September 5 2002

California HMO regulators have fined Kaiser Permanente $100,000 for failing to provide a disabled member with home health-care services despite agreeing to do so, officials said Wednesday.

In levying the fine, the state Department of Managed Health Care cited the experience of Alex Stoyanovsky, a Fairfield resident with Lou Gehrig's disease, who received inconsistent home health-care services from a Kaiser contractor between February 2001 and March of this year.

The agency said Kaiser violated a decision by an independent panel of medical experts requiring the HMO to provide 12 hours of home health care each day to Stoyanovsky, who died in July at age 41. Regulators did not, however, contend that Stoyanovsky died as a result of deficient home health care.

Daniel Zingale, director of the managed-care agency, said Kaiser's failings extended beyond Stoyanovsky's case. A survey conducted by the agency found other patients who did not receive home health-care services as promised.

"The fine was magnified by the fact that it wasn't an isolated case," Zingale said. "It's a very positive sign that Kaiser is willing to accept responsibility for failing in the area of home health care and working with us to do better."

Kaiser officials said they chose not to contest the state's findings and instead would work to correct them. In particular, the HMO agreed to create a system to monitor the performance of home health-care agencies that provide services under contracts with Kaiser.

"We're satisfied with how this whole process worked," said Kaiser spokesman Tom Debley. "There's certainly work to be done, but we are underway."

Lina Stoyanovsky, Alex's wife, said she hopes no other family has to go through the ordeal of caring for a terminally ill loved one without enough support. When home health-care nurses didn't show up--sometimes because the agency didn't have enough staff--Stoyanovsky was her husband's only caregiver. "At one point, I was suicidal. I couldn't handle it," said Stoyanovsky, who emigrated from Russia 15 years ago. "There were weeks when I couldn't wash my hair ....I just couldn't leave the room."

Stoyanovsky said she hopes the insurer will improve its system soon. "I still believe that even one person can make a difference," she said. "I hope ... that in the future, other people can benefit somehow."
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Copyright 2002 Los Angeles Times