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Martin Luther King Jr. Outpatient Center

The Martin Luther King Jr. Outpatient Center, formerly known as Martin Luther King Jr. Multi-Service Ambulatory Care Center, Martin Luther King Jr./Drew Medical Center (King/Drew), and later Martin Luther King Jr.–Harbor Hospital (MLK–Harbor or King–Harbor), was a public urgent care center and outpatient clinic and former hospital in Willowbrook, an unincorporated section of Los Angeles County, California, north of the city of Compton and south of the Watts neighborhood of Los Angeles.

Martin Luther King Jr. Outpatient Center
Los Angeles County Department of Health Services
Geography
LocationWillowbrook, California, United States
Organization
Care systemPublic
FundingGovernment hospital
TypeCommunity
History
Opened1972; 52 years ago (1972)
Links
Websitedhs.lacounty.gov/wps/portal/dhs/mlk
ListsHospitals in California

Founded as a major public hospital, it was shut down in August 2007 because of its poor record of patient care. The urgent care center and outpatient clinic, however, remained operating on the site. In 2014, a smaller hospital under a partnership between Los Angeles County and the University of California opened as a nonprofit organization governed by a seven-member board of directors.[1][2]

MLK Outpatient Center was operated by the Los Angeles County Department of Health Services. In the 2000s, widely publicized problems related to incompetence and mismanagement caused the hospital to undergo a radical overhaul, which reduced the number of beds from 233 to 42 before it finally closed.[3]

Since 2004, 260 hospital staffers, including 41 doctors, had been fired or had resigned as a result of disciplinary proceedings. To alleviate the impact on the community of this large loss of capacity, the Los Angeles County Medical Alert Center contracts ambulances take approximately 250 patients per month to other local hospitals.[3]

At the beginning of the 21st century and before its crisis, MLK–MACC (then MLK/Drew) had 537 beds, was the teaching hospital of the adjacent Charles R. Drew University of Medicine and Science, spread over a 38.5-acre (156,000 m2) site, which included a dormitory for medical residents, employed 2,238 full-time personnel, and in 2004 treated 11,000 inpatients and 167,000 outpatients.

Located near high-crime streets, the hospital had a very active trauma unit. In 2003, it handled 2,150 gunshot wounds and other life-threatening injuries. Because of the large number of gunshot wounds the trauma unit saw, the US military sent their trauma teams to MLK/Drew for training.

History edit

Founding and early history edit

The facility's founding was spurred by the 1965 Watts Riots. In the aftermath of the unrest, Governor Pat Brown appointed a commission to identify factors that contributed to the unrest. This result was the December 1965 McCone Report. One major finding of the report was the lack of healthcare access near the low-income neighborhoods of South Central Los Angeles. At the time, the closest major public trauma center was Los Angeles County-USC Medical Center, located over 10 miles (16 km) away—a problem heightened by the amount of gang violence in the area.

In 1966, DHS established a task force to develop a full-service community and teaching hospital operated by the County in conjunction with the USC and UCLA Medical Schools as well as the newly formed Charles R. Drew Postgraduate Medical School, a private nonprofit medical school formed to train doctors to work in areas of urban poverty.

Ground was broken on the hospital in April 1968. It was originally named the Los Angeles County Southeast General Hospital but was soon renamed Martin Luther King Jr. General Hospital, days after the namesake's assassination.[4] After a dedication in February, it opened on March 27, 1972, as a full-service medical center. The facility changed its name again, to Martin Luther King Jr./Drew Medical Center, when it became the teaching hospital of the adjacent Charles R. Drew University of Medicine and Science.

In 1981, the hospital expanded into psychiatric care by opening the Augustus F. Hawkins Mental Health Center. In 1998, it expanded its trauma center. By the 1980s, King/Drew was part of the Drew/UCLA Undergraduate Medical Education Program, training physicians through a partnership of UCLA and Drew medical schools, and was a source of pride and jobs in the community.

The fall of King/Drew edit

King/Drew entered the 21st century with an array of problems related to incompetence and mismanagement. A perceived lack of quality at the hospital had earned it the nickname of "Killer King."[5] The facility employed travel nurses from across the country in an attempt to improve conditions.

Troubles come to light edit

On August 22, 2003, the Los Angeles Times reported that two women connected to cardiac monitors at King/Drew died after their deteriorating vital signs went undetected. In December 2003, DHS closed the cardiac monitoring ward at the hospital after a third patient died under questionable circumstances. A consulting group was hired to help fix issues with the nursing staff; DHS spent nearly $1 million on this effort.

In a January 13, 2004, report, the federal Centers for Medicare and Medicaid Services determined that King/Drew was out of compliance with minimum requirements for receiving federal funding, citing the work of government inspectors who identified three patients who died at King/Drew after what were determined to have been grave errors by staff members. By March, CMS declared King/Drew patients were in "immediate jeopardy" of harm or death because of medication errors at the hospital, citing numerous mistakes and threatening to pull federal government funding from the public hospital.

In June, 2004 CMS again stated that patients were in jeopardy, citing the use of Taser stun guns to subdue psychiatric patients. Yet again, it threatened to pull federal funding but backed away; federal funding made up over half of King/Drew's $400 million operating budget.

Closure of the trauma center edit

On September 13, 2004, DHS recommended the closure of King/Drew's busy trauma unit, saying the hospital needed to put its full energy into fixing problems in other areas. Soon after, the Los Angeles Times revealed that the American College of Surgeons had revoked its approval of the quality of King/Drew's trauma unit in 1999 and 2003 because it failed to properly investigate questionable patient deaths, and that doctors routinely skipped meetings held to discuss treatment problems. Also in September, the Los Angeles County Board of Supervisors agreed with CMS to hire a new consulting firm to take over operations at the hospital.

By November 2004, neighborhood resistance to the proposed closures (particularly the trauma center) formed, led by U.S. Representative Maxine Waters and joined by the Rev. Jesse Jackson, Los Angeles Mayor James K. Hahn, actress Angela Bassett, and children of the Rev. Dr. Martin Luther King, Jr. In December 2004, CMS declared King/Drew patients were in "immediate jeopardy" for a third time. This time it cited the staff's heavy reliance on Los Angeles County Police personnel to deploy Tasers to subdue combative and violent psychiatric patients. Federal funds were again threatened, but as in previous times, action was not taken.

