Edgemoor Passes State Review, Given Renewed License

Edgemoor Geriatric Hospital has passed a state health department inspection that will allow the troubled facility to remain open, county officials learned Tuesday.

Last month, federal officials threatened to cut off about $8 million in Medi-Cal and Medicare funds for Edgemoor’s indigent patients by Sunday if the pattern of problems and abuse of patients at the hospital was not reversed.

The state inspection conducted last week found that all 18 conditions cited in an earlier survey had been corrected. But the inspectors also found that improvements in patient care, rehabilitation services and food preparation still need to be made.

“They made significant efforts to correct (problems), and they did,” said Ernest Trujillo, San Diego district administrator of the state health department’s licensing and certification division. “They did a good job in getting back into compliance.”

County officials were ecstatic when they received the news Tuesday morning.

“I am elated at the efforts put forth by county employees at Edgemoor,” said Clifford Graves, county chief administrative officer. “A tremendous feat has been accomplished in a very short time.”

County Supervisor George Bailey said the Edgemoor staff deserves the highest praise for “working under considerable pressure to bring the facility into compliance.”

But state inspectors recommended that Edgemoor’s certification be renewed for only six months, licensing supervisor Donna Loza said. Most licensed nursing facilities are certified for one year.

And critics of Edgemoor warned county officials that they have a long way to go before they turn the aging facility around.

Michael Ellentuck, administrator of the San Diego Hebrew Home and vice president of the San Diego Health Assn., said, “I just hope they don’t take this as a message that all is fine and that they are now out of the woods. They have made an effort, but there is still quite a bit to be done.

“I hope the powers that be recognize that, as quickly as they turned things around, they can go the other way.”

Edgemoor officials are expected to learn today the results of a separate investigation by the state auditor general’s office into the use of state funds by Edgemoor administrators. The investigation was requested by Assemblyman Larry Stirling (R-San Diego).

On Tuesday morning, county officials met with state inspectors to review the state licensing report, which says that all five conditions cited in a May letter to hospital administrators had been corrected. They were nursing services, dietary services, rehabilitative services, medical records and the governing body, a general category involving the county’s administration of the hospital.

After receiving the good news, Edgemoor interim administrator Paul B. Simms held a 15-minute briefing with about 100 employees in the hospital cafeteria.

“There were cheers and tears,” said Robert Lerner, the county’s public affairs manager.

County officials credited Simms, who in April replaced Francoise Euliss, Edgemoor administrator for eight years, for engineering the improvement at the 323-bed Santee hospital that cares for the elderly, disabled and mentally disturbed.

Despite a long history of problems there, the state did not begin to crack down on the hospital until recently, said Stirling, who has actively monitored the facility’s problems and called for reforms.

A state licensing inspection in August found 134 minor deficiencies at Edgemoor, including improper handling and storage of drugs, failure to notify physicians of sudden changes in the condition of patients, and kitchen areas infested with rodents, cockroaches and flies.

During the first four months of this year, Edgemoor was cited for four serious Class A citations and fined $13,000 in connection with the deaths of two patients due to negligent care, the use of strong-arm tactics by staff members on a patient, and for giving penicillin to a patient whose medical records indicated he was allergic to it.

During the inspection last week, state officials found about 50 minor deficiencies--some new, but many that had been found in an earlier survey and had not been corrected.

The areas that need improvement include 24-hour nursing, patient care planning, therapeutic diets, rehabilitation staffing and food service.

To prevent conditions at Edgemoor from deteriorating again, Stirling called for county supervisors to fire James Forde, director of the county Department of Health Services, which oversees operations at Edgemoor, and set up a private nonprofit corporation to run the hospital.

“Counties are constitutionally incapable of operating these enterprises,” Stirling said.

One private San Diego nursing home administrator familiar with operations at Edgemoor said he feels that Edgemoor officials did not demonstrate a genuine concern to correct the problems until they were forced to do so.

“They have their own agenda and they’re going for it regardless of what makes sense,” said the administrator, who asked not to be identified. “I’m concerned that this will save the jobs of some people who shouldn’t be (employed there).”

The board of supervisors will soon take up the long-term needs of Edgemoor, Supervisor George Bailey said.

Bailey said he hopes that state inspectors re-examine Edgemoor periodically to keep hospital administrators on their toes.

“Edgemoor is a vital link in our health care system and we owe it to the patients, their families and the community to not only keep it open, but to make it a model statewide,” Bailey said.