Nursing Home Chain Is Fined for Negligence

California’s second-largest nursing home chain agreed Wednesday to pay $1.3 million to the state to settle civil allegations that it provided negligent care to scores of frail patients, including two who died.

The agreement resolved a lawsuit against Pleasant Care Corp., a La Canada Flintridge firm that owns 30 nursing homes in California, 10 of them in Los Angeles County. It marked a victory in state Atty. Gen. Bill Lockyer’s effort to aggressively penalize negligent nursing home operators, a tactic previous state prosecutors have not used. The settlement came in the third major legal action taken by Lockyer’s office against a large nursing home chain since he took office in 1999.

The suit accused Pleasant Care of a “pattern of poor quality of care that we found permeated their operations statewide,” said Collin Wong-Martinusen, who directs Lockyer’s Bureau of Medi-Cal Fraud and Elder Abuse. The case was lodged under the state Unfair Business Practices Act.

“Our investigation revealed that Pleasant Care Corp. grossly failed to fulfill their patient stewardship responsibility, and as a result, some of the defendants’ patients suffered needless harm,” he said.

Separately, Pleasant Care is expected to plead no contest today in Napa County Superior Court to misdemeanor criminal charges filed by Lockyer’s office. The company’s Northern California subsidiary is charged with five counts of elder abuse and one count of violating state patient-care regulations.

Pleasant Care officials could not be reached for comment late Wednesday.

Emmanuel I. Bernabe, who has owned or had a major stake in the company’s nursing homes, donated $67,300 to Gov. Arnold Schwarzenegger early last year, before the criminal charges were filed.

The basis for the civil action was more than 160 regulatory violations cited by the state Department of Health Services over the last five years. Brenda Klutz, the state health department official who oversees nursing homes, said last year that the company had “serious compliance problems.”

In one case in 2003, a resident whose airway became blocked during a seizure died at a Pleasant Care home in Ukiah because a suction machine was broken, according to the attorney general’s office.

In 2004, a resident at a Novato facility died from a pressure sore that employees allowed to worsen. A coroner concluded that the patient suffered “abominable wound-care management,” Wong-Martinusen said.

Other problems cited at Pleasant Care homes included “deplorable track records” in patient dehydration, malnutrition, care of pressure wounds and proper administration of medications, Wong-Martinusen said.

“When the operators of these nursing homes fail to fulfill their responsibility, and instead ... engage in practices that are more consistent with the warehousing of chattel than to the care of human life, they invite prosecution from our office,” he said.

Lockyer decided to beef up scrutiny of nursing-home operators after concluding that the current system of enforcement -- overseen by the state health department -- was inadequate, Wong-Martinusen said.

Just before Lockyer was sworn into office, the U.S. Government Accountability Office released a report in 1998 concluding that one in three California nursing homes had been cited for serious or potentially life-threatening problems with its care.

On Wednesday, a legislative panel approved an audit to determine whether the state health department promptly investigates complaints of mistreatment at nursing homes.

In addition to the fine, the 65-page injunction approved Wednesday by Los Angeles County Superior Court Judge Laura Metz also requires Pleasant Care to hire a government-appointed independent monitor, a compliance officer to make sure each nursing home follows the law and more nurses.

The agreement also establishes whistle-blower protections for staff members, pledges prompt investigation of any alleged abuse and mandates staff training in patient care.

Failure to comply with the injunction’s measures could result in civil penalties of up to $6,000 per violation.

Pleasant Care’s operations include East Los Angeles Convalescent Hospital; Ember Care facilities in Sylmar, Pomona, Glendale and Los Angeles; and Emmanuel convalescent or rehabilitation homes in West Covina, Norwalk, Glendora and Maywood.

The company also operates Ember Care Health Center in Perris and Pleasant Care facilities in Riverside and Corona.

Other large nursing home chains taken on by Lockyer include Sun Healthcare Group of Irvine, once the state’s largest nursing home operator, which pleaded no contest in 2001 to a felony elder abuse charge when two residents died and six fell ill at a nursing home during a June 2000 heat wave.

In September, Sun Healthcare was taken back to court and hit with $2.5 million in fines, after the attorney general’s office found substantial noncompliance with its permanent injunction.

In 2002 a subsidiary of Beverly Enterprises, an Arkansas company that had been California’s second-largest nursing home chain with 60 facilities, pleaded no contest to two elder neglect charges.

Both Sun and Beverly have since sold many of their nursing homes.

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Times staff writer Dan Morain contributed to this report.