Consulting Company Requests Additional Funds To Address Problems at King/Drew Medical Center
Navigant Consulting, the company hired to address patient care problems at Martin Luther King Jr./Drew Medical Center, has requested a 25% increase in funds to hire a temporary management team for the hospital, the Los Angeles Times reports (Ornstein/Weber, Los Angeles Times, 3/21). Los Angeles County in November 2004 awarded Navigant a one-year contract to develop proposals to address problems at King/Drew, and the company in February issued a report that included about 1,000 recommendations to improve patient care at the facility (California Healthline, 2/1).
The Joint Commission on Accreditation of Healthcare Organizations in February revoked accreditation for King/Drew and denied a second appeal by the Los Angeles County Board of Supervisors to reverse the decision. Loss of JCAHO accreditation for hospitals affects contracts with private health insurers, eligibility to participate in federal health care programs and physician-training programs. In addition, the Accreditation Council for Graduate Medical Education in most cases requires teaching hospitals to have JCAHO accreditation. The King/Drew trauma center also cannot reopen without JCAHO accreditation (California Healthline, 2/2).
In addition, CMS officials had threatened to withhold federal Medicare and Medicaid funds from King/Drew because of allegations that hospital administrators allowed police to use Taser stun guns to subdue certain psychiatric patients. That funding was restored after King/Drew staff in February passed a surprise inspection (California Healthline, 2/16).
Navigant, which will receive $13.2 million under the current contract with the county, has requested an additional $3.4 million. The additional funds would provide $36,000 a month for each of five nurse managers and $52,200 monthly for a physician manager at King/Drew. Last month, the county Department of Health Services denied a request from Navigant for $5 million in additional funds and asked the company to request a lower amount.
According to the Times, the county currently pays $52,200 monthly for each temporary CEO, chief operating officer and chief nursing officer at King/Drew and $45,000 monthly for each department adviser.
Navigant Director Kae Robertson said that, although the request for additional funds was expected when the company signed the contract with the county, the problems at King/Drew were more serious than expected. Robertson said, "Even though we had done our homework, and we knew that things were very broken here, what we found was that even simple, basic operational systems were broken."
County DHS Director Thomas Garthwaite said that the request from Navigant for additional funds is a not a "long-term solution." He added, "What it does is gets you quick leadership, quick assessment, quick knowledge. I feel like they're doing the hard work, and they're making progress."
According to the Times, the county Board of Supervisors asked Navigant officials during contract negotiations whether the company would request additional funds at a later date, and "Navigant officials assured them at a public meeting that the bid was based on a thorough assessment."
Supervisor Gloria Molina said, "We agreed to hire them at a set price. Now, I can't say they're nickel-and-diming us because it's multimillions of dollars. ... That bothers me."
Kathy Ochoa -- health policy analyst for Service Employees International Union Local 660, which represents King/Drew employees -- said that Navigant has made some progress at the hospital, but she added, "Where is the incentive for them to quickly, expeditiously, efficiently implement their recommendations? I really think it's time to start seeing some results from the ideas that have been proposed."
However, Supervisor Yvonne Brathwaite Burke said, "I think it's still a little early to measure total performance. I was skeptical as to whether you could really do that in nine months or a year." Supervisor Michael Antonovich added, "Racing at a snail's pace will not achieve the immediate action required to get the hospital on its feet in providing safe, needed medical care."
Navigant officials said that the company remains on schedule to address problems at King/Drew. The county DHS in the next few months plans to send inspectors to evaluate the progress Navigant has made (Los Angeles Times, 3/21).