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Hospital Backers Concede Choices Tough

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A day after Martin Luther King Jr./Drew Medical Center resoundingly failed a "make or break" federal inspection, some of the iconic public hospital's most vocal supporters conceded that it may not be fixable — at least not by the county.

Supervisor Gloria Molina, who long maintained that King/Drew could be revamped, now believes that the county should hand it over to a private firm to run.

"I have no pride of ownership at this point," she said. "At this point, I'd give it to them, OK? I'd give it to them as long as they would take indigent patients."

On Friday, federal regulators notified King/Drew that it had failed nine of the government's 23 conditions for federal funding, falling below minimum standards in such key areas as nursing, surgical services, infection control and the pharmacy.

As a result, the U.S. Centers for Medicare and Medicaid Services said it would cut off annual funding of about $200 million at the end of the year — about half the hospital's budget.

County supervisors have repeatedly said that should King/Drew lose this funding, they would have to close it, turn it into a clinic or give it to a private firm to run.

Now that this worst-case scenario apparently has come to pass, some city and county leaders said it marks a turning point in how they view the hospital and its future.

Los Angeles City Councilwoman Janice Hahn said her father, former county Supervisor Kenneth Hahn, would be devastated by King/Drew's failure — and the county board's inability to fix it.

"Every action the board has taken has not resulted in positive results," she said. "They clearly need to turn it over to someone who can do the job."

The elder Hahn fought to build King/Drew after the 1965 Watts riots, and a photograph of him with the Rev. Martin Luther King Jr. appears in at least eight places in the hospital.

Right now, the councilwoman said, "he's turning over in his grave."

Even some residents think it might be time for the county to let someone else take the helm at King/Drew.

"It should be turned over to someone who could run it better," said Ricki West, 49, of Compton, a patient at the hospital Saturday. "I feel strongly about it. The hospital needs to stay here but needs to have a tighter ring around it…. It's needed right where it is. Closing it would be disastrous. It would hurt the whole community."

West said some hospital staff members lack compassion. Earlier that morning, she said, when she went to refill her blood pressure medication, she saw a staff member bellowing loud enough for everyone to hear at a patient as he tried to explain his ailment, "What do you mean, you got a rash on your booty?"

West said it was mortifying for both the patient and those listening.

But other area residents worried that a private firm, however needed, might not be as willing to treat the area's mostly poor families, the vast majority of which are African American or Latino.

"It's like stepping on a half-full balloon. You squish one problem, but then you get another one," said Yves Miller, a Compton math teacher tutoring students at a coffee shop across from the hospital.

Failure of the inspection took both King/Drew's staff and community leaders by surprise. Most said hospital and county health officials had reassured them that the medical center was much improved and ready for scrutiny.

King/Drew's chief executive, Antionette Smith-Epps, said Saturday that she had believed that to be true.

"My staff worked incredibly hard, and we did everything we could. In the end it wasn't enough," she said. "We are very disappointed."

Staffers entering and leaving the hospital Saturday said they thought they would pass the inspection, which was unannounced and took place between July 31 and Aug. 10.

One pharmacy employee stopped in mid-walk when told by a reporter that the hospital had not. "We failed?" he asked, his tone disbelieving.

Other staffers raged at Navigant Consulting Inc., the hospital turnaround firm that the county paid more than $17 million to overhaul King/Drew.

Molina shared their disgust. "Navigant was the biggest waste of time," she said. "They said, 'We can fix it.' They were more interested in keeping the money rolling in."

The staffers, most of whom declined to be identified for fear of losing their jobs, described the mood at the hospital as depressing. "Everyone is on edge," one contract nurse said.

Sitting and smoking on the sidewalk in front of King/Drew, some patients vehemently defended the hospital, saying the entire South Los Angeles area would suffer if it closed.

With his heavily bandaged left leg propped up in front of him, PK Dip praised the 252-bed medical center for piecing his limbs back together.

Two weeks ago, gunshots shattered one of his legs and injured the other. The 23-year-old Compton resident said he was rushed to King/Drew by ambulance, even though its trauma unit was no longer open.

If he'd had to go to Lynwood's St. Francis Medical Center, which is farther away, things might have gone differently, Dip said.

"By the grace of God, they took me," said Dip, who has had two surgeries and faces two more. "This hospital has been here for years and years…. You may look at it as a bad hospital. But it's a good hospital. You got to look at what they've done."

That's what Rep. Juanita Millender-McDonald (D-Los Angeles) continues to believe, and she said she is gearing up to try to save King/Drew.

The congresswoman said she received a personal call Friday afternoon from Mark McClellan, outgoing head of the Medicare agency, telling her about the hospital's failure of the inspection. McClellan, she said, assured her that there is still some "wiggle room" for King/Drew.

"Dr. McClellan is still open to any recommendations or suggestions," said Millender-McDonald, who declined to specify what the "wiggle room" might be.

She plans to hold a community meeting at King/Drew on Monday to pass along the latest news.

County supervisors plan to hold their own private emergency meeting Monday. On Saturday, aides to Supervisors Don Knabe, Zev Yaroslavsky and Yvonne Brathwaite Burke — whose district includes King/Drew — said their bosses would not comment until after that meeting. Supervisor Mike Antonovich was not available because he was returning home from China.

Molina said she didn't know whether her plan for turning King/Drew over to someone else would even work.

The supervisors had been so confident that the hospital was improving, she said, that they had not been focusing on alternatives should it fail the inspection.

"Our contingency plan was prayers and hopes and aspirations that we would pass," she said.

Copyright © 2014, Los Angeles Times
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HealthMedicareMartin Luther King Jr.Minority GroupsCrime, Law and JusticeNavigant Consulting Incorporated
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