Articles Posted in California Department of Public Health

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San Dimas nursing home Casa Bonita Convalescent Hospital was fined $121,000 by the Department of Public Health after the death of 88-year-old resident Rita Twomey. State regulators issued three citations after finding that caregivers turned off the alarm of a ventilator keeping the resident alive. When the ventilator malfunctioned, no alarm was sounded and the resident died.

According to reports, Twomey’s daughter found her mother in bed with her lips and fingers blue. Tragically, the daughter tried to keep her 91-year-old father, whom she had brought for a visit, from going into the room. “They didn’t even get to say goodbye,” the daughter said. “That’s the heartache.”

The 106-bed Casa Bonita disputes the allegations made by the state, and intends on appealing the fines in Superior Court.

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The California Long-Term Care Ombudsman Program is the state program responsible to investigate and resolve complaints made by individuals (or their representatives) residing in long-term care facilities such as nursing homes. Last week, when the California budget was signed by Governor Schwarzenegger, he cut state funding for the ombudsman program.

The decision has not gone over well with elder care advocates. The governor’s cuts removes roughly 15% of the budget for the program, which translates into a loss of 1.25 of every 3.7 positions.

To contact your local ombudsman’s office call the appropriate telephone number in the geographical area the incident leading to the complaint occurred.

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The New York Times is reporting this morning that 90% of all nursing homes were cited for violations of federal health and safety standards. Approximately 17% of U.S. nursing homes had deficiencies that caused actual harm. As mentioned in this blog previously, nursing facilities that operate “for-profit” were more likely to have problems than non-profit homes.

Federal inspectors received 37,150 complaints in 2007 about nursing home conditions, the bulk of which involved bed sores, abuse and neglect of residents, medication errors, and nutritional issues. Failure to sufficiently staff was noted as a particular concern in the report, including the allegation that nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.” Not surprisingly, researchers learned that elderly patients receive better care at homes with a higher ratio of nursing staff members to patients.

The U.S. has approximately 15,000 nursing homes, housing nearly 2 million people. Under the laws of most states, including California, these homes are inspected once a year.

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This list contains the issuance of citations to Southern California nursing facilities by the California Department of Public Health over the last six months. All the citations listed are issued for reasons related to patient care. For verification of the citation, please contact the local department office or Walton Law Firm LLP.

<font size='2'Facility Date Citation
Los Angeles County Elder Abuse
Brighton Convalescent Center 05/23/08 Class B
Heritage Manor 03/7/08 Class B
Imperial Convalescent Hosp 03/26/08 Class B
Ramona Care Center 05/23/08 Class B
Studio City Rehabilitation Center 02/21/08 Class A
Villa Oaks Convalescent 06/23/08 Class B
Windsor Convalescent Long Beach. 05/22/08 Class B
Windsor Palms Artesia 05/23/08 Class A
Orange County
Evergreen Fullerton Healthcare 04/15/08 Class B
French Park Care Center 05/20/08 Class B
Kindred Healthcare of Orange 04/29/08 Class B
New Orange Hills 04/16/08 Class B
Parkview Healthcare 04/15/08 Class AA
Riverside County
Cypress Gardens 06/10/08 Class AA
San Diego County
Edgemoor Geriatric Hosp. 06/26/08 Class A
Cypress Gardens Rehabilitation 03/20/08 Class A
Lemon Grove Care & Rehab. 07/16/08 Class B
Villa Las Palmas 07/01/08 Class B
Vista Healthcare 04/11/08 Class B
Santa Barbara Nursing Home Neglect
La Cumbre Senior Living 07/24/08 Class B & A
Country Oaks Care Center 5/20/08 Class B

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

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Nursing home residents have clearly defined rights when it comes to being transferred or discharged from a nursing facility, and may be evicted or moved under certain circumstances. Under California law, a nursing home may discharge or transfer a resident only if:

  1. the resident’s health has improved and is no longer need of skilled nursing services;
  2. the resident’s needs can no longer be met in the nursing home;
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This list contains the issuance of citations to Southern California nursing facilities by the California Department of Public Health over the last six months. All the citations listed are issued for reasons related to patient care. For verification of the citation, please contact the local department office or Walton Law Firm LLP.

