How California handles complaints about patient care at hospitals

A Placer County man said he had trouble trying to file a complaint against a hospital following concerns about his mother’s treatment as a patient there.KCRA 3 Investigates discovered the difficulties may have been linked to a change over the last few years in the way the state has been handling complaints from Californians about health care facilities.Matthew Tartoria said he was sent from agency to agency, all while his mother’s condition got worse and worse.“If the point is to help, then this doesn’t make sense,” he said. His 60-year-old mother, Socorro Tartoria, had been battling cancer when an injury in September sent her to the hospital.“As she was just standing, her femur snapped, and she fell to the ground,” Matthew Tartoria said.From there, he said, things only got worse at the hospital. With serious concerns about her treatment there, he tried to file a complaint.However, he said that turned out to be tough, too.“No one could help,” Matthew Tartoria said.The California Department of Public Health licenses and regulates health care facilities in the state, including the hospital treating Matthew Tartoria’s mother. But in a letter, the agency said his allegations didn’t “fall within its limited jurisdiction to investigate” because it’s a “deemed hospital.” That means the hospital got its Medicare certification to confirm that it meets federal standards through an organization that accredits hospitals called the Joint Commission. So, CDPH told Matthew Tartoria to go there for an investigation into his complaint.However, the Joint Commission told him that, while it monitors patterns and trends over time to evaluate quality and safety issues, it “does not assess specific care of an individual patient.”“I had started calling every single organization I could,” Matthew Tartoria said.That eventually led him to Carole Herman, the president and founder of Foundation Aiding the Elderly.“We work for the prevention of elder abuse,” Herman said. “I have filed many, many hundreds of complaints against acute hospitals in the state.”She said she even helped file complaints involving the very same hospital that Matthew Tartoria was dealing with — complaints that CDPH investigated. That is why, she said, she was “appalled” when she saw the letter Matthew Tartoria received from CDPH, referring him elsewhere.“They are the ones that go in there, investigate complaints,” she said.In fact, that is what the agency told us in an email back in November. We asked if CDPH is the proper agency to receive complaints or if there would be any cases in which that complaint should be made to a different entity.“CDPH is the appropriate department to receive a complaint about care at hospitals we license and regulate,” a spokesperson wrote.So, why did the state agency tell Matthew Tartoria to have another organization investigate? When KCRA 3 Investigates asked, CDPH then said that there actually were exceptions in which the state would not be the proper entity to investigate.CDPH said it follows a federal triage process in accordance with the Centers for Medicare and Medicaid Services (CMS), which would have it refer cases considered “medium or low priority for deemed facilities to the proper accrediting organization for investigation.”To find out if a hospital is a “deemed facility” or not, CDPH referred us to its Cal Health Find database online. However, it featured the hospital in question, a complaint button and said it was not a deemed facility.It turns out that the website the CDPH referred us to was wrong.“We will update our Cal Health Find database to correctly note this hospital’s status as a deemed facility,” a spokesperson wrote in an email.Roughly two weeks later, the website began showing that the hospital does in fact have “deemed status.” CDPH said it stands by the fact that the website is still the best resource for people who want to file a complaint.Ultimately, Matthew Tartoria had to go through CMS, the federal agency, which then enlisted the state, or the CDPH, to do the investigation on its behalf.KCRA is not naming the hospital because the agency said it couldn’t “validate the complaint allegation.”Still, it was an answer that took a lot of effort on Matthew Tartoria’s part to even get, all while witnessing his mother’s condition deteriorate.At 60 years old, Socorro Tartoria died last December in the hospital.“She only ever exuded happiness and positivity,” Matthew Tartoria said.CDPH told KCRA that its process of referring complaints elsewhere in some cases comes amid “additional oversight” from CMS over the last three years because CDPH had to clear a backlog of complaints.“This renewed effort and oversight includes the expectation that complaints will be properly triaged and referred to the accrediting organization for investigation per CMS timelines,” CDPH said.CDPH had to clear its backlog of complaints after an order from a judge came down in 2021 in a civil suit that FATE filed against the state agency in San Francisco County Superior Court.At the time, Judge Ethan Schulman called out CDPH for its “historic failure” to investigate complaints against health care facilities in a timely manner.While CDPH told KCRA that the agency was correct to refer Matthew Tartoria to the Joint Commission for an investigation, Carole Herman of FATE later also filed a complaint on behalf of the Tartoria family. The response she has received thus far has been different.In a letter last week, CDPH told her that its Center for Health Care Quality (CHCQ) “is responsible for the licensing and certification of health facilities and the investigation of complaints.” It stated that “CHCQ must verify the violation through direct observation, interviews or review of documents.”At last check, Herman said she was still awaiting CDPH’s findings.See more coverage of top California stories here | Download our app | Subscribe to our morning newsletter | Find us on YouTube here and subscribe to our channel

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