Bid to Close 3 Nursing Homes Stymies Chain’s Expansion
In the wake of the death of nine patients at its facilities, Beverly Enterprises, the nation’s largest nursing home chain, has found its California expansion plans stymied as state officials seek to shut down three of its 93 nursing homes in California and to block the opening of six more.
The state attorney general’s office asked the state Department of Health Services in January to revoke the licenses of Beverly Manor of Los Gatos, Julia Convalescent Hospital in Mountain View and Beverly Manor in Santa Cruz--all owned by Beverly Enterprises, which is based in Pasadena. A hearing on the matter is scheduled for Nov. 3.
After the request for license revocation, the regional offices of the health department in May refused to grant operating licenses to a Beverly nursing home now under construction, a Beverly home health agency and four nursing home facilities that Beverly recently acquired from Pritchard Enterprises of Ukiah, Calif. That decision is being challenged in court by Beverly.
The actions did not receive widespread attention until an article about them appeared recently in a publication of the American Medical Assn.
The loss of the nine facilities could pose a significant setback for Beverly--which has been eyeing California’s 2.6 million residents age 65 or older as a prime source of new business.
Jack Toney, deputy director of licensing and certification for the Department of Health Services, said he expects Beverly to be among a flood of nursing operators seeking permission to build new nursing homes in California due to the shortage of facilities in the state and the expiration Jan. 1, 1987, of a state law that had subjected new nursing homes to additional review by the Office of Statewide Health Planning and Development.
Beverly officials agree that the company is trying to expand in California as well as across the rest of the nation but they deny undertaking any special efforts here.
The health department, however, said it opposes further expansion by Beverly in California because of allegations of substandard patient care at several Beverly nursing homes--including the circumstances surrounding the deaths of four patients at Beverly Manor of Los Gatos and five at Julia Convalescent. Both facilities are involved in the revocation proceeding.
The attorney general’s office alleged in its formal complaint filed with the health department that the homes “engaged in conduct inimical to the public health, welfare and safety” by failing to properly care for patients. In one case in which a patient died, the state alleged that Beverly failed “to inform (the patient’s) physician of the patient’s obviously worsening condition.”
Robert Van Tuyle, chairman of Beverly Enterprises, said that problems have been corrected and that the incidents the attorney general’s office cites occurred more than a year ago. Since then, Van Tuyle said, the nursing homes in question have “received clean bills of health” from state inspectors. He added that the deaths of the nine patients were due to their age, not to any substandard care by Beverly.
“We deal with the elderly and the frail in our business,” Van Tuyle said. “Those patients that died were terminal patients” and were suffering from ailments beyond the control of the nursing home, he said.
But Janet G. Sherwood, a deputy state attorney general who is handling the state’s case, said in an interview: “The allegations against the Beverly facilities are the most serious I’ve seen in a long time.” The allegations against the three Beverly nursing homes involved claims as varied as complaints that patients were placed out of reach of nurse-call buzzers to claims that the dressings of some patients were infested by ants.
However, the most serious allegations against Beverly involve the deaths of the nine patients last summer.
The attorney general’s office said that on July 10, 1985, when William B., a man with a history of congestive heart failure, experienced difficulty breathing and had a sudden drop in blood pressure, nurses at Beverly Manor in Los Gatos allegedly waited 22 minutes to transfer him to a hospital next door. He died the same afternoon.
Another Los Gatos patient, a man identified as Clarence L., experienced rapid weight loss and developed a grossly swollen hand during a 14-month stay, the attorney general’s office stated. He died Aug. 13, 1985, of complications arising from degenerative arthritis. But the attorney general contends that the facility repeatedly failed to develop a plan to adequately treat numerous ailments the man suffered.
Deficiencies in care also allegedly led to the death of two women patients at the Los Gatos nursing home.
At Julia Convalescent Hospital in Mountain View a patient, identified by the state as Edith S., died of cardiac shock after the staff waited 45 minutes to call an ambulance when she exhibited symptoms of heart failure.
According to the complaint, another woman at the hospital died when nurses waited 26 minutes after receiving a physician’s order to call paramedics to assist her when she was believed to be dying of pneumonia.
Three other deaths involved patients who had developed numerous serious bedsores.
If Atty. Gen. John K. Van de Kamp prevails against Beverly, the chain’s three nursing homes will be suspended from the state Medicaid program and the officials who administered and managed them could be barred from California’s nursing home industry.
However, revocation of nursing home licenses in California is rare. It occurs only when the state health director concludes that a nursing home presents a serious health hazard to its residents.
Last year, the state health director revoked only six nursing home licenses, according to the Department of Health Services. In all of 1984 there were just three revocations.
Although the action by the state threatens the operation of Beverly facilities valued at roughly $20 million, Van Tuyle, Beverly’s chairman, said closing the nursing homes would have little substantial financial impact on Beverly Enterprises, which had 1985 revenues of $1.7 billion from operating 1,000 nursing homes with about 115,000 beds nationwide.
