A state assemblyman is trying to block the expansion of troubled Sierra Vista Hospital in Sacramento, despite arguments that the region is facing a critical shortage of beds for psychiatric patients.
"I am not going to enable dysfunction," said Assemblyman Ted Gaines, a Republican from Roseville. "I will apply as much pressure as possible to see that this expansion does not go forward" until Sierra Vista passes a state audit and shows "true management accountability," he said.
The hospital, which has been cited by state inspectors more frequently than any private psychiatric facility in California since 2004, is planning to add 48 beds. Construction has begun at the facility on Bruceville Road, but before Sierra Vista begins treating more patients, the hospital needs approval from the state Department of Public Health.
In a recent letter to public health director Mark Horton, Gaines said he has "grave concerns" about the quality of care at the hospital. He urged the department to fully investigate Sierra Vista and "if necessary, revoke their state license."
Sierra Vista officials responded Wednesday by announcing they have hired two administrators to work with a "best practices" team to improve conditions at the facility.
"Our goal is to provide the highest level of quality, compassionate care for individuals and their families during times of crisis," Sierra Vista's chief executive officer, Nancy Purtell, said in a written statement.
Hospital administrators argue in their expansion application that more psychiatric beds are badly needed. Sierra Vista has 72 beds.
Figures from the California Hospital Association show that Sacramento County and the state have far fewer beds for mentally ill patients than experts consider "minimal."Sacramento County has one psychiatric hospital bed for every 4,336 people, compared with the one bed per 2,000 people recommended by national experts.
"We're in dire straits," said Sheree Kruckenberg, vice president of behavioral health for the hospital association. "We are a state of 37 million people, and we have only 6,000 psychiatric beds. We are at crisis proportions."
People in immediate need of mental health services in the area routinely get stranded in emergency rooms, endure treatment delays or are sent far outside the region, Kruckenberg said.
State officials will not consider the bed shortage when deciding whether to approve Sierra Vista's $8 million expansion.
"The application will be evaluated on its merits," said state health department spokesman Ken August.
The hospital's regulatory record includes 111 citations by state inspectors since 2004. At least three patients have died because of poor care at the facility since 2000, according to state regulators. Most of Sierra Vista's problems stem from inadequate staff and training, according to records.
Including Sierra Vista, Sacramento County has three private, acute psychiatric hospitals, plus a county mental health center, for a total of 317 beds, according to the hospital association. Yolo, Placer and El Dorado counties have a combined total of only 51 beds, according to the hospital association's figures.
The association's figures show that the number of psychiatric beds in California has plunged by 31 percent since 1995.
Part of the reason for the shortage, Kruckenberg said, is that insurance reimbursement rates often fail to cover the full costs of psychiatric care. California hospitals also are subject to costly requirements for earthquake protection and relatively high mandates for nursing coverage, she said.
In a report released earlier this year, the Treatment Advocacy Center, a nonprofit advocacy group for mentally ill people and their families, said California has about 17 public psychiatric beds per 100,000 people, and that represents a "severe" shortage.
Georgia Jenkins, whose daughter Jennifer died at Sierra Vista in 2000 at age 16, said her family felt they had no choice but to send her to the hospital when she expressed fear that she might harm herself. "Nobody really gave me an option," Jenkins said.
Records show that the Sierra Vista staff ignored "critical changes" in the teen's condition and failed to keep close watch on her. Jennifer Jenkins tied a sheet around her neck and hanged herself from a doorknob.
"The place is not safe," said Georgia Jenkins, who successfully sued Sierra Vista for wrongful death. "It scares the hell out of me that they are thinking of expanding."
Sierra Vista's new management structure should help iron out problems, Purtell said.
Sierra Vista has added a chief operating officer who will work with Purtell on "implementation of ongoing improvements," her statement said, and a new compliance officer will seek guidance from the state to make sure the hospital meets regulatory standards.
Call The Bee's Cynthia Hubert, (916) 321-1082.