Despite protests, negative media and the near-unanimous opposition of city political leaders, the five-member Board of Supervisors voted four to zero, with one abstention, to move forward with closure of the trauma center. A temporary restraining order was filed by a group of doctors and residents, but was denied. The trauma unit was closed in early 2005. Patients were diverted to three other hospitals, both public and private (with county subsidy).

A few days later, the Joint Commission on Accreditation of Healthcare Organizations (now simply the Joint Commission), citing the medical center for failing to correct severe lapses in patient care, threatened to pull its seal of approval, jeopardizing over $14 million in physician training funds. King/Drew's seal of approval was revoked in February 2005.[6]

This move gained national attention after the Los Angeles Times ran a Pulitzer Prize–winning[7] five-part series reporting on "The Troubles at King/Drew." The series found that the problems at the hospital were far deeper than the public already knew and faulted the Board of Supervisors for shying away from making needed changes, often because of racial politics. Among the other findings was that King/Drew spent more per patient than any of the three other general hospitals run by Los Angeles County, the opposite of what many hospital supporters had assumed.

Problems for King/Drew became even worse over a period of four days in March 2005, when three patients died as a result of mistakes and lapses in medical care. The Board of Supervisors considered severing the hospital's relationship with Charles R. Drew University of Medicine and Science and partnering with another medical school such as UCLA, USC, or Loma Linda University.

In April, the Los Angeles Times reported a seventh death attributed to lapses in care by the hospital. This time, nurses and staff virtually ignored the audio and visual cues of vital-sign monitors over a period of hours.

"Make-or-break" inspection edit

After the three previous warning holding King/Drew out of compliance with federal guidelines since January 2004, CMS and federal authorities held an unannounced last-chance inspection of the hospital that began on July 31, 2006, and was finished on August 10. On September 22, CMS informed King/Drew that the hospital still did not meet minimum patient-care standards, failing nine of the government's 23 conditions for federal funding, and thus failing the final "make-or-break" inspection. Federal regulators identified problems in nursing, pharmacy, infection control, surgical services, rehabilitation services, quality control, patients' rights, and the hospital's governing body and physical plant. Inspectors found more problems during the final inspection than they had at any time in the previous three years.

King/Drew becomes King–Harbor edit

Radical restructuring edit

DHS elected to move forward with a radical restructuring plan that eliminated the hospital's specialty services, severed its relationship with the Drew medical school, and proposed to place it under the management of Harbor–UCLA Medical Center (Harbor–UCLA).[3] The plan downsized and refocused the hospital on community medical care, including emergency department and outpatient services; the two central pillars of the plan were identifying and removing under-performing staff and integrating the two hospitals "under one medical management and administrative leadership team at Harbor–UCLA."[8] King/Drew became King–Harbor to reflect the change.

All employees of the hospital were interviewed, with half permitted to stay and the rest transferred to other hospitals. Approximately 1,400 employees remained. As a result of these measures, Medicare agreed to continue funding the hospital until March 31, 2007. After further negotiations, federal inspectors agreed to delay inspection until August 2007. King/Harbor had to pass this inspection. Otherwise federal funding would end on November 30, 2007.[6] As a part of the March deal with the federal government, Los Angeles County agreed not to bill Medicare for hospital services until August 2007, giving it time to fix problems at the hospital.[9] If federal funding ended, among other problems, MLK–Harbor would permanently lose 250 medical resident slots, 15% of the 1,700 in Los Angeles County.[10]

On March 6, 2007, officials from Charles R. Drew University of Medicine and Science announced they were suing Los Angeles County for $125 million for breach of contract, claiming that the restructuring of the hospital terminated support to 248 medical residents and gutted the adjacent university.[11] The two entities had collaborated since 1972. In response, Los Angeles County Board Supervisor Mike Antonovich stated "Drew University will fail in court as they failed as a medical school."[11]

Problems surface again edit

Despite initially upbeat official reports from hospital officials,[12] King–Harbor found itself under public criticism once again after different stories ran in both the Los Angeles Times[13][14] and LA Weekly[15] in late May 2007 citing serious lapses in care, one of which was fatal, at the renamed hospital. In particular, the case of patient Edith Isabel Rodriguez, who bled to death on the emergency room floor after being ignored for 45 minutes, became a cause célèbre of the failures and bureaucratic indifference of King–Harbor as well as political and health leaders in Los Angeles, creating or reinforcing fears that the healthcare system could not take care of people in a time of dire need.[16] In response to public outcry, the chairman of the U.S. Senate Finance Committee, Senator Max Baucus (D-Mont.) asked federal regulators to address how they will protect patients at King–Harbor in light of "horrific" and "appalling" lapses in patient care.[17]

The news reports prompted a multi-day inspection by state and federal officials, and on June 7, 2007, federal health officials declared that King–Harbor had put emergency department patients in "immediate jeopardy" of harm or death, that it remained in violation of the Emergency Medical Treatment and Active Labor Act, and gave it 23 days to fix the problems or lose federal funding once and for all.[9] During the inspection, CMS found that 17 patients, among 60 whose cases were reviewed, received substandard care at the hospital.[18] If the problems were resolved in that timeline, the hospital still could have lost its federal certification because it had failed to meet the terms of a March agreement with the U.S. Centers for Medicare and Medicaid Services.[9] Despite multiple threats from the government, experts in hospital accreditation cite the federal government's relatively tempered response due to the hospital's unique history and special standing in the community, as well as its support from African American politicians.[6]

On June 12, 2007, the Los Angeles Times reported that King–Harbor had replaced its chief medical officer, Dr. Roger Peeks, who had been brought in to fix problems three years earlier.[19] During a June 18, 2007, meeting with the County Board of Supervisors, county health officials disclosed that they were still unable to meet the cornerstone pledges they had made to CMS: only about one-third of the 1,200 employees they initially projected would be shifted to other institutions had actually been reassigned, and significant control had not been effectively handed off to Harbor–UCLA.[8] In April, 60% of 285 registered and licensed vocational nurses failed one or more parts of basic clinical competency assessments; while more than 10% failed three or more sections of the assessment.[8] The staff of Harbor–UCLA was surprised by the amount of training King–Harbor employees needed.[8]

