As published in The Independent June 7, 2000
This is the first in an ongoing investigative series examining the ill-treatment patients claim to have endured at the SunBridge Care and Rehabilitation facility in Burlingame. Following an article written about the site in March, the Independent has received numerous calls from both inside and outside the facility with similar complaints of abuse and neglect. After visiting the site, the newspaper decided to investigate the cases further.
By Dwana Bain
She's dubbed it "The bridge to hell."
Two months after an article about the nursing home first appeared in the Independent -- in which the daughter of a resident alleged elder abuse -- SunBridge is facing further complaints from Burton, as well as a current resident and family members and friends of former residents.
Recent allegations include inadequate and poorly trained staff, neglect, and verbal and physical abuse.
"The things that happened to me were unbelievable," said Burton, who contacted the Independent last month after reading the first story about the nursing home.
Burton alleges that during her 13-day stay at SunBridge, she developed a hematoma -- a blood clot caused by a broken blood vessel -- where she was recklessly stabbed by a needle used for an insulin shot. She said she had a bedpan spilled on her. She was allegedly forced to take medicine she was allergic to and then left lying in her own vomit for more than an hour while waiting for a nurse.
Because she complained, Burton alleges, she was called a "bitch" by the nursing home staff, and was later verbally abused by SunBridge's director, who called her a "goddamned liar" and a "senile old lady."
Before entering SunBridge, Burton was already familiar with the nursing home, through several friends that had lived there.
The facility -- which has also operated as Burlingame Nursing and Rehabilitation Center and as Care West -- has a long history of citations for neglect, abuse and patient rights violations. Since at least 1994, the number of complaints and deficiencies, violations issued by the federal government, against the nursing home has far exceeded the state and county average.
With 260 patients, the nursing home is large compared to others. However, Louis Nuyens, who gathers nursing home statistics for California Advocates for Nursing Home Reform, stated that citations are not proportional to a facility's size.
While several facilities in the county have received no citations in that time frame, the Burlingame facility under its various owners has been cited 10 times, with fines totaling more than $45,000.
Over the past several years, complaints to Department of Health Services have far exceeded the state average. For example, in 1998 there were 48 complaints against the facility, almost 10 times the state average for that year and more than three times what could normally be expected for a facility of its size, according to statistics from CANHR.
SunBridge's current owners -- Albuquerque New Mexico-based Sun Healthcare Group - has racked up several lawsuits and substantial fines in California and throughout the country.
Through written statements, the company continues to deny wrongdoing.
Karen Gilliland, Sun Healthcare's official corporate spokesperson did not respond to the latest allegations against the Burlingame facility, but a representative from the SunBridge Burlingame issued a statement denying the allegations.
According to Burton, most of the nursing home's patients are unable to speak for themselves. "I was the only one on my floor who was clear and lucid," she said. For this reason, Burton said, she will continue campaigning to ensure that others are not mistreated. She said she was particularly disturbed by staff members' treatment of mentally impaired patients. She allegedly witnessed employees pinch these patients, pull their hair and mimic them.
Burton also voiced her complaints to Katrina Angeli, a continuing care leader with Kaiser in San Francisco. Angeli oversees nursing home care for Kaiser patients in the San Francisco and San Mateo areas. Kaiser has contracts with several area nursing homes, including SunBridge. According to Angeli, about 17 percent of SunBridge's population are patients sent by Kaiser.
Along with complaints of her treatment overall, Burton, a diabetic, told Angeli that was fed a non-diabetic diet, which caused her blood sugar levels to fluctuate significantly.
In an interview, Angeli told the Independent that specifics of the investigation into Burton's claims are confidential, but that the case is not closed.
"We will continue to follow up until we're satisfied that everything that she talked about has been resolved appropriately."
In accordance with Kaiser's grievance process, Sally Burke Wingard, manager of long-term care for Kaiser San Francisco sent Burton written confirmation of her complaints. The April 21 letter acknowledged several specific complaints - including the facility's alleged dirty restrooms and the bedsores Burton allegedly received. The letter stated that Kaiser would conduct an appropriate follow up.
The HMO's grievance process dictates that it will either address the complaints within 30 days or notify patients of more time needed. At press time - several weeks past the 30-day deadline - Burton said she'd heard nothing from Kaiser.
Burton isn't the only person to have complained about the nursing home.
San Bruno resident Walter O'Toole said he was extremely upset with the treatment his friend Don -- who is now deceased -- received at the facility. Don, a former teacher, was dying of cancer. "He was in pain very much," said O'Toole. But he alleges that employees refused to give him pain medication. "He's in pain, can't you give him a shot?" O'Toole recalls telling an employee. "They said, 'No we'll go look at him' ...I sat there about an hour and they never came in."
O'Toole had other complaints. For example, he said when he helped Don to the restroom, the toilet was filthy, a claim also asserted by Burton and the daughter of a current resident.
