Widespread Violations Found at Care Homes

In surprise inspections of 44 randomly selected nursing homes statewide, authorities found problems ranging from suspected embezzlement to patient neglect, according to a report released Tuesday by the state attorney general’s office.

And seven of the 25 facilities inspected in Southern California face allegations of criminal wrongdoing that inspectors referred to the district attorney’s office, officials said.

Although they would not provide details of the alleged criminal violations, officials said the allegations included improper accounting practices and embezzlement.

“One of the problems we notice as being pervasive throughout the 44 facilities we inspected was . . . irregularities related to patient trust accounts and the management of patient assets,” said Collin Wong, director of the Bureau of Medi-Cal Fraud and Elder Abuse, a division of the attorney general’s office.

Operation Guardians was launched in March as part of Atty. Gen. Bill Lockyer’s efforts to crack down on nursing home abuses and hold private nursing homes and chains accountable for patient care. Inspections are to be conducted annually.

The report, released at a news conference at the attorney general’s office in downtown Los Angeles, identified substantial problems in the quality of patient care and administrative practices at nursing homes.

“We want to hold people at that level responsible for their benign neglect or their greed,” Wong said in a telephone interview.

The multi-agency effort included fire marshals, physicians and building code inspectors who participated in random visits to 44 of the states’ estimated 1,500 skilled nursing home facilities.

The surprise inspections in 12 counties--six in Southern California--were in addition to routine state health inspections.

The report comes nearly two weeks after the state’s first civil action against a nursing home owner. Rocky Lemon, owner of TLC Health Care, is facing more than $2 million in civil penalties and restitution to the Medi-Cal program.

Unlocked medicine cabinets, sticky floors and broken windows were common infractions cited in the attorney general’s report. Other problems related directly to patient care.

At Angels Nursing Center in Los Angeles, the report stated, nurses did not take special precautions to dress the open wounds of a resident infected with hepatitis B.

At San Jose’s Courtyard Care Center, inspectors determined that nurses had poorly documented the condition of one patient, saying that she had a foot lesion when in fact she had gangrene and maggots in her wounds.

While the report did not provide information on the cases referred to prosecutors, it did detail other accounting problems.

According to the report, staff at the Bay View Nursing and Rehabilitation Center in Alameda failed to get authorizing signatures before making purchases from trust accounts. Other homes were found to have patient account records that were 6 months old or improperly maintained.

Neither Bay View nor Courtyard officials could be reached late Tuesday for comment.

According to a written response addressed to a special agent with the attorney general’s office, Courtyard administrator Grace Ku said the home was unfairly targeted.

Roland Santos, administrator of Angels Nursing Center, said: “If these things were observed by the people who participated in Operation Guardians . . . I’m sure it has already been corrected.”

Wong agreed that many of the problems found by Operation Guardians have since been resolved.