Federal regulators announced Friday they are pulling $200 million in funding from Martin Luther King Jr.-Harbor Hospital, forcing a medical center that serves one of the city's poorest inner-city neighborhoods to all but shut down.
The decision was made after the hospital failed two federal inspections, including one last month, in which it was found that "conditions at the facility have placed the health and safety of
patients at great risk," said Herb Kuhn, the acting deputy administrator for the U.S. Centers of Medicare and Medical Services.
"While some progress has been made, significant problems persist," Kuhn said in a statement.
At a news conference hours after Kuhn's announcement, Los Angeles County's chief medical officer told reporters the hospital would close its emergency room Friday night and patients would be moved to other hospitals within two weeks.
"We brought every resource to bear but in the end it just wasn't enough, fast enough," said Dr. Bruce Chernof.
"It is very distressing to have to close a hospital that we worked so hard to preserve."
Chernof said King-Harbor would remain open 16 hours a day, seven
days a week to offer outpatient care to people with routine medical
Ambulances will be available to take the more seriously ill to other hospitals.
He said the county Health Department is committed to eventually reopening King-Harbor as a full-service hospital, perhaps under the
direction of a private contractor.
But he warned that could take 15 months or longer.
King-Harbor has been under the gun for months to improve operations, and poor patient care has been blamed for several deaths there.
A woman died in May after writhing untreated on the floor of the emergency room lobby for 45 minutes, and in February a brain tumor
patient languished in the emergency room for four days before his
family drove him to another hospital for emergency surgery.
The hospital failed a federal inspection in September 2006, but managed to remain open under a reorganization that shifted services to Harbor-UCLA Medical Center and reduced King-Harbor's inpatient beds from 250 to 48.
The second inspection, conducted last month, found the hospital still had failed to comply with federal standards in eight of 23 areas, ranging from nursing services to patients' rights, according to a letter to King's administrator, Antoinette Epps.
"We worked day and night to reform the hospital while keeping it open, and in the end the risk was worth the effort because the need is so great," Chernof said.
"This decision is a blow to the community, but the department will not operate a hospital that cannot meet national standards."
The second inspection found that in one case a woman in the emergency department managed to obtain a scalpel and cut her arms,
while other patients considered a danger to themselves or others were allowed unsupervised access to a bathroom.
The letter to Epps also said that:
- Patients were placed at "serious risk" of contracting tuberculosis or other diseases, including dialysis patients who were improperly treated.
- Regarding nursing and drug services, pediatric staffers were unable to find critical equipment or calculate proper drug doses during an emergency drill.
- The hospital "failed to analyze pharmacy data adequately for medication errors."
The U.S. Centers of Medicare and Medical Services said it would end its hospital provider agreement with King-Harbor on Wednesday.
That means the hospital will no longer be reimbursed for the costs of caring for Medicare patients, who represent a large proportion of its clients.
King-Harbor had been receiving about $200 million a year in federal funding, although the county had not billed for any non-emergency Medicare or Medi-Cal patients since April.
The county had warned that loss of the funding - which represents about half the hospital's budget - would force King-Harbor to close.
The hospital, formerly known as King-Drew, was built after the 1965 Watts riots to bring health care to poor, minority communities in South Los Angeles.
"This is a sad day for the Watts/Willowbrook community. They are going to be left without a safety net for health care. There will be no trauma care, no emergency care and a lack of the basic services this community needs and deserves," said City Councilwoman Janice Hahn.
Lark Galloway, executive director of Community Health Councils, called the news "disappointing and hurtful" and blamed the county for King-Harbor's failures.
"This community needs this hospital," Galloway said. "Someone has to go in there and clean house and bring in competent staff. The county has failed to do that."
King-Harbor has about 1,600 employees and saw about 50,000 emergency room patients last year.
Chernof asked the employees to continue reporting to work as the hospital is closed, saying much remains to be done.
He also said plans have already been put in place to shift inpatient services to two other hospitals and to redirect ambulances picking up patients in need of care to nine other hospitals.