On June 21, 2007, the state California Department of Health Services moved to revoke the license of King–Harbor.[20] The process, supported by state politicians, including Gov. Schwarzenegger, could take six months to a year and would force the hospital's closure.[5] CDHS could rescind the action if the hospital was able to show that it met state and federal standards.[21] There remained serious concerns over how King–Harbor's 47,000 annual emergency department visits might be spread across the system with minimum disruption if the hospital were to close.[5]

In response to the state's decision, Los Angeles County supervisors considered having the county close the hospital ahead of the state,[22] hoping to thereby formulate and implement an orderly plan for diverting patients[22] and, by suspending King–Harbor instead of allowing it to lose its state license, making an easier task reopening it.[23] The County ultimately decided to not move for closure. The hospital received a brief reprieve when a June 25, 2007, inspection showed critical problems with its emergency department identified earlier in the month had been corrected, preserving federal certification and funding for the hospital until August 2007, when it must pass a broader federal review.[23]

The weeklong federal inspection began on July 23, 2007. The next day, inspectors from CMS once again cited King–Harbor for placing patients in "immediate jeopardy" of harm, hours after a psychiatric patient cut herself with a scalpel in an emergency department bathroom.[24]

Closure edit

On August 10, 2007, after the hospital failed a comprehensive review by the U.S. Centers for Medicare and Medicaid Services, federal officials decided to revoke $200 million in funding.[25] Inspectors concluded that there was no functioning quality improvement plan at the hospital.[26] Los Angeles County health director Dr. Bruce Chernof moved quickly to notify the county Board of Supervisors of his decision to begin shutting down the facility. The emergency department was closed by 7 p.m. that day, and ambulances were diverted to other area hospitals. The rest of the hospital was closed by August 27, 2007.[25] Some of King–Harbor's 1 600 employees would likely be reassigned to jobs at other county facilities.[25]

On August 13, at a specially convened board meeting, county supervisors voted unanimously to shut inpatient services and promised to pay up to $16.3 million to nearby private hospitals and doctors bracing for a deluge of patients from the closed facility.[26] They also released the 124-page report by federal inspectors that detailed dozens of errors and failures by the hospital during their final make-or-break review. The citations included improperly sterilized medical equipment, nurses who could not rapidly find medication, a nurse who did not know how to mix medication in an emergency, and a patient who complained of severe chest pain but was not given pain medication for four and a half hours.[26]

With the hospital closed, the facility continued to operate as the Martin Luther King Jr. Multi-Service Ambulatory Care Center, an urgent care facility and outpatient clinic.

Ramifications of closure edit

The closure of King–Harbor had an immediate effect on health care services in the region. Nine nearby hospitals were declared "impacted" by the distribution of former King–Harbor patients. The greatest burden fell on St. Francis Medical Center in nearby Lynwood, which expanded its emergency department by 14 beds and saw an increase in patients from 155 per day to 180 per day, with the intensive care unit seeing an average rise from 26 patients to 33. Nearby clinics were also impacted. The nine clinics that were part of the St. John's Well Child and Family Centers saw a 157 per cent increase in visits after King–Harbor closed. Meanwhile, the remaining outpatient clinic at King–Harbor saw patient totals fall well below the target of 190,000 visits a year, due to the poor reputation of the facility. As King–Harbor was long a major hospital for the city's sickest and poorest residents, the increase in uninsured and under-insured patients put major stress on the financial health of relieving institutions.[27] With the closure of the hospital, South Los Angeles had one hospital bed per 1,000 residents, compared with a national average of three beds per 1,000 residents.[2]

New replacement hospital edit

As soon as MLK–Harbor was closed, efforts were begun to find a way to reopen the facility as soon as possible. Los Angeles County officials originally planned a 2009 reopening, but that proved unfeasible.[2] The County found a partnership with the University of California system to reopen the hospital as a nonprofit organization governed by a seven-member board of directors; the hospital would no longer be run by the county. The board of directors would consist of two appointees chosen by the university system, two chosen by county officials, and three chosen jointly. The county was to contribute $50 million annually to cover expenses and operating costs and $13.3 million a year toward the care of uninsured patients. The county would continue to staff and operate the hospital's outpatient services center, which has remained open.[1] The hospital, now named Martin Luther King, Jr. Community Hospital opened on 7 July 2015.[2]

The new nonprofit entity handles all hiring for the Martin Luther King Jr. Community Hospital. This had been a major point of negotiation because the hospital staff had gained a reputation for being packed with people politically connected to various elected officials, leading to criticism that problems with hospital staff tended to be ignored. At the time of its closure it had about 11.5 workers per bed, compared with the statewide average of four workers per bed.[1]Civil service rules and labor contracts would have required former MLK–Harbor employees to be given first chance at a replacement hospital if it were directly owned and operated by Los Angeles County. Chartering the replacement hospital under a Section 501(c)(3) nonprofit organization made it a distinct entity from the county, unencumbered by legacy hiring rules.[2]

The hospital reopened as a smaller facility, with 131 beds instead of 233 (compared to 537 at its height). It has an emergency department and four operating rooms. The UC system provides fourteen to twenty physicians and medical oversight for the inpatient hospital, with a goal of eventually providing medical residents to again train there. Other improvements are an upgraded central plant, new emergency generators, and two new buildings, one with six out-patient surgeries and a dental clinic, with an estimated total cost of more than $350 million.[2]

Affiliated high school edit

King Drew Magnet High School of Medicine and Science,[28] is located adjacent to the hospital in Willowbrook. It is a Los Angeles Unified School District magnet school affiliated with the MLK Jr. hospital [29]

