Federal health officials said Tuesday that they were stunned by the ability of Martin Luther King Jr./Drew Medical Center to correct widespread patient care problems that jeopardized the facility's future, saying that they had expected the hospital to fail a critical inspection last month.
"I frankly did not think they could do it," said Tom Morford, an official of the U.S. Health Care Financing Administration in Washington. "I would have put money on (funding for) this hospital being terminated. In a lot of cases, they haven't addressed long-term problems, but this is a real success story."
In what they described as a "herculean effort," Los Angeles County health department administrators pumped an additional $4 million into King to hire 175 additional employees during the last three months and closed four hospital wards to offset a critical nursing shortage. Workers were brought in from other county facilities and hospital workers were exhorted at regular staff meetings to get ready for the pending inspection.
That effort allowed King to clear a key hurdle this week when the health-financing agency announced that the hospital will receive $60 million in public health care funds that the agency had threatened to cut off by Thursday. County officials acknowledged that they must still address long-term solutions for King's problems, but vowed that they will continue to focus attention on the Watts facility.
The hospital's continued success will be dependent on an infusion of capital and the county's ability to recruit nurses and other key staff members, according to several health care analysts. State health investigators noted in their report that there was a shortage of nurses in key areas of the hospital for all 15 days that they monitored King, and county officials said it would be difficult to permanently replace as many as 100 temporary workers they hired to help fix the problems there.
The 50-page report released Tuesday also noted numerous deficiencies in the hospital plant, including an inadequate fire alarm system that will cost county officials up to $2 million to replace. However, the report painted a highly favorable portrait of King, noting that scores of serious patient care deficiencies had been corrected, all the way down to the "properly handled hospital linen."
After reviewing the records of 102 patients, state investigators concluded that King was in compliance in five of the six areas--hospital administration, nursing, food and dietetic services, quality control and infection control--that the Watts facility had been cited for earlier. Although the hospital's physical condition is still not up to par, the inspectors noted, federal officials said correcting on-site maintenance problems usually takes more than a year.
The state health inspections followed a series of articles in The Times detailing numerous deficiencies in patient care and administration at the hospital and a national study of death rates of elderly Medicare patients that ranked King among the bottom 50 of 5,577 hospitals surveyed.
"Obviously we feel very good about it," said Edward Renford, King's acting administrator and the person largely credited for the turnaround. "We definitely have turned the corner and the staff is working very hard to ensure that this is the way we will do business in the future.
"There was in the minds of some people doubt as to whether we could do it at all, but at this point, I don't think we will have any problems maintaining the quality of care. We just focused attention on the most pressing issue, and that was that we could not afford to allow this hospital to lose its (federal) funding."
Health care analysts questioned some of the tactics used by the county to allow King to pass the inspection, particularly the decision to offset the nursing shortage by reducing the number of patients at the 480-bed county facility. Some of those patients were transferred to other county medical facilities, according to Carl Williams, county hospital director. However, the number of occupied beds was reduced primarily by not accepting new patients at four of King's hospital wards.
"In a sense, it appears that they raised the bridge to lower the river but now that the immediate pressure is off, they're going to have to continue to make it a top priority," said Lynn Kersey, an official with Health Access, a statewide advocacy group.
County Supervisor Ed Edelman said that while funding continues to be the key issue, the county can never again ignore lingering problems at any of its medical facilities.
"We've reached a point where what happened at Martin Luther King could happen elsewhere if we're not careful," he said. "In this case we waited too long."