King/Drew Medical Center Could Lose CMS Funding Following Most Recent Inspection
Martin Luther King Jr./Drew Medical Center on Jan. 19 is scheduled to lose $200 million in CMS funding after failing the most recent inspection by federal regulators in December, according to an e-mail sent Wednesday to the Los Angeles County Board of Supervisors by a county health official, the Los Angeles Times reports. County health officials said King/Drew would have one final opportunity to prove before the January cutoff that it has addressed the issues (Ornstein, Los Angeles Times, 12/30/04).
CMS officials previously threatened to withhold federal funding over allegations that administrators continue to allow police to use Taser stun guns to subdue aggressive psychiatric patients.
CMS officials in June cited King/Drew for allowing police to use Tasers and gave the facility 23 days to develop new policies to reduce the use of Tasers or risk losing federal funding. Hospital officials agreed to limit the use of police officers and Taser stun guns and remained eligible for federal funding.
Following the June citation, hospital staff received training in how to better manage aggressive patients. Staff members were told to document all their actions prior to calling police.
State inspectors two years ago cited King/Drew for allowing county police to use Tasers without instituting formal guidelines for the stun guns' use. King/Drew officials prohibited the use of Tasers following that citation, but Los Angeles County officials in March 2003 reversed the ban on Tasers, saying that they could be a useful tool but police needed additional training (California Healthline, 12/20/04).
For the latest report, CMS inspectors conducted three drills in which doctors and hospital staff members were asked how they would respond to aggressive patients with mental disorders. According to the e-mail to the board of supervisors, staff members were not able to "clearly describe and demonstrate their roles in managing assaultive patients."
In addition, county police officers participating in the drills came armed with Taser guns. County health officials told CMS officials that officers would not be armed when they initially responded to calls, the Times reports.
Navigant Consulting, a management consulting firm tasked with proposing strategies to address the hospital's problems, is expected to deliver soon a report outlining the extent of problems at King/Drew.
CMS regional administrator Jeff Flick said agency officials have not made a final decision about the hospital's status.
Los Angeles County Department of Health Services Chief Operating Officer Fred Leaf said, "It is really unexplainable at this point to me how a professional staff ... can't follow what really is a fairly simple policy."
County Supervisor Mike Antonovich said he is aware of the problems and their ramifications, adding that he is confident Navigant will be able to provide solutions. Antonovich said, "We're moving forward and removing incompetent personnel and replacing them with health professionals who will provide quality care" (Los Angeles Times, 12/30/04).
King/Drew's problems can be repaired "but only if some difficult choices are made and only if public outrage forces public officials to remain focused on King/Drew's failings until they are remedied," a Times editorial states. "Keeping the medical center open in its present condition serves no one's purpose," the editorial continues.
"[T]he needed remedies are clear, if not politically easy," according to the editorial. The editorial states that such solutions include removing the county Board of Supervisors "from the day-to-day governance of the entire county health care system" and managing hospitals as a single system "with more coordination and less duplication."
According to the editorial, the "worst possible scenario would be to hand King/Drew off to an autonomous board." Another option would be for the University of California to assume control of the hospital or become a partner "in a drastically downsized training program," the editorial states. "[T]he best alternative may be for the medical center to abandon its role as a teaching hospital altogether" and "focus on the surrounding residents, who suffer disproportionately from such treatable illnesses as diabetes, asthma, hypertension and congestive heart failure," the editorial states (Los Angeles Times, 12/26/04).