State workplace regulators have issued one of the largest fines yet for failing to protect employees from COVID-19 on the job to a Bakersfield nursing home where nearly 200 staff and residents were infected with the coronavirus.
Kingston Healthcare Center, a 184-bed skilled nursing facility on Real Road in Bakersfield, was fined $92,500 as a result of numerous violations detailed in a 23-page citation report issued by Cal/OSHA last month.
In total, 71 health care workers at Kingston fell ill from COVID-19 since March, according to a state website that tracks the virus in nursing homes.
The virus also infected 112 residents at Kingston, 19 of whom eventually died. As of Wednesday there were no recent infections reported at the facility.
"We think they've addressed the systemic issues they were having where they made improvements but ...we keep a very close eye out on their practices and infection control procedures because it's really important," said Kern County Public Health Services Director Matt Constantine.
The large outbreak at the nursing home in April and May strained staffing to the point that a state medical strike team was sent in by the state to allow the facility to continue operating. Kern County also became involved, even though nursing homes are typically regulated only by the state and federal government. The county provided personal protective equipment, infection control guidance and testing, Constantine said.
"We clearly identified significant infection control breakdowns and lack of training," Constantine said of his experience working with Kingston.
Constantine's department had numerous phone calls with administrators of the facility, he said, including a late-night, panicked phone call on at least one occasion from the facility with concerns about staffing shortages because so many employees were sick with COVID-19.
Kingston, owned by David Silver, a Los Angeles rheumatologist, referred media calls to Rockport Healthcare Services, which did not immediately return a request seeking comment Wednesday. Rockport, for which Silver is CEO, manages nursing homes throughout California.
A state Department of Industrial Relations spokesman said Wednesday the penalty amount had since been lowered by $17,315 after Kingston provided proof it corrected some of the hazards in the citation. Cal/OSHA is a division of that department.
"As of today, the employer has not filed an appeal of the citations," spokesman Frank Polizzi said in an email. Normally, an employer has 15 working days to initiate an appeal but the deadline may have been extended under emergency orders issued by the governor due to COVID-19, Polizzi said.
The Cal/OSHA report says Kingston allegedly failed to report to Cal/OSHA four instances where its employees were hospitalized for COVID-19 illness. Employers are required to report serious on-the-job injuries that require hospitalization to the state within eight hours, according to regulations cited in the report.
The citation says multiple employees became seriously ill with COVID-19 between April 22 and July 27 due to Kingston's failure to:
- follow infection control procedures to reduce employees' risks of contracting the virus
- notify employees of COVID-19 cases at the facility
- ensure employees wore face coverings
- provide N95 masks to employees working in patient rooms
- determine which employees had significant exposures to COVID-19
- notify employees who may have had significant exposures within 96 hours
- provide employees proper training on infection control.
Kingston is one of about 50 companies cited so far in California for COVID-19-related workplace safety violations. Four other companies received higher fines, mainly for violations at large food-processing facilities. In total, seven of the companies cited were nursing facilities. Kingston is the only workplace cited in Kern County.
Government records show Kingston has a track record of questionable care and practices facility-wide. It has received three times more complaints and citations related to patient care than the state average for such facilities, according to Medicare.gov.
Its history of issues and citations prompted the Medicare system 25 months ago to withdraw Kingston's quality rating and instead label it a "special focus facility," a designation reserved for the most troubled nursing homes. Kingston is one of six nursing homes in California with that designation and one of three currently listed as a facility that has not improved.
So far this year 17 deficiencies have been reported by state regulators at the facility, including one so egregious the facility was temporarily deemed to be in "immediate jeopardy," a situation California Department of Public Health defines as likely to cause serious injury or death to the patient.
That deficiency report described a situation observed in early May in which eight residents were seen not social distancing and not wearing masks on the facility's smoking patio. A certified nursing assistant was observed handing cigarettes to the residents and lighting them but did not wash his hands or use hand sanitizer in between assisting each of them. It was later found in facility records that two of the residents in the group were suspected of having COVID-19 while the other six had tested negative for the virus.
The nursing assistant told state investigators in a subsequent interview he was not aware which residents at the facility were infected or suspected of being infected with COVID-19 and had not been trained how to prevent possible transmission between residents on the smoking patio.
Within four days of the incident, five of the six residents on the smoking patio who were negative had tested positive for COVID-19.