Mental Hospital Faces Sanctions After State Probe

A West Hills mental hospital sanctioned by Los Angeles County for patient-care violations that included sexual misconduct has been cited by state officials for another series of problems, including failure to perform psychiatric evaluations, inadequate staffing and improper administration of drugs, according to documents released Friday.

State officials conducting the probe of the 80-bed Pine Grove Hospital said the problems “resulted in the facility’s inability to ensure the provision of quality health care in a safe environment,” records show.

Since the October investigation, the state Department of Health Services has posted a full-time monitor at the hospital to ensure the safety of patients.

And in coming weeks, state and federal officials will evaluate improvements the hospital has made and decide whether it should receive further sanctions, which could include the revocation of Medicare and Medicaid funding.

Pine Grove administrator Larry McFarland said the hospital has corrected the problems, though he would not specify what actions were taken. He said he was confident that the hospital would avoid any further penalty.

“I think we certainly have moved forward to take any corrective action on every deficiency that was noted,” he said. “We’ve taken every measure to ensure that our patients are safe.”

Still, the revelations pose new challenges for Pine Grove, a private institution that had to lay off 85 workers in December after the county’s sanctions, which significantly limited the type of patients the hospital could treat.

Both the county and state investigations were sparked by the rape in August of a 13-year-old girl by a 17-year-old fellow patient -- one of five incidents of sexual molestation involving current and former Pine Grove patients that police have investigated in the last three years.

The 17-year-old patient and two former mental health workers were convicted of sexually assaulting teenage girls they met at the hospital.

In their report, the state investigators concurred with county officials that Pine Grove was deficient in supervising staff and patients, factors contributing to two of the sexual assaults.

Other violations of federal health regulations cited by state officials included “nonexistent” or incomplete psychiatric evaluations, medical treatments conducted without patients’ consent and a two-year stretch -- between 2000 and 2002 -- when the hospital did not have a medical director to assess the “appropriateness of care,” leaving psychiatrists to review each other’s work.

Investigators also noted a September 2001 incident in which staffers administered a heartbeat-altering drug to a patient who had previously had a heart attack.

The county’s sanctions rescinded Pine Grove’s ability to treat patients admitted against their will -- those who are admitted by police, for example. That has resulted in a significant change in the culture at Pine Grove, because such “involuntary holds” were often those with the most severe psychiatric problems, McFarland said.

County officials said that the sanctions could be an economic blow to the hospital, because it is typically reimbursed with Medi-Cal funds when it treats involuntarily detained patients.

But McFarland has vowed to keep Pine Grove’s doors open, even though its parent company, the Arizona-based Doctors Community Healthcare Corp., filed for Chapter 11 bankruptcy protection in November.

The bankruptcy has stayed two civil suits filed by families of the victims of the sexual assaults.

Meanwhile, a national agency that accredits hospitals has asked Pine Grove officials to report on how the hospital has improved its policies since the August rape.

If the Joint Commission on Accreditation of Healthcare Organizations finds the report inadequate, Pine Grove’s current accreditation status could be jeopardized. The hospital now has the commission’s highest rating.