Deteriorating LA patient populations are destined for expulsion; families are angry

Jennifer Aust's heart aches.

All his life, he watched his father, Pat, give back to the South Bay community in which he grew up. He joined the Redondo Beach Fire Department in 1970 and held nearly every rank in the department – including chief – before retiring in 2002.

Then came eight years as a member of the City Council. Finally, he was on the board of a health care district that leased land for a home for seniors with dementia – a much-loved community service, which had sadly become his home.

Now that same board is firing Aust and nearly 100 other patients at Silverado Beach Cities Memory Care Community.

Families are angry. They say there are not enough facilities in the region to provide the specialized care their loved ones need, and they are concerned that forced migration poses a serious health threat.

“When I think about the way elected leaders are treating him now, I think he would be mad and disappointed because he had a lot of love for this community,” said Jennifer Aust.

He can only guess how his father must have felt. He and many other patients living at home do not have the cognitive ability to understand what is happening to them.

On May 27, the Beach Cities Health District board of directors voted to move forward with a plan to redevelop its 11-acre Redondo Beach campus that will permanently close Silverado. Within the next year, all residents will have to leave.

Dr. David Presser, an emergency physician, wrote a letter urging the county not to rescue the Silverado. Moving patients with Alzheimer's disease, he said, is associated with “behavioral deterioration, increased agitation, rapid functional decline and a higher likelihood of emergency care use.”

He wrote: “Continuity of caregivers, physical environment, and routine are not only factors in quality of life for this nation, they are clinical protective factors.”

Local families are worried about how far they will have to travel to get proper care.

“We visited several memory care facilities and in total there were about twenty beds available in the South Bay,” said Nicole Purohit, whose mother lives in Silverado. “It creates a small public health problem.”

Nicole Purohit chats with caretaker Jay Splung while visiting his mother, Annette Rippe, in Silverado.

A long-planned project but a sudden twist

The health district has been planning to upgrade its health care campus for about a decade to replace aging and earthquake-prone buildings with facilities that will provide more health and community health services.

The project was born because Purohit was afraid to move his mother to Silverado last winter. But then came a letter signed by the county's chief health officer, Tom Bakaly.

“For families considering moving to Silverado Memory Care in the Beach Cities today, please know that you can do so with confidence,” the Dec. 23 letter said. “Residents moving in now will be protected in their care and will continue to receive a Silverado bed during the rebuilding process.”

Purohit's mother, Annette Rippe, had to leave two other foster homes that could not take care of his behavioral needs. But Purohit took the letter to heart and brought his mother in, watching with relief as she thrived under Silverado's special care and attention.

Silverado residents Marlene Naraghi, left, and Cathy Stewart dance together during happy hour entertainment.

“I had a strong feeling that this would be the last time I had to leave my mother – that she would be able to live out her years here,” she said.

Presser, an emergency physician, said Silverado's model of caring only for dementia patients and having clinical nurses on site 24/7 sets it apart from many other facilities and reduces the number of trips residents need to the emergency room.

“The gap they're covering is not true,” Presser wrote. “It's the difference between proper, stable placement and the revolving door of hospitalization, psychiatric hospitalization, and a failed transition of care.”

Christian Horvath and his daughter Reese Charfen-Horvath, 17, were among those pushing for the memory care facility at the May 27 Beach Cities Health District board meeting.

(Kayla Bartkowski/Los Angeles Times)

'A difficult decision and, I think, the right one'

Wearing blue “Save Silverado” T-shirts and badges with the same message, more than a dozen community members packed the May 27 Beach Cities Health District board of directors meeting to make a tough plea to save the beloved facility.

The district issued a request for proposals from developers interested in leading the development of the facility last June. Of the 12 proposals received, the board initially preferred working with Continental Development and Mar Ventures on a plan to keep Silverado in the area.

However, the terms of that proposal “changed significantly” after negotiations began in January, reducing the board's confidence in the plan, according to a district spokeswoman. Changes include a longer project timeline, uncertainty over whether developers can provide community amenities such as a swimming pool and less lucrative lease terms, according to the district.

Continental Development CEO Bob Tarnofsky said the team learned about the “undisclosed high cost of abandonment and demolition, the complex permitting process, and environmental risk mitigation” after submitting the proposal.

Even so, he said the team is always confident that they can complete the project.

“Yes, our proposal had more costs and may have taken more time,” he said. “But we feel strongly that it was the best solution to significantly improve the existing health and memory care services offered to our South Bay community.”

In February, the board voted to enter into negotiations with Sunrise Senior Living, whose proposal is more profitable, has a faster timeline and provides more space for community services, according to the district.

The board determined that the lower lease terms proposed by Sunrise would generate significant profits over the entire 99-year lease term, helping to fund free district programs for residents of Hermosa Beach, Manhattan Beach and Redondo Beach for years to come.

Sunrise, on the other hand, views Silverado as a competitor and has no interest in collaborating on the development project. The company will instead build its senior home on a site with a mix of independent living, assisted living and memory care facilities.

“We are confident that the breadth of Sunrise's offerings will serve the needs of this community well,” said Philip Kroskin, head of real estate and senior vice president of investments at Sunrise. The company is “working with BCD to provide direct support to residents and community members affected by the upcoming community changes.”

Ultimately, the board decided that the long-term community benefits of the Sunrise project outweighed the short-term pain of displacing Silverado residents.

“That was one of the most difficult meetings I've been in, because our friends are there, my friends' parents are there, a former member of the district board is in Silverado,” Bakaly told The Times. “At the end of the day, the board made a difficult decision and, I think, the right decision.”

Christian Horvath, left, kisses father-in-law Alex Charfen goodbye at a Redondo Beach memory care facility.

'I have to be his voice'

Families who rely on special care at Silverado disagree.

Christian Horvath, whose father-in-law lives in Silverado, said as a member of the Redondo Beach City Council he understands the challenges of considering complex development proposals.

Still, he believes the board was too quick to jump ship when the original development proposal — which would have kept the Silverado on site — became too difficult.

“I feel like they're in a rush and they want to do it,” he said. “But doing that doesn't mean it's done right.”

Although the Beach Cities Health District has entered into a lease agreement with Sunrise, the project still needs to move through several stages of city approval before it can begin.

In the meantime, many Silverado families are trying to figure out their next steps — and they're not giving up hope that something can be done to save the care home.

“There needs to be accountability here,” said Jennifer Wade, a stepmother who lives in Silverado. “We are talking about people who cannot speak for themselves, most of them are always confused but they are stable where they are.”

Jennifer Aust visits her father as much as possible in Silverado, where she can be found wearing the trademark flannel and Redondo Fire Department baseball cap.

Years before his diagnosis, Pat Aust advocated for a sprinkler system to be installed within the care home. Now, he is part of the center's weekly car collectors club, which Silverado employees decided to start after learning about his famous love of classic cars.

“Part of me is fighting this, because I know that's what my father would do,” said Jennifer Aust. “Dad would do the best for others, and I feel I should be his voice at this time.”