<font size='2'Facility Date Citation
Los Angeles County
Alden Terrace Convalescent Hosp. 04/09/08 Class B
Chandler Convalescent 02/13/08 Class A
Chatsworth Park Care Center 03/13/08 Class B
Country Villa Park Marino 01/28/08 Class B(3)
Country Villa Pavilion Nursing 03/19/08 Class B
Ember Health Care 01/31/08 Class AA
Gardena Convalescent Hosp. 02/05/08 Class B
Heritage Manor 03/07/08 Class B
Imperial Convalescent 03/27/08 Class B
Lancaster Health Care Center 02/13/08 Class A
Oceanview Convalescent 02/20/08 Class B
Royal Oaks Care Center 12/11/07 Class B
Sophia Lyn Convalescent 04/14/08 Class B
St. John of God Retirement 02/27/08 Class B
Studio City Rehabilitation 04/02/08 Class A
Sunnyview Care Center 04/29/08 Class B
Tarzana Health and Rehab. 02/13/08 Class A
Whittier Hills Health Care Center 01/07/08 Class B
Windsor Palms Care Center of Artesia 04/15/08 Class B
Orange County
Country Villa Plaza Convalescent 03/12/08 Class B
Fountain Care Center 03/13/08 Class B
Newport Subacute Healthcare 02/06/08 Class A
Palm Terrace Healthcare & Rehab Center 02/01/08 Class AA
Park Regency Care Center 04/11/08 Class B
San Bernardino County Elder Abuse
Cherry Valley Healthcare 02/14/08 Class B
Country Villa Rancho Mirage 02/05/08 Class A(2)
Cypress Gardens Rehabilitation 03/20/08 Class A
The Springs At The Carlotta 03/21/08 Class AA
San Diego County
Children’s Convalescent Hospital 02/21/08 Class B
Edgemoor Geriatric Hospital 05/09/08 Class B
Point Loma Convalescent Hosp. 03/10/08 Class B
Ventura County
Brighton Gardens of Camirillo. 4/16/08. Class B

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

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Yesterday the Bush Administration announced that it will create a nursing home rating system by the end of the year. The criteria for ratings has not yet been established, but will likely be a combination of state and federal inspection reports, staffing reports, and resident and family satisfaction surveys. The ratings would be placed on a government website.

“The fact a home has a lower rating will likely put them on the path to improvement,” said Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services. “I don’t think we’re going to see many people who are very anxious to put a loved one in a one-star home.”

Those looking for information about California nursing homes already have a few options when looking at prospective homes. The California Advocates for Nursing Home Reform have a nursing home guide resource, and the California Healthcare Foundation has its own rating system. Both use the government surveys and staffing reports as a basis for the rankings, so the accuracy of the ratings is based primarily on the government’s information, which can be notoriously unreliable.

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A nursing home in Anaheim has received a $50,000 fine in the choking death of a resident. The resident, a brain injured man in his forties who had swallowing difficulty, choked on a piece of burrito.

According to reports, a caregiver was preparing the man’s meal at Parkview Healthcare Center when he reached for the burrito and put it in his mouth. When he began choking, the Heimlich maneuver was attempted but failed. Caregivers were then instructed to begin CPR, but before doing so, looked in the resident’s file to determine to see of there was a DNR (do not resuscitate) order. There was.

A doubtful nursing then called the man’s sister, telling her “your bother is turning black, do you want him revived?” When the sister responded “yes.” The DNR order was wrong. CPR was started. The man was pronounced dead approximately 30 minutes later. The fine was issued due to the nursing facility’s failure to provide “prompt emergency medical care” as requested by the resident.

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The son of Maria Cobian, the elderly woman who was hit by a car and killed when she wandered away from her nursing home, has filed a wrongful death lawsuit in Vista Superior Court.

The lawsuit alleges that Palomar Heights Continuing Care Center in Escondido negligently failed to supervise Ms. Cobian, and to ensure the safety of 94-year-old resident, who also suffered from dementia. Ms. Cobian was only a few hundred yards away from the nursing facility when she walked into traffic and was struck by a car. The company of the car that hit Cobian was also named in the lawsuit.

Despite her alleged documented history of trying to leave the facility, and the nursing home’s failure to prevent it, it doesn’t appear that there are allegations of elder neglect under the Elder Abuse and Dependent Adult Civil Protection Act against the facility, which allows for enhanced damages against nursing homes, including pre-death pain and suffering, when certain burdens of proof are met.

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The California Advocates for Nursing Home Reform has issued its 2007 Nursing Home Citation Report. CANHR has prepared a citation summary, including the name of the nursing facility, the date, the level of citation, and a brief summary of the facts that led up to the citation. There is also an instructional key to help readers understand how the individual nursing home citations summaries are displayed. The report, which is broken down by California counties, can be found here. (.pdf)

In summary, a total of 651 citations were issued against nursing homes in California by the Department of Public Health in the year 2007, 22 of which were Class AA citations (violations caused a death), and 122 were Class A (violations present imminent danger and a substantial probability of death).

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