Nursing Home’s Record Termed ‘Not That Bad’

Despite numerous health violations in the past, a Pomona nursing home where two patients died this month of food poisoning has not been shut down or heavily fined because its track record is “not that bad,” a top Los Angeles County health official said Thursday.

Marvin Brandon, the Los Angeles health official in charge of nursing home inspections, said that none of the deficiencies at the Towne Avenue Convalescent Hospital were major enough to warrant big fines or license revocation.

“It’s a matter of perspective,” Brandon said. Compared with all 1,000 nursing homes statewide, he said, the number of deficiencies against the Pomona home are “about average.”

Two elderly patients died and almost half the patients became ill in a food poisoning outbreak Aug. 11.

Records show that in the last three years one patient had to have her foot amputated because of infected bedsores that went untreated. Some patients have not received their medicine or proper meals while others have languished in beds soiled with human waste.

“There’s no excuse for letting a place operate like that,” said Sharlene Harrington, professor of sociology and a UC San Francisco expert on nursing homes. “It appears to me that the system has broken down, because they have plenty of tools to go after these facilities. . . . It’s a failure of willpower.”

Critics complain that “average” care in the state’s nursing homes is not good. They have called for reforms, including better enforcement of the 500 health care regulations governing the state’s nursing homes and for stronger penalties against providers of substandard care.

The system for ensuring good patient care in nursing homes is “not very effective,” said Jason Shankel, an official with the Bay Area Advocates for Nursing Home Reform in San Francisco.

Very few homes have had their licenses revoked for providing substandard patient care, he pointed out. Four were revoked by state officials in 1987.

Because the license revocation process can take years and the end result is loss of scarce nursing home beds, health inspectors have relied on a system of citations and fines to try to force substandard homes to make improvements.

However, this system has its weaknesses. A state study several years ago showed that of the $5.3 million in fines levied against nursing home operators in 1985, $2.1 million was forgiven after operators corrected deficiencies. Because of other factors, the state expected to collect only $1.1 million of the amount.

“Many of these facilities treat these things (citations and fines) like parking tickets,” Shankel said.

Fred Hill, acting director of the Los Angeles County Long-Term Care Ombudsman Program, said, “There’s got to be better enforcement and more teeth in the system so that they can really hit the pockets of the operators.”

The Towne Avenue Convalescent Hospital was assessed a $700 fine for improperly treating the patient whose foot had to be amputated due to infected bedsores. Another $1,000 penalty was assessed against the home for endangering patients by failing to lock up bleach and other chemicals.

But Glen Crume, administrator of the nursing home, said he has never had to actually pay a fine.

“That’s true,” Brandon said. He pointed out that the law provides that fines automatically are waived for certain types of citations, such as those at Towne, if the deficiencies are promptly corrected and are not recurrent.

Scores of other infractions found by county health inspectors at the Towne Avenue Convalescent Hospital were not major enough to warrant a citation and fine, Brandon said.