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"County’s largest nursing home under fire again"

Santa Cruz Sentinel

Kurtis Alexander – Sentinel Staff Writer
Article Launched:02/15/2008 04:02:06 AM PST

SANTA CRUZ — The county's largest and most notorious nursing home is back in the news this week, after the Centers for Medicare and Medicaid Services named it one of the 131 worst care facilities in the nation.

But the new owners of the former Pleasant Care nursing home on Soquel Drive, whose reputation was made by urine-soaked beds and substandard senior care, say it's their last time making headlines.

The rebuke by the federal government is another in a long list of problems left behind by the now bankrupt Pleasant Care Corp. that San Mateo-based Nazareth Health Care says it will fix.

"Are we going to be perfect? No," said Helen Richardson-Davis, president of Nazareth Health Care. "But will we have anything that will put our facility in jeopardy? No. Our residents are safe and happy."

The federal inspection that landed the 212-bed nursing home on this week's watch list was conducted Oct. 16, exactly a month before Nazareth Health Care took over.

The facility's listing does not implicate Richardson-Davis and the new administrators but it does mean their work will face greater scrutiny. Not meeting federal performance criteria, which health officials say the Pleasant Care facility had not done for 20 months, means an increase in the number of annual inspections.

"We don't like that, but we understand," said Richardson-Davis.

The federal report is the culmination of health inspections at more than 16,000 nursing homes nationwide and serves to incentivize, if not penalize, those sites with substandard evaluations through sanctions, fines or withholding federal subsidies.

The inspection report for the Santa Cruz facility was not immediately available. But federal officials said its ranking means it had about twice the problems of other facilities and that the problems were consistent and sometimes harmful to residents -- such as giving residents the wrong medication, failing to prevent abuse or ignoring a resident's complaint.

Local officials say the issues are not new to the nursing home.

"Historically, it's where we've got the most complaints," said Linda Robinson, ombudsman for the nonprofit Advocacy Inc. Her organization is charged by the state and federal government with monitoring care facilities in Santa Cruz and San Benito counties.

But Robinson is hopeful the new owner will turn things around.

"We don't know a lot about them, but they've been putting a lot of money and effort into improving the facility," she said.

Nazareth Health Care, which runs two other nursing homes, took over the Santa Cruz property Nov. 16 after a Campbell man, who had been operating the site, failed to win licensing from the state. Pleasant Care, which had owned the property for years, put the nursing home on the block in July, following a series of lawsuits against its parent company alleging negligent care, including a $1.3 million case that was fought successfully by then state Attorney General Bill Lockyear.

Richardson-Davis, whose company secured the license to run the facility last month, says several changes have already been made.

One was changing the name to Santa Cruz Skilled Nursing Center. But the first and foremost was to the staff, Richardson-Davis said, noting that a number of layoffs had been made in both the nursing and executive ranks, though she declined to say exactly how many.

The patient-to-staff ratio is now at 8-to-1, she said, lower than what is was -- partly because of more employees and partly because of the elimination of 12 resident beds.

Richardson-Davis said her staff was working closely with the federal inspection teams that gave failing grades to the last owner and that she expected a clean bill of health in the next report, due in April.

"I think we'll do well," she said.

Running a nursing home, though, has always been a tough trade in Santa Cruz County, dogged by a shortage of skilled staff and the area's high cost of doing business.

The margins are thin and rely heavily on federal reimbursements for the low-income, disabled and elderly residents that are dependent on Medi-Cal and Medicare.

Local health officials worry about the county's dwindling number of beds which, with the closing of Capitola Care in 2005, is now less than 1,000. Meanwhile, the demand for full-service care rises as baby boomers age and health care costs go up.

The shortage of care is why federal officials have been reluctant to put too much pressure on substandard facilities like Pleasant Care, says Jack Cheevers, spokesman for the Centers for Medicare and Medicaid Services.

In fact, his agency withheld funds to only three of the state's 1,350 nursing homes last year.

"Some of these nursing homes are the only facility in 150 miles," he said. "This creates not only a huge burden for the residents but for their families who have to come a long way to visit them."

Cheevers said his agency prefers to work positively with the sites.

"We hope to see improvements," he said.