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Problems Dogged Veterans Home

Barstow facility opened to accolades in 1996, but trouble soon followed. Ward's closure leaves some feeling betrayed.

March 30, 2003|Louis Sahagun, Lisa Richardson and Lee Romney | Times Staff Writers

When the California Veterans Home opened its doors seven years ago amid imported palms and a man-made brook in Barstow's high desert, its nursing facility was hailed as a high-class operation by many of the state's aging soldiers and their supporters.

It was only the second skilled nursing center for veterans in the state -- and the first in Southern California, where two-thirds of California's veterans live.

But just a few years after its opening, its promise was tarnished. Regulators cited and fined the facility for alleged substandard conditions, patient abuse and a spate of preventable deaths. Federal authorities temporarily pulled its Medicare and Medi-Cal funding. At least five administrators came and went. Critics, including Gov. Gray Davis, demanded reforms.

Last week, Secretary of Veterans Affairs K. Maurice Johannessen announced that the skilled nursing section of the home would be closed altogether, and its 90 residents moved to either Yountville or the state's newest home in Chula Vista. Officials said they hoped to take action before further fines were imposed.

A day later, on Friday, regulators with the state Department of Health Services imposed a $100,000 fine -- the highest possible -- against the home for the death of an 80-year-old man who they said was not promptly treated for an infected hernia. It was the second fine in two months stemming from a patient death. Two such violations within a year's time spark revocation of a home's license under recently passed state law.

"We have no choice now," said California Department of Veteran Affairs Undersecretary Tom Kraus, as he left a meeting at the facility Friday with administrators, residents and their families. "We're closing."

The entire veterans' home is not closing. There are 278 residents who can care for themselves or need only limited nursing care. They will remain at the home, but the skilled nursing portion, where round-the-clock care is required, will cease operations.

The rapid rise and fall of such an eagerly anticipated and critically needed nursing facility has left residents, families and staff members feeling betrayed. Elderly or disabled patients will be uprooted, loved ones will no longer be able to visit easily and many employees, who complained they were overworked before, will be out of work altogether.

Former boosters of the facility mourn the loss.

"There was a time when it was highly thought of -- a hallmark of state veterans' homes," said Thomas R. Langley, the home's second administrator, who stepped down in 1998 citing health reasons. "I was very proud of the home.... I will never forget seeing those old vets sitting outside watching the sun rise over the desert."

Troubles Surface

In fact, problems, including inspections that yielded evidence of patient abuse and staffing deficiencies, began not long after the home opened its doors in 1996. (The inspections were conducted by the state Department of Health Services, which regulates nursing homes -- including those like the Barstow facility, which are run by the state VA).

By 1999, enough trouble had surfaced that the California Department of Veterans Affairs launched its first internal review of the Barstow home. But it was the events of the following year that drew the concern and dismay of top government officials, including Davis.

The home was cited in three patient deaths, and federal officials withdrew the facility's certification for Medicare and Medi-Cal funding -- an unusual move that deprived the home of about $80,000 per month in reimbursements. The U.S. Department of Veterans Affairs yanked funding too, citing poor medical care and record-keeping, medication errors and high administrative turnover.

A routine state inspection that year also uncovered an unusually high number of failings at the home, including untreated bedsores, unexplained bruises, use of antipsychotic medication without consent and theft. Five residents reported having money stolen -- one man was robbed of $800 locked in his nightstand -- but administrators did not promptly investigate, inspectors found.

One of the men who died was Paul Stevens, 76, a World War II Army drill sergeant who choked to death on a piece of broccoli Feb. 11, 2000.

Officials at the home insisted he had died of a heart attack, but autopsy findings revealed otherwise. The home was also cited for altering medical records related to Stevens' death and for retaliating against a doctor who declined to corroborate the heart-attack explanation, according to state Department of Health Services records.

In March of 2000, one 78-year-old diabetic man died after his blood sugar level soared and a physician wasn't promptly summoned. That led to a $25,000 fine.

Another death, in May of the same year, also resulted in a citation and $10,000 fine. A 62-year-old diabetic patient had refused food or finger pricks to check his blood glucose level, but the staff made no attempt to intervene or call a doctor, according to inspection records.

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