Los Angeles’ King-Harbor To Close After Losing Federal Funding
CMS officials on Friday announced that Martin Luther King Jr.-Harbor Hospital, which serves one of Los Angeles' lowest-income neighborhoods, no longer will be eligible to receive $200 million in federal funding after failing two inspections, the Los Angeles Times reports (Ornstein et al., Los Angeles Times, 8/11). The hospital historically has served the county's low-income and black neighborhoods (Kaiser Health Disparities Report, 6/13).The hospital closed its emergency department Friday night and will close completely within two weeks, according to Bruce Chernof, health director for Los Angeles County, which runs the hospital (Los Angeles Times, 8/11). The Los Angeles County Board of Supervisors on Monday voted unanimously to put its seal on the closure of the hospital (Leonard, Los Angeles Times, 8/14). The county plans to contract with surrounding private hospitals and add beds at public facilities in order to continue to serve the mostly low-income and minority residents of the area (Los Angeles Times, 8/11). Supervisors voted to pay up to $16.3 million to private hospitals and physicians "bracing for a deluge of patients," according to the Los Angeles Times (Los Angeles Times, 8/14). The hospital's outpatient clinics and an urgent-care center will remain open (Los Angeles Times, 8/11).
In a letter to the hospital, CMS said that "repeated certification surveys and complaint investigations have identified serious health and safety violations and documented the hospital's inability to comply with these federal standards" (Steinhauer/Morris, New York Times, 8/11).
A CMS inspection last month found the hospital fell below minimum federal standards in eight out of 23 areas assessed. The decision to withdraw funding "underscores the failure of Los Angeles County government, which despite slashing services, firing hundreds of workers and paying tens of millions of dollars to consultants, could not ensure the basic safety of patients" at the hospital, according to the Los Angeles Times (Los Angeles Times, 8/11). The hospital since January 2004 has been out of compliance with federal standards. It lost accreditation in 2005 but remained open "while political leaders tried to turn the institution around," according to the Washington Post (Geis, Washington Post, 8/11).
In August 2006, the hospital failed a federal inspection, after which it made major changes -- including limiting services offered, reducing from about 250 to 48 the number of inpatient beds and closing its physician-training programs with Charles R. Drew University of Medicine and Science -- in order to avoid losing federal funding. However, it "became clear" in May that the hospital had not improved after a 43-year-old woman died on the floor of the ED's lobby after waiting 45 minutes for care, a case that made national headlines, according to the Los Angeles Times (Los Angeles Times, 8/11). Federal funding accounts for about half of the hospital's budget (Jablon, AP/Orlando Sentinel, 8/11).
Reopening Plans
The revoked funding and closure of the hospital "mark an end to nearly four years of failed attempts to reform" the hospital, according to the Los Angeles Times. County officials will solicit bids from private operators to take over King-Harbor and reopen it within 12 to 18 months. However "previous attempts to find any takers failed, and success this time is by no means assured," the Los Angeles Times reports. If a private operator cannot be found, the county might attempt to reopen the hospital itself within the same time period. In addition, the county hopes to voluntarily suspend the hospital's license rather than have it revoked entirely, which would make it easier for a new operator to reopen King-Harbor (Los Angeles Times, 8/11).
Comments
Chernof said, "I speak on behalf of the entire Department of Health Services when I say how disappointed we all are that the hospital failed to meet national standards of care despite the best efforts of hundreds and hundreds of dedicated people" (New York Times, 8/11). Chernof also said, "The only real failure in my mind will be if we don't ultimately get to a place where we have a hospital in the community that meets national standards."
Los Angeles County Supervisor Mike Antonovich said, "For too long, the status quo allowed mediocrity to be the norm. There is no excuse or reason that we had to waste tax dollars and continue to support a failed system" (Los Angeles Times, 8/11).
Earl Ofari Hutchinson, a Los Angeles political commentator, said, "The Board of Supervisors failed to put enough money and personnel into the hospital," and "now we are asking the question we always ask: Where are all these people going to go?"
Los Angeles City Council member Janice Hahn (D) said residents "are going to be left without a safety net for health care," adding, "There will be no trauma care, no emergency care and a lack of the basic services this community needs and deserves" (New York Times, 8/11).