Turnaround by King Hospital Rescues Funds

Citing a “dramatic turnaround” in patient care, federal health officials announced Monday that Martin Luther King Jr./Drew Medical Center will receive $60 million in public health care funds that had been jeopardized by scores of deficiencies.

Officials from the U.S. Health Care Financing Administration said a recent inspection of the 480-bed county hospital showed that it has corrected many of the problems that prompted several investigations earlier this year and threatened to close the beleaguered facility.

Unless corrections were made, the agency had said it would withhold next year’s Medicare and Medicaid funding from King beginning Thursday, after the hospital was cited for massive Health Code violations in September. A loss of federal funding would have effectively shut down the hospital.

“In no way could we have suffered the financial losses that would have come if we were not in compliance,” said Robert Gates, county Department of Health Services director.

In their inspection, however, officials noted that a number of stopgap measures instituted by the hospital to come into compliance with state and federal health guidelines, such as greatly reducing the patient load because of a critical nursing shortage, will need to be addressed in the future.

“Patient care has certainly improved, and a number of critical things that needed to be taken care of were taken care of,” said Jerry Moskowitz, the Health Care Financing Administration’s regional administrator. “But even with all the work they did, a lot more needs to be done. It’s a situation that we will continue to follow very closely.”

Moskowitz said a Nov. 30 site inspection by state health authorities found that King was in compliance in five of the six areas--hospital administration, nursing, food and dietetic services, quality control and infection control--that the Watts facility had been cited for earlier. The hospital’s physical condition is still not up to par, the inspectors noted, but federal officials said correcting on-site maintenance problems usually takes more than a year.

The state health inspections followed a series of articles in The Times detailing numerous deficiencies in patient care and administration at the hospital and a national study of death rates of elderly Medicare patients that ranked King among the bottom 50 of 5,577 hospitals surveyed.

State health officials reviewed the records of 102 patients during their recent inspection and reported that the hospital had greatly reduced nursing shortage problems, increased cleanliness, streamlined record-keeping and hired needed clerical workers. Their report is scheduled to be released to county officials today.

“We’ve come a very long way in a very short period of time,” Gates said. “We’ve made a tremendous turnaround, but there is still room for improvement.”

However, some hospital analysts have questioned the county’s methods in addressing the violations, such as hiring a number of temporary workers to fill staff vacancies, hiring staff from other county hospitals and reducing the patient-nurse ratio by not admitting new patients to the hospital. Gates said while no patients were transferred from King, the number of occupied beds was reduced by more than 60 in the last three months by the county’s decision to direct most patients to other public and private hospitals.

“I’m not sure that reducing the number of patients to reduce the nursing shortage is the best solution,” said one county hospital consultant who asked not to be identified. “It certainly is not a good long-term solution, and it needs to be addressed.”

Moskowitz said the practice was becoming increasingly common among the nation’s hospitals, which are all suffering from the nursing shortage.

“I think a lot of hospitals are finding that it is a good way to survive,” he said. “Some of these measures are temporary, but they do meet the conditions that we set.”

Gates credited Edward Renford, King’s acting hospital administrator, for making the necessary improvements to prevent the shut-off of federal funds. Renford was still meeting with the hospital staff Monday night and could not be reached for comment.

Officials at the Chicago-based Joint Commission on Accreditation of Healthcare Organizations, which accredits more than 5,000 hospitals nationwide, is conducting its own investigation of King. The agency is expected to release its report next month, but the Health Care Financing Administration’s findings are likely to weigh heavily in its conclusions.

During the original inspection, state health officials cited instances in which patients at King languished for hours in the emergency room without care. Others, believed to have infectious diseases, were not properly isolated, the health officials concluded.

In addition, equipment had fallen into disrepair, drugs were left out in the open and patient records were misfiled. The surprise inspection last month, however, found “that they made a tremendous turnaround in those areas,” according to Moskowitz.

David Langness, a spokesman for the Hospital Council of Southern California, said he was extremely pleased that King would not lose its federal health care funds.

“This is a tremendous credit to the Department of Health Services that they’ve corrected a lot of problems that some people thought were unsolvable,” Langness said. “King is a very important hospital to the county of Los Angeles, and they’ve managed to turn it around over there.”