County Takes Cautious Step on Edgemoor : Health Care: Supervisors begin to plan a $55-million rebuilding of the aging Santee geriatric hospital but need community support.

The San Diego County Board of Supervisors took the first tentative steps Tuesday toward rebuilding Edgemoor Geriatric Hospital, the aging Santee facility that serves as the hospital of last resort for chronically disabled county residents.

Supervisors cautiously outlined a general course to begin planning for a rebuilt hospital and to seek donations to help with the projected $55-million price tag. They also agreed to keep $500,000 in unencumbered funds in an account to be used as a buffer against unexpected expenses.

But supervisors also agreed to wait until October before determining whether the county should spend money on geologic and architectural consultants who would help determine where the new complex could be built.

Supervisor John MacDonald said the financially strapped county, which already faces probable expenses generated by a court order to reduce jail crowding, must approach an expensive new project with caution, especially if support from the private sector is not guaranteed.

Community support will be important because, although construction of the new hospital would be paid for through a bond offering, the funding scheme also includes an $8-million shortfall that must be covered through donations or funds from other government agencies.

“What (supervisors) said was go out and show us that there’s support for it in the community,” said an optimistic Dr. G. William Cox, director of the county’s Department of Health Services, which operates the 323-bed Edgemoor. He believes San Diegans will eagerly support the project, which would house extremely sick patients who are usually turned away by private or nonprofit hospitals and nursing homes.

The county is considering a new hospital because of problems that almost led federal and state regulators to close the institution, which is beset by budget difficulties and staff shortages. Edgemoor’s problems, which peaked in 1985, have largely been remedied, and the facility has scored well in recent inspections by the state health department’s licensing and certification teams.

However, the U. S. Justice Department said in 1986 that future waivers needed to keep the hospital open would be granted only if the county showed a clear intention to rebuild the facility that originally served as the county poor farm. A 1986 study uncovered serious structural and design deficiencies that cannot be corrected by remodeling the existing buildings, which range in age from 25 to 60 years.

Cox and other health officials at Tuesday’s Board of Supervisors meeting bristled at a nursing home association spokesman’s contention that private and nonprofit nursing homes are “able, willing and capable” to treat the county residents now cared for at Edgemoor.

Joe Diaz, representing the Sacramento-based California Assn. of Health Facilities, said the growing number of nursing homes in San Diego are now equipped to care for Edgemoor’s population.

Construction of a new facility would leave the county with “an overpriced Cadillac and no fuel to operate it,” Diaz said. “The nursing homes of today are not the nursing homes of five years ago.”

“That’s ridiculous,” Cox said after the meeting. “Day after day, week after week, sick people are turned away by nursing homes.”

He presented lists of current Edgemoor patients, all of whom were rejected for care by at least five skilled-nursing facilities because of their condition and the fact that they were largely under-insured.

Diaz’s claim is “an absolute falsehood,” said James Lott, executive director of the Hospital Council of San Diego and Imperial Counties, who also spoke for the San Diego Medical Society.

“These people can’t be in acute-care hospitals, and they can’t be in nursing homes. They’re somewhere in the twilight zone,” he said.