A new hospital planned for the campus of St. Elizabeths would replace United Medical Center as Southeast Washington’s only full-service hospital. (Michael Robinson Chavez/The Washington Post)

George Washington University Hospital would take the helm of a hospital to be built in Southeast Washington over the next several years, according to a tentative agreement D.C. Mayor Muriel E. Bowser (D) signed Friday, establishing the presence of one of the city’s top medical institutions east of the Anacostia River.

Under the agreement, GW would run, and perhaps eventually own, a new medical facility catering to the District’s poorest and most violence-plagued neighborhoods. The new hospital would replace United Medical Center, the District’s troubled public hospital, which has struggled to make money and last year was rocked by questionable patient deaths.

D.C. and GWU officials will negotiate exclusively over the coming months to finalize the terms of their partnership. The letter of intent that Bowser and GWU hospital chief executive Kimberly Russo signed states that their goal is to have an agreement ready for approval by the D.C. Council by year’s end.

The letter says officials hope to open the hospital on the campus of St. Elizabeths — a 19th-century psychiatric facility that today houses a small public hospital for the mentally ill and a large area of land slated for redevelopment — in 2023.

In an op-ed published Friday in The Washington Post, Bowser said the new hospital would help address disproportionately high rates of HIV, cancer, and infant and maternal mortality that afflict the predominantly African American neighborhoods east of the river, long a dividing line between the city’s haves and have-nots.

“With this new hospital, we can, at the very least, take on this geographical disparity and make access to fully integrated health-care systems easier for thousands of Washingtonians,” Bowser wrote.

Many cities and counties across the country have abandoned government-run hospitals because of their financial challenges. Neighboring Prince George’s County is building a regional hospital that will be run by a partnership that includes the University of Maryland.

City Administrator Rashad M. Young said the District’s partnership would allow the city to move toward its goal of preserving health-care access for residents of Wards 7 and 8 without having to shoulder the day-to-day responsibility of operating a medical facility.

“We are doing this to get the District out of the hospital business,” Young said.

Unlike UMC — which is governed by a public board that has faced criticism over its professionalism and transparency — the new hospital would be overseen by a board appointed mostly by GWU. Other details of the facility’s construction, operation and management will be worked out in the negotiating process, Young said.

The District government has already set aside $300 million to build the new hospital. It is not yet clear whether GWU will also contribute to construction costs.

“One thing we want to make abundantly clear here is that we’re talking about a new entity being built that is going to be operated and run by GW,” Young said. “We don’t want anybody to be thinking — and I want to be very clear — that this is about transferring the existing UMC” to a new location.

The hospital would have between 100 and 125 inpatient beds and would offer obstetric and nursery services — a key provision for Southeast residents, who suffer from the District’s highest infant mortality rates and have lacked a nearby hospital at which they can give birth since August 2017, when regulators shuttered UMC’s obstetrics ward.

Russo said in an interview that a downsized hospital catering more precisely to its patients’ medical needs could succeed financially where UMC has failed.

UMC was built at a time when hospitals offered fewer outpatient services, and it has 234 beds, according to health department records.

“The difference here is that there’s going to be an appropriately sized hospital with the right lines of services to meet the community’s needs,” Russo said. “We believe that that can be financially viable.”

Russo said patients at the new hospital also will have access to doctors and services at the university’s existing 385-bed university hospital in Foggy Bottom. GWU also may open additional, smaller medical facilities at other sites in Wards 7 and 8, she said.

George Washington University Hospital is jointly owned and operated by George Washington University and Universal Health Services, a national hospital-management company.

D.C. officials have sought a private-sector partner for a new hospital for years. But pressure to replace UMC grew last year, as nursing-home and obstetric patients died under questionable circumstances, and the D.C. Council removed the politically connected consulting firm that was running the facility amid allegations of mismanagement.

Council member Vincent C. Gray (D-Ward 7), who chairs the council’s health committee, welcomed the announcement of the new partnership.

“GW is clearly a credible entity,” Gray said. “They’ve run good health services in the District of Columbia. They’ve run a good hospital. I’m hopeful that their selection signals that the city is very serious about making this a successful endeavor.”

However, Gray — who has criticized Bowser for what he has said is a lack of urgency in decommissioning and replacing UMC — said the new hospital’s projected opening date is still too far off and should happen by the end of 2021.

“I’m excited that this is moving along,” he said. “I just think it needs to move more quickly.”