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Director Fired During Probe of Health Facility

County is investigating the Sylmar psychiatric center for escapes and assaults. Ousted official had said the center was singled out.

May 01, 2003|Charles Ornstein | Times Staff Writer

The administrator of a private psychiatric facility in Sylmar was fired this week amid an investigation by Los Angeles County mental health officials into escapes, assaults and patient-care violations at the center.

Golden State Health Centers Inc. dismissed Rich Terrell as administrator of Foothill Health and Rehabilitation Center on Monday, officials at the county Mental Health Department said.

Two weeks ago, Terrell wrote a letter accusing the county of singling out his center for frequent inspections and holding it to a higher standard than similar locked institutions.

"I would like to point out that for these inspections you control the content, definitions and provide the surveyor," he wrote. "Should you decide to make us look bad, there would be no way for us to avoid your predetermined outcome."

The county is finalizing a recommendation, expected any day, on whether to renew its multimillion-dollar contract with Foothill and its adjacent sister facility, Sylmar Health and Rehabilitation Center. The current pact expires in June. The Board of Supervisors has twice extended the county's contract with the centers for six months instead of the usual three years because of the problems.

Officials at Golden State would not confirm Terrell's job status, citing the privacy rights of its employees. But firm spokesman Dan Durazo said in a statement that Foothill "works diligently to ensure that patients are well cared for and that they do not leave the facility unattended or without permission."

The centers, owned by Golden State, house 400 mentally ill residents -- 180 placed by Los Angeles County and the rest by the state, other counties and the U.S. Department of Veterans Affairs.

In recent months, L.A. County officials have kept a close watch on the centers because of concerns about possible patient-care violations.

Marvin Southard, the county's director of mental health, said agency officials had discovered in the last few weeks that Foothill had not reported all escapes at the facility to the county. "They were basically hidden from us," he said.

Terrell could not be reached for comment.

Foothill and Sylmar are among 12 centers in Los Angeles County called "institutions for mental disease." The facilities are essentially state-licensed nursing homes for psychiatric patients, less restrictive than acute-care hospitals but more so than unlocked group homes. Patients are able to move about the facilities and sometimes are allowed out on passes.

Nearly all facilities treating seriously mentally ill patients have problems with escapes, assaults or patient-care violations. It is the number and degree at Foothill and Sylmar that concern authorities.

In his April 15 letter to the county mental health department, Terrell questioned whether the county treated all locked psychiatric facilities the same as Foothill.

He also questioned the county's focus on patient escapes and assaults at Foothill, given the serious mental illnesses among residents. Sixty-four patients escaped from Foothill and Sylmar or tried to last year, according to Golden State statistics provided to The Times.

The mental health department said earlier this year that it had only been informed of 50 escapes and attempted escapes. In nearly all of the cases, residents returned quickly.

Given the high number of residents at the two centers, Golden State officials say their rate of escapes and attempted escapes is comparable to or lower than at similar facilities.

To cut the number of patients who escape or try to, the facility recently installed video cameras to watch all exits and the perimeter, Durazo said.

Foothill has received two letters from the state Department of Mental Health since March 18 concluding that the center was in compliance with state mental health regulations.

But state officials said Wednesday that their most recent letter, dated April 18, should not have been sent because the inquiry was incomplete. "We're coming to a different conclusion than that letter implies," said Ruben Lozano of the state mental health agency.

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