Private hospital

Las Encinas, a psychiatric hospital in Pasadena, has a reputation for world-renowned care that can cost up to $1,400 a night. But regulators have documented numerous failures in patient care, The Times has found. (Anne Cusack, Los Angeles Times)

Those seeking treatment at Aurora Las Encinas Hospital pass through manicured gardens on their way to a facility that costs as much as $1,400 a night. For the money, the private Pasadena psychiatric hospital promises world-renowned care and privacy, with a decades-long reputation for service to the rich and famous.

In the last year, however, Las Encinas has been inspected at least six times by government regulators who have documented numerous failures in patient care, The Times has found. Despite hospital officials' promises to fix deficiencies, many of the same problems were found by inspectors when they went back late last year to check on progress at the facility.

Among significant problems reported in documents newly released to The Times:

* A 26-year-old patient died in 2006 after staffers failed to check on him for 24 hours, despite a doctor's orders that he be monitored "very closely." The circumstances are very similar to a death reported last year by The Times. In both cases, Las Encinas mental health workers falsified logs to show that the patients had been checked every 15 minutes, according to government inspection reports.

* An internal memo indicates that hospital administrators knew last May that they had a problem with people sleeping at work. Diane Hobbs, the facility's nursing director, warned staffers they could be fired if caught. Three months later, law enforcement officials told The Times that a 14-year-old female patient had been raped by a 16-year-old patient while hospital workers and the suspect's probation officer slept nearby. Prosecutors have charged the boy with rape, and he will be tried as an adult.

* A 10-year-old boy was exposed to "cursing language as well as sexually explicit language" in a group session after he was placed in a program intended for 12- to 17-year-olds. He had been admitted for treatment after attacking his brother and threatening to jump out of a second-story window. Hospital officials admitted they erred in the placement.

* Doctors allowed a patient to remain at the hospital's expensive and exclusive Two South unit -- which offered concierge service and a personal attendant -- even though she was no longer receiving psychiatric care. A doctor told inspectors in October that the patient, who began treatment 10 months earlier for depression and alcohol abuse, "was not acutely mentally ill" but "had the resources" to continue staying at the hospital in order to meet the terms of a court order.

* No translator was provided for a 79-year-old Vietnamese-speaking woman during group sessions and numerous other assessments, meaning that the woman, who had hallucinations, had never been fully evaluated and went without treatment.

"I stay in my room. I haven't gone to any groups because I don't understand English," she told inspectors. Her son reported that at one point, a nurse called him by phone so he could "ask my mother why she was lying on the floor."

Her case was documented by regulators after a surprise inspection of Las Encinas in late October. The inspection was done after the deaths of three patients in five months and after the reported rape of the teenage patient. The Times reported those incidents last summer.

Inspectors also faulted the hospital for using pre-printed generic treatment plans for some patients and failing to document neurological testing in others.

Regulators put Las Encinas officials on notice that the facility was in danger of losing Medicaid and Medicare funding if the problems continued.

In a plan of correction filed Dec. 11, Linda Parks, the hospital's chief executive, promised to correct the deficiencies. Among the steps she said had already been taken: "The facility posted a notice in their lobby informing the public that interpretive services will be arranged for patients free of charge."

Little progress

Four days after Parks filed her plan, government inspectors were back at the facility, which has 118 licensed beds. They found little progress at the 29-acre campus, according to reports obtained last week by The Times.

Despite Parks' assurances that the hospital had been offering free translation services since late November, inspectors found an Arabic-speaking patient who had been without a translator for two weeks after his insurance company stopped paying for the service.

By then, hospital records indicate, his doctor had described the man, considered potentially homicidal and suicidal, as increasingly angry and upset. The patient could not easily express his feelings to therapists in English and was "becoming very paranoid with a lot of persecutory ideas" and was "losing a lot of hope," according to a doctor's note.

Inspectors who interviewed the doctor reported that no one had told him about the hospital's promise to provide free translators. Las Encinas' medical director later acknowledged that he had not told the staff about the change in the hospital's policy, according to the report.

In addition, inspectors found that the hospital had continued to use pre-printed generic treatment plans despite being warned that it was a violation. Staffers were also still failing to document neurological testing.