While Lytton Gardens in Palo Alto was the focus of a recent state investigation into patient-care violations that involved unanswered call buttons, other Palo Alto-area skilled-nursing facilities have come under state scrutiny in recent years.

Some have been fined thousands of dollars for violations related to nursing care, according to California Department of Public Health records.

The biggest fines occurred in 2008, when Atherton Healthcare in Menlo Park was penalized $100,000 by the state. That May, the facility had failed to consistently maintain and update a required written plan that would have detailed the care of a patient who had a history of falling. She fell 14 times and sustained injuries while at Atherton. Eventually she died from injuries caused by a fall, according to the state citation.

Atherton's parent company, CalCare Inc., appealed the fine. It also filed suit against the state in San Mateo County Superior Court to vacate the penalty. Records show the facility was ultimately fined $20,000.

In April 2008, the state also fined Atherton $20,000 for violations related to poor nursing care and not having adequate written plans for patients' care. CalCare appealed that fine as well. The facility filed a lawsuit against the state on April 26, 2012, for not considering the appeal for four years, according to court records.

A skilled-nursing facility on Sand Hill Road, Vi at Palo Alto (then called Classic Residence by Hyatt), was fined $15,000 in 2008 for also not having a proper plan for patient care and treatment and for other violations related to nursing care, according to state records.

In Palo Alto, an annual review by state inspectors of the Palo Alto SubAcute and Rehabilitation Center LLC (previously Palo Alto Nursing Center) found 15 violations this year. The Bryant Street facility had 30 violations during a 2011 inspection, according to state records.

Palo Alto SubAcute was fined $2,000 this year for having inadequate plans for care and treatment of patients; not adequately helping patients who cannot eat independently and failure to keep a patient properly nourished.

But care is improving at some facilities.

During annual state inspections, Atherton Healthcare had 31 violations in 2009, 29 in 2010 and 23 in 2011 -- but only one in 2012.

Vi at Palo Alto had 24 annual state-inspection violations in 2008 but only six in 2011, and The Sequoias in Portola Valley had nine in 2009 but none in 2012. Lytton Gardens had 20 violations in 2011 but none in 2012, records show.

Below are 2012 records for each local skilled-nursing facility. The list does not differentiate between complaints that the state found "substantiated"or "unsubstantiated." The state's website offers more detailed information at http://hfcis.cdph.ca.gov. Click on "health information" and "health facility consumer information."

Facility name: Atherton Healthcare
No. of beds: 160
No. 2012 complaints: 3
Self-reported incidents: 12
State-enforcement actions (including fines): 0
Violations during annual survey: 1

Facility name: Channing House
No. of beds: 21
No. 2012 complaints: 0
Self-reported incidents: 0
State-enforcement actions (including fines): 0
Violations during annual survey: 0

Facility name: Lytton Gardens
No. of beds: 145
No. 2012 complaints: 1
Self-reported incidents: 0
State-enforcement actions (including fines): 0
Violations during annual survey: 0

Facility name: Mountain View Healthcare Center
No. of beds: 138
No. 2012 complaints: 5
Self-reported incidents: 3
State-enforcement actions (including fines): 0
Violations during annual survey: 24

Facility name: Palo Alto SubAcute and Rehabilitation Center LLC
No. of beds: 66
No. 2012 complaints: 0
Self-reported incidents: 1
State-enforcement actions (including fines): 1
Violations during annual survey: 15

Facility name: The Sequoias (Portola Valley)
No. of beds: 43
No. 2012 complaints: 1
Self-reported incidents: 1
State-enforcement actions (including fines): 0
Violations during annual survey: 0

Facility name: Vi at Palo Alto (No records for 2012)
No. of beds: 44
No. 2011 complaints: 0
Self-reported incidents: 0
State-enforcement actions (including fines): 0
Violations during annual survey: 0

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