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10% at King had criminal records

An audit also finds that hospital nurses failed exams on basic skills -- repeatedly.

September 09, 2008|Garrett Therolf | Times Staff Writer

More than 10% of the Martin Luther King Jr.-Harbor Hospital employees whose backgrounds were examined by the county had criminal histories, according to a long-awaited analysis released Monday that also found the King nurses provided inferior care.

The hospital had about 1,600 employees when the background checks were conducted a year ago, according to the report by the auditor-controller's department. Of those, 1,356 had their backgrounds examined, and 152 of those came back with criminal or arrest records.

The number is far larger than the 17 employees with criminal histories that the county has previously acknowledged and included convictions ranging from misdemeanors (but not most vehicle code violations) to serious felonies.

"If 10% of the employees in my office had criminal records, I'd have a big problem," Supervisor Zev Yaroslavsky said. "My level of frustration is very high."

The report was done at the behest of the Board of Supervisors after The Times reported that the county's Department of Health Services had fallen short of supervisors' promise to "wipe the slate clean" of problem employees.

When federal regulators forced the closure of inpatient services at the hospital a year ago, supervisors blamed their own employees for the regulators' finding that the hospital did not meet minimum standards for patient care.

In the cases of 99 of the workers with criminal records, county managers determined that the crime did not prevent the worker from continuing on the job. But the auditor-controller questioned the reasoning used to make that determination. In one case, for instance, county managers decided that it was not a problem that a custodian had been convicted of first-degree burglary and felony grand theft.

Eighteen other employees have been suspended with pay pending an administrative investigation, but some cases languished for six months to a year before the county initiated action.

The audit also found that 29 King employees omitted their convictions on a questionnaire, but none were disciplined and some were improperly allowed by managers to resubmit a corrected form.

King struggled for years with a series of problems, including some mistakes that left patients dead or with serious injuries.

The new audit concluded that King staffers often delivered poor patient care in part because the exams that assess their competency were weaker and managers improperly allowed staffers to take the exams until they passed. Among King workers tested in 2008, for example, 57% failed at least one area of competency on their first attempt, and 21% failed three or more skills on the first attempt, the audit found.

Thirty percent failed the medication safety test, and 18% failed a test of how they would deal with a code-blue patient on their first attempt.

By contrast, the audit said, the failure rate at Harbor-UCLA Medical Center was 3% for medication safety and 0% for the mock code-blue test.

"We directed the department and were assured that they would determine the level of competence of every employee," Yaroslavsky said. "It turns out that people were given exams. They flunked. They were given another chance. They flunked."

For several months in 2007, Harbor-UCLA Medical Center in Torrance conducted competency testing that caused Harbor officials, the auditor's report said, to "question whether King-Harbor nurses, some of whom required as many as four attempts to pass a test . . . retained sufficient mastery of basic skills to apply them in practice."

The Harbor-UCLA officials wrote in a report last year to King administrators that "this generic competency assessment reflects that a majority of the staff do not have a basic working knowledge or skills to perform the generic competencies in a simulated environment. The knowledge and skills tested are truly basic."

Harbor-UCLA officials also reported that five King employees engaged in improper conduct, including "one instance of outright cheating during the competency testing." No one was disciplined in those cases.

Some of the nurses identified by Harbor-UCLA as having competency problems were transferred to other county medical facilities, but the majority remained at King, where the county continues to operate an outpatient clinic.

John Schunhoff, the Department of Health Services' interim director, said he was concerned about the findings and is working on a way to improve the way nurses are tested. "That's something we are going to get outside independent help on and we are going to standardize it across the department," Schunhoff said. "I don't think that there is anything in this that directly speaks to the quality of care, however."

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