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"State investigating Kern Valley nursing home again"

The Bakersfield Californian

BY EMILY HAGEDORN, Californian staff writer
Tuesday, Jun 10 2008 6:51 PM

The state Department of Justice is investigating the Kern Valley Healthcare District, according to one of the district’s top officials.

Based on the documents the investigators are interested in and the employees they’ve talked to, the department’s Bureau of Medi–Cal Fraud and Elder Abuse is focusing on the hospital’s 74–bed skilled nursing facility, said Bob Jamison, chairman of the Lake Isabella hospital’s board of directors.

The nursing facility has been disciplined before for overprescribing psychiatric medicine and having a high medication error rate, according to federal inspection reports.

"They didn’t say exactly what they are investigating," Jamison said. "We’re anxiously waiting for them to come back, and hopefully they’ll give us some more information."

Jamison wasn’t present for the inspection but heard that more than one investigator visited the facility two weeks ago.

The district plans to cooperate with the investigators, he said.

"We have received complaints about the facility and can’t comment on the status of any investigation," said Abraham Arredondo, spokesman for the Justice Department. The department won’t be able to comment until a decision is made whether to prosecute.

Jamison didn’t know whether the investigation was tied to last year’s inspections on behalf of the federal Centers for Medicare and Medicaid Services, which found that the facility’s staff was improperly prescribing psychiatric medicine to patients, without a psychiatric evaluation, to chemically restrain them.

"Depakote (a drug used to treat seizures that can cause drowsiness, weakness and depression) was off the radar and did not need a consent," the unnamed master of social work says in the January 2007 report. "If the resident did not want to go to the dining room, then an anti–psychotic drug would be started. If the residents yelled out, the medication would be started. None of the resident’s family members were notified about starting Depakote on any of the residents."

Twenty–two of 29 sampled residents were prescribed unnecessary medication, the filing says.

The skilled nursing facility was placed on "immediate jeopardy" status Jan. 11, 2007, which meant that some systemic problem in the hospital was jeopardizing patients’ health. The issues were resolved, and the status was lifted Jan. 19, 2007.

The facility was placed on jeopardy status again April 18, 2007 for failing to ensure medications were given without error, according to another inspection.

A facility must ensure that its medication error rate is less than 5 percent. Kern Valley’s rate was 16 percent, the filing says.

According to Medicare’s Nursing Home Compare Web site, that issue was resolved May 17, 2007.

The facility is deemed a "special focus facility," meaning "this nursing home has a record of persistently poor survey performance and has been selected for more frequent inspections and monitoring," the Web site says.

After the reports, Kern Valley hired consultant Sycamore Asset Management to bring the nursing facility into full compliance, Jamison said.

"They did update some of the procedures and policies within the unit," he said. "They tell us we’re in good shape now."

The nursing facility was inspected again in February and was not placed on jeopardy status, according to the report.

The district also includes a 27–bed in–patient acute care unit, a three–bed intensive care unit, an emergency department, rural health clinic and rehabilitation services. It is managed by an elected five–person board of directors.

Kern Valley’s nursing facility is the only facility in the Lake Isabella area, Jamison said. The next closest facilities are in Bakersfield.

"We’re a health care district. We’re certainly not there to harm people," Jamison said. "They’re being well taken care of."