeral home director noticed bruises on Neff's body. An autopsy revealed five broken ribs and a pint of blood in Neff's chest cavity.

Gibbons said the inquiry was hampered by poor records and a cover-up by employees who claimed not to have seen Neff's injuries.

"It was a constant battle to get information," she said. "I can tell you that there were suspicious injuries to other patients as well that were never investigated. "

Also arrested Monday were Patricia Policino, 57, a registered nurse who was charged with caring for Neff; Julia Pearson, 53, the aide who allegedly took the abuse report; and Brian Gunther, 41, a worker with Heartland Hospice who authorities said had seen the bruises and not reported them. The three were initially ordered held on $100,000 bail.

The facility's director, Ann McClintock, 31, had not yet been located by police Tuesday but was also to be charged.

Attorneys for the suspects could not immediately be located. A manager at the Heartland Hospice office in Plymouth Meeting declined to comment on Gunther's arrest.

A phone message left at Alterra Clair Bridge in Lower Makefield was not immediately returned.

Alterra owns more than 350 assisted living residences and nursing homes nationwide. The company has faced severe financial difficulties and is in the midst of a restructuring. It lost $90 million in the fiscal quarter that ended June 30, according to the company's financial filings.

A spokesman for Alterra Healthcare and the company's president, Patrick Kennedy, did not return numerous phone messages.