Nurse Says Signature Forged at CPC : Medicine: Ex-employee alleges managers falsified her name on documents for use in involuntary commitments to company’s psychiatric hospitals.

LAGUNA HILLS —  A former Community Psychiatric Centers nurse is alleging that managers at the company forged her name on documents that authorized her to help determine if patients were to be involuntarily committed to the company’s psychiatric hospitals.

During a May 27 hearing before a state Unemployment Insurance Appeals Board official, Susan E. Arnett testified that someone had forged her name on documents stating that she had completed a two-hour training session and passed a required written examination. Arnett testified that she was “taken off the (work) schedule” after complaining to supervisors about the improper paperwork.

Arnett also alleged that CPC executives know of at least 30 other cases involving “forged” documents, according to board records.

CPC spokeswoman Suzanne Hovdey, who on Friday described Arnett as “a disgruntled former employee,” maintained that CPC employees are “properly certified and credentialed” and that “doctors alone have the power to admit patients.”

“These are unproved allegations, and we don’t think (Arnett) has any evidence to support them,” Hovdey said. “We emphasize that doctors are the only ones qualified to admit patients.”

In February, CPC fired a manager who supervised workers involved in the evaluation process, Hovdey said. But a subsequent investigation “found nothing to support . . . (Arnett’s claims),” Hovdey said. “We did find mismanagement and poor judgment on the part of the supervisor, but because of ongoing litigation we can’t divulge the details.”

Arnett’s allegations shed light on the complicated and often emotional way that involuntary admissions occur.

California law allows officials to hospitalize patients against their will to determine whether they are a danger to themselves or to others. But after 72 hours, patients have the right to meet with an attorney and appear before a judge.

Most involuntary admissions occur after a suicidal or otherwise mentally disturbed person ends up in a police station or a hospital emergency room. Officials typically send for a patient evaluation team from a nearby psychiatric hospital to help determine a patient’s status.

John Garrett, executive director of the Mental Health Assn. of Orange County, which serves as an advocate for the county’s mentally ill, has heard few patient complaints about the involuntary admission process, he said, in large part because state law offers such strong protections for patients.

“California has swung, many people think, much too far to protect the rights of the mentally ill individual, so much so that it is hard to get them hospitalized unless they have hit the bottom of the barrel,” Garrett said.

Dr. Woodrow Wilson, an emergency physician at Mission Hospital Regional Medical Center in Mission Viejo, said CPC’s Laguna Hills facility regularly evaluates patients for his hospital.

CPC’s psychiatric evaluation teams are called to Mission Hospital’s emergency room, where team members calm patients down and conduct in-depth interviews. The team then consults by telephone with a CPC psychiatrist, who determines whether hospitalization is required. CPC’s services are “invaluable” to the hospital, Wilson said, in part because CPC often takes uninsured patients.

During a five-month period ended April 30, CPC’s “psychiatric assessment teams” responded to 2,869 calls from emergency rooms, police officials and others. Only 756 patients subsequently were admitted to CPC hospitals, and of that total, 98 were indigent, Hovdey said.

CPC’s admission statistics contradict Arnett’s allegation that CPC is using involuntary admissions to fill hospital beds, Hovdey said. “We’re not going to fill beds with patients who don’t need treatment,” Hovdey said.

Arnett’s allegations came just months after a lengthy investigation of CPC’s marketing and admissions policies by the Texas attorney general found no evidence of wrongdoing.

“We went through 15 months of investigation in Texas . . . and were found to be not guilty of any marketing abuses,” Hovdey said. “We did have a manager (in Orange County) who we found had violated company policy, and we fired him; we took action.”

In Orange County, CPC operates hospitals in Brea, Laguna Hills and Santa Ana. It also operates facilities in Los Angeles, Alhambra, Ventura, Fontana and Encinitas. CPC delivers psychiatric services and long-term acute care services through 53 hospitals in the United States and the United Kingdom.