It isn't easy to find Kevin J. McLaughlin's office at D.C. General Hospital in Southeast Washington. He works in a third-floor room at the end of a long hallway in a nondescript brick building next to the main hospital complex. No number adorns his door, and no sign bears his name.

But compared with the challenges McLaughlin faces as the hospital's new chief financial officer, directing visitors to his office is simple. A former chief financial officer at Howard University Hospital, McLaughlin, 43, now oversees finances for D.C. General -- the city's only public hospital and one that has struggled for funding throughout its existence.

The hospital treats the city's poorest residents, and two of every three patients treated there have no insurance. The hospital depends on government subsidies for nearly half its budget and on reimbursement from Medicaid and other welfare programs for much of the rest.

"It's not a very pleasant picture," said Paul Wallace, chairman of the Health Services Administration program at Howard University Hospital. "Between {budget cuts by} the city government and the federal government, it's easy to say the hospital's in a plight."

McLaughlin, a native of suburban Boston who attended Bentley College in Waltham, Mass., has spent his entire career at urban hospitals in the Washington area.

He worked at Prince George's Hospital Commission and the Columbia Hospital for Women before coming to Howard as assistant controller in 1980. He lectures on health administration for Howard University's Health Services Administration programs and the University of Maryland.

"I studied to be an accountant because I thought, 'business will always be running, and they'll always need someone to count the coins,' " McLaughlin said. "In health care, though, people can derive direct benefit from how I count the coins."

Officials at both Howard and D.C. General hospitals said McLaughlin's knowledge of financial systems, especially ways of receiving payment for care of uninsured patients, are crucial for success at D.C. General.

"His greatest asset is ... his superb understanding of the reimbursement system," said Russell Miller, acting director of the Howard University Hospital. "Kevin knows how to make the system responsive to the needs of the patient and can get the hospital to collect what is due."

McLaughlin, whose $81,885 annual salary at D.C. General is determined by the D.C. Council, resigned as chief financial officer at Howard early last spring and worked as a private consultant until July.

He then sailed the East Coast in his 40-foot sailboat with friends and family, capturing third place in a race from Newport, R.I., to Bermuda in 103 hours, and on Oct. 22 began working at D.C. General.

McLaughlin said he will lobby for increased government subsidies at D.C. General.

But he noted that federal budget constraints make it necessary to stretch the hospital's resources further.

"The money tree simply isn't there anymore ... There's no light on the horizon that leads me to believe that's going to change," he said.

He predicted that competition for public funds for schools, police and fire departments and health care will only grow more fierce in the future.

"If any one person can make a difference, I'd say Kevin has the background and the experience to do it," Wallace said.

He added, "But the question is, can a hospital continue to survive in this era of dwindling resources?"