William Delgardo, administrator of Martin Luther King Jr./Drew Medical Center for the past 14 years, was removed from his hospital post, along with two of his top aides, during a private meeting of the Los Angeles County Board of Supervisors on Tuesday.
The action followed a threat by federal authorities Monday to cut off $60 million in public health care funds to the hospital unless serious, systemwide patient care deficiencies are corrected by Dec. 21. Such a cutback would almost assuredly force the closure of King, a vital link in the county's health care system.
"The potential loss of (money) . . . is extremely serious," said Robert Gates, chief of the county's Department of Health Services. "We literally could not operate that hospital" if the funds are cut off. "It is a very grave concern."
In a personnel shuffle that county officials said is designed to improve the management of the hospital, Delgardo will be transferred to the administrative offices of the county health department downtown. He will be succeeded, temporarily, by Edward Renford, who has been working in the health department's downtown office for several months and who has worked in the administrative and fiscal offices of other county hospitals since 1970.
Renford apparently has no knowledge of his new assignment. Colleagues said he is vacationing "in a different continent."
In an interview after the meeting, Gates said, "We'll make sure (Renford) is up to speed when he returns" next week.
Gates called the management shuffle at King "part of a rejuvenation of management at the hospital, which we consider to be desirable."
As for its reflection on Delgardo, Gates said, "It would be hard to interpret it as a complement to his administration."
Delgardo was not available for comment.
An ailing Supervisor Kenneth Hahn left his sickbed, where he has been recovering from respiratory problems, to attend Tuesday's board meeting, where he protested Delgardo's transfer.
"Let the record show that I support Bill Delgardo," Hahn declared. "I think what was wrong at King was that we did not appropriate enough money or put enough physicians there."
Earlier this month, Hahn called for a county investigation of "serious charges of substandard health care" based on a series of articles in The Times. The articles, he said, pointed out "poor administration, a lack of highly skilled medical staff and a severe shortage of space, staff and funding to adequately deal with the hospital's increasing load."
A recent study of death rates among elderly Medicare patients nationwide ranked King among the bottom 50 of 5,577 hospitals surveyed.
State health officials, who did a hospitalwide investigation of King in June, released two reports earlier this month. They cited massive, wide-ranging health care deficiencies in six key areas: quality assurance, infection control, nursing, dietary services, administrative leadership and physical environment.
The problems are so numerous and severe, according to federal officials, that they have taken the rare step of threatening to cut off health care funds in December.
Gates acknowledged that the deficiencies unearthed at King are extensive and said that most of them have not yet been corrected.
"I don't believe this type of problem exists at other hospitals," he said.
Gates stressed that the board's action Tuesday affects only the administrative management of King and that other moves involving the medical staff, for example, could be made when several investigations are concluded. He also said the supervisors recognize that they may have to provide King with additional resources, such as "equipment, supplies and staffing."
Supervisor Pete Schabarum said that he supported Delgardo's transfer in the hopes that King "will be a well-operated hospital."
Supervisor Mike Antonovich heralded the personnel shuffle as "the first step in restoring integrity and quality of management" at King. He warned too that the supervisors would not tolerate "political interference" with their decision.
Several doctors interviewed Tuesday at King suggested that there are other underlying problems at the hospital.
Dr. Paul Kelly, who said he has been in the internal medicine/dermatology department at King for 16 years, declared, "Somebody has to answer to these criticisms. He (Delgardo) is the most visible. The supervisors are doing this because they have to show that they are doing something."
Kelly said that he has often heard King's service area called a battlefield because of the number of homicides there.
"If this is a war zone, they should give us a military budget to deal with it," he said.
"The problems lie with attending physicians who don't work," said a resident doctor in training in the internal medicine department.