D.C. General Hospital has been put on notice by the federal government that unless the hospital makes marked improvements in several areas by Jan. 15, it will no longer be eligible to receive Medicare funds.
U.S. Health, Education and Welfare officials warned D.C. General last month that "despite considerable efforts and progress toward correcting many of the previously cited deficiencies, the hospital remains out of compliance with two conditions and is barely in compliance with a third . . ."
City government officials estimate the hospital would lose $5.4 million in fiscal year 1979 (beginning next October) if Medicare funding were cut off.
Medicare is the federal program that provides medical care for the elderly. D.C. General, which has for years been used as a dumping ground for those poor persons whose only infirmity is their age, cares for a large number of Medicare-eligible patients.
The two areas in which the hospital still fails to meet federal standards, according to HEW, are life safety codes - meeting fire and other safety regulations - and dietary services.
Last month's letter from HEW warns that "it was noted in our letter of March 3, 1977, that the dietary staffing deficiency alone was critical enough to prevent compliance regardless of what physical improvements were made in the department.
"Far from improving since that time, the situation appears to have worsened.
"In addition," the letter said, "although nursing has been found in compliance, it is a marginal situation. Staff shortages continue to exist, creating an obvious potential for adverse effects on patient care."
HEW noted that D.C. General's overall "plan of correction has not been satisfactorily implemented and the hospital has not achieved compliance" with federal standards but the recent letter also states that "commendable corrective efforts appear to be under way in many areas."
In 1975, the hospital lost its accreditation from the Joint Commission on the Accreditation of Hospitals, the national organization that inspects and accredits hospitals.
D.C. General is the only public, acute-care hospital in the city and primarily serves the city's poor.
Last month control of the institution was transferred by the City Council from the city's Department of Human Resources to an independent commission, despite strenuous objections from DHR officials and Mayor Walter E. Washington's veto of the transfer legislation. The veto was overriden by the Council.
Gilbert Hahn, former City Council member and now chairman of the new D.C. General Hospital Commission, said "one of the items for discussion (at the commission's Nov. 15 meeting) is an HEW (acceditation) survey that is to take place in the first week in December."
That survey will determine whether the hospital, which in theory is expected to be financially independent within two years, will continue to be eligible to receive federal Medicare funds.
Hahn said this week that the restoration of accreditation is at the "top of the list" of the problems with which the new board has to deal. "We have given the executive director (Robert Johnson) our full backing to go forward on what needs to be done to regain accreditation . . . Obviously we'll greatly handicapped if . . . the revenue from Medicaid and Medicare is not forthcoming.
"The goal of the commission is ultimately to have the hospital as self-supporting as possible from its own revenues," Hahn said.
In 1975, a study by the private D.C. Municipal Research Bureau found that the hospital was collecting in fees only half of the cost of running the hospital. The study reported a lag of up to two years in patient billing and said little or no attempt was being made to collect on delinquent accounts.