See also edit

Notes edit

  1. ^ a b c Jennifer Steinhauer, Deal Will Turn a Los Angeles Hospital Private, The New York Times, November 23, 2009, Accessed November 23, 2009.
  2. ^ a b c d e f Molly Hennessy-Fiske, UC regents approve partnership with L.A. County to reopen King medical facility, Los Angeles Times, November 20, 2009, Accessed November 23, 2009.
  3. ^ a b c Susannah Rosenblatt, Former King/Drew scales down to smallest size, Los Angeles Times, March 1, 2007.
  4. ^ Cosgrove, Jaclyn (March 28, 2024). "When Martin Luther King Jr. came to L.A., only one white politician was willing to greet him". Los Angeles Times. Research by Scott Wilson. Retrieved March 29, 2024.
  5. ^ a b c Charles Ornstein and Rich Connell, State moves to revoke King–Harbor's license, Los Angeles Times, June 22, 2007.
  6. ^ a b c Charles Ornstein, How King–Harbor has stayed alive, Los Angeles Times, June 12, 2007
  7. ^ "Los Angeles Times". The Pulitzer Prizes.
  8. ^ a b c d Rich Connell, Robert J. Lopez and Susannah Rosenblatt, King–Harbor efforts faltering, Los Angeles Times, June 19, 2007.
  9. ^ a b c Charles Ornstein and Robert J. Lopez, King–Harbor ordered to fix problems or else, Los Angeles Times, June 8, 2007.
  10. ^ Susannah Rosenblatt, Hospital could lose 250 resident positions, Los Angeles Times, March 1, 2007.
  11. ^ a b Susannah Rosenblatt, Medical school to sue L.A. County, Los Angeles Times, March 7, 2007.
  12. ^ Rich Connell and Susannah Rosenblatt, King status reports were upbeat, Los Angeles Times, June 9, 2007.
  13. ^ Charles Ornstein, , Los Angeles Times, May 20, 2007.
  14. ^ Charles Ornstein and Francisco Vara-Orta, , Los Angeles Times, June 13, 2007.
  15. ^ Celeste Fremon, Escaping With His Life 2007-06-25 at the Wayback Machine, LA Weekly, May 23, 2007.
  16. ^ Charles Ornstein (June 15, 2007). . Los Angeles Times. Archived from the original on June 29, 2009. Retrieved June 15, 2007.
  17. ^ Ornstein, Charles; Rosenblatt, Susannah (June 16, 2007). "6 King staffers disciplined with letters". Los Angeles Times. Retrieved June 16, 2007.
  18. ^ Charles Ornstein, Report details risks to patients' lives, Los Angeles Times, June 19, 2007.
  19. ^ Susannah Rosenblatt and Rich Connell, King–Harbor medical chief is ousted; nursing woes are disclosed[dead link], Los Angeles Times, June 12, 2007.
  20. ^ Kathleen Billingsley, Letter to Dr. Bruce Chernoff, Re: Martin Luther King/Harbor Hospital License (), California Department of Health Services, June 21, 2007.
  21. ^ State Department of Health Services Initiates Action to Revoke Martin Luther King–Harbor Hospital's License 2007-06-29 at the Wayback Machine, California Department of Health Services, June 21, 2007.
  22. ^ a b Charles Ornstein and Jack Leonard, Vote on closing King–Harbor anticipated, Los Angeles Times, June 23, 2007.
  23. ^ a b Jack Leonard, Burke silent as panel debates hospital's fate, Los Angeles Times, June 26, 2007.
  24. ^ Susannah Rosenblatt and Charles Ornstein, U.S. cites King–Harbor for poor care, Los Angeles Times, 26 July 2007.
  25. ^ a b c Charles Ornstein, Tracy Weber and Jack Leonard, , Los Angeles Times, August 11, 2007.
  26. ^ a b c Jack Leonard, King–Harbor inspection report released, Los Angeles Times, August 14, 2007.
  27. ^ Jennifer Steinhauser, A City Where Hospitals Are as Ill as the Patients, The New York Times, June 5, 2008, Accessed June 6, 2008.
  28. ^ LAUSD: King Drew Magnet High School of Medicine and Science website
  29. ^ LAUSD: King Drew Medical Magnet Course Offerings 2007-06-26 at the Wayback Machine.

References edit

  • Charles Ornstein et al., King/Drew Fallout Is Keenly Felt, Los Angeles Times, September 26, 2006, Accessed Sept. 26, 2006.
  • Tracy Weber and Deborah Schoch, Hospital Backers Concede Choices Tough, Los Angeles Times, September 24, 2006, Accessed Sept. 26, 2006.
  • Charles Ornstein and Tracy Weber, King/Drew Fails Final U.S. Test, Los Angeles Times, September 23, 2006, Accessed Sept. 26, 2006.
  • Kevin Roderick, Killer King on KCRW, LA Observed, August 17, 2005, Accessed Sept. 26, 2006.
  • Tracy Weber and Charles Ornstein, Another Fatal Failure at King/Drew, Los Angeles Times, April 12, 2005, Accessed Sept. 26, 2006.
  • Charles Ornstein and Tracy Weber, 3 King/Drew Deaths Blamed on Lapses, Los Angeles Times, April 6, 2005, Accessed Sept. 26, 2006.
  • Tracy Weber et al., The Troubles at King/Drew (5-part series), Los Angeles Times, December 2004, Accessed Sept. 26, 2006.
  • Jia-Rui Chong, Judge Denies Bid to Halt Trauma Unit's Closure, Los Angeles Times, December 3, 2004, Accessed Sept. 26, 2006.
  • Kevin Roderick, Blame for Killer King, LA Observed, December 9, 2004, Accessed Sept. 26, 2006.
  • Bill Boyarsky, USC, practical politics and King hospital, LA Observed, May 4, 2008, Accessed July 9, 2008.
  • Mitchell Landsberg and Jack Leonard, King/Drew's Trauma Unit Ordered Shut, Los Angeles Times, November 24, 2004, Accessed Sept. 26, 2006.
  • Jack Leonard, Closure of King/Drew Unit Likely, Los Angeles Times, November 22, 2004, Accessed Sept. 26, 2006.
  • Jia-Rui Chong et al., Waters at Center Stage in King/Drew Drama, Los Angeles Times, November 17, 2004, Accessed Sept. 26, 2006.
  • Mitchell Landsberg et al., Reaction to King/Drew Plan Loud and Clear, Los Angeles Times, November 16, 2004, Accessed Sept. 26, 2006.
  • Charles Ornstein et al., A Reeling King/Drew Receives Huge Blow, Los Angeles Times, September 16, 2004, Accessed Sept. 26, 2006.
  • Tracy Weber and Charles Ornstein, King/Drew to Shut Down Trauma Unit, Los Angeles Times, September 13, 2004, Accessed Sept. 26, 2006.
  • Charles Ornstein and Tracy Weber, Report Assails Hospital Lapses, Los Angeles Times, January 30, 2004, Accessed Sept. 26, 2006.
  • Garrett Therolf, More King–Harbor hospital workers have criminal backgrounds, Los Angeles Times, September 9, 2008.
  • Araceli Gonzalez Deputy Director, Community Liaison, Los Angeles Office of Governor Arnold Schwarzenegger.

