By Rong-Gong Lin II
The Los Angeles Times
LOS ALAMITOS, Calif. — State officials have fined two nursing homes in Orange County for providing care so inadequate that it led to the deaths of two patients.
In one case, a woman died from dehydration. In the other, staff failed to provide CPR to a man suffering a heart attack because they mistakenly believed he was under orders not to be resuscitated.
Alamitos West Health Care Center in Los Alamitos was fined $100,000, and state officials levied an $80,000 fine on the Huntington Valley Healthcare Center in Huntington Beach.
At Alamitos West, the California Department of Public Health found that the nursing home failed to give an 82-year-old woman sufficient fluids, causing her to suffer dehydration and acute kidney failure.
On Dec. 19, the woman’s condition had deteriorated so much that she was transferred to a hospital, where she was diagnosed with a urinary tract infection, dehydration and an “altered mental status.”
The patient died six days later, on Christmas Day.
The woman was admitted to the nursing home in late November. A doctor ordered that the patient’s fluid intake and urine output be monitored during every shift.
But a registered dietitian at the nursing home could not prove to state officials that nurses had ensured that the patient was drinking enough fluids every day; in some cases, review of the patient’s intake and output of fluids was blank or illegible.
Betsy Hite, a spokeswoman for Alamitos West, said the fine will be appealed. She declined to discuss the incident in detail, but said that the nursing home was “taking this as an opportunity to look at systems and see if there’s opportunity for improvement.”
At Huntington Valley Healthcare Center, the nursing home’s administrator told state officials that on March 2 a registered nurse supervisor did not call 911 as a patient was dying “because she thought the patient had orders” not to be resuscitated. In fact, the patient’s medical record included an advance directive form from a family member on which was marked the option, “I DO WANT C.P.R.” in an emergency situation.
Nursing personnel who were present at the time of the patient’s death were no longer employed by the time state officials investigated.
State officials said that at one point, a licensed vocational nurse called to inform a family member that the patient had died. According to the state, the nurse told the family member that the patient was dead and that paramedics were not called because the facility had orders not to resuscitate the patient.
The family member told the nurse to hang up and call 911.
By the time paramedics arrived, they found the patient in bed with no heartbeat. He was covered with a sheet with no signs that CPR had been initiated.
Curt Rodriguez, administrator for Huntington Valley Healthcare Center, said the facility has not decided whether to appeal the fine.
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