Hillcrest Hospital Gets Good Marks in State Health Review

San Diego County’s Hillcrest mental hospital got a good review Tuesday from state regulators whose harsh criticism during the last year has threatened the facility’s federal funding.

State Department of Health Services officials said unannounced visits last week to the 60-bed emergency hospital, and another county hospital in Loma Portal, turned up just six deficiencies--compared to more than 100 a year ago.

“I am pleasantly surprised at their progress,” said Ernest Trujillo, head of the state Department of Health Service’s licensing office here. “It’s a 180-degree turnaround.”

The two hospitals treat mentally ill patients who are poor or lack private health insurance. Hillcrest treats adults, and Loma Portal serves adolescents and the elderly.

Trujillo said the department has decided no action should be taken to revoke Hillcrest’s license, and has recommended to the federal government that the Loma Portal hospital remain eligible to be reimbursed under the Medicare and Medi-Cal health programs.

Of the six deficiencies found, two were at Hillcrest and four at Loma Portal.

The two at Hillcrest involved vague medical records and “scratched and marred” furniture in patient rooms.

Loma Portal, which also had some minor problems with records and furniture, was cited for an incident in which a young patient who went home to visit his family did not take the proper dose of over-the-counter medication while he was away. The state was also critical of instructions on several patients’ charts which investigators said were too vague to provide proper direction for solving the patients’ nutritional problems.

Despite the state’s findings, the county still faces a fight to reverse the federal Department of Health and Human Services’ separate action halting Medicare funding for patients at Hillcrest.

Trujillo said the state’s recommendation in January that Hillcrest’s Medicare eligibility be revoked was set aside when federal action suspended Medicare payments. He said Tuesday’s report did not address the problems that led to that action.

Still, county officials said they hoped the state’s review will aid the county’s appeal of the funding cutoff, which was based on a study of medical records at Hillcrest last June.

“I hope this will send a message that Hillcrest is in fact a facility that meets state and federal regulations,” said Kathy Wachter-Poynor, director of the county’s mental health programs. “Outside officials have come in and validated what the county has been saying.”

Wachter-Poynor said the county will show the state’s findings to the administrative law judge who will hear the county’s appeal. No date has been set for that hearing.

Federal officials have argued that the county should be penalized for allowing conditions to become as bad as they were in June, regardless of what has been done to improve care at Hillcrest since then.

The county, on the other hand, has said it makes little sense to cut off Medicare funding to a hospital where patients are now receiving adequate care.

Since reports of substandard patient care and mismanagement at Hillcrest surfaced in 1985, the county has hired a new hospital administrator, new psychiatrists and a medical records specialist, and has cut the number of beds from 92 to 60. Wachter-Poynor said bills for a recently completed renovation of the building may total $500,000.

“I think the quality of care at Hillcrest is comparable with any community standard in San Diego,” said Dr. Harold Mavritte, the acting medical director at the hospital.