External links edit

  • Official website
  • C-SPAN Q&A interview with Tracy Weber and Charles Ornstein about "The Troubles at King/Drew", July 17, 2005

33°55′26″N 118°14′30″W / 33.9238°N 118.2416°W / 33.9238; -118.2416

martin, luther, king, outpatient, center, replacement, hospital, martin, luther, king, community, hospital, adjacent, high, school, king, drew, magnet, high, school, medicine, science, this, article, needs, updated, please, help, update, this, article, reflect. For the replacement hospital see Martin Luther King Jr Community Hospital For adjacent high school see King Drew Magnet High School of Medicine and Science This article needs to be updated Please help update this article to reflect recent events or newly available information November 2015 The Martin Luther King Jr Outpatient Center formerly known as Martin Luther King Jr Multi Service Ambulatory Care Center Martin Luther King Jr Drew Medical Center King Drew and later Martin Luther King Jr Harbor Hospital MLK Harbor or King Harbor was a public urgent care center and outpatient clinic and former hospital in Willowbrook an unincorporated section of Los Angeles County California north of the city of Compton and south of the Watts neighborhood of Los Angeles Martin Luther King Jr Outpatient CenterLos Angeles County Department of Health ServicesGeographyLocationWillowbrook California United StatesOrganizationCare systemPublicFundingGovernment hospitalTypeCommunityHistoryOpened1972 52 years ago 1972 LinksWebsitedhs wbr lacounty wbr gov wbr wps wbr portal wbr dhs wbr mlkListsHospitals in CaliforniaFounded as a major public hospital it was shut down in August 2007 because of its poor record of patient care The urgent care center and outpatient clinic however remained operating on the site In 2014 a smaller hospital under a partnership between Los Angeles County and the University of California opened as a nonprofit organization governed by a seven member board of directors 1 2 MLK Outpatient Center was operated by the Los Angeles County Department of Health Services In the 2000s widely publicized problems related to incompetence and mismanagement caused the hospital to undergo a radical overhaul which reduced the number of beds from 233 to 42 before it finally closed 3 Since 2004 260 hospital staffers including 41 doctors had been fired or had resigned as a result of disciplinary proceedings To alleviate the impact on the community of this large loss of capacity the Los Angeles County Medical Alert Center contracts ambulances take approximately 250 patients per month to other local hospitals 3 At the beginning of the 21st century and before its crisis MLK MACC then MLK Drew had 537 beds was the teaching hospital of the adjacent Charles R Drew University of Medicine and Science spread over a 38 5 acre 156 000 m2 site which included a dormitory for medical residents employed 2 238 full time personnel and in 2004 treated 11 000 inpatients and 167 000 outpatients Located near high crime streets the hospital had a very active trauma unit In 2003 it handled 2 150 gunshot wounds and other life threatening injuries Because of the large number of gunshot wounds the trauma unit saw the US military sent their trauma teams to MLK Drew for training Contents 1 History 1 1 Founding and early history 1 2 The fall of King Drew 1 2 1 Troubles come to light 1 2 2 Closure of the trauma center 1 2 3 Make or break inspection 1 3 King Drew becomes King Harbor 1 3 1 Radical restructuring 1 3 2 Problems surface again 1 3 3 Closure 1 3 4 Ramifications of closure 2 New replacement hospital 3 Affiliated high school 4 See also 5 Notes 5 1 References 6 External linksHistory editFounding and early history edit The facility s founding was spurred by the 1965 Watts Riots In the aftermath of the unrest Governor Pat Brown appointed a commission to identify factors that contributed to the unrest This result was the December 1965 McCone Report One major finding of the report was the lack of healthcare access near the low income neighborhoods of South Central Los Angeles At the time the closest major public trauma center was Los Angeles County USC Medical Center located over 10 miles 16 km away a problem heightened by the amount of gang violence in the area In 1966 DHS established a task force to develop a full service community and teaching hospital operated by the County in conjunction with the USC and UCLA Medical Schools as well as the newly formed Charles R Drew Postgraduate Medical School a private nonprofit medical school formed to train doctors to work in areas of urban poverty Ground was broken on the hospital in April 1968 It was originally named the Los Angeles County Southeast General Hospital but was soon renamed Martin Luther King Jr General Hospital days after the namesake s assassination 4 After a dedication in February it opened on March 27 1972 as a full service medical center The facility changed its name again to Martin Luther King Jr Drew Medical Center when it became the teaching hospital of the adjacent Charles R Drew University of Medicine and Science In 1981 the hospital expanded into psychiatric care by opening the Augustus F Hawkins Mental Health Center In 1998 it expanded its trauma center By the 1980s King Drew was part of the Drew UCLA Undergraduate Medical Education Program training physicians through a partnership of UCLA and Drew medical schools and was a source of pride and jobs in the community The fall of King Drew edit King Drew entered the 21st century with an array of problems related to incompetence and mismanagement A perceived lack of quality at the hospital had earned it the nickname of Killer King 5 The facility employed travel nurses from across the country in an attempt to improve conditions Troubles come to light edit On August 22 2003 the Los Angeles Times reported that two women connected to cardiac monitors at King Drew died after their deteriorating vital signs went undetected In December 2003 DHS closed the cardiac monitoring ward at the hospital after a third patient died under questionable circumstances A consulting group was hired to help fix issues with the nursing staff DHS spent nearly 1 million on this effort In a January 13 2004 report the federal Centers for Medicare and Medicaid Services determined that King Drew was out of compliance with minimum requirements for receiving federal funding citing the work of government inspectors who identified three patients who died at King Drew after what were determined to have been grave errors by staff members By March CMS declared King Drew patients were in immediate jeopardy of harm or death because of medication errors at the hospital citing numerous mistakes and threatening to pull federal government funding from the public hospital In June 2004 CMS again stated that patients were in jeopardy citing the use of Taser stun guns to subdue psychiatric patients Yet again it threatened to pull federal funding but backed away federal funding made up over half of King Drew s 400 million operating budget Closure of the trauma center edit On September 13 2004 DHS recommended the closure of King Drew s busy trauma unit saying the hospital needed to put its full energy into fixing problems in other areas Soon