HOSPITAL: New El Cajon Facility Sits Empty : County Deems New Hospital Unsuitable

To Carl Honour, it seems like a marriage made in heaven.

The county Department of Health Services is looking for a new hospital, and Honour just happens to have one to sell.

Just a few months ago, the county was more than a little interested in buying the unoccupied 305-bed facility at Broadway and East Main in El Cajon to replace the aging and troubled Edgemoor Geriatric Hospital in Santee. The price was set at $12.8 million.

An architectural firm told county health officials that the three-story building was sound, unlike Edgemoor. A mortgage banker assured the county that tax-exempt bond financing could be arranged for the sale.

But now county officials have decided that the new facility, called Valley House, is unsuited for the special needs of Edgemoor patients, who are frail and failing, sometimes senile, and often in need of constant supervision.

Honour’s Carlsbad-based contracting firm, AmeriCal General Corp., built Valley House as a nursing home for a nationwide health-care chain, Care Enterprises, but that deal fell through when the chain was sold. Construction was completed in mid-June.

The collapse of negotiations with the county has left Honour puzzled. Out of frustration, his firm appealed this week to the Board of Supervisors to intervene.

“It boggles my mind to think that the county knows Edgemoor is inadequate for its patients, but it will let Valley House sit empty,” Honour said.

“It could be used within just a matter of weeks,” he said. “The county says they would prefer something else in their master plan, but that could take 10 years, while Edgemoor patients suffer. When is the last time the county ever accomplished anything in a master plan?”

Paul Simms, deputy director for physical health services, said the county is leaning toward a plan that would involve a new hospital and some sort of commercial development at the Santee site. An evaluation of alternatives will probably be delivered to county supervisors within the next 45 days, he said.

“We were quite interested in finding a replacement facility, but we realized there were deficits in the physical plant design (of Valley House) that presented both a physical and a mental health problem,” Simms said.

In a four-page memo to Health Director Dr. J. William Cox on April 30, Simms listed a variety of reasons for rejecting Valley House. According to Simms:

Since the building is three stories, stairwells could prove dangerous for feeble patients and hard for nurses to supervise. Wheelchair patients might crash into the floor-to-ceiling windows. Patients might panic in elevators.

Most of the rooms are for three beds, but the preferred size for patients with psychiatric and behavior problems, like many Edgemoor patients, is two beds. The loading dock is inadequate. The roof patio might encourage suicides.

‘Lack of Open Space’

“Further,” Simms wrote Cox, “it (Valley House) is located in a moderately developed area adjacent to a busy intersection, with lack of open space as a built-in buffer for wandering patients.

“Lack of open space for patient movement is not conducive to good restorative care. The more urban setting offers easier access to convenience and other stores, which may contribute to patient wandering.”

Simms’ memo was based on a negative evaluation of Valley House by Edgemoor Administrator Florence McCarthy and Edgemoor Medical Director Dr. William Bailey.

Carl Honour, president of AmeriCal, maintains that all of the physical problems cited by Simms--except for the fact that the building is located on two busy streets--can be remedied.

“The county is always waiting--for more money, for a consultant’s report, for a master plan to fix everything,” Honour said. “Patients at Edgemoor can’t wait. We’re offering a modern hospital that with modifications could fit perfectly.”

Doesn’t Meet Some Codes

The Stichler Design Group, a San Diego-based architecture and planning firm, was hired by the Department of Health Services to evaluate Valley House as a possible replacement for Edgemoor.

The firm began its report by noting that Edgemoor fails to meet many code requirements, from not meeting minimum space standards for nursing care to “the total inadequacy of the mechanical system to provide heating, ventilation and air conditioning.”

It placed at no more than $250,000 the cost of modifications needed to make Valley House safe for patients, by including railings near windows, closed-circuit television in stairwells and alarms on exits.

Buying Valley House, even with its more urban location, would “remove the possibility of Edgemoor being forced into closure due to excessive code violations and inadequate buildings,” and free the county to make a profit by selling the Santee property, the Stichler report said.

Simms, who served as interim administrator at Edgemoor until McCarthy was hired, said Edgemoor’s future may become less murky within a few months when a consultant’s report is completed on the possibility of a partnership between the county and private interests.

Watching Bill’s Progress

Also, county officials are watching the progress of a bill submitted by State Sen. Jim Ellis, R-San Diego, that would boost state payments for the 325-bed Edgemoor facility.

The hospital has been the target of several scathing reports from state health officials in recent years, although Simms says the problems of substandard care have been corrected through additional employees and tighter management.

Honour insists that there are private hospital chains bidding for Valley House, although he declines to name them. “I would rather help the Edgemoor patients,” he said.

Honour’s father, J.H. Honour Jr., AmeriCal’s chairman and chief executive officer, sent a letter of protest this week to Supervisors Chairman Brian Bilbray.

An aide to Supervisor George Bailey, whose district includes both Santee and El Cajon and who has taken a lead role in the Edgemoor issue, said supervisors were unaware of the Valley House offer and would probably add Honour’s letter to the upcoming board discussion.