State Health Department Cites Ahimsa Center

The state health department Tuesday released a 123-page list of health and safety code violations discovered during a surprise four-day visit last month at Ahimsa Care Center, the only nursing home in Orange County for AIDS patients.

The most serious violations resulted in three citations where there was “potential for harm to the patient,” according to a licensing official.

But the administrator for the Laguna Beach skilled nursing facility said that after reviewing the report she is satisfied that most of the violations were “procedural and documentation problems.”

“I’m confident we’re continuing to provide good patient care,” administrator Sharon Jo Lucas said. The staff will prepare a plan to correct the deficiencies and change its own internal policies where needed, she added.

One of the citations was for not notifying the physician of an AIDS patient who was unable to eat or take his medication for his final eight days, who was receiving insufficient nutrition by intravenous solution and who had apnea--periods when he stopped breathing. The patient died, although his death was not directly connected to the nursing home’s actions, said Jacqueline Lincer, district administrator for the Department of Health and Human Services’ licensing division.

Lesser “deficiencies” listed by inspectors included instances of lax infection control, improper food storage, poor patient hygiene, failure to treat patients with dignity and failure to respond to the concerns of the residents’ council, according to the health department’s report.

Ahimsa, a 47-bed skilled nursing home that also cares for cancer and geriatric patients, does not need to close down but must show the health department a correction plan within 10 working days, Lincer said. After the plan is approved, the home will have 30 days to implement changes, and health department inspectors will return for another visit, she said.

“It is our hope they (the violations) will be corrected, and that’s what the facility has assured us,” Lincer said. “They were very receptive to us when we discussed it with them, and we were told they are going to correct them. But we always go back to check.”

Administrator Lucas said she anticipates that the nursing home will be in full compliance when the inspectors return. “We are devoted and dedicated to what we’re doing,” Lucas said. “We will make this work.”

Laguna Beach City Councilman Robert F. Gentry, who is gay and a supporter of Ahimsa, said that he has not seen the health department report but that his impression of the facility has been “quite positive.”

Ahimsa “is a wonderful setting as a hospice for patients and families to deal with a terminal illness with dignity and compassion,” Gentry said.

The health department’s four-day surprise visit, which concluded Oct. 30, was conducted for routine licensing purposes, but it marked the fifth visit by inspectors at Ahimsa this year. The previous four visits were in response to complaints and resulted in the recording of deficiencies.

The three citations given were Class B, which means they potentially could have harmed the patient. More serious are Class A, which means there is “substantial probability that serious physical harm or death would result,” and Class AA, issued when a patient dies because of a violation, Lincer said.

In addition to the citation involving the AIDS patient, a second citation concerned the care given to a 90-year-old stroke and heart patient who nurses had noted was “abusive and very noisy with much swearing and yelling.” The patient was confined to her five-bed room, an action that failed “to ensure that the patient be treated with dignity and respect.”

The third citation was issued when a licensed nurse used only gloves but did not wear a mask and goggles as the facility’s policy states, to administer cytotoxic intravenous medication, which can burn the skin. The nurse also regulated the IV by hand, instead of using a mechanical pump, as policy dictates, according to the report.

Administrator Lucas said the doctor of the AIDS patient was fully aware of the man’s condition and had visited him at the nursing home, but it was not recorded in the patient’s records. The elderly woman came to Ahimsa after another nursing home could not handle her abusive, disruptive behavior, and Ahimsa’s staff put the patient in her room when she verbally abused others, Lucas said.

The cytotoxic IV citation is a reflection of Ahimsa’s outdated and excessively strict policies, she said. The nurse’s behavior that was cited was standard nursing home practice throughout the industry, and Ahimsa’s policy and procedures will be changed to reflect that, Lucas said.