Why the Feds Killed King-Harbor Hospital

I’ll post more on this tomorrow when my very quick and dirty MLK-Harbor postmortem goes up on the LA Weekly website. But, in the meantime, for the morbidly curious, you can read the entire 124-page final survey report in which CMS (federal Centers of Medicare and Medicaid Services) listed MLK’s failures that led to the feds yanking their Medicare certification, and the $200 mil that went with it.

At first, county officials had no intention of handing over the CMS report. But when a lot of press and community members threw fits at this withholding behavior, County Supervisor Gloria Molina wisely urged the board to release the thing at Monday’s special Board of Sups meeting. So, Monday night the full report quietly appeared in PDF form on the Board’s website.

The CMS report describes in dizzying detail a staggering level of incompetence. For instance, inspectors found MLK nurses who were unable to “correctly calculate dosages for medication” to be given to pediatric patients, and worse, other nurses incapable of locating “critical equipment and medications on the pediatric emergency cart.”

CMS also outlined how MLK patients were “placed at serious risk for exposure to contagions, such as tuberculosis” because of such basic lapses in hospital hygiene as the staff’s failure to “clean and track” bronchoscopes.

One particularly alarming section describes a psychiatric patient who was “observed through the window of the room door, cutting both arms with a scalpel.” When first questioned, MLK staff members insisted that the arm-gouging patient brought the scalpel in with him in “a bag of Doritos chips.” (Unfortunately, I’m not kidding about this.) Yet when the fed team looked a bit further they noticed that the scalpel’s lot number matched that of other scalpels stored in MLK’s locked ER supply cabinet. In other words, the instrument came from the hospital—not a Doritos bag. And when the CMS people looked still further, they found that the psych patient had been observed alone next to a “gurney that had open drawers” —inside which there was a supply of “needles, ….tubes, and scalpels.”

Now remember, all this leaving of scalpels within reach of suicidal psych patients, and the inability to mix kids’ medicines, occurred during the feds’ make-or-break inspection–i.e., when hospital personnel were theoretically on their best behavior.

Not good.

We all truly hope that King-Harbor Hospital will eventually reopen, since the more than 45,000 emergency room patients that use its services each year, desperately need the facility back up and running—as does the County of Los Angeles, with its already overburdened emergency health system.

At Monday’s four-hour long, specially-convened County Board of Supervisors meeting, I talked privately to two of the heads of the hospital ERs that are expected to pick up MLK’s slack. They were somewhat freaked at the prospect.

And, as one county official said to me Tuesday, “Yeah, and what if LA had a real emergency medical crisis—like a terrorist attack. Then what would we do?”

What indeed?

Yet, if we are to have a prayer of MLK rising again Phoenix-like, we need to really understand what went wrong. And so far no county official in a position to know seems willing or able to tell us.