Modesto memory care center cited for numerous violations. Facility may lose license.
A state agency is taking legal action to revoke the license of a residential care facility in Modesto for seniors with Alzheimer’s disease and dementia.
The California Department of Social Services (DSS) filed the action Sept. 30 against Pacifica Senior Living Modesto, on St. Paul’s Way, accusing the facility of serious lapses in care and supervision of residents with dementia, as well as under-staffing, violation of personal rights and failure to notify families when residents fell and were injured.
The department is also seeking to revoke the administrator certificate of Deborah Lucas, a former facility director, for conduct inimical to the health, morals and welfare of clients at the Pacifica center.
State inspections and complaint investigations discovered severe under-staffing in the Pacifica center, even before the COVID-19 pandemic made things challenging for long-term care facilities starting last year.
A November 2019 inspection found a severe shortage of staff caregivers in the center’s wings named for California destinations. The Yosemite wing had one caregiver for 16 residents; the Napa had 1 caregiver for 11 residents; Monterey had 1 for 13; and Central Valley had 1 for 15.
While there are no required staffing ratios in residential care, facilities are expected to have adequate staffing for supervision and care of residents. On multiple occasions the only staff member in the Napa wing was called away to help in other wings, leaving vulnerable residents unattended in Napa, the state complaint says.
On Nov. 26, 2019, the only staff member working in the Napa wing was absent when three residents got in a physical altercation, with hair pulling, a person thrown to the floor and kicking, the state complaint says.
In August, the state assessed a $10,000 civil penalty against Pacifica Senior Living based on allegations it failed to supervise a resident whose dementia symptoms included sexual aggression. According to the state, the lack of supervision resulted in the resident inappropriately touching another resident without consent.
The state complaint notes that many of the violations occurred when Lucas managed the facility from November 2019 to July 2021.
In November 2019, a person from an outside agency made a comment to a DSS inspector about the care and supervision at the facility. According to the state, Lucas told the person: “Keep your mouth shut. You are only here to assist your client.”
Lucas denied the outburst when contacted by The Modesto Bee on Wednesday.
Lucas said she doesn’t think the allegations in the state complaint are valid but she’s not able to fight state government. “They go out with their investigators and make their determinations without the proper facts,” Lucas said. “We send in appeals and they deny the appeals. They get away with it because they are the state of California.”
In another allegation, a Department of Social Services investigation found that a Pacifica resident fell at least 10 times between July 31 and Sept. 6 in 2019. One of the falling incidents that August left him with a laceration to the head, requiring a visit to a hospital emergency room and staples to close the wound.
Pacifica did not update the man’s fall risk appraisal or implement measures to prevent him from falling, the state said. He fell again later that month, requiring another trip to the emergency room.
The state’s enforcement record for Pacific Senior Living Modesto shows 43 Type A citations for violations and 36 Type B citations. The facility with capacity for 73 residents was licensed in 2010 and is part of a chain of senior care facilities across 13 states.
Type A citations are for more serious violations posing an immediate risk to the health, safety or personal rights of those in care. Type B are regulatory violations, such as faulty medical records or lack of staff training, that may put clients at risk if not corrected.
Jason Montiel, a spokesman for the Department of Social Services, said the state action may result in license revocation, the facility being placed on conditional probation, or a judge could dismiss the allegations. The facility owner may appeal and continue to operate the center during the legal process, he said.
Theresa Pettapiece said last week she took over as executive director of Pacifica Modesto two months ago.
“I know some of the accusations by the state are things that happened previous to my taking over,” said Pettapiece, a former business office manager at Pacifica. “I believe we will be going on probation for a period of time. ... I believe it can be resolved.”
Family has bad experience
Ron and Stephanie Hannink of Modesto said they were appalled by the treatment of Ron’s grandmother at Pacifica.
Ron said he walked into the facility in May 2020 to visit his grandmother, Carol, who was 98 and lived at Pacifica for six years.
Ron found Carol had been placed on a urine-stained mattress and box spring on the floor of a room. She had been moved from her private room to a room shared with three other residents.
“The bed was pushed up against the clothes closet, with no sheets or bedding,” Ron said. “She was in an extremely terrified fetal position in urine-soaked clothing.”
Stephanie said that Ron tried to touch his grandmother to reassure her and she took a defensive measure as though she was fighting off an aggressor.
Stephanie said her husband thought it was his duty to provide quality care for his grandparents in their old age because they had helped to raise him. Pacifica Senior Living was three minutes from their home. Stephanie purchased nice clothing for Carol every year and bought furniture to make her feel comfortable in her room at the center.
The family was happy with the care Carol received under a previous administrator, but that changed when Lucas took over, they said. Pacifica raised the cost from $4,800 a month to $5,600 monthly.
“They hit us with a massive increase,” Stephanie said.
The Hanninks said a couple of times a Pacifica caregiver called and told them “you need to get down here” but they were refused access to check on Carol.
Stephanie said they never recovered most of the furniture or clothing they purchased for Carol, and don’t know what became of it.
They tried finding another memory care facility for Carol in the middle of the COVID-19 pandemic last year but the restrictions on care facilities made it almost impossible. Carol died in November 2020.
