How can Shlomo Rechnitz and Brius Healthcare assemble a stable of 81 California nursing homes while racking up 386 health and safety violations over a recent three-year period?

The answer may be found in a report issued last week by Disability Rights California. The nonprofit concluded that the state often issues strikingly different penalties for seemingly identical violations and often declines to seek the maximum penalty for nursing homes found to have violated safety rules.

Issuing lower-level penalties helps unsafe facilities stay open and deprives the state of lost fine revenue, the report found. And it keeps patients and their families in the dark about the safety risks posed by certain facilities.

The Sacramento Bee highlighted one of Rechnitz’s nursing homes to illustrate this practice in its article detailing the report.

In 2010, Armando Reagan was rushed from Rechnitz’s Vedugo Valley Skilled Nursing & Wellness Centre in suburban Los Angeles to a hospital bleeding from bedsores in his groin. Within an hour, he was dead.

Instead of issuing Verdugo Valley the harshest punishment – A Type AA citation and a $100,000 fine, the California Department of Public Health issued a milder Type A citation and a $20,000 fine.

That decision had consequences, the Bee noted, because Verdugo Valley had already received a AA citation in 2009. Had Reagan’s death in 2010 also resulted in an AA citation, the state would have had to revoke or suspend the facility’s license.

Instead, the facility remained open and was later hit with another AA citation in connection with the 2014 death of James Populus.

In fact, Disability Rights California found that state regulators classified more deaths as Class A Citations than Class AA citations between 2000 and 2014.