King Hospital Appeal to Agency Saves Certification

Following a last-ditch plea by Los Angeles County health officials, the agency that certifies most of the nation’s hospitals on Friday placed Martin Luther King Jr./Drew Medical Center on conditional accreditation, temporarily avoiding a serious blow to the facility’s residency programs and its public standing.

The action came one day after King’s administrator and the head of the county hospital system flew to Chicago and convinced the staff of the Joint Commission on Accreditation of Healthcare Organizations that the hospital was not out of compliance in one key area of patient care--the monitoring of its blood supply. The staff reversed its earlier recommendation, based on its initial health investigation, that the 430-bed Watts hospital lose its accreditation.

The hospital’s probationary status means that King must file a plan of correction with the commission within 30 days. If the plan is accepted, then King will have six months to clean up the problem areas before the commission sends another inspection team to the hospital.

When a team of medical investigators from the commission made a surprise visit to King in October, they found widespread problems in staffing, record-keeping and patient care. On the commission’s complicated rating system, King scored 46 out of a possible 100 points, automatically placing the 430-bed hospital on conditional accreditation.

But because the hospital’s quality assurance programs and medical staff monitoring systems--the two areas that weigh most heavily in the scoring system--fared so poorly, the commission staff later said it had no choice but to recommend that King lose its accreditation entirely.

However, Carl A. Williams, director of hospitals for the county, and Edward Renford, King’s acting administrator, convinced commission officials that the hospital’s program to monitor its blood supply was not out of compliance with the agency’s standards.

“They made a compelling argument that the survey (investigation) team had missed some things,” said Donald W. Avant, the commission’s vice president for accreditation surveys. “It bumped their score up enough to bring them to conditional status.”

Avant said the investigators gave King the lowest score possible for its policy of sampling only the blood supply used by the hospital’s trauma patients. But the investigators failed to note that trauma patients use 70% of the hospital’s blood supply, he said.

However, Avant noted that King still has some serious patient-care deficiencies that must be corrected. Fewer than 8% of the nation’s hospitals are placed on conditional accreditation because of failure to meet national health care standards.

Nonetheless, Robert Gates, director of the Department of Health Services, was overjoyed by the commission’s action.

“It’s great news for us,” Gates said. “It would have been a real damper if we had lost our accreditation. The hospital has already corrected many of the areas that they were cited for, so the potential loss of accreditation is no longer a concern.”

If King had lost its accreditation, it would have seriously jeopardized more than a dozen residency programs at the teaching hospital and King would have become the largest medical facility in the state to lose its good standing.

The commission’s investigation was spurred by a state Health Department report in which King was cited for massive health code violations and a series of articles in The Times last year detailing numerous problems in patient care and administration at the hospital.

Although a final state review of King found numerous deficiencies in the hospital plan, a severe shortage of registered nurses and other problems in December, federal health officials lauded the hospital for launching a “herculean effort” to bring the facility into compliance in most areas. The turnaround allowed King to keep $60 million in Medicare and Medicaid funds.