after the Los Angeles Times revealed that the American College of Surgeons had revoked its approval of the quality of King Drew s trauma unit in 1999 and 2003 because it failed to properly investigate questionable patient deaths and that doctors routinely skipped meetings held to discuss treatment problems Also in September the Los Angeles County Board of Supervisors agreed with CMS to hire a new consulting firm to take over operations at the hospital By November 2004 neighborhood resistance to the proposed closures particularly the trauma center formed led by U S Representative Maxine Waters and joined by the Rev Jesse Jackson Los Angeles Mayor James K Hahn actress Angela Bassett and children of the Rev Dr Martin Luther King Jr In December 2004 CMS declared King Drew patients were in immediate jeopardy for a third time This time it cited the staff s heavy reliance on Los Angeles County Police personnel to deploy Tasers to subdue combative and violent psychiatric patients Federal funds were again threatened but as in previous times action was not taken Despite protests negative media and the near unanimous opposition of city political leaders the five member Board of Supervisors voted four to zero with one abstention to move forward with closure of the trauma center A temporary restraining order was filed by a group of doctors and residents but was denied The trauma unit was closed in early 2005 Patients were diverted to three other hospitals both public and private with county subsidy A few days later the Joint Commission on Accreditation of Healthcare Organizations now simply the Joint Commission citing the medical center for failing to correct severe lapses in patient care threatened to pull its seal of approval jeopardizing over 14 million in physician training funds King Drew s seal of approval was revoked in February 2005 6 This move gained national attention after the Los Angeles Times ran a Pulitzer Prize winning 7 five part series reporting on The Troubles at King Drew The series found that the problems at the hospital were far deeper than the public already knew and faulted the Board of Supervisors for shying away from making needed changes often because of racial politics Among the other findings was that King Drew spent more per patient than any of the three other general hospitals run by Los Angeles County the opposite of what many hospital supporters had assumed Problems for King Drew became even worse over a period of four days in March 2005 when three patients died as a result of mistakes and lapses in medical care The Board of Supervisors considered severing the hospital s relationship with Charles R Drew University of Medicine and Science and partnering with another medical school such as UCLA USC or Loma Linda University In April the Los Angeles Times reported a seventh death attributed to lapses in care by the hospital This time nurses and staff virtually ignored the audio and visual cues of vital sign monitors over a period of hours Make or break inspection edit After the three previous warning holding King Drew out of compliance with federal guidelines since January 2004 CMS and federal authorities held an unannounced last chance inspection of the hospital that began on July 31 2006 and was finished on August 10 On September 22 CMS informed King Drew that the hospital still did not meet minimum patient care standards failing nine of the government s 23 conditions for federal funding and thus failing the final make or break inspection Federal regulators identified problems in nursing pharmacy infection control surgical services rehabilitation services quality control patients rights and the hospital s governing body and physical plant Inspectors found more problems during the final inspection than they had at any time in the previous three years King Drew becomes King Harbor edit Radical restructuring edit DHS elected to move forward with a radical restructuring plan that eliminated the hospital s specialty services severed its relationship with the Drew medical school and proposed to place it under the management of Harbor UCLA Medical Center Harbor UCLA 3 The plan downsized and refocused the hospital on community medical care including emergency department and outpatient services the two central pillars of the plan were identifying and removing under performing staff and integrating the two hospitals under one medical management and administrative leadership team at Harbor UCLA 8 King Drew became King Harbor to reflect the change All employees of the hospital were interviewed with half permitted to stay and the rest transferred to other hospitals Approximately 1 400 employees remained As a result of these measures Medicare agreed to continue funding the hospital until March 31 2007 After further negotiations federal inspectors agreed to delay inspection until August 2007 King Harbor had to pass this inspection Otherwise federal funding would end on November 30 2007 6 As a part of the March deal with the federal government Los Angeles County agreed not to bill Medicare for hospital services until August 2007 giving it time to fix problems at the hospital 9 If federal funding ended among other problems MLK Harbor would permanently lose 250 medical resident slots 15 of the 1 700 in Los Angeles County 10 On March 6 2007 officials from Charles R Drew University of Medicine and Science announced they were suing Los Angeles County for 125 million for breach of contract claiming that the restructuring of the hospital terminated support to 248 medical residents and gutted the adjacent university 11 The two entities had collaborated since 1972 In response Los Angeles County Board Supervisor Mike Antonovich stated Drew University will fail in court as they failed as a medical school 11 Problems surface again edit Despite initially upbeat official reports from hospital officials 12 King Harbor found itself under public criticism once again after different stories ran in both the Los Angeles Times 13 14 and LA Weekly 15 in late May 2007 citing serious lapses in care one of which was fatal at the renamed hospital In particular the case of patient Edith Isabel Rodriguez who bled to death on the emergency room floor after being ignored for 45 minutes became a cause celebre of the failures and bureaucratic indifference of King Harbor as well as political and health leaders in Los Angeles creating or reinforcing fears that the healthcare system could not take care of people in a time of dire need 16 In response to public outcry the chairman of the U S Senate Finance Committee Senator Max Baucus D Mont asked federal regulators to address how they will protect patients at King Harbor in light of horrific and appalling lapses in patient care 17 The news reports prompted a multi day inspection by state and federal officials and on June 7 2007 federal health officials declared that King Harbor had put emergency department patients in immediate jeopardy of harm or death that it remained in violation of the Emergency Medical Treatment and Active Labor Act and gave it 23 days to fix the problems or lose federal funding once and for all 9 During the inspection CMS found that 17 patients among 60 whose cases were reviewed received substandard