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The Disaster at LA's King/Drew Medical Center By: Charles Ornstein and Tracy Weber and Steve Hymon
Los Angeles Times | Monday, December 13, 2004


For years it has been a heartfelt cry: "This hospital desperately needs more money!"

Whenever Martin Luther King Jr./Drew Medical Center is criticized, as it often is, the response from supporters is the same. They say Los Angeles County leaders never wanted King/Drew built in the first place — and have been trying to starve it ever since.

"You know damn well the county knows what we need," said "Sweet Alice" Harris, long revered for her charitable efforts in South Los Angeles' black and Latino neighborhoods. "My problem is: Why is it that they don't love the poor people and want to help them? We're the first to be cut and the last to be rewarded."

Amen to that, said Dr. Xylina Bean, who started at King/Drew in 1973, the year after it opened, and is now director of neonatology.

"We have a saying here which we all understand, 'The Lord giveth and the Lord taketh away,' and usually King hospital has always been on the taketh away list, OK?"

Spend any time at the county-run hospital near Watts and it's easy to reach the same conclusion: Patients linger unattended, walls are gouged with holes, mattresses are worn and stained, even ink cartridges are in short supply.

The numbers, however, tell a different story. Though widely believed, the notion that King/Drew is being shortchanged is false.

The medical center spent more per patient than 75% of the public and teaching hospitals in California, according to a 2002 state audit that looked at fiscal year 2000.

The difference is stark when King/Drew is measured against the three other general hospitals run by Los Angeles County.

It spent $492 more per patient daily than Olive View-UCLA Medical Center, $685 more than County-USC and $815 more than Harbor-UCLA in 2002-03, county figures show.

The hospital with the most comparable budget is Harbor-UCLA, a much bigger facility 10 miles away. Last year, Harbor-UCLA had nearly $372 million to work with, not much more than King/Drew's $342 million.

Harbor-UCLA, however, did far more with its money.

It treated 61% more people in its emergency room and admitted 91% more patients. And it performed certain complex procedures, such as open heart surgery and kidney transplants, that King/Drew did not — drawing in patients who were sicker and more expensive to care for.

King/Drew's problem is not the amount of money it gets but the way the money is squandered, according to audits, financial records, legal filings and dozens of interviews.

As at most hospitals, its greatest cost is employees. But King/Drew, with a staff of nearly 2,500, spends inordinate sums on people who do little or no work. The rest of the hospital — hardworking employees, patients and their families — often make do or do without.

Here are some examples:

•  In the last five years, King/Drew has spent nearly $34 million on employee injuries — 53% more than Harbor-UCLA and more than any of the University of California medical centers, some of which are double or triple King/Drew's size. Employees make claims for such things as damage to their "psyche," assaults by their colleagues and a variety of freak accidents, according to a Times review of workers' compensation claims.

•  Last year, King/Drew employees billed for 299,804 hours of overtime, costing the hospital nearly $9.9 million. That's 61% more than the sum spent by Harbor-UCLA, which has about 400 more workers. Fourteen King/Drew employees pulled in more than $50,000 each in overtime. At Harbor-UCLA, there was one.

•  Some employees habitually fail to show up, logging weeks, even months, of unexcused absences each year. And those who do come to work often don't do their jobs, causing one consultant in 2002 to remark that they had "retired in place." Others are distracted or impaired. County Civil Service Commission filings tell of staff members grabbing and clawing each other's necks; inspection reports tell of patients literally dying of neglect.

•  King/Drew pays its ranking doctors lavishly. Some draw twice what their counterparts make at other public hospitals — often for doing less. Eighteen King/Drew physicians earned more than $250,000 in the last fiscal year, including their academic stipends. Harbor-UCLA had nine.

If King/Drew and county health officials had controlled this excess spending, the hospital could have used the money in other areas, or even put it back into county coffers.

The mismanagement of the hospital is no secret.

The county Board of Supervisors and the Department of Health Services it oversees have received decades of warnings. Since 2000, there have been dozens of audits, scores of disciplinary reports and hundreds of workers' compensation claims.

Yet even as the county has faced enormous pressures over the years to trim its health budget, the board has largely spared King/Drew. The slightest suspicion that a cut might be coming mobilizes activists who treasure the black-run hospital.

So the waste continues. And so does the perception among King/Drew supporters that their hospital is being maliciously underfunded.

At a town hall meeting in the fall of 2003, a King/Drew doctor angrily jabbed his forefinger in the air as he accused the county health director, who is white, of punishing the hospital.

"I've been here 31 years and watched this hospital be yanked and pulled … shot and kicked," said Dr. Ernie Smith, an African American pediatric cardiologist who has since left King/Drew. "This is nothing more than racism and white supremacy."

