Psychiatric Hospital Hit With Sanctions

After uncovering nearly a dozen incidents of sexual misconduct and other patient-care violations, Los Angeles County mental health officials said Wednesday they are imposing sanctions against a West Hills psychiatric hospital that will limit the type of patients it can treat.

Officials notified Pine Grove Hospital this week that it will no longer be allowed to detain and treat any new involuntarily admitted mentally ill patients, a move that could deprive the 80-bed hospital of a significant portion of its MediCal funding. The mandate, the severest penalty that county officials can levy, takes effect Saturday.

“Our first concern is for the safety of patients and for the quality of clinical care they are receiving,” said David Meyer, chief deputy director of the county’s Department of Mental Health. “On balance, we decided this is what we needed to do.”

Meyer said the county has already begun relocating 15 child patients at Pine Grove, the only mental health hospital in the San Fernando Valley that accepts adolescent patients eligible for MediCal. County officials said their action will very likely place a significant financial burden on the hospital because many of its patients are detained involuntarily.

Pine Grove administrator Larry McFarland declined to comment Wednesday on the county’s investigation. But he said his staff members would “continue to work for the viability of keeping Pine Grove open” and to ensure the safety of its patients.

The county’s action follows a three-month investigation of the hospital that turned up 11 patient rights violations due to poor supervision, including sexual assault, sex between minors, self-mutilation by two patients and a suicide attempt by another with documented suicidal tendencies, records show.

The investigation of the hospital was launched after a 13-year-old girl was raped by a 17-year-old fellow patient in August. In the last three years, law enforcement officials have investigated five incidents of sexual molestation involving current and former Pine Grove patients. Two former mental health workers and the 17-year-old boy have been convicted of sexually assaulting teenage girls they met at the hospital.

Ten separate violations, which occurred between March 2001 and October 2002, are spelled out in a letter that Meyer wrote to hospital officials on Oct. 29, informing them of the county’s preliminary decision to restrict patient care.

The letter, obtained by The Times, cites the August rape as one instance in which a patient’s rights were violated. The incident occurred after hospital workers failed to monitor the hallways of the adolescent ward, according to an inquiry by the state Department of Health Services.

The letter also cites two incidents involving consensual sex between adolescents, and an episode in which poorly supervised adolescent patients were able to cut themselves. In another incident in January, a 12-year-old patient was arrested on suspicion of sexual assault after three female patients reported he had groped them, the letter said.

In October, the letter stated, a patient with “documented suicidal intent” was left unsupervised in her room and attempted to hang herself. According to the letter, the hospital failed to notify county officials, as they are required to do under the Department of Mental Health’s guidelines.

The incidents, Meyer wrote, were examples of Pine Grove’s “failure to provide adequate supervision and care of patients.”

The hospital was given one month to respond to the allegations and show it had taken steps to improve its operations. In a letter to the county dated Nov. 8, McFarland listed some of the changes: adolescent patients were segregated by sex, stricter hallway monitoring rules were in effect, and patients from Juvenile Hall were no longer welcome.

Hospital officials also met with county representatives on Monday, hoping to convince them that the hospital should just be placed on a closely monitored probation status. Meyer said hospital officials presented a new course of action that included staffing increases and physical changes to the facility.

Meyer said the plan was impressive. But it was also expensive, and county officials worried about the hospital’s ability to pay for the changes, since its parent company, Arizona-based Doctors Community Healthcare Corp., filed for Chapter 11 bankruptcy protection in November.

“We were concerned,” Meyer said. “If you can’t get the financing to beef up your operations, then we have concerns about that for your future, and any corrective action plan.”

Pine Grove can still treat patients who check into the hospital of their own volition. It may also continue to treat involuntarily detained adults who are currently housed there.

The hospital cannot appeal the county’s decision, but it may eventually reapply for the authority to again expand its patient-care operations, county officials said.

Meanwhile, Pine Grove faces two civil lawsuits brought by the families of victims of sexual assaults, but both of those suits have been stayed until further notice from bankruptcy court.

The hospital is also the subject of a separate investigation by state health officials that could result in a number of sanctions, from stricter state monitoring to a ban on federal welfare payments. The results of that investigation may be released by the end of the month.

A national agency that inspects hospitals, the Joint Commission on Accreditation of Healthcare Organizations, also has opened an inquiry into sexual misconduct at Pine Grove.