Board votes to keep King open

Los Angeles County supervisors Tuesday backed off a threat to begin closing Martin Luther King Jr.-Harbor Hospital, opting instead to give the beleaguered facility a reprieve as it prepares for a last-chance government inspection next month.

The board shelved a motion that would have started the clock ticking toward shutting the facility near Willowbrook after its top healthcare officials warned the move could trigger a stampede of departing employees that would in turn undermine efforts to pass the federal survey.

Others decried the effects of a closure on patients and nearby hospitals, which have dealt with a string of emergency room closures over the last few years. King-Harbor is the only public hospital serving a large swath of South Los Angeles. It treated 47,000 emergency room patients last year.

Closing the hospital early is “a callous approach to people,” said Supervisor Yvonne B. Burke, who represents the area and had been criticized for not speaking out in recent days. “Someone has to take a position that the people of Los Angeles County who are poor, who are uninsured, have medical care.”

Rejecting a closure, supervisors asked the county’s Department of Health Services to begin negotiating with other local hospitals to accept King-Harbor patients in the event that state or federal regulators force the facility to close. The state announced last week it had moved to revoke the hospital’s license.

But the board’s decision drew fire from some who said the panel had not taken a bold enough step to fix long-standing healthcare failures at the hospital.

Joe R. Hicks, vice president of Community Advocates Inc. and a longtime civil rights activist, said shutting the hospital would allow the county to more quickly rebuild it with “professional, competent” staff.

“It’s really unfortunate that they sort of stepped back from the brink here and let some other agency, the feds or someone else, take the heat for eventually moving to close this hospital,” Hicks said. “What I think we’re seeing here is a lack of courage in the face of an incredible problem.”

King-Harbor, formerly known as Martin Luther King Jr./Drew Medical Center, when it was affiliated with an adjacent medical school, has been out of compliance with the federal government’s minimum patient care standards since 2004.

In recent weeks, another failure in patient care at the hospital made national news when 43-year-old Edith Rodriguez died after writhing unattended on the floor of the emergency room lobby for 45 minutes.

At one point, a janitor cleaned around Rodriguez as she vomited blood.

The most dramatic moment of Tuesday’s debate came when Rodriguez’s brother and sister told board members they needed to prevent further deaths.

“It wasn’t just my sister that died at the hospital. There has been more that have been not treated there,” said Columba Avena. “People say that it should stay open. It should stay open because communities do need hospitals that are going to take care of people, but not like this.”

Several supervisors offered apologies. Burke described Rodriguez’s death as “absolutely unacceptable” and vowed that “You can be sure I’ll make sure that no one else suffers that way.”

Supervisor Zev Yaroslavsky, chairman of the board, said the tragedy would not be forgotten.

“Your sister’s experience at this hospital is motivating all of us,” he said.

The U.S. Centers for Medicare and Medicaid has threatened to pull King-Harbor’s funding if it fails to meet federal healthcare standards during next month’s inspection.

Supervisors welcomed news that federal regulators had determined the hospital had corrected problems that earlier this month had put emergency room patients in immediate jeopardy of harm or death.

But they said far more improvement was needed if the hospital is to survive.

Supervisors Gloria Molina and Mike Antonovich said the panel should take the initiative and move before their hands are forced.

They proposed scheduling the necessary public hearings and 90-day notices that California law requires before an emergency room is shut.

They said that starting the process would allow the county to better prepare for a closure than simply waiting until the state or federal governments act. A voluntary closure would allow the county to rebuild the hospital from scratch without losing its state license.

“We need to have acted yesterday and we didn’t,” Antonovich said. “That procrastination has continued to create a substandard level of care, and we ought to be responsible.”

Molina said that a move to close the hospital might spur employees to improve their performance.

“The problem is ... these people are letting us down,” she said. “Those that are coasters at Martin Luther King hospital should not be there. We need people of integrity. We need people of responsibility.”

But Supervisor Don Knabe questioned whether the county’s emergency medical system could absorb patients from King-Harbor. Ten emergency rooms have closed in the county over the last six years because of financial strains.

“This is moving a whole lot of patients into a very fragile system of emergency room treatment,” Knabe told colleagues. This “could have an even more damaging impact than a hospital with problems from time to time because this system is overloaded.”

Yaroslavsky had said last week that he was prepared to begin the closure process now. But Tuesday, he said he was willing to wait until after the federal inspection. He noted that if the hospital fails, the state can suspend its license immediately, forcing a closure.

A procession of South L.A. residents and hospital supporters implored supervisors to keep the facility open.

“Once you tear something down, its more difficult to put it back,” said Geraldine R. Washington, president of the National Assn. for the Advancement of Colored People’s Los Angeles chapter.

The county’s top health officials also cautioned against a closure.

“I don’t think we need to start now,” said Dr. Bruce Chernof, the county’s director of health services. “I don’t think it is helpful.”

Carol Meyer, acting director of governmental affairs for the health department, said issuing an intent to close the hospital could jeopardize efforts to pass the federal inspection.

“I am very fearful that this hospital is going to become destabilized because staff will leave,” she said.

Supervisors unanimously voted for a compromise that pledges not to reduce services at the hospital until the outcome of the federal inspection is known.

The compromise calls on health officials to begin talks with area hospitals to take on more patients if King-Harbor does close and to increase the number of beds at other county hospitals.

In addition, the board moved to start identifying private hospital operators interested in running King-Harbor.

jack.leonard@latimes.com

charles.ornstein@latimes.com