State Regulators Temporarily Close Angels Hospital
State regulators this month temporarily shut down Angels Hospital in Rancho Cucamonga because of patient care deficiencies -- some of which may have resulted in deaths -- and other issues, the Riverside Press-Enterprise reports (Beeman, Riverside Press-Enterprise, 5/24). According to the Los Angeles Times, the immediate closure is "extremely rare"; typically, regulators allow facilities time to correct problems before shutting them down. Brenda Klutz, deputy director of the Department of Health Services, ordered that all surgeries be cancelled and all inpatients be relocated within hours of state inspectors' visit to the hospital on May 7. On May 12, she signed the temporary suspension order to shut down Angels and ordered the hospital to halt submission of any Medicare or Medi-Cal claims. Details of some issues cited by inspectors are provided below.
- On at least two occasions, no doctor was present for emergencies, which required staff to call 911 to seek help from paramedics (Wilson, Los Angeles Times, 5/26).
- Two patients were improperly nourished (Riverside Press-Enterprise, 5/24).
- Staff members failed to change a patient's ventilator tubes in a timely manner (Los Angeles Times, 5/26).
- Staff did not monitor cardiac telemetry machines, which alert them to potentially fatal heart disruptions, for three hours on March 21.
- Sound alarms on the telemetry machines were turned down too low to be heard throughout the unit.
- Medical records concerning one patient's death included conflicting details. One record said the patient died at 2 p.m., but another said the patient was still alive and being administered medication nearly two hours later.
- Staff did not administer adequate amounts of medications to patients (Riverside Press-Enterprise, 5/24).
- Prescriptions were not always obtained and administered to patients.
- The facility did not have a registered pharmacist on staff (Los Angeles Times, 5/26).
- Staff did not follow physicians' orders to consult with other specialty physicians.
- The hospital did not maintain adequate staffing levels.
- Some staff members were not qualified to perform their assigned duties (Riverside Press-Enterprise, 5/24).
State regulators said they likely will conclude their investigation this week. Their report will be forwarded to CMS regulators, and an administrative law judge will determine whether Angels should close permanently. Local law enforcement and the state attorney general's office also will receive copies of the report, and either may decide to file criminal charges (Los Angeles Times, 5/26). One physician has been referred to the state medical board for possible disciplinary action, and others -- including several nurses -- may face similar reviews (Riverside Press-Enterprise, 5/24).
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