State Moves Again to Revoke License of N. Hollywood Home

When the state Department of Health Services revoked the operating license of the Riverside Convalescent Hospital in 1982, it simultaneously gave the nursing home one more chance to improve. The state placed the facility on probation for three years.

But today health officials are once again trying to revoke the license that Vernon Will needs to run the 108-bed nursing home.

Health officials say that since 1982 the nursing home operated by Will and his wife, Connie, has continued to fail to meet minimum health and safety codes. What’s more, the state contends, conditions there have threatened the health and even the lives of some of the residents.

The revocation process was set in motion once again after Los Angeles County health inspectors, during surprise visits in October and November, 1984, said they uncovered serious patient-care problems. The health department issued three “A citations,” which are given for conditions that pose an imminent danger of death or serious harm to a patient.

Recommended Revocation

One of the citations was “of such severity” that county officials decided to recommend license revocation, said Michael McSkane, supervisor of the county health department’s San Fernando Valley office.

That citation was issued after an elderly patient ended up in the hospital semi-comatose, curled into a fetal position and suffering from a decaying bedsore less than a month after she entered Riverside free of those conditions. She was also dehydrated. After a hospital stay, the woman, Margaret Kribs, was returned to Riverside. A month later she was back in the hospital, suffering from malnourishment and more bedsores, according to health department records.

Jeannee Russell, who until recently was the administrator at Riverside, denied that Kribs’ condition was caused by neglect. She said the charts, which she showed to a reporter, indicated that Kribs had been fed and had been turned to prevent bedsores. The muscle contractures that caused Kribs to curl into a fetal position, Russell insisted, were caused by prescribed medicines.

Will, an Orange County businessman, calls the state and county regulatory agencies’ allegations “totally ridiculous.” Maintaining that he operates a facility as fine as any in the state, he said he is convinced that the county health department is unjustly picking on him because he criticized it in the past.

The Wills have their supporters. In August, just after the state notified them that it would begin revocation proceedings, patients, their families and staff members at Riverside sent dozens of letters to the Los Angeles County health department asking officials not to shut down the facility.

“I’ve found the place to be very good,” said one letter writer, Jack Richards, who noted that his wife, a patient at Riverside for several years, is “alert and happy where she is.”

Indeed, a visitor to the Riverside Convalescent Hospital these days would find little to indicate why the state is trying to revoke the license of its owners.

Atmosphere Appeared Pleasant

The atmosphere at the North Hollywood nursing home appeared pleasant on a recent visit. Pastel wallpaper brightened the well-scrubbed halls. The staff keeps the patients occupied with bingo, occasional candlelight dinners and other activities, and the patients greeted an administrator enthusiastically as she smilingly went from room to room.

Inspections conducted since the fall, 1984, survey have turned up mostly minor deficiencies. Health regulators, however, say that it is typical for a facility on the brink of losing its license to obey all the rules in the hope of winning the legal battle.

Since the state put Riverside on three years’ probation in 1982, inspectors have issued four A citations and three B citations. The B citations are issued for conditions having a “direct or immediate relationship to the health, safety or security” of residents.

One of those citations was written in 1983 when an inspector discovered a seriously ill man gasping for breath because he was receiving too much oxygen through his nasal tubes. The inspector and a nurse suctioned the man’s throat. After reporting the incident to the nursing director and the administrator, the health inspector assumed a doctor would be called, according to McSkane. But no vital signs were taken and no physician was notified until almost four hours later. The man died the next day.

Health department officials said they could not determine whether the incident could be blamed for the death of an already seriously ill man. They fined the facility $5,000 for failing to call a doctor quickly.

One of the more recent citations involved a 91-year-old woman who was recovering from a fractured hip. Despite a history of falls and failing mental capacity, the woman was allowed to get out of bed by herself. Once she was found lying on a bathroom floor in pain. Another time her son found her screaming on the bedroom floor. She had hurt her elbow and fractured her other hip, health department records indicate.

Citations Called Unjust

The other A citation issued during the November, 1984, inspection was for a patient’s bedsore that had not been treated properly and grew worse.

Russell insisted that both citations were unjust. She said that the patient who broke her hip suffered either a spontaneous hip fracture and crumpled to the floor or experienced a stroke. In either case, she said, the nursing home could not have prevented the incident. She said that the other patient’s bedsore worsened despite medical treatment because he was generally in extremely poor health.

Since 1982, the health inspectors have reported numerous deficiencies: Patients were immodestly exposed as they were wheeled down hallways to the shower. Residents lay on urine-soaked sheets and lacked oral hygiene. There were nursing shortages. Mattresses sagged. Social activities were inadequate. Drugs were not always administered on time or properly.

In August, the state notified the Wills that it had started license revocation proceedings which, if successful, would force the two out of the facility sometime this year.

The state seeks a revocation when it concludes that the owner has chronically failed to operate a nursing home that meets minimal health and safety standards. Typically, nursing homes are targeted after repeatedly being cited for endangering patients through neglect.

Hearing Set for June

The Wills have decided to contest the proposed revocation at an administrative hearing scheduled for June. The administrative judge will forward his or her recommendation to the director of the state Department of Health Services. The director has the ultimate authority to revoke or restore the Wills’ license.

As in all revocation actions, the state wants to repossess the operator’s license. It does not want to shut down the facility because that would disrupt the facility’s patients.

“What we want to do is get people in there who can provide good care,” McSkane said.

Will has tried to block the revocation action in court. In October he lost his bid for a temporary restraining order.

The Wills and Russell, the former Riverside administrator, insisted that regulatory agencies are out to get the facility again. Consequently, they said, regulators from not only the county health department, but also the fire marshal’s office, Medi-Cal and other government agencies have dropped in lately.

“I think it’s a political problem here, not an actual problem,” Russell said. She invited a reporter to tour the facility with her.

Gave a Tour

Russell, an outgoing, cheerful woman, conducted the lengthy, prearranged tour, which included the basement, the walk-in refrigerator, the nurses’ stations, supply closets and patients’ rooms.

Those patients who were alert seemed pleased to see Russell. She stopped and chatted with many of them. The handful of patients who were asked if they liked the facility all said they would naturally rather be home, but said the Riverside staff was treating them well.

Joan Pershing, the daughter of Margaret Kribs, said she too was struck by the cheerful, clean appearance of the place in August, 1984, when she first brought her mother, who was suffering from Alzheimer’s disease.

But shortly thereafter, Pershing said she noticed that her mother seemed always to be sleepy, too sleepy even to eat. She said the staff told her not to worry, that her mother was alert at other times. When her condition worsened, Pershing said she found someone to carry her mother across the street to the Medical Center of North Hollywood to find out what was wrong.

Pershing is one of several people who have sued Will over the care their relatives have received at Riverside or other facilities.

“It was a nightmare,” Pershing said of her mother’s experience at Riverside. “It was a living nightmare.”