Doctors, nurses and other staff members in the audience applauded, amid approving murmurs of "Mmm-hmm, all right."

Supervisor Yvonne Brathwaite Burke, who has represented the hospital's district for 12 years and is the sole African American board member, bristled at the charge.

"We have spent money and money and money, far beyond what we've spent anywhere else," she said. "Whenever anything goes wrong, they say, 'We don't have enough people. We don't have enough money.' "

Dr. Bean and many other King/Drew supporters don't buy that argument.

"There is a credibility gap here," Bean said. "I will tell you, I ain't got no excess nothing."

*

Employee Injury Claims

Vast sums at King/Drew go to workers injured in encounters with seemingly harmless objects.

Take, for instance, the chair.

Employees have been tumbling from their seats at King/Drew almost since it opened its doors. The hospital's oldest open workers' compensation claim involves Franza Zachary, now 71, who sprained her back falling from a chair in October 1975 — costing the hospital more than $300,000 so far.

The bills for two other chair-fallers have topped $350,000 each, county records show.

Between April 1994 and April 2004, employees filed 122 chair-fall claims at King/Drew, more than double the number at Harbor-UCLA. And King/Drew has spent $3.2 million -- and counting -- to pay for them.

"Sitting down. Eating lunch. [Chair] broke" was how licensed vocational nurse Elizabeth Rugley described her mishap in a 1999 claim. "Fell to floor. Hit the floor. Landed on my buttock."

In the last nine years, records show, Rugley, now 51, has had three other on-the-job accidents at King/Drew: a second chair misadventure in which she slipped and banged her head on a wall, a tumble, and a trip over an elevator entrance. As a result, according to her filings with the state, she has strained her neck, wrenched her back and injured her right shoulder.

To treat Rugley's last three injuries and pay her when she has been unable to work, King/Drew has spent $364,435.

In an interview, Rugley said her doctor told her that a person was prone to accidents after a back injury. "I'd rather be working and healthy and not hurting," she said.

Phyllis Butler-Young's chair gave way at King/Drew in 1999, according to her workers' compensation claim.

A year later, she said, she re-injured herself pushing and pulling gurneys in her job as a licensed vocational nurse. And in 2001, during training at a rehabilitation center, Butler-Young was "jolted" while trapped in an elevator, according to records she filed with the state.

All told, her claims have cost King/Drew more than $100,000.

Butler-Young, now 42, said chair falls were "common" at King/Drew.

"They're old," she said of the chairs. "They claim they didn't have any money, so they took chairs from County-USC … [that] had to be welded back together."

The cost of King/Drew's various injury claims runs higher than that of comparable hospitals.

Averaged over its entire staff, King/Drew spent $2,326 per employee on workers' compensation in each of the last six years, more than all but one of the 17 other California public or teaching hospitals for which The Times could obtain similar records. The average for all the surveyed hospitals was $1,342 per employee annually.

King/Drew was expected to pay more than $50,000 each on 385 active claims as of August, according to county records. Harbor-UCLA had 210 claims projected to cost that much.

"My eyebrows start raising at the $50,000 mark," said Vickie Wells, director of occupational safety for the public agency that runs San Francisco General Hospital Medical Center. "Every claim where we spent more than $50,000, there is something usually going on."

Los Angeles County regularly challenges workers' comp filings it considers questionable, but it must pay if administrative law judges rule in a worker's favor.

The high number and cost of claims at King/Drew may stem more from bad morale than clumsiness or unsafe conditions, workers' compensation specialists said.

"If you like your employer and you love what you're doing and you like the environment you're in, you're much less likely to say, 'I hurt my back or finger' or that 'I'm stressed out,' " said Priscilla Morse, who handles workers' comp claims for San Mateo County.

King/Drew's claims show that its employees often don't seem to like each other much — let alone their employer. Some of the filings cite assaults and psychological wounds.

One cashier filed a claim in 1999 saying she was overwhelmed by stress. The tipping point, she told her workers' comp psychiatrist, was when her supervisor grew angry at not being asked to be one of the cashier's bridesmaids. The cashier said her resulting anxiety triggered headaches, chest pain and chronic fatigue.

A judge agreed, and King/Drew so far has paid more than $216,000 on the claim.

Operating room nurse Santiago Blanco, injured six years ago, is still collecting from the hospital as well.

He reported being slugged in the back by a female colleague while tending to a semi-conscious patient having a leg operation. The punch, delivered about 20 minutes into the surgery, threw him four feet from the table, causing back and neck injuries, he said.

"I don't know what the patient's reaction was," Blanco, 47, said in an interview. "I was on the floor."

His injuries have cost King/Drew $316,500 so far, and are expected to ultimately cost it more than $500,000.