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State takes step to close King-Harbor

Regulators move to revoke its license to operate. 'I think it's over for us,' one county supervisor says.

June 22, 2007|Charles Ornstein and Rich Connell | Times Staff Writers

California regulators moved Thursday to revoke the license of Martin Luther King Jr.-Harbor Hospital, an action that, if not reversed, would force its closure.

The move, the boldest thus far by the state, follows recent findings by the federal government that patients at the public hospital are in immediate jeopardy of harm or death despite years of reform efforts.

The state Department of Health Services has never before made such a threat against King-Harbor and has not revoked any hospital's license since 2004.

Two of the five members of the Los Angeles County Board of Supervisors said Thursday that they now support closing the hospital without delay.

"I think it's over for us," Supervisor Gloria Molina said. "I'm in fact terrified that somebody else might be hurt or neglected or abused at Martin Luther King hospital."

Supervisor Mike Antonovich agreed. "The time has come to put patients' lives before incompetent employees or political agendas," he said.

The state's decision, which was approved by Gov. Arnold Schwarzenegger, is subject to appeal. That process could take six months to a year.

The state suggested in a letter Thursday to county health director Dr. Bruce Chernof that it could rescind the action if the hospital was able to show that it met state and federal standards -- a goal it has been unable to achieve since 2004.

The hospital will remain open in the meantime.

"We're really worried that the people will think the hospital closes tomorrow," said Sandra Shewry, director of the state health department. "It doesn't mean that. Services continue while this process plays out. The best end point is for that hospital to come into compliance."

The state's intervention dramatically increases the pressure on King-Harbor, formerly King/Drew, whose turbulent history traces back almost to its inception. It also marks a change in direction for the state, which in recent months had urged the federal government to continue funding the hospital in hopes that reforms would succeed.

The federal government has for some time dangled the threat of pulling crucial Medicare and Medi-Cal funding -- a matter that could be settled by an inspection next month. But the state's threat is potentially more potent: A hospital cannot operate, period, without a license.

Concern about King-Harbor has been building in recent weeks after highly publicized lapses in care.

In one case, a 43-year-old woman writhed untreated on the floor of King-Harbor's emergency room lobby for 45 minutes before dying. In another, a brain tumor patient waited four days for treatment before his family drove him to Harbor-UCLA Medical Center for emergency surgery.

On Tuesday, The Times reported that health inspectors, dispatched to investigate the brain tumor patient's case, found 16 additional cases of substandard care in the King-Harbor emergency room.

County supervisors are expected to discuss contingency plans for the hospital Tuesday. Supervisor Zev Yaroslavsky said that if King-Harbor failed the upcoming federal inspection, it would need to be shut -- but not suddenly.

For one thing, the county must hold a public hearing before it scales back any services at the hospital.

"If you don't do it in an orderly fashion, you run the risk of destabilizing not only the clientele who are served by King but the other facilities that serve the southern part of L.A. County," he said.

Yaroslavsky said he was "very pessimistic" about the hospital's chances.

"The state has lit the fuse," he said. "I think it's going to be hard to stop it. They very well may be justified in it."

Community advocates said the state's threat, if carried out, would be a disaster for residents of South Los Angeles who have few other options for care.

"We are playing with not only fire, we have gasoline in the other hand," said Lark Galloway Gilliam, executive director of Community Health Councils. "That emergency room, you can't let that go. Closure to me is not an option."

Chernof said he understood why the state believed that it had to act.

"The state, the federal government and the department and the Board [of Supervisors] all believe the hospital has to meet national standards. Period," he said. "This is the state's effort to assure that."

Chernof said hospital staffers are making changes and correcting problems, trying to prepare for the upcoming federal inspection.

"The hospital is already under very significant pressure to prepare and pass this survey. They have been for months, and the events of the past few weeks just highlight the need," he said.

Founded in a largely African American area in the wake of the Watts riots, the medical center was seen as a symbol of hope, a testament to racial justice in healthcare and a jobs engine for a struggling region.

But soon after it opened in 1972, the hospital became mired in problems, and it eventually gained the moniker "Killer King." Over the years, it attracted publicity for patient care failures, some of which resulted in deaths.

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