Medical Center Born Out of Watts Riots Tries to Save Its Accreditation After Years of Deteriorating Care, Administrative Neglect
By John Pomfret and Sonya Geis
Washington Post Staff Writers
Saturday, August 26, 2006
LOS ANGELES -- A storied hospital, born out of the ashes of the iconic Watts riots of 1965 and a symbol of the promise of black political power, is on life support, and a federal agency could soon pull the plug.
Investigators from the Centers for Medicare and Medicaid Services descended on the King/Drew Medical Center in South Central Los Angeles earlier this month and will soon determine whether the hospital meets standards of care in 23 areas. If it doesn't, King/Drew will lose $200 million of its $380 million budget and could face closure.
Should that happen, county officials predict a health crisis across this county of 10 million people as emergency rooms from tony Beverly Hills to the middle-class San Fernando Valley are flooded with patients. "It will set off a medical meltdown in terms of emergency service," predicted Zev Yaroslavsky, a member of the Los Angeles County Board of Supervisors, which oversees the facility.
The story of the Martin Luther King Jr./Charles R. Drew Medical Center is a tangled web of race relations, urban poverty, liberal guilt and the type of ward politics more at home in Chicago than in sprawling Los Angeles.
After the deadly riots in Watts 41 years ago, politicians and grass-roots leaders agreed to build a hospital in the area to serve a poor, underserved African American community.
"The hospital was not so much a memorial to the revolt, rather it was a beacon of hope for this poor place. It promised jobs. It promised to catalyze development in the area. It promised opportunities to professionals to move back into the community," said Timothy Watkins, head of the Watts Labor Community Action Committee whose father, Ted, was one of the crusaders for the hospital. From the start, King/Drew was a busy place. Its trauma center handled more gunshot wounds than any other Los Angeles County hospital, and the military dispatched combat surgery teams there for real-life practice.
At the same time, King/Drew's unique history sheltered it from necessary reforms, said Joe R. Hicks, another black political activist who participated in the Watts riots. White power brokers treated the hospital with a mixture of benign neglect and liberal guilt, never fully funding it and never fully taking it to task when serious problems surfaced, he said. And he said African American leaders, for their part, turned the place into a "black patronage outfit, doling out jobs to friends and supporters."
As care deteriorated, Hicks said, black political leaders would intimate that its critics were racist and stymie attempts at change. "Anyone who wanted to reform the hospital was called a bigot, so few people wanted to take that on," he said.
Starting in the 1980s, King/Drew gained a new nickname: Killer King.
Nurses slept through patient trauma and death and turned down noisy heart monitors, missing fatal cardiac arrests. Patients with minor injuries died in the emergency room of neglect or mistreatment. A radiologist was accused of billing the hospital for 24 hours a day of work, for weeks on end. The hospital led the state in malpractice suits and paid millions of dollars for dubious workers' compensation claims.
Staff members at King/Drew also inappropriately employed stun guns to restrain psychiatric patients, allowed employees to stay on the payroll long after they stopped working, and performed lucrative elective surgeries while patients with open wounds were forced to wait for an operating room. One patient had a hysterectomy after a King/Drew doctor told her she had cancer that she did not have. Another patient won a hefty settlement after she was given HIV-infected blood at the hospital and developed AIDS.
King/Drew has been out of compliance with Medicare standards since January 2004, said Medicare and Medicaid Services spokesman Jack Cheevers. It lost its national accreditation in early 2005.
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.
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