The state health department has fined three Bay Area nursing homes a total of $200,000 for incidents that led to the deaths of three residents.

A facility formerly known as Kindred Transitional Care and Rehabilitation-Bay View in Alameda was fined $75,000, O'Connor Hospital's skilled nursing facility in San Jose was fined $65,000, and St. John Kronstadt Convalescent Center in Castro Valley was fined $60,000.

The class AA citations by the California Department of Public Health are the most severe penalty state law allows.

At the Bay View facility in Alameda, staff members in 2010 found a 74-year-old resident with an arm bandage soaked in blood where he had a shunt, according to a staff report. A registered nurse told police and state investigators that she did not identify the source of the bleeding or apply direct pressure to the bleeding area.

Emergency crews arrived, but the resident bled to death, the state alleges.

A Kindred representative declined to comment in detail because of patient confidentiality, but said, "Resident care and safety is our No. 1 concern. We take seriously every issue brought to our attention by the state and we worked with the state to address their concerns."

The Bay View facility is now under new management and Kindred is no longer involved.

At O'Connor's skilled nursing facility, a resident who had amyotrophic lateral sclerosis and paralyzed arms and legs had been placed on a ventilator to help with breathing. Last year, staff members found the resident unresponsive and noticed that the ventilator was on standby mode, which suspends air flow and safety alarms, according to a state report.


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A respiratory therapist told investigators he had placed the ventilator on standby while cleaning the resident's tracheostomy, a surgical opening in the neck. The therapist told investigators he could not recall if he had turned the ventilator back on when he was done.

Staff members performed cardiopulmonary resuscitation and the resident was taken to a hospital, but died.

O'Connor is appealing the citation, said spokeswoman Donna Cumming. She declined to discuss the incident in detail, but said O'Connor makes sure that staff members are trained in proper procedures for respiratory therapy.

"Patient safety remains a priority for us and we sympathize with the family over the loss of their loved one," she said.

At St. John Kronstadt Convalescent Center, staff members took three residents to a ballgame last year, including one who had a history of choking and thus was on restricted diet permitting only chopped or ground food. During the game, the staff members bought hot dogs for the residents.

The man on a restricted diet began to choke and lost consciousness, according to a state report. He was taken to a hospital, where he died.

An administrator told investigators that when residents were taken on field trips, no medical information was sent with them. The staff members on the trip said they were unaware of the diet restrictions.

"We have taken measures so this won't happen again," an administrator told state officials.

Managers of St. John Kronstadt were not immediately available for comment.

Sandy Kleffman covers health. Contact her at 510-293-2478. Follow her at Twitter.com/skleffman.