Report on Geriatric Hospital : Graves Urges Replacement of Edgemoor

San Diego County’s troubled Edgemoor Geriatric Hospital in Santee should be replaced within five years by an expanded, modern facility, the county’s top administrator recommended in a report released Thursday.

In the meantime, Chief Administrative Officer Clifford Graves said, many of Edgemoor’s problems could be solved by increasing the size of the 323-bed hospital’s professional and maintenance staffs and changing its style of management.

Graves’ long-awaited report, which will be the basis of a Board of Supervisors’ conference on Edgemoor on Tuesday, calls for the county to increase the hospital’s operating budget by $687,000--about 5% --next year and add $350,000 more for maintenance, an increase of more than 25% from this year’s budget. Millions more would be dedicated to the institution in the years to come.

Edgemoor’s problems have been investigated by the county grand jury and Civil Service Commission, the state auditor general’s office and the state Department of Health Services, which has fined the county $35,000 for violations committed in the past year. Among the incidents: a woman whose ailing foot was infested by maggots, a legless man who died after falling out of his bed, and an unattended woman who drowned in a bathtub.

Last week, Francoise Euliss, the hospital’s longtime administrator, was transferred and replaced on an interim basis by her immediate supervisor, Paul Simms. Simms, a deputy director in the county Health Services Department, wrote the 62-page report on Edgemoor for Graves.

Amid the allegations of mismanagement and revelations about the hospital’s deteriorating physical structure, several supervisors have suggested that the county consider closing the hospital or turning its operation over to a private contractor.

But both those options were rejected in Thursday’s report, in which Graves suggested that the county do more, not less, for the elderly, disabled and poor patients who turn to Edgemoor when they have nowhere else to go.

Specifically, the report recommended that:

- Seventeen professional positions, including seven to create a records division and one to create an on-site pharmacy, be added to Edgemoor’s staff in the fiscal year beginning July 1.

- Four maintenance positions be added at the same time.

- At least 12 more nurses and two other employees be added at a later date.

- Edgemoor’s management style be changed to allow for more delegation of responsibility and less centralization of decisions in the office of the administrator.

- Edgemoor use a computer to improve efficiency and be given more flexibility in hiring workers under the county’s civil service system.

- The hospital, the first parts of which were built as a county “poor farm” in 1922, be torn down and replaced by a modern building housing 400 patients. Under Graves’ plan, the new hospital would cost $16 million and would be built by 1989.

Graves’ report was released late Thursday, and none of the supervisors could be reached for comment on its recommendations.

Edward Maguire, chairman of a committee of health professionals that advises the county on Edgemoor, said the panel was shown the final draft Thursday morning and was pleased with the report “as far as it goes.”

“It dealt very well with some of the symptoms, the immediate problems,” Maguire said. “But it didn’t deal with the cause of the situation.”

Maguire, an administrator at Grossmont Hospital in La Mesa, said he and a handful of other committee members will address the supervisors Tuesday. He said he will repeat the panel’s call to allow the institution to control its own hiring and maintenance needs, rather than having to compete with other county programs for assistance from the personnel and general services departments.