The Bakersfield nursing home at the center of Kern's only publicly confirmed COVID-19 outbreak has faced formal accusations of inadequate patient care more frequently in recent years than the state and federal averages.
The federal website Medicare.gov says that during the past three years inspectors have given Kingston Healthcare Center 39 citations — three times the state average and more than four times the national rate.
The California Department of Public Health's website says 129 complaints or incidents were filed last year against Kingston at 329 Real Road. That's more than three times the state average for a facility that size. The allegations ranged from patient abuse to inadequate quality of care to safety problems.
Complaints against the facility also exceeded the state average within its category in 2017 and 2018, with 55 and 73 complaints, respectively. Records show there have been 32 such complaint filings so far this year.
The facility's compliance problems have prompted the Medicare system to withdraw Kingston's quality rating and instead attach an online warning that reads, "This facility is not rated due to a history of serious quality issues and is included in the special focus facility program."
Thirty-five residents at Kingston recently tested positive for the new coronavirus, up 84 percent from Friday's county-reported total, state records show. Prior reports stated that 35 workers at the 184-bed facility also tested positive, but by Thursday that state-reported tally had dropped to zero.
It's unclear how severe the cases are. State officials and a representative of the Los Angeles based company declined to say whether any of the infected patients has been hospitalized or died.
Kingston, without responding to questions but issuing a written statement, said it is working with state and Kern County public health officials to manage the COVID-19 cases and that it is doing "everything possible for the safety and well-being" of its residents and staff.
"Residents and family members have all been notified and any questions they may have are being addressed," Chief Clinical Officer Kristen Morris said by email.
"California Department of Public Health is on-site daily at the center and working together with center staff to ensure infection control process are being followed and assisting with some staffing needs," she continued. "Kingston Healthcare Center has increased (its) housekeeping services and (currently) has the appropriate PPE (personal protective equipment, such as masks) for our staff."
Kern County Public Health Director Matt Constantine said Kingston reached out to the county about 10 days ago for help because the facility's staffing was not adequate.
Constantine said after the county "scrambled" to assist the facility, county officials contacted the state Department of Public Health for help.
The state sent in a medical assistant team made up of 28 staff members to help aid 140 residents at the facility. After Kingston asked for additional help Wednesday, the state provided seven more medical staff members that arrived Wednesday night to support the facility, Constantine said.
"We're going to continue to monitor it," Constantine said. "We're going to ensure that the facility is successful and proper care is given. But this is a state-regulated site and it is Kingston's obligation and the state's ability to provide resources that's important. We'll continue to monitor."
According to Medicare.gov, the federal government levied a fine of $11,616 against Kingston. That was the only federal penalty given to the nursing home in the last three years, the website shows. It did not state what the fine was for.
While Kingston stands out in terms of the number of regulatory actions taken against it, nearly two dozen skilled-nursing facilities across California have reported more COVID-19 positive tests among their residents. Records show many others have not provided data to the state, including Kingston's sister location in Oakland.
The sister facility, Princeton Manor Healthcare Center, an 82-bed nursing home also owned by Dr. David Silver, has also encountered patient-care problems but not as many as the Bakersfield center.
Princeton had 51 complaints or reported incidents last year, more than double California's average of 21 for similarly sized nursing homes, according to state records. They show the Oakland facility exceeded the state average in 2018 and 2017 as well.
A big difference between the two sister facilities, both at least 99 percent owned by Dr. Silver, is Princeton's relatively positive ratings. Its quality-measures rating was well above average, while its staffing was average and its health-inspection rating was below average.
Federal records show Kingston's nurse-staffing levels are below the state and national averages.
Kingston most recently averaged 76 minutes of licensed nurse staffing per resident per day, according to Medicare.gov. That amount of professional attention is 28 percent below the state average and 19 percent under the U.S. average.
The nursing home has been sued in Kern County Superior Court at least five times since mid-2017
A lawsuit filed against Kingston in July 2017 says a man who was transferred to the facility in November 2016, when it was called Parkview Healthcare Center, suffered multiple falls at the nursing home. It alleged he also contracted an infection because of inadequate medical care at the site.
A separate lawsuit filed against Kingston in October 2018 says a man taken to the facility after lumbar surgery in Bakersfield in 2017 suffered a rapid decline in health.
It alleges nurses there failed to clean his wounds or monitor for infection and that the man had to be readmitted to a local hospital. He was then readmitted to Kingston, where caregivers allegedly neglected to provide treatment as planned and the man's condition worsened quickly, the suit states. He died soon afterward in hospice.
A suit filed in February 2019 says a man admitted to Kingston in early 2018 did not receive appropriate care for his hip problem, infections or diabetes. It alleges the facility falsified records to conceal inappropriate care while at the facility. The man died weeks later after being transferred to a local hospital.
Another suit, filed in April 2019, says Kingston and two local hospitals failed to provide appropriate care to the plaintiff, causing him lasting physical and financial harm.
A claim filed against Kingston in June 2017 says a car belonging to a visitor to the nursing home sustained $1,000 in damage from rebar protruding from a cement berm in the facility's parking lot.
After cutting off communication earlier in the week the company could not be reached for comment late Thursday.