care at the hospital 18 If the problems were resolved in that timeline the hospital still could have lost its federal certification because it had failed to meet the terms of a March agreement with the U S Centers for Medicare and Medicaid Services 9 Despite multiple threats from the government experts in hospital accreditation cite the federal government s relatively tempered response due to the hospital s unique history and special standing in the community as well as its support from African American politicians 6 On June 12 2007 the Los Angeles Times reported that King Harbor had replaced its chief medical officer Dr Roger Peeks who had been brought in to fix problems three years earlier 19 During a June 18 2007 meeting with the County Board of Supervisors county health officials disclosed that they were still unable to meet the cornerstone pledges they had made to CMS only about one third of the 1 200 employees they initially projected would be shifted to other institutions had actually been reassigned and significant control had not been effectively handed off to Harbor UCLA 8 In April 60 of 285 registered and licensed vocational nurses failed one or more parts of basic clinical competency assessments while more than 10 failed three or more sections of the assessment 8 The staff of Harbor UCLA was surprised by the amount of training King Harbor employees needed 8 On June 21 2007 the state California Department of Health Services moved to revoke the license of King Harbor 20 The process supported by state politicians including Gov Schwarzenegger could take six months to a year and would force the hospital s closure 5 CDHS could rescind the action if the hospital was able to show that it met state and federal standards 21 There remained serious concerns over how King Harbor s 47 000 annual emergency department visits might be spread across the system with minimum disruption if the hospital were to close 5 In response to the state s decision Los Angeles County supervisors considered having the county close the hospital ahead of the state 22 hoping to thereby formulate and implement an orderly plan for diverting patients 22 and by suspending King Harbor instead of allowing it to lose its state license making an easier task reopening it 23 The County ultimately decided to not move for closure The hospital received a brief reprieve when a June 25 2007 inspection showed critical problems with its emergency department identified earlier in the month had been corrected preserving federal certification and funding for the hospital until August 2007 when it must pass a broader federal review 23 The weeklong federal inspection began on July 23 2007 The next day inspectors from CMS once again cited King Harbor for placing patients in immediate jeopardy of harm hours after a psychiatric patient cut herself with a scalpel in an emergency department bathroom 24 Closure edit On August 10 2007 after the hospital failed a comprehensive review by the U S Centers for Medicare and Medicaid Services federal officials decided to revoke 200 million in funding 25 Inspectors concluded that there was no functioning quality improvement plan at the hospital 26 Los Angeles County health director Dr Bruce Chernof moved quickly to notify the county Board of Supervisors of his decision to begin shutting down the facility The emergency department was closed by 7 p m that day and ambulances were diverted to other area hospitals The rest of the hospital was closed by August 27 2007 25 Some of King Harbor s 1 600 employees would likely be reassigned to jobs at other county facilities 25 On August 13 at a specially convened board meeting county supervisors voted unanimously to shut inpatient services and promised to pay up to 16 3 million to nearby private hospitals and doctors bracing for a deluge of patients from the closed facility 26 They also released the 124 page report by federal inspectors that detailed dozens of errors and failures by the hospital during their final make or break review The citations included improperly sterilized medical equipment nurses who could not rapidly find medication a nurse who did not know how to mix medication in an emergency and a patient who complained of severe chest pain but was not given pain medication for four and a half hours 26 With the hospital closed the facility continued to operate as the Martin Luther King Jr Multi Service Ambulatory Care Center an urgent care facility and outpatient clinic Ramifications of closure edit The closure of King Harbor had an immediate effect on health care services in the region Nine nearby hospitals were declared impacted by the distribution of former King Harbor patients The greatest burden fell on St Francis Medical Center in nearby Lynwood which expanded its emergency department by 14 beds and saw an increase in patients from 155 per day to 180 per day with the intensive care unit seeing an average rise from 26 patients to 33 Nearby clinics were also impacted The nine clinics that were part of the St John s Well Child and Family Centers saw a 157 per cent increase in visits after King Harbor closed Meanwhile the remaining outpatient clinic at King Harbor saw patient totals fall well below the target of 190 000 visits a year due to the poor reputation of the facility As King Harbor was long a major hospital for the city s sickest and poorest residents the increase in uninsured and under insured patients put major stress on the financial health of relieving institutions 27 With the closure of the hospital South Los Angeles had one hospital bed per 1 000 residents compared with a national average of three beds per 1 000 residents 2 New replacement hospital editMain article Martin Luther King Jr Community Hospital As soon as MLK Harbor was closed efforts were begun to find a way to reopen the facility as soon as possible Los Angeles County officials originally planned a 2009 reopening but that proved unfeasible 2 The County found a partnership with the University of California system to reopen the hospital as a nonprofit organization governed by a seven member board of directors the hospital would no longer be run by the county The board of directors would consist of two appointees chosen by the university system two chosen by county officials and three chosen jointly The county was to contribute 50 million annually to cover expenses and operating costs and 13 3 million a year toward the care of uninsured patients The county would continue to staff and operate the hospital s outpatient services center which has remained open 1 The hospital now named Martin Luther King Jr Community Hospital opened on 7 July 2015 2 The new nonprofit entity handles all hiring for the Martin Luther King Jr Community Hospital This had been a major point of negotiation because the hospital staff had gained a reputation for being packed with people politically connected to various elected officials leading to criticism that problems with hospital staff tended to be ignored At the time of its closure it had about 11 5 workers per bed compared with the statewide average of four workers per bed 1 Civil service rules and labor contracts would have required former MLK Harbor employees to be given first chance at a