Hospital’s overseer still has a mission

Fifteen months ago, he was brought in to save Martin Luther King Jr./Drew Medical Center, which had struggled for decades with patient-care problems.

But last Friday, Dr. Bruce Chernof presided over the shutdown of the much smaller entity it had become.

The public hospital, now known as Martin Luther King Jr.-Harbor Hospital, failed a critical federal inspection and was notified last week that it had lost $200 million in federal funding. Its emergency room was closed within hours.

Its 48 remaining inpatient beds are being emptied, and an estimated 48,000 patients -- the number who passed through King-Harbor’s emergency room in the last year -- will have to turn elsewhere for care.

Chernof, as head of Los Angeles County’s Department of Health Services, remains in the hot seat, facing questions about where King-Harbor patients will go, how medical staff will be shuffled and whether a private operator will take over the facility in Willowbrook, south of Watts. Finding answers won’t be easy.

Those who know the 45-year-old Chernof say they expect him to retain his signature calm focus as the county faces a healthcare catastrophe likely to ignite fresh recriminations.

“To the extent that we all bear a share of the responsibility, Bruce does too, but he’s not the reason this place failed,” Supervisor Zev Yaroslavsky said last week. “This is bigger than any one of us, and it’s gone on much longer than most of us have been here. It’s in the walls.”

After Chernof was selected to replace Dr. Thomas Garthwaite, he brought sweeping change to the troubled hospital: He eliminated specialty services, reduced inpatient beds and placed the facility under the management of Harbor-UCLA Medical Center near Torrance.

He also pledged to clean house among the King-Harbor staff, re-interviewing every employee who would be under Harbor-UCLA’s oversight.

He received mostly high marks from the supervisors as well as from one key critic of the county: Rep. Maxine Waters (D-Los Angeles). A staunch supporter of the hospital, Waters particularly disliked Garthwaite, who had tried to tighten hospital operations by advocating closure of the facility’s trauma center. It shut down in 2005.

“Prior to Mr. Chernof’s taking over, we had issues with the previous head of that department,” Waters told supervisors at an emergency board meeting Monday. “But we found no issues with Mr. Chernof.” He has “been very cooperative. He’s engaged the community. We simply commend him for the job that he’s done.”

Yet during a June board meeting, supervisors had lambasted Chernof for providing what they described as overly optimistic updates on improvements at the hospital and for failing to train King-Harbor staff at Harbor-UCLA. County health officials said that there weren’t enough medical personnel to send to Harbor-UCLA for education and also keep King-Harbor operating.

“I sometimes think that he paints the picture a little rosier than he should,” said Supervisor Gloria Molina, one of the few officials to publicly criticize Chernof, even as she praised his hard work and “level head” in the midst of crisis.

“Sometimes I would like some of the hard, cold facts so that we can make the decisions we need to make,” she said in an interview last week.

Contrary to supervisors’ belief, county health officials “really didn’t clean the slate” of problem employees, Supervisor Don Knabe said during Monday’s meeting.

Kathy Ochoa, director of strategic initiatives for Service Employees International Union Local 721, which represents many hospital workers, agreed.

“There was certainly a missed opportunity with the failure of Harbor-UCLA to step up and become more deeply engaged in the day-to-day operations of the hospital,” Ochoa said.

After launching a nationwide search to replace Garthwaite, who had become a lightning rod for criticism from the supervisors and local activists fighting to save the hospital, the board promoted Chernof from his post as the county’s senior medical director. Supervisors said they were impressed by the enthusiasm of the internist and were already familiar with his work.

A San Fernando Valley native, Chernof got his start in medicine tagging along on rounds with his father, Dr. David Chernof.

“That was a really important influence, to see what a difference one person could make in the lives of others,” Chernof said of his dad, 71, who now lives in Santa Barbara.

Chernof arrived at the county’s top medical job -- he oversees five public hospitals, 20,000 employees and a $3.2-billion budget -- with a hefty resume. The West Los Angeles resident had created a family health program for private healthcare provider Health Net; helped establish a healthcare system for uninsured patients in the Valley while a medical director at the county’s Olive View-UCLA Medical Center; and helped run a program at UCLA’s Geffen School of Medicine, of which he is a graduate. The program allows students to earn both a medical degree and a master’s in business administration.

Victor Tabbush, who worked with Chernof on that program, which Chernof helped found, recalled the health chief’s integrity, business savvy and willingness to make time for students. He has “one of the most difficult jobs in all of medicine,” said Tabbush, an adjunct professor of business economics at UCLA’s Anderson School of Management.

Despite continuing troubles at King-Harbor with Chernof at the helm of the county health system, supervisors and others offer glowing appraisals.

“He’s done an excellent job in pulling together solutions that the county needs,” said Jim Lott, executive vice president of the Hospital Assn. of Southern California. Supervisors often cite Chernof’s regular communications with them and his straightforward assessments of circumstances at King-Harbor. And they say he is more energetic and innovative than previous county health chiefs.

“Dr. Chernof has done the best job of any director of keeping us informed,” Knabe said.

Some community health advocates criticize Chernof, however, for not including them in discussions about the King-Harbor overhaul.

“The public voice is sort of missing, the community’s voice,” said Lark Galloway-Gilliam, executive director of Community Health Councils Inc., a health advocacy group. She said Chernof rebuffed several attempts by her organization before its representatives finally met with him.

“He picks and chooses who he’ll talk to,” Galloway-Gilliam said. “Often times, [Chernof] didn’t include people in the very community he’s focusing his efforts on.”

Others say Chernof doesn’t tolerate disagreement and clings to information, cutting some out of the loop. Molina said she was “discouraged” that county health officials “have a tendency to hide the negative from us.”

Chernof said his focus has been “doing what we need to do to provide quality care that meets national standards,” rather than community outreach. The department -- but not necessarily Chernof himself -- is available to respond to community concerns, he said.

Even as he had expressed hope for the hospital’s turnaround, Chernof had warned supervisors that its closure was always a possibility.

And with the federal evaluation looming, bad things happened at King-Harbor on Chernof’s watch. In May, a hospital security video caught the agony of a 43-year-old woman writhing on the waiting room floor after being refused treatment; she later died. After a patient waited days to be transferred for brain surgery, his family eventually drove him to another county hospital for help. More recently, a psychiatric patient cut herself with a scalpel and county inspectors cited the hospital for mishandling radioactive waste.

But resuscitating a chronically mismanaged hospital is a daunting task, supervisors and Chernof’s former colleagues say; they don’t blame recent incidents there on him.

“He’s shown uncommon administrative courage in the way he’s approached it,” Yaroslavsky said. “He’s not pulled any punches with the board on where things are going or where they’ll need to go.

“There’s no prescription for finding the right person who covers all the bases every time you hire somebody,” he added. “Bruce has been pretty good. I give him high marks. He’s not perfect, and he’s going to make mistakes.”

Chernof said he doesn’t consider the hospital’s current dilemma a failure. “The only failure that I see is if we had to close the hospital for a period of time and then not find a way to reopen it,” he said as he awaited the results of the federal review.

“It has been worth every effort that we have made to keep the hospital open, because there are limited healthcare resources in the South Los Angeles community,” Chernof said. “If it closes for a while, it needs to be temporary.”

Earlier attempts to find a private operator, however, did not yield concrete results.

“It’s been a risk long before my time in the department,” Chernof said after he announced its closure. “Somebody had to step in and do this work. We gave it a great shot.”

susannah.rosenblatt @latimes.com

Times staff writers Jack Leonard and Charles Ornstein contributed to this report.