King/Drew Stripped of Accredited Standing

A national healthcare accrediting agency revoked its seal of approval Tuesday from troubled Martin Luther King Jr./Drew Medical Center, a rare sanction that underscored repeated lapses in patient care at the hospital.

The action will not lead to closure of the Los Angeles County-owned hospital in Willowbrook, south of Watts, but will mean that many private insurance companies will no longer pay for care there. The loss also jeopardizes some of the doctor-training programs run by the affiliated Charles R. Drew University of Medicine and Science and emergency psychiatric services at the hospital.

More broadly, the move is a vote of no confidence by medical experts in the hospital’s quality. The Joint Commission on Accreditation of Healthcare Organizations credentials about 4,600 hospitals nationwide. King/Drew is only the second in the last year to lose the panel’s accreditation and one of just 13 since 1998.

“It’s a stain on the hospital,” said county Supervisor Zev Yaroslavsky. “We lost the accreditation because the hospital is in an absolute mess. It’s far worse than anybody had known.”

The revocation follows the inspection of King/Drew by the commission’s staff in August. The inspection found incompetent employees, failures to prevent hospital-acquired infections, inconsistent patient care, failure to maintain medical equipment and incomplete medical charts.

Since then, county supervisors and health officials have anticipated the loss of accreditation and planned for it, although the county did file an unsuccessful appeal to the commission to keep the credential. Officials say they are working to enable King/Drew to win back accreditation, perhaps before the end of the year.

In the fall, the county hired Navigant Consulting Inc. for $13.2 million to run day-to-day operations at the hospital in an effort to turn it around. Part of the county’s one-year contract with the firm calls for Navigant to successfully reapply for the hospital’s accreditation.

A more serious test of King/Drew’s ability to survive is expected later this month, when the federal government decides whether the hospital can continue receiving Medicare and Medicaid funds.

Because the vast majority of patients at the 200-bed medical center have no private insurance, those government programs are its main sources of revenue, providing about $200 million a year.

King/Drew supporters denounced the decision on accreditation, noting that it will further cut services at the hospital, which already is closing its trauma center. The hospital cannot reopen that unit unless it wins back accreditation.

“They’re taking the hospital piece by piece,” said Royce Esters, a Compton resident and president of the National Assn. for Equal Justice in America. “The next thing we know, we’ll have a skeleton, we’ll have nothing.”

Some activists said the latest blow added to their resolve to support King/Drew by urging neighbors to use the hospital rather than go elsewhere.

“We live down here. We know it makes a difference,” said “Sweet” Alice Harris, 70, a longtime Watts activist. “I’m going to keep the community going for services, keep talking to the community.”

Los Angeles City Councilwoman Janice Hahn, a critic of the Board of Supervisors’ handling of King/Drew, said she worried that the loss of accreditation would make it harder to recruit good doctors. She blamed the county for failing to solve the hospital’s problems.

“Clearly, the Department of Health Services just cannot fix what’s wrong,” said Hahn, whose father, the late Supervisor Kenneth Hahn, led efforts in the late 1960s to have the hospital built.

Dr. Thomas Garthwaite, director of the county health department, denied the councilwoman’s accusation.

“I don’t think this reflects any failures in the revamping, the transformation of King/Drew,” he said. “It really just speaks to how broken [the hospital] was before many of the latest actions were really implemented.”

County Supervisor Mike Antonovich said the loss of accreditation should strengthen health officials’ resolve to improve the quality of care at King/Drew.

“Now we have the opportunity to bring in new management and remove those employees who are part of the problem,” he said.

Other hospitals have earned back the joint commission’s approval under similar circumstances. Greater Southeast Community Hospital in Washington, D.C., for example, lost its accreditation in August 2003 after being faulted for substandard care. Four months later, the hospital won it back.

Garthwaite said King/Drew was making improvements but was not yet ready to pass an inspection. He said the county would reapply to the joint commission as soon as he believed the hospital was ready, most likely in about six to eight months.

The accreditation loss, which is effective immediately, will require some patients to be shifted to other hospitals, primarily the private St. Francis Medical Center in Lynwood and the publicly owned County-USC Medical Center in Boyle Heights and Harbor-UCLA Medical Center near Torrance. Doing so will cost $3 million to $5 million over the next six months, Garthwaite said

The hospital currently receives two or three patients a day from the Community Health Plan, a managed-care program funded by the state and federal governments for low-income people. That plan requires that its patients be treated at accredited hospitals only.

Without accreditation, King/Drew might also lose county approval to treat emergency psychiatric patients, forcing already overburdened psychiatric facilities elsewhere to pick up the load. Each year, King/Drew treats about 3,000 psychiatric patients involuntarily taken there by police.

The loss could also endanger Drew University’s ability to train medical specialists.

The Accreditation Council for Graduate Medical Education, the national group that oversees doctor-training programs, generally requires hospitals where teaching takes place to be accredited. If a hospital loses accreditation, the group decides whether to allow training programs to continue.

Garthwaite said the county would try to show it had taken steps toward regaining accreditation in a bid to keep Drew’s residency programs running.

County Supervisor Yvonne Brathwaite Burke, whose district includes the hospital, said King/Drew had been unfortunate to be examined by the joint commission soon after the panel raised its standards for hospital inspections.

“This is really a new approach by [the commission] that Martin Luther King hospital is on the front end of,” she said. “It’s a good thing for patients, but it’s a bad thing when you happen to be the first one it hits.”