The $8 million structure rising behind a south Sacramento psychiatric hospital offers concrete proof of the facility's determination to become the region's largest destination for people in mental health crisis.

Yet Sierra Vista Hospital has one of California's worst patient mistreatment records, with 111 violations since 2004, ranging from understaffing to lax drug controls and failures to protect patients from violence, according to hundreds of pages of government inspections and court records reviewed by The Bee.

Such lapses are blamed for at least three patient deaths since 2000, most recently Steven Grant Burton, a Camino man who collapsed in his room Feb. 17 after the hospital failed to provide the respirator he needed while sleeping, according to a federal report obtained last week by The Bee.

Burton's widow, Vickie, said she's baffled regulators would even consider allowing construction of a new wing – adding 48 beds to the current 72 – in light of Sierra Vista's history.

"How many more families will have to go through this?" she asked during a tearful interview at the office of her attorney, who is planning a wrongful death lawsuit.

The fate of Sierra Vista Hospital's expansion rests with multiple government agencies – each with different oversight responsibilities.

The Sacramento City Planning Commission reviews compliance with environmental and planning requirements. Last year, it endorsed the addition to the Bruceville Road facility.

But the hospital cannot treat patients in the new wing without approval from the state Department of Public Health, which has yet to receive an application. The health department will take into consideration "recent compliance history," said Kathleen Billingsley, deputy director of the department's Center for Healthcare Quality.

That history includes two $25,000 state fines in the past four months for jeopardizing the lives of patients – including Burton. Of California's 147 licensed acute psychiatric hospitals, Sierra Vista is the only one to have received that penalty, the harshest for negligent care under a new 2007 law.

Hospitals such as Sierra Vista serve those deemed an immediate threat to themselves or others, many of them suffering from schizophrenia or suicidal tendencies. Advocates are dismayed at the prospect of admitting additional vulnerable patients to an already troubled facility.

"This is a public health emergency," said Laurel Mildred, executive director of the California Network of Mental Health Clients. "And to have them getting even bigger, it just goes to show how patchwork the oversight is."

A Sierra Vista spokesman declined to comment, and a spokesman for the hospital's parent company, Psychiatric Solutions Inc., would not discuss specific cases.

Corporate President Joey Jacobs did assure investors during a 2006 conference call that Sierra Vista remained top-notch.

"We have an absolutely strong team at that facility, and they are delivering great care there," Jacobs said, according to a transcript. He added that the regulatory scrutiny has "not impacted our growth strategy on the beds there whatsoever."

Long history of complaints

Since 1986, Sierra Vista has occupied a one-story brick building off Highway 99, across the street from the Kaiser Permanente complex. Psychiatric Solutions bought the hospital in 2005.

Based in Tennessee, Psychiatric Solutions is one of the country's largest psychiatric hospital chains, ranked 49th on Fortune Magazine's list of 100 fastest-growing companies last year. It owns 101 facilities nationwide and six in California, including Heritage Oaks Hospital on Auburn Boulevard.

(Heritage Oaks has been cited twice since 2004, compared with Sierra Vista's 111 violations. Sutter Center for Psychiatry on Folsom Boulevard – Sacramento's only other acute psychiatric facility – had seven violations, according to a state data run.)

Despite its troubles with the state, plus a pair of threats from Medicare to cut off its funding, Sierra Vista has consistently received passing marks from the Joint Commission on the Accreditation of Healthcare Organizations. The commission, an industry-funded agency, conducts inspections every three years on behalf of the federal government.

Call The Bee's Todd Milbourn, (916) 321-1063.