In his Nov. 5 Metro article, "Hospital Removes Top Two Officials,"

Avram Goldstein said, "The two top executives of Shady Grove Adventist Hospital in Rockville have been removed by its board following a month of criticism from patients, doctors, employees and government regulators." This is not the case.

The Adventist HealthCare Board of Directors accepted the resignation of the chief executive officer, Cory Chambers. The chief operating officer (COO), Kiltie Leach, was appointed president and COO at Washington Adventist Hospital, a position that gives him greater autonomy and a leadership role of equal significance to the president and COO position at Shady Grove. This action was taken to improve oversight.

In addition, necessary and important context was omitted in relation to another issue in the article, patient census levels. Mr. Goldstein also was provided the average daily census for October 1999 (187.3) and the average daily census for October 1998 (186.9). It is inaccurate to say that hospital census dropped below expected levels, (as attributed to an unnamed Shady Grove official).

ROBERT E. JEPSON

Regional Director, Communications

Adventist HealthCare

Rockville

The Nov. 16 front-page story about Shady Grove Adventist Hospital ["Md. Hospital Facing Loss of Accreditation"] is a warning: This may happen to many hospitals if we keep chipping away at their revenue sources and suffocating them with avalanches of bureaucratic regulations.

Legislators and leaders of industry and commerce should be doing everything in their power to pour more money into our community's hospitals. Instead, Medicare and Medicaid legislation and regulations are aimed at curtailing reimbursements for hospital care, while private-sector health insurance organizations are encouraged to ratchet down the flow of hospital revenues through market manipulations and intimidations.

This is very good for certain corporate profits, entrepreneur enrichment and political power bases, but the unfortunate result is that hard-pressed hospital administrations are forced to cut staffing and to hold down the earnings of nurses, technicians, janitors, dietary aides, clerks and other personnel to keep the hospital doors open.

The feeding frenzy of regulators, overseers, criticizers and analyzers descending on Shady Grove Adventist Hospital contributes nothing to the solution of the fundamental problem: Our hospitals are being starved.

HENRY ROTH

Bethesda

Officials at Shady Grove Adventist Hospital are dumbfounded that their accreditation may be revoked after receiving a near-perfect score a year ago from inspectors.

Poor patient care conditions don't happen overnight. Something is wrong with the hospital inspection system. Almost every hospital surveyed by the Joint Commission for Accreditation of Healthcare Organizations (JCAHO) passes inspection and receives accreditation.

In July 1998, Shady Grove passed its JCAHO inspection with flying colors, receiving a score of 99 out of 100. Now, after public exposure of serious patient care lapses, the hospital is facing loss of accreditation and a state takeover.

To raise the standards and quality of hospital inspections, all inspections should be unannounced. Front-line health care workers should be given the opportunity to tell surveyors what's really going on in the facility and receive whistleblower protection. Meaningful standards should be developed and enforced.

Inspectors should see hospitals the way patients and health care workers see them every day. Otherwise, inferior care won't be improved.

SANDRA FELDMAN

Washington

The writer is president of the American Federation of Teachers, which represents 53,000 nurses and other health care workers nationwide.