A Suffolk judge on Friday ordered the re-evaluation of a man’s mental competency to stand trial over the alleged assault of a 92-year-old woman inside now-closed Oakwood Assisted Living.

According to Circuit Court filings, William Keith Ruffin, exactly two years ago Saturday and then 42 years old, responded to internal voices when he allegedly beat Violet Compton nearly to death.

Ruffin had been diagnosed with paranoid schizophrenia and schizoaffective disorder and has abused crack cocaine, alcohol and marijuana, according to the court documents, which stated he had told investigators he had been napping in his room at the East Washington Street facility, when “he began to hear voices in his head.”

The voices told him, “Get up N—!” “The people” were “trying to take his face,” the voices said.

Ruffin told investigators that he thought Compton was one of the main people “trying to take his face off.”

Arriving at the facility about 6:12 p.m., first-responders found Compton “severely beaten and injured” after Ruffin “(beat) her about her face and head with (his) fists.” She was airlifted to Sentara Norfolk General Hospital.

Charged with aggravated malicious wounding, Ruffin has since been remanded to Western Tidewater Regional Jail in Suffolk and Central State Hospital in Petersburg, where staff have been working on his psychological rehabilitation.

His first hospitalization, according to court filings, was in 1999, and the pattern has been “involuntary psychiatric admission,” court-ordered medical treatment, improvement, but then relapse into substance abuse upon discharge.

Court filings describe two contacts with Western Tidewater Community Services Board. On March 26, 2012, he presented with “somatic delusions,” but improved “with support and being able to share his feelings;” he received an injection of Invega Sustenna, used in the treatment of schizophrenia, but resisted taking his anti-depressant Zoloft.

Ruffin’s second contact with board staff was on April 2, 2012 — three days before Compton was beaten at Oakwood — when “there was no indication given that he was suicidal or homicidal.”

At the beginning of February, concerned that his responses to questions indicated poor mental health, Judge Carl E. Eason Jr. declined to accept Ruffin’s not-guilty plea, and ordered the first evaluation of his competency to stand trial.

When Ruffin was later back before the court with his “competency restored,” doubts arose over whether he was still receiving, inside the jail, the same medications the state hospital had prescribed, Eason said in court Friday.

As a sheriff’s deputy escorted him into the courtroom, Ruffin gazed into the public gallery with an unfocused stare.

Ruffin’s attorney, Lori Butts, said he had been taking his three oral medications but resisting a fourth, injected medication. She described a “downward spiral” since a favorable psychological evaluation on Feb. 28.

“I have not been able to accomplish anything,” Butts said. “I have not been really able to get through to Mr. Ruffin.”

Continuing Ruffin’s arraignment for the fourth time, Eason ordered the re-evaluation to be carried out by the Virginia Department of Behavioral Health and Developmental Services instead of local psychiatrists, perhaps “streamlining the process,” he said, so Ruffin could stand trial before his mental state deteriorated again.

As the commonwealth’s case against Ruffin grinds on, the administrator of his alleged victim’s estate, Nathaniel H. Compton, one of Violet Compton’s two sons, is suing Oakwood Assisted Living, its former administrator, Scott Schuett, and ProPlusCare, Schuett’s company that operated six assisted-living facilities in Hampton Roads, five of which have been closed down for license violations.

The state closed Oakwood last year after more than 100 alleged license violations,

Filed in Circuit Court in Hampton, where ProPlusCare is based, on Tuesday, the suit seeks $10 million in compensatory damages and $350,000 in punitive damages, plus interest and costs. It claims Violet Compton’s various health problems, including dementia, and Ruffin’s history of “drug abuse, serious mental illness … as well as history of violent assaultive behavior,” plus his probation for several felonies, including assaulting a police officer, were all known by the defendants.

Included in the suit is a wrongful death claim, after, “as a direct and proximate result of the negligence” on the part of the defendants, Compton died on Jan. 21, 2013.

“Based on everything we know … it’s the (adult living facility) and Mr. Schuett that’s responsible for making sure that the residents in the facility are safe, and making sure that they can take care of folks,” said attorney C. Stewart Gill Jr., representing the Compton family.

“It seems to me that they should have transferred Mr. Ruffin out of the facility a long time before that incident ever happened.”

He said it was no surprise Ruffin’s mental state had deteriorated again, adding, “That’s something I guess they are going to have to work on, and they will give it another shot to try to restore him, and hopefully they will.”

Nathaniel Compton said he had learned of his mother’s beating when a television news crew arrived at this doorstep requesting an interview.

Declining an interview at that stage, he rushed to the hospital. “When I saw her condition, that was a shock,” he said.

Compton said a neurologist told him the only reason his mother survived was because her advanced age meant she had more room inside her skull for her swollen brain.

Compton said he later visited Oakwood, where a local hospital had sent his mother after her dementia deteriorated, and learned that the cook had kept her from being beaten to death after confronting her attacker, while a nurse had also protected her.

“I was just amazed by the lack of security,” he said of the facility. “There were four staff members in the entire place … and I was able to walk through the entire facility.”

“I don’t in my heart blame Ruffin,” he said, “because had he been in the right facility, and my mother had been in the right facility, it wouldn’t have happened.

“Having him thrown in jail isn’t going to do anything to cause other people in the future to not have to go through this.”

Scott Schuett could not be reached for comment.