Four months into a radical overhaul of the former Martin Luther King Jr./Drew Medical Center near Watts, the long-troubled hospital shrinks to its smallest size today.
The restructured medical center, renamed Martin Luther King Jr.-Harbor Hospital, has been scaled down to just 48 beds, including six for obstetrics. Plans call for the hospital to grow to 120 beds -- far fewer than the 233 it once had.
All its employees were required to undergo interviews, after which more than half were allowed to stay while the rest were transferred to other county facilities.
The shift comes as county health officials await word on a requested extension of federal funding to keep afloat the reorganization, which also involves Harbor-UCLA Medical Center near Torrance.
MLK-Harbor was forced to dramatically reduce services after failing a crucial inspection last fall, jeopardizing $200 million in federal funding -- a large chunk of its annual operating budget.
Chronic mismanagement had plagued the hospital for decades, in some instances leading to patient deaths. The medical center had been established to serve what was then a largely African American community a few years after the 1965 Watts riots.
To save the hospital after the federal government warned that it would cut off funding, supervisors approved a radical restructuring plan. It eliminated the hospital's specialty services and placed it under the management of Harbor-UCLA.
As management changes unfolded, some patients have been gradually shuffled to other area hospitals, public and private.
Since the transformation began in November, the county has interviewed and placed 1,786 hospital employees. Almost 1,400 remain at MLK-Harbor, down from 2,286 previously. Nearly 400 workers were transferred to other county health facilities last month. The remaining employees were unavailable for interviews or were medical residents at Charles R. Drew University of Medicine and Science; the hospital severed ties with the medical school late last year as part of the downsizing.
Since 2004, 260 hospital staffers, including 41 doctors, had been fired or had resigned as a result of disciplinary proceedings.
Medicare officials agreed to provide federal funds to MLK-Harbor through March 31 on the condition that the hospital was measurably improving patient care. But county health chief Dr. Bruce Chernof last month requested an extension of that deadline to Aug. 15 to "fully complete" the hospital's transition. It is uncertain whether federal officials will grant that extension, or how the county will complete MLK-Harbor's improvement plan without federal dollars. If federal funding is cut off March 31, it could cost the county as much as $87 million, health department officials said.
Supervisor Yvonne Brathwaite Burke is in Washington this week lobbying for a deadline extension. Burke, whose district includes MLK-Harbor, is concerned that the hospital won't be able to complete its reforms without additional funding, spokesman James Bolden said.
Federal officials did not return repeated calls for comment.
"There isn't a formal contingency plan at this point in time, because we need to see how" federal officials respond, Chernof said. "The most important thing we can do now is continue to stay on time and on target."
State and federal officials toured MLK-Harbor and Harbor-UCLA on Feb. 9, a visit that Chernof said went very well. "We are extremely proud of the work that has been done to date," Chernof said.
Gov. Arnold Schwarzenegger also called for federal support of the hospital in a letter this week to Secretary of Health and Human Services Michael O. Leavitt.
"The county has made significant progress in restructuring this hospital and addressing quality of care issues and is meeting the expectations of the federal and state governments in its reform efforts," Schwarzenegger wrote. Sticking with the March 31 deadline would "penalize the hospital when it is showing major progress," he added.
Contract ambulances carry patients from MLK-Harbor to other local hospitals; more than 200 patients were transferred in December, 238 in January.
The board this week approved contracting for 10 more beds at the private Downey Regional Medical Center.
Healthcare advocates initially had voiced concern about reducing services at the hospital. But at least one complimented the county on the transition.
"We've been pleasantly surprised and excited about the fact that they were able to make the transition ... with minimal disruption to the community," said Jim Lott, executive vice president of the Hospital Assn. of Southern California.
"We thought there was going to a be lot more fallout from reduction in capacity," Lott said.