State May Seek to Close Care Center in Santa Ana

A Santa Ana nursing home accused of having cockroaches and failing to treat a patient’s bedsores is one of two such facilities that may face closure following a recent series of surprise inspections, state Health Services Department officials said Friday.

Health Services Director Kenneth W. Kizer said license revocations are being considered for the Bristol Care Center, 1092 Hemlock Way, and the Northlake Convalescent Hospital in San Jose, where an 83-year-old woman died of dehydration. He said the San Jose case might be referred for possible criminal prosecution.

The inspections, conducted during off hours in Orange, Riverside, Kern, Santa Clara and Fresno counties, are part of an experimental crackdown on nursing home abuses that will be expanded throughout California, state officials said.

Sunday Morning Inspection

Six health inspectors toured Bristol Care Sunday morning, April 27, and reported that an elderly male patient suffering from bedsores was denied treatment for four days. They also cited the facility for having cockroaches, for the failure of its emergency generator to work properly and for failure to maintain hot water at a safe temperature.

The nursing home faces fines totaling $30,000. Kizer indicated that the department was considering whether to revoke Bristol Care’s license.

Robert L. Pruett, executive director of the South Coast Care Corp. of Huntington Beach, which operates Bristol Care and five other nursing homes, said the nonprofit company intends to appeal the citations and fines.

Contract Canceled

The bedsore problem, he said, was not a failure to treat the patient, but simply a failure to document the treatment in writing. He said the cockroaches appeared when workmen tore off old paneling during an extensive remodeling project at the 145-bed facility.

Pruett said that even before the inspection last month the company had canceled its contract with Health Care Enterprises of San Clemente, the management firm that had been operating Bristol Care.

South Coast Care assumed control of the 20-year-old nursing home in October, 1983, Pruett said, but it wasn’t until “February or March” of this year that refurbishing plans were approved by the state.

“It had been a problematic facility for years,” Pruett said. “We’ve made substantial improvements. What we’re experiencing now is the residuals of those problems.”

Pruett said he was surprised that Kizer is threatening to close the facility. “Nobody ever talked about or gave me any indication that was even being considered,” he said.

By selecting nursing homes with a history of problems and inspecting them on weekends and during early morning or night hours, the state hopes to get a better idea of actual conditions facing the mostly elderly patients in the facilities.

Kizer said the off-hour inspections during the past three weeks represented “a much more aggressive approach” by the Department of Health Services in clearing up problems in the nursing home industry.

Until now, the department has inspected nursing homes only once a year or in response to specific complaints. These visits usually have occurred during normal working hours.

After conducting the surprise visits to 10 facilities on a test basis, the department decided to continue the program indefinitely and expand it.

Surprises to Continue

Under the new program, Kizer said, state licensing officials will continue to schedule off-hour, surprise inspections in the worst of the state’s 1,200 nursing homes.

Kizer singled out the Northlake Convalescent Hospital in San Jose as having the most serious problems. The facility faces $55,000 in fines, and officials are deciding whether to attempt to close the home and possibly seek criminal prosecution in the death of the elderly woman, he said.

The investigators reported finding patients left in their own urine and feces, and others with serious medical problems unattended. They also cited the facility for unsanitary conditions, including puddles of urine on the floor. The inspectors charged that the 83-bed nursing home was inadequately staffed.

The most serious charge against Northlake involved the woman’s death, in April. The 83-year-old woman’s medical records showed she had all the symptoms of extreme dehydration, including urine that was “cloudy, sticky as syrup.” But for several days, the staff did nothing to treat her condition, the investigators said.

Comment Refused

A Northlake spokeswoman, who refused to identify herself, said the facility would have no comment on the state inspection report.

Under state law, nursing homes can take their appeals to the department and then to the courts before fines are actually collected.

Kizer indicated that three of the 10 facilities inspected had no problems; others faced only relatively small fines.

None of the facilities were in Los Angeles County, where the county Department of Health Services conducts all nursing home inspections under a contract with the state.

Ralph Lopez, chief of the county’s health facilities division, said the county for five years has had staff members on call at all hours, including weekends, to field complaints against nursing homes and make immediate inspections if necessary.