“They were way understaffed; hardly anybody was there,” Ron said of Pacifica Modesto. “Deborah should be held liable for what was inflicted on these residents who relied on them for care.”
Lucas said the state investigated Hanninck’s complaint and “we proved he was wrong.” The former administrator would not discuss the details.
The Department of Social Services looked into Hannink’s complaint of unsanitary living accommodations and substantiated what he reported, according to the state report dated Dec. 28, 2020. The facility submitted a plan for corrections.
A previous investigation in May 2020 dismissed other complaints claiming the family wasn’t notified about a room change and a change in Carol’s health condition.
Lucas said she is retired and contended that Pacifica Senior Living Modesto has been managed as well as other senior care facilities in the city.
“They have no idea how hard we as employees work to protect these people,” Lucas said. “People don’t understand what the industry is about. I would like them to walk a mile in my shoes.”
Delayed treatment for injuries
A lawsuit filed last month against Pacifica alleges elder abuse and negligence in the death of 67-year-old Eric Spansel on Nov. 4, 2020. Spansel, who had Lewy body dementia, was placed in the facility in October 2020 and was only there a couple of weeks when he was found laying in a garden area one evening.
According to the lawsuit filed Sept. 21, Spansel had fallen and suffered a hip and elbow injury and black eye. Pacifica did not tell the family about his fall until the man’s daughter called two days later to check on him, the suit alleges.
Two days after that — or four days since Spansel fell — he was finally taken to the hospital for treatment. His injuries required surgery and Spansel came down with pneumonia in the hospital. He never recovered and was transferred to hospice care where he died within hours, the lawsuit says.
“They should have been watching him and made sure he did not injure himself in the first place,” said attorney Neil Berman of Salinas, who filed the lawsuit on behalf of Spansel’s surviving children. “Not only did they fail to attend to him, which led to his injuries, they did not get him the treatment he needed right away. There was also failure to communicate with the family.”
Berman said another issue is misrepresentation. Pacifica made claims to Spansel’s family the center can care for and meet the needs of people with dementia and Alzheimer’s disease. Those representations were “known to be false ... and were made to induce the plaintiffs and Eric Spansel to enter the defendant’s facility with the intent to defraud, so the defendants could profit,” the lawsuit charges.
The lawsuit is seeking general, special and punitive damages, funeral and burial costs and restitution.
A second suit claims negligence
Another wrongful death lawsuit filed in Stanislaus Superior Court has sought damages following the death of Miles Riley, 86, of Modesto in September 2019.
Riley, who was known to have balance problems, suffered a fall for the first time eight days after starting to live at Pacifica Modesto in August 2019, resulting in a lacerated scalp, bruises and abrasions to his upper arms. (Riley’s case is one of the allegations in the state complaint.)
The lawsuit charges that Pacifica didn’t act to mitigate the fall risk after Riley returned from the Kaiser hospital. He fell at least three additional times.
Riley’s condition declined after each falling incident. A Pacifica staff member noticed that Riley’s stomach was swelling into a “huge bump,” prompting another visit to the Kaiser hospital, where it was determined he was retaining urine and had a bad pressure wound on his buttock. He was sent home to hospice care and never recovered, the lawsuit says.
The plaintiffs are seeking general damages, compensation for hospital, medical and funeral expenses, exemplary damages and attorney fees.
Riley’s injuries were “a result of the facility choosing not to follow the rules,” said Attorney Stephanie Johnson of Thousand Oaks, representing the Riley family. “There are good people who operate good facilities and they want us to bring these kind of cases. If there is no downside to not following the rules, what is the upside to following the rules?”
Pacifica denied the allegations in a response to the Riley lawsuit last year. The company said the facility rendered reasonable and necessary care to Riley and said his injuries were caused by his comorbitities, diseases and physical conditions.
After consulting with corporate management, Pettapiece said she would not comment on the lawsuits or the complaints about injured residents not getting prompt medical attention. She said some of the state citations and claims in litigation have been unsubstantiated.
“We are working with the state closely and I am working with their (licensing program analyst) on a weekly basis,” Pettapiece said. “I think the standards have been raised. We are trying to make sure residents are well taken care of.”
The state Department of Social Services would not comment on whether 43 Type A citations and 36 B citations are an unusually large number.
The San Diego-based owner, Pacifica Senior Living, says it has almost 90 senior care facilities in 13 states. Its assisted living and senior residential center in Merced has 15 A citations and 27 B citations on the DSS enforcement site and its Fresno facility has five Type A and four Type B citations.
By comparison, the Dale Commons assisted living center in Modesto has three A citations on record and one B citation. Another Modesto memory care facility, Stratford at Beyer Park, has four A and five B citations. Hospitality House in Salida has five A and eight of the B citations.
“The department licenses facilities in accordance with state law, and each facility is unique,” said Montiel, the DSS spokesman. “Speaking in general terms, compliance and enforcement actions can range from offering the facility technical assistance, entering into a plan of correction, civil penalties, and in some cases, revocation of a facility license.”
Ron Hannink said he hopes the state enforcement action results in real changes for the sake of residents at Pacifica and families that have their loved ones there. “I want to see more than just a slap on the wrist,” he said.
This story was originally published November 1, 2021 at 4:00 AM.
