In South Central L.A., a Hospital Fights for Its Life

In 2004, the Los Angeles Times produced a Pulitzer Prize-winning series of articles on the failings of the hospital and its affiliated medical school, Charles R. Drew University. A public outcry followed. With public opinion souring and malpractice payments skyrocketing, the Board of Supervisors realized that it could no longer afford to treat the facilities as "out of sight, out of mind," Yaroslavsky said.

"We conducted a house cleaning," he said, "from the CEO to the janitors who weren't keeping the operating rooms clean." Between 2004 and earlier this year, more than one in five of the hospital's 2,300 staff members were disciplined or fired, he said. The trauma center was shut in November 2004. But when the county moved to also cut the hospital's obstetrics, neonatal and pediatrics wards, Rep. Maxine Waters (D-Calif.) and other leaders pushed back. Yaroslavsky alleged that Waters and other black leaders were interested only in protecting jobs for the African American community. Waters, however, said she was just trying to save King/Drew.

"I don't have any interest in protecting the jobs of the people who are there," she said. "It's not even in my district. My work is based on fairness, justice and equality. It is not about individuals; it is not about black people. I want services for the people in the area."

The county hired a new chief executive for the hospital, Antionette Smith Epps, whom Yaroslavsky described as "tough as nails." Epps has been credited with major improvements at the facility.

Still, Epps has acknowledged that King/Drew continues to have problems recruiting permanent staff and improving its reputation among potential patients. A new obstetrics ward averages 60 births a month -- small compared with the 600 born at the nearby St. Francis Medical Center. Los Angeles police officers, sheriff's deputies and firefighters all oppose being taken to the hospital if they are hurt in the line of duty. And during a recent trip to the emergency room, several patients and family members expressed fears about the care.

"I don't have anywhere else to go," said Miranda Lopez, a 28-year-old mother of four who had brought her son to the emergency room after he fell riding his bike. "But I am worried about this place. You would be, too. It's called Killer King."

Lopez represents another trend at the hospital. While the region King/Drew serves remains poor -- It's No. 1 in Los Angeles in coronary heart disease, diabetes, homicides, poverty, uninsured children, teen birth rate, unvaccinated elderly and total death rate -- a demographic change has swept the community. What was once an all-black region being served by a largely black hospital has morphed into a predominately Hispanic area being served by an institution that is slowly changing, too. Thirty years ago, 85 percent of King/Drew's patients were black. Today, 70 percent are Hispanic.

"This change makes the policies of the past untenable and has emboldened those of us who are trying to transform King/Drew," Yaroslavsky said. "Whether we've done enough, we'll soon find out." A decision on Medicare and Medicaid funding is expected in early September.