A giant in the industry
Prohibited from speaking
In spite of SunBridge's assertion that she did not complain while she was a patient, Burton maintains that she did complain, to the very person who made that assertion.
State Citations 1996-1999
1999 - A resident developed a severely infected wound on his ankle but staff noted it for the first time on the day the resident was admitted to an acute care hospital where his leg was amputated.. Cited for failure to continually assess resident's skin condition or to treat the infection. Fine $10,000
Staff Reporter
After a serious back injury landed 77-year-old Joan Burton in the hospital, she was sent to a rehabilitation facility.
Though nearly blind, she recognized the building where she'd visited friends in the past -- SunBridge Care and Rehabilitation, on Trousdale Drive at El Camino Real in Burlingame.
"When I saw the sign I thought, 'Oh my God! I'd rather die than go in there!'" she said.
Sitting in her apartment, Burton seems far from senile or otherwise mentally impaired. She speaks clearly and coherently. Every time she tells her story, the details are the same.
But Burton, traumatized by her experience, filed numerous complaints with her HMO, Kaiser Permanente, which sends many patients to SunBridge. She also filed a complaint with California Department of Health Services Licensing and Certification.
"Lucy" a custodial patient at SunBridge who asked that her real name not be used, said she has also seen employees mimicking patients "Anything that [the mentally impaired] people do that [staff] think is funny, they just burst out laughing," Lucy said.
Feeding a patient the wrong diet is grounds for a citation, according to Pat McGinnis, the executive director and founder of California Advocates for Nursing Home Reform.
But McGinnis said she doubts Kaiser has done much, despite its rhetoric about caring for patients.
"It doesn't matter what the administrators say because actions speak louder than words."
Further, O'Toole alleges that the employees neglected and mistreated many of the residents. "I saw people tied in their chairs," O'Toole said.
"I noticed there was a lack of attention toward the people there. You can hear people moaning and groaning."
"The people weren't helping," O'Toole said. "It seemed to me either they were understaffed or they didn't have enough people."
SunBridge is no small player in the nursing home industry. Its parent company, Albuquerque New Mexico-based Sun Healthcare Group Inc. is a dominating force - one of the largest nursing home chains in the country -- owning 369 such facilities in the United States and155 facilities in Europe. Many of the nursing homes have been acquired by Sun Healthcare in the past few years, including the Burlingame site. The homes operate under a number of different names, including SunRise, SunDance, SunBridge.
In the past few years, Sun Healthcare-owned facilities have racked up a series of citations, complaints and lawsuits against its facilities. According to the Health Care Workers Union Local 250, in 1998, government health officials cited Sun for nearly 1,000 deficiencies in its California nursing homes alone. Its Northern California facilities received 20 percent more deficiencies than did the average California nursing home that year.
The company has a tightly controlled public relations department. The company's corporate headquarters in New Mexico speaks for all United States facilities.
The administrator who allegedly verbally abused Burton has in the past refused to answer allegations against the Burlingame facility, stating that he was not allowed to speak to the media. He was not available for comment on the remarks he made. His assistant - an executive director who requested her name not be published reiterated that employees are prohibited from communicating with the press.
However, she issued the following written statement: "We take all allegations of abuse and neglect very seriously. We have policies in place for employees to follow if allegations of abuse or neglect arise. We expect 100 percent compliance from our employees with regards to these policies. We have no record of any allegations of abuse or neglect being filed by this resident [Burton] while she was in our care. If a resident or their family member has a concern about the care provided in our facility, they can raise this concern with any member of our management team."
In addition, the statement said, there are other mechanisms in place to ensure that residents and family members are able to voice their concerns. These include: a customer response phone number posted in the lobby which connects to corporate headquarters; biannual surveys of residents and their responsible parties; and monthly family and resident council meetings.
1998 -- A 91-year-old resident began eating only half of her meals, lost 10 percent of her weight in 16 days and became unresponsive. She was sent to emergency hospital where she died a day later from shock attributable to dehydration, sepsis, and urinary tract infection. Cited for failure to properly assess a resident's change in condition. Fine $20,000
1998 -- A male housekeeper licked and sucked a resident's breast. Resident reported incident to nurse but nurse did not inform supervisors or administrators. Cited for failure to keep residents free from mental and physical abuse. Fine $500
1996 -- A resident was given incorrect dosages of medication and was not monitored for toxicity. When infection occurred, staff did not notify physician that antibiotic was ineffective. Resident developed allergic rash and staff did not provide further treatment for infection. Resident died six weeks after admission to facility. Fine: $600
1996 -- One resident's abusive daughters threatened and intimidated her and other residents with yelling, verbal abuse and physical threats. Cited for failure to protect residents from verbal abuse. Fine $600
1996 -- A resident with a history of wandering and taking food from other residents was restrained by tying her wheelchair to her bed. Cited for violation of patient's rights. Fine $400
1996 -- A resident developed a serious bed sore within a month of admittance to the facility which required surgical closure. Cited for failure to provide required preventive care. Fine: $800