replacement hospital if it were directly owned and operated by Los Angeles County Chartering the replacement hospital under a Section 501 c 3 nonprofit organization made it a distinct entity from the county unencumbered by legacy hiring rules 2 The hospital reopened as a smaller facility with 131 beds instead of 233 compared to 537 at its height It has an emergency department and four operating rooms The UC system provides fourteen to twenty physicians and medical oversight for the inpatient hospital with a goal of eventually providing medical residents to again train there Other improvements are an upgraded central plant new emergency generators and two new buildings one with six out patient surgeries and a dental clinic with an estimated total cost of more than 350 million 2 Affiliated high school editKing Drew Magnet High School of Medicine and Science 28 is located adjacent to the hospital in Willowbrook It is a Los Angeles Unified School District magnet school affiliated with the MLK Jr hospital 29 See also edit nbsp Los Angeles portalMartin Luther King Jr Community Hospital opened on site in 2015 Charles R Drew University of Medicine and Science adjacent King Drew Magnet High School of Medicine and Science adjacent History of the African Americans in Los Angeles South Los Angeles related topicsNotes edit a b c Jennifer Steinhauer Deal Will Turn a Los Angeles Hospital Private The New York Times November 23 2009 Accessed November 23 2009 a b c d e f Molly Hennessy Fiske UC regents approve partnership with L A County to reopen King medical facility Los Angeles Times November 20 2009 Accessed November 23 2009 a b c Susannah Rosenblatt Former King Drew scales down to smallest size Los Angeles Times March 1 2007 Cosgrove Jaclyn March 28 2024 When Martin Luther King Jr came to L A only one white politician was willing to greet him Los Angeles Times Research by Scott Wilson Retrieved March 29 2024 a b c Charles Ornstein and Rich Connell State moves to revoke King Harbor s license Los Angeles Times June 22 2007 a b c Charles Ornstein How King Harbor has stayed alive Los Angeles Times June 12 2007 Los Angeles Times The Pulitzer Prizes a b c d Rich Connell Robert J Lopez and Susannah Rosenblatt King Harbor efforts faltering Los Angeles Times June 19 2007 a b c Charles Ornstein and Robert J Lopez King Harbor ordered to fix problems or else Los Angeles Times June 8 2007 Susannah Rosenblatt Hospital could lose 250 resident positions Los Angeles Times March 1 2007 a b Susannah Rosenblatt Medical school to sue L A County Los Angeles Times March 7 2007 Rich Connell and Susannah Rosenblatt King status reports were upbeat Los Angeles Times June 9 2007 Charles Ornstein Tale of last 90 minutes of woman s life Los Angeles Times May 20 2007 Charles Ornstein and Francisco Vara Orta Tragic Catch 911 for dying woman Los Angeles Times June 13 2007 Celeste Fremon Escaping With His Life Archived 2007 06 25 at the Wayback Machine LA Weekly May 23 2007 Charles Ornstein June 15 2007 How a hospital death became a cause celebre Los Angeles Times Archived from the original on June 29 2009 Retrieved June 15 2007 Ornstein Charles Rosenblatt Susannah June 16 2007 6 King staffers disciplined with letters Los Angeles Times Retrieved June 16 2007 Charles Ornstein Report details risks to patients lives Los Angeles Times June 19 2007 Susannah Rosenblatt and Rich Connell King Harbor medical chief is ousted nursing woes are disclosed dead link Los Angeles Times June 12 2007 Kathleen Billingsley Letter to Dr Bruce Chernoff Re Martin Luther King Harbor Hospital License Archive California Department of Health Services June 21 2007 State Department of Health Services Initiates Action to Revoke Martin Luther King Harbor Hospital s License Archived 2007 06 29 at the Wayback Machine California Department of Health Services June 21 2007 a b Charles Ornstein and Jack Leonard Vote on closing King Harbor anticipated Los Angeles Times June 23 2007 a b Jack Leonard Burke silent as panel debates hospital s fate Los Angeles Times June 26 2007 Susannah Rosenblatt and Charles Ornstein U S cites King Harbor for poor care Los Angeles Times 26 July 2007 a b c Charles Ornstein Tracy Weber and Jack Leonard King Harbor fails final check will close soon Los Angeles Times August 11 2007 a b c Jack Leonard King Harbor inspection report released Los Angeles Times August 14 2007 Jennifer Steinhauser A City Where Hospitals Are as Ill as the Patients The New York Times June 5 2008 Accessed June 6 2008 LAUSD King Drew Magnet High School of Medicine and Science website LAUSD King Drew Medical Magnet Course Offerings Archived 2007 06 26 at the Wayback Machine References edit Charles Ornstein et al King Drew Fallout Is Keenly Felt Los Angeles Times September 26 2006 Accessed Sept 26 2006 Tracy Weber and Deborah Schoch Hospital Backers Concede Choices Tough Los Angeles Times September 24 2006 Accessed Sept 26 2006 Charles Ornstein and Tracy Weber King Drew Fails Final U S Test Los Angeles Times September 23 2006 Accessed Sept 26 2006 Kevin Roderick Killer King on KCRW LA Observed August 17 2005 Accessed Sept 26 2006 Tracy Weber and Charles Ornstein Another Fatal Failure at King Drew Los Angeles Times April 12 2005 Accessed Sept 26 2006 Charles Ornstein and Tracy Weber 3 King Drew Deaths Blamed on Lapses Los Angeles Times April 6 2005 Accessed Sept 26 2006 Tracy Weber et al The Troubles at King Drew 5 part series Los Angeles Times December 2004 Accessed Sept 26 2006 Jia Rui Chong Judge Denies Bid to Halt Trauma Unit s Closure Los Angeles Times December 3 2004 Accessed Sept 26 2006 Kevin Roderick Blame for Killer King LA Observed December 9 2004 Accessed Sept 26 2006 Bill Boyarsky USC practical politics and King hospital LA Observed May 4 2008 Accessed July 9 2008 Mitchell Landsberg and Jack Leonard King Drew s Trauma Unit Ordered Shut Los Angeles Times November 24 2004 Accessed Sept 26 2006 Jack Leonard Closure of King Drew Unit Likely Los Angeles Times November 22 2004 Accessed Sept 26 2006 Jia Rui Chong et al Waters at Center Stage in King Drew Drama Los Angeles Times November 17 2004 Accessed Sept 26 2006 Mitchell Landsberg et al Reaction to King Drew Plan Loud and Clear Los Angeles Times November 16 2004 Accessed Sept 26 2006 Charles Ornstein et al A Reeling King Drew Receives Huge Blow Los Angeles Times September 16 2004 Accessed Sept 26 2006 Tracy Weber and Charles Ornstein King Drew to Shut Down Trauma Unit Los Angeles Times September 13 2004 Accessed Sept 26 2006 Charles Ornstein and Tracy Weber Report Assails Hospital Lapses Los Angeles Times January 30 2004 Accessed Sept 26 2006 Garrett Therolf More King Harbor hospital workers have criminal backgrounds Los Angeles Times September 9 2008 Araceli Gonzalez Deputy Director Community Liaison Los Angeles Office of Governor Arnold Schwarzenegger 1 External links editOfficial website C SPAN Q amp A interview with Tracy Weber and Charles Ornstein about The Troubles at King Drew July 17 200533 55 26 N 118 14 30 W 33 9238 N 118 2416 W 33 9238 118 2416 Retrieved from https en wikipedia org w index php title Martin Luther King Jr Outpatient Center amp oldid 1216112681, wikipedia, wiki, book, books, library,

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