A top state health official Tuesday leveled a rare public barrage of criticism at San Diego County's Edgemoor Geriatric Hospital and the county officials responsible for running it.
Charlene Stewart, deputy director of the state Department of Health Services, chastised county officials for allowing the conditions at Edgemoor to deteriorate and called the lack of an adequate medical records system at the hospital "appalling."
Stewart said Edgemoor still is not in compliance with five of seven conditions for which it was cited in March. The conditions must be satisfied by June 30 or waived by the state for the hospital to remain eligible for Medicare and MediCal funds, which make up more than 80% of its budget.
Stewart's comments came as the San Diego County Board of Supervisors met in a special conference session to consider Chief Administrative Officer Clifford Graves' proposal to expand Edgemoor's staff, improve its maintenance and make plans for a $16-million construction project to replace the aging Santee facility, parts of which were built more than 50 years ago.
Any hope the county had Tuesday of finding a long-term solution to the hospital's problems was put on hold by Stewart's blunt remarks about Edgemoor's condition.
"The department is very concerned at the highest levels about the (county's) response," Stewart said. "There has been some improvement. We have seen some progress. It hasn't been enough, frankly.
"There are some very serious situations that exist there that need immediate attention. We can't wait for studies. We can't wait for automated systems. These conditions will have to be corrected immediately or the state will have to take some drastic action."
Although she said the county had made progress in providing a medical records system at Edgemoor, Stewart said such a service should have been in place years ago.
"For a facility with that number of clients, that's appalling," she said.
Stewart also criticized Edgemoor's nutrition program, which she said was particularly important because about 180 of the hospital's 323 patients are not able to feed themselves.
"Our dietitian on her inspection observed trays passed out and she observed people who did not eat because they did not have anyone to assist them," Stewart said. "Then she saw the trays were collected and people who needed nourishment did not receive it, either because the people who were there were busy feeding other people or else the staff who was there was not proficient enough."
In addition to the medical records and the nutrition program, which must be corrected by Friday, Stewart made public for the first time three other categories in which Edgemoor does not comply with federal standards. They are nursing, special rehabilitative services and "governing body," a category Stewart said represented the overall administration of the facility.
Two other areas--the activity program and physical environment--have been judged in compliance since they were cited March 14.
Stewart said the "drastic action" to which she referred could involve anything from calling a halt to admissions at Edgemoor, ordering specific administrative changes or even closing the hospital or putting it into a receivership. But she said the prospect of closing Edgemoor was "highly unlikely" because of the shortage of nursing home beds in the county.
Stewart's agency is just one of several investigating Edgemoor amid allegations of mismanagement and revelations about the hospital's deteriorating physical structure. Also looking into problems at the institution are the state auditor-general's office, the county Grand Jury and the Civil Service Commission.
The supervisors Tuesday asked Chief Administrative Officer Graves to return on May 7 with two specific plans of action. One of the plans calls for a list of short-term moves that could bring Edgemoor into compliance with state and federal regulations, the other calls for a long-term plan for the replacement or rehabilitation of the hospital's aging buildings.
County Health Services Director James Forde said in an interview that he was "confident that we will make every effort to resolve" the problems at Edgemoor by June 30.