Los Angeles - City Attorney Mike Feuer announced today that his office has reached a settlement with Lakeview Terrace Skilled Nursing Facility to resolve allegations of patient dumping during the pandemic, abuse and neglect, denial of care and efforts to conceal its conduct. The settlement with the Westlake/MacArthur Park facility, following Feuer’s second lawsuit against Lakeview Terrace in two years, installs sweeping changes and practices to remedy allegedly unlawful discharge protocols and treatment deficiencies amidst the COVID pandemic, and requires payment of $275,000 in penalties, costs and expenses tied to ongoing monitoring of the nursing home’s practices.
“This victory for these patients is all the more important given COVID-19’s devastating impact on nursing home residents in L.A. and across the nation,” said Feuer. “Now there will be dramatic improvements in patient care, new COVID-related protections, improved oversight when patients are discharged, and ongoing work by a Performance Monitor to ensure critical safeguards are followed.”
Feuer added, “The fact we filed a second lawsuit against this facility, and demanded important new protections, shows just how tenacious we’ll be in standing up for vulnerable patients like these.”
“The City Attorney has achieved a crucial victory for our seniors, one of our most vulnerable populations,” stated Councilmember Gil Cedillo. “Patient dumping, abuse, neglect and denial of care by Lakeview Terrace Skilled Nursing Facility is outrageous and unacceptable. I took action against the dumping issue when I introduced SB 275 in the state legislature that would outlaw patient dumping by hospitals. This was occurring in Skid Row and the bill made it a misdemeanor to leave a hospital patient at a facility without his or her consent. We must remain vigilant in keeping nursing home operators accountable to ensure the best care for our seniors.”
The settlement, approved by the court on February 25, builds on the permanent injunction Feuer obtained against Lakeview Terrace two years ago. It enhances requirements to protect residents and adds mandates to address issues related to COVID-19, an issue that did not exist at the time the previous judgment was entered. Key provisions include:
Dramatically expanding nursing staff: The settlement almost doubles the number of R.N.s at the nursing home.
Installing a Performance Monitor: The Monitor is appointed by the City Attorney’s Office to inspect, observe, provide guidance and ensure that all laws, regulations and the highest standards of patient care are adhered to. The Monitor has been appointed to a six-month term that can be extended to 18-months at the City Attorney’s sole discretion. Lakeview Terrace is required to pay for the Monitor, up to $105,000 for the first six months and up to an additional $210,000 if the term is fully extended.
Conferring broad powers on the Monitor: The Monitor is empowered to improve the care provided by Lakeview Terrace and to curb unlawful discharge and unsafe patient care. The Monitor is guaranteed 24-hour access to all patient medical records and can make unannounced inspections. Lakeview Terrace staff must notify and copy the Monitor in real time of all patient discharge communications, provide doctors’ orders for each discharge and coordinate follow-up care. The Monitor can obtain, on an expedited basis, court orders to implement their recommendations if Lakeview Terrace staff refuses to follow their guidance.
Protecting residents and staff from COVID-19 : Among other mandates, Lakeview Terrace must maintain a fourteen-day supply of N95 masks, surgical masks and gowns at all times, achieve full compliance with the California Department of Public Health’s COVID-19 Mitigation Plan, train staff on COVID-19 protocols, and take steps to reduce resident COVID-19 test positivity rates to less than ten percent.
Improving patient quality of care: The settlement institutes new requirements to improve patient care and ensure that all residents receive medications prescribed by their doctors. In addition to expanding its nursing staff, Lakeview Terrace must provide to the Monitor timely and accurate records of distribution and administration of medication to patients consistent with physician’s orders.
Requiring payment of penalties and costs: The settlement requires Lakeview Terrace to pay $130,000 in civil penalties and $40,000 in costs and fees incurred by the City Attorney’s Office. Going forward, Lakeview Terrace must automatically pay the City and County of Los Angeles $6,000 in civil penalties each time any regulator declares an Immediate Jeopardy, a violation of law or regulation that has caused or is likely to cause serious injury or death to a resident.. Lakeview Terrace must also continue to comply with the 2019 permanent injunction issued after the resolution of the City Attorney’s prior lawsuit.
The settlement resolves allegations that Lakeview Terrace Skilled Nursing Facility:
Failed to administer prescribed medications to chronically ill patients and falsely recorded that the medications had been given;
Unlawfully discharged elderly and seriously ill patients onto the street or into lower level-of-care facilities that were unable to properly care for them and did so without notifying or obtaining consent from family members;
Failed to protect patients from neglect and abuse and then failed to report those incidents to the court-appointed Performance Monitor and the L.A. County Long-Term Care Ombudsman, both of which were required following the February 2019 settlement in the case prosecuted by the City Attorney’s Office; and
Failed to meet certain quality of care standards in caring for patients as required by the permanent injunction ordered in that previous settlement.
In December, 2020, in accordance with the 2019 settlement, the City Attorney’s Office appointed a new Monitor to observe, provide recommendations and ensure compliance with state and federal standards. The Monitor reported that conditions and performance improved in some areas over the past three months. The Monitor’s initial term under the 2019 settlement expired in early February, but he will continue his work—with broader powers to protect residents—under the new settlement.
Lakeview Terrace has cooperated with the City Attorney’s Office throughout this process.
The L.A. County Department of Public Health, Health Facilities Inspection Division, and Molly Davies of the WISE and Healthy Aging Long-Term Care Ombudsman Program all provided key assistance with this matter.
Deputy Chief Will Rivera, Supervising Deputy City Attorney Christina Tusan, along with Deputy City Attorneys Gina Lee, Alex Bergjans, William Pletcher and Miguel Ruiz handled the litigation and settlement of the case.
A longtime leading champion for seniors, Feuer – while in the California State Assembly – authored the law requiring all certified nursing homes to post the quality care rating that has been given to them by the Centers for Medicare and Medicaid Services. Feuer also led the legislative effort to restore funding to the Long Term Care Ombudsman program, which investigates nursing home abuse and neglect. As City Attorney, Feuer has filed numerous cases against hospitals and nursing homes alleging that they engaged in inappropriate discharges of homeless patients and also held a Symposium with the Hospital Association of Southern California and the Los Angeles District Attorney to propose solutions to address the challenges associated with homeless patient dischargesAs a City Council member, Feuer created and funded the elder abuse coordinator in the City Department of Aging. As Executive Director of Bet Tzedek Legal Services, which provides free legal services to indigent clients, Feuer oversaw a Nursing Home Advocacy Project that combated abuse and neglect, and educated patients and family members about patient rights.