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Wednesday, September 27, 2006

What to Do with “Killer” King Hospital?

By Jennifer Solis
As a pre-med student, I shouldn’t repeat such aspersions about an institution in which I might someday consider for enrollment or residency, but as a taxpayer, I can’t help but feel that KDMC has long passed the point of no return as a viable medical facility.

Let’s put the recent federal evaluation in teaching terms: they not only got an advance copy of the test, but were given the answer key, and a multitude of coaches to make sure they copied it down right. A failure under these conditions would lead an academic to conclude that the student better take up manual labor as a career.

The millions of dollars paid to Navigant, one of only two companies that perform hospital management consulting, could not turn around three decades of a culture of incompetence. Despite getting rid of a large number of staff, from administrators to scrubs, the company was unable to help the hospital to pass 15 inspections in the past two years.The last inspection was the final exam – and King failed 9 of the 23 categories, including nursing, pharmacy, governing staff, as well as infection control, surgical services, rehabilitation, oversight – the list goes on.

An interesting statistic is that about 98-percent of South Central mothers go elsewhere than King to give birth – they vote with their feet. The hospital is averaging about $5-million in annual payouts for medical malpractice since 2000. More than half the current nursing staff is temporary, or “floaters.” Most hospitals keep this percentage to no more than 20-percent, in order to provide acceptable patient care.

Navigant told the county when it took over interim management, that it had dealt previously with all of the problems a hospital could have, with other of its medical operation clients. But this was the first time it had confronted almost all possible problems in one single hospital. This is not to imply that there are not many dedicated workers at KDMC.

Over the decades, many of the hardest working, most competent staffers have complained to their supervisors, administrators and even the county supervisors regarding problems. Their reward has been ostracism and punishment, but they stayed because they believe in the original mission of the institution. Politics and accusations of racism have insulated the hospital from meaningful reform. Even this week, with the frantic search for a solution, these roadblocks continue, as evidenced by Monday night’s community meeting held by Congresswoman McDonald.

Would Catholic HealthCare West, or any other private non-profit be willing to take over management of the hospital under present conditions? Not likely. Any new provider would have to demand two conditions: that its costs would be covered, and that it would have a free hand in personnel. Let’s examine these two requirements.

The county civil service structure guarantees even the most incompetent worker a job based on seniority, after joining the union. Any displaced King employee would have the right to be transferred to another county hospital at the same pay grade. Recruiting new personnel, with the current reputation of KDMC, will be a challenge. The new provider will probably have to offer higher-than-normal pay and benefits for decent replacements.

The new operation would have to be guaranteed that it could at least break even, without having to drain its other operations of funds to support a loss, due to the high number of uninsured patients in Los Angeles – probably the highest percentage in the nation. King has typically 42,000 to 50,000 annual emergency room patients – a third of which are not covered (a fifth of those are illegal immigrants), who use local emergency rooms for their primary care.

Because Los Angeles is a “sanctuary city,” it attracts thousands of new arrivals every month. Thousands of Mexican residents, who don’t even desire to move here, are encouraged by their government to come to Los Angeles for acute medical procedures. They consider the worst American hospital to be better than the best Mexican facility.

One in six California hospitals have already closed due to unreimbursed treatment, and more will follow. Every time there is an emergency room closure, it puts additional demand on nearby facilities, and the dominoes continue to fall.

If Harbor UCLA Hospital takes over the license and Medicare certification of KDMC, the threatened loss of $200-million in federal funds might be avoided. But one has to ask why the trustees of the successful university medical center would want to tackle these problems. Another option would be to reduce King Drew to a local clinic, offering only the most essential services for the community.

Meanwhile, Los Angeles County has a two month deadline to avoid closing KDMC by coming up with a solution which nobody will appreciate.


Anonymous Anonymous said:

Re-name it Benito Juarez Hospital and send the bills to the Mexican Government.

September 28, 2006 7:04 AM  

Anonymous Anonymous said:

Close it down already, and blame the white man!! how about that...

September 28, 2006 10:31 AM  

Anonymous Anonymous said:

Maxine Waters and her cohorts must be given a good amount of the blame for the continueing crisis at "KILLER KING".

September 28, 2006 1:31 PM  

Blogger Gaussia said:

10 emergency rooms have closed in LA county in the past 5 years.

I wonder what Cedillo, Nunez, Romero, de Leon, Villaraigosa et al think about that, or if they have even the most remote idea what could be done about it.

September 28, 2006 10:05 PM  

Anonymous Anonymous said:

I can hardly wait for the lawsuits to begin from relatives who have lost loved ones because the ER rooms are either closed down or taken over by illegals!!!!!!

There is only ONE reason for this crisis!!!! Everyone knows the 5M illegals in this city are highjacking hospitals, schools, welfare and our quality of life!

The assholes in power are Mexicans and don't give a shit about taxpaying Americans. Wake up CA and throw their butts out of our country before it's too late!

September 30, 2006 9:09 AM  

Anonymous Anonymous said:

Addendum to Ms. Solis -- TO -- Board of Supervisors in advance of 10/3/06 Discussion and Vote:
While it is disturbing that (a) UCLA/Harbor-General would be considered "manager" of MLK Hospital, given certain of its leadership's direct and indirect engagement with current and former DHS staff of antics against the King/Drew medical complex, and (b) the County spent more energy diverting staff and expertise (and patients) to other facilities rather than uplifting the skill and care sets within MLK, including the agreement in advance of the 2004 "bar" on which a deficiency schedule was based to reconstruct MLK's catchment area and solicit "...22 noncounty.." entities for the County's emergency/trauma needs, whatever efforts to ensure (a) the termination of over $200 million in medical reimbursement services is averted, (b) the return of the MLK facility to a full-service hospital as it was a few years ago with accountable leadership and fiscal, managerial controls (i.e., not "compressed" or clinic-type reduced facility), and (c) the long-term sustainability for providing Service Planning Area 6 and vicinity with quality health care accommodations are hereby encouraged and supported for today's discussion and vote.

October 03, 2006 6:13 AM  

Anonymous Anonymous said:

Why would you ever consider Killer King for enrollment or residency? That's a certain way to ruin your career.

Killer King has had problems since it opened in 1972. The County Board of Supervisors refuse to fire everybody and hire competent people in their place because they are afraid of charges of racism.

The latest tragedy: The death of Edith Rodriguez, an emergency room patient left to writhe in a pool of her own blood and vomit for 45 minutes while nurses and other members of the staff stood by and did nothing. It was all captured on hospital surveillance video.

Two people waiting in the emergency room even called 911 to ask for help.

Linda Ruttlen, the triage nurse on duty, is being investigated by the state licensing board. In today's LA Times (7/1/07) Congresswoman Maxine Waters defends Ruttlen saying that she thought Edith Rodriguez was "faking pain."

Was she faking the blood and vomit too?

Sadly, this hospital needs to close down. If anybody had any balls, they would insist that everybody who works at Killer King be fired and the hospital rebuilt from the bottom up. But nobody has any guts. Meanwhile more patients die.

July 01, 2007 8:05 PM  

Anonymous Anonymous said:

There is only ONE reason for this crisis!!!! Everyone knows the 5M illegals in this city are highjacking hospitals,

To the mental midget who posted the above comment: The problem with Killer King is INCOMPETENCE. It has nothing to do with illegal immigration, as Killer King has had problems dating back to 1975 when employees were caught stealing the hospital's pharmeceuticals.

And don't blame elected officls who happen to be Mexican-American. Killer King is a County Hospital, regulated by the 5 member LA County Board of Supervisors. Three of the Board Members are white, one is Mexican-American and one is black.

Every time they tried to hold the hospital responsible Maxine Waters started a protest and for some stupid reason, they always gave in to her.

But not anymore. After the death of Edith Rodriguez--caught on tape--the hospital will finally close and hopefully a new and improved one will open in its place.

African-Americans run that hospital. They are the hospital's doctors, nurses and administrators. Don't blame this mess on anybody else.

July 01, 2007 8:17 PM  

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