Certification Expected at Edgemoor : But Length of Medi-Cal, Medicare Eligibility Disputed

A county status report released Wednesday on improvements at beleaguered Edgemoor Geriatric Hospital predicted that the Santee facility would be certified to receive Medicare and Medi-Cal funding for the next 12 months. But a local state Health Services Department official said the county “is being extremely optimistic.”

The report, which will be discussed next week by the county Board of Supervisors, followed a four-day state inspection of the 323-bed county hospital in Santee that ended Sept. 20. Without Medicare and Medi-Cal funds, the hospital, which serves elderly and indigent residents who have exhausted other treatment sources, would be forced to close.

Ernie Trujillo, a spokesman for the local office of the state Health Services Department’s licensing section, said he planned to recommend that Edgemoor be certified for only six months of Medicare and Medi-Cal funding. The final decision, Trujillo said, will be made by the federal government.

Trujillo praised the county’s progress in correcting the widespread deficiencies at Edgemoor since March, when his department found that the facility did not comply with 7 of the 18 federal criteria for hospitals treating Medicare and Medi-Cal patients. Infractions included the prescription of penicillin to a patient whose health charts showed he was allergic to the drug; inadequate nursing care in connection with the death last December of a paralyzed woman who drowned after being left unattended in a bathtub, and the death of a legless patient who fell out of bed and later suffered a heart attack.

But Trujillo, who participated in the recent inspection at Edgemoor, said it was “standard to recommend only six months’ certification after violations have been found. If the county thinks it will receive 12 months, I’d say it was being extremely optimistic. But the final decision rests with the federal government.”

Trujillo said that decision would follow an “exit interview” to be held shortly with state and county officials.

“It sure looks like the county has made significant progress at Edgemoor,” Trujillo said. “But even still, six months would be the standard certification, given the past situation there.”

The county report stated that “all indications are that Edgemoor will have met all conditions and be certified in the Medicare and Medi-Cal programs for the next 12 months. Informally, the inspectors recognized (that) the varied improvements in condition of buildings and grounds, feeding assistance, appearance of patients and documentation efforts in all facets of the operation, and recruitment and retention of qualified staff will make sure the facility is in compliance with federal and state licensing regulations.”

The report also addressed the question of whether Edgemoor should be overseen by a nonprofit corporation or a publicly elected board of directors, and concluded that “establishment of a nonprofit corporation would be easier than establishment of new governmental entities since it could be done at the local level without the enactment of new laws.”