Fairview Care Not Adequate, Review Finds

COSTA MESA —  Patients at Fairview Developmental Center are not receiving proper care and adequate supervision in several major areas, a state licensing report has found.

The “statement of deficiencies” found that the state hospital for the developmentally disabled failed to meet standards regarding staffing, treatment and governing during evaluators’ annual visit.

In one example, the evaluators from the state Department of Health and Human Services note that a patient with a history of walking in front of cars wandered away from the hospital grounds and was later found more than a mile away. Another example involved a patient who was eating the contact paper off of the hospital wall, with no intervention by workers.

The hospital administration has until Monday to submit a plan of correction. Failure to fix the problems could result in the loss of federal and state funds, a state official said.

A Fairview official said 51 more caregivers already are being hired in response to the report. The hospital has received $1.5 million for the new staff positions from the state Department of Developmental Services, said Lynne McKnight, assistant to the executive director.

“We want to provide the best level of care that we can here,” she said. “This isn’t anything we are trying to get out of.”

Many of the problems cited in the report concerned patients transferred to Fairview from Camarillo State Hospital. Last spring, Fairview received 177 patients when the Camarillo hospital was shut down.

McKnight noted that the diagnoses and needs of those patients are different from those of the rest of the Fairview patients. The majority of Fairview patients suffer severe mental retardation and associated physical disabilities. The former Camarillo patients are largely higher functioning, many with dual diagnoses involving psychiatric conditions.

McKnight said that the state has authorized $200,000 to be spent on vocational training to provide job opportunities for the former Camarillo patients, many of whom held jobs at their previous residence.

The evaluation team found that Fairview “failed to ensure that there were sufficient number of competent, trained staff to provide active treatment and protect [patients’] health and safety.”

It mentioned the case of a 25-year-old woman, a recent transfer to Fairview, who suffered hallucinations and repeatedly left the hospital grounds. On Aug. 1, she left the grounds while unattended and was found 1 1/2 miles away. She was escorted back to Fairview by police more than three hours later.

The lack of a system to track the whereabouts of patients is “a potential serious and immediate threat to the health, safety and welfare of the clients,” the report states.

The staff also repeatedly failed to carry out patients’ treatment programs and to intervene properly when patients were behaving inappropriately, the report says.

For example, according to the report, the staff was supposed to closely monitor a patient with a history of eating inedible items, telling him to remove items when he put them in his mouth and forcibly removing them if necessary. But the patient was observed picking the foam out of a sofa and eating it without the caregivers noticing. Later that afternoon, evaluators saw him tearing off the contact paper from the wall and eating it.

Upon closer observation, the entire wall appeared to have had its contact paper peeled off, the report states.

Other instances of insufficient care noted by the evaluators:

* A patient was unhappily confined to bed most of the day because of a pressure sore, but upon examination of the dressing, there was no sore. A review of the doctor’s orders disclosed that the patient had not been ordered to be on bed rest.

* A patient kept slapping his face all day, but there were no efforts by staff to stop him from the “self-abusive behavior.”

The report also cites several instances of patients being left unattended temporarily and of inadequate monitoring of patients who are prone to choking.

The Fairview report will be discussed by the directors of a local developmental disabilities board at its Oct. 14 meeting, a state official said. The board is a state-funded agency that protects and advocates for disabled people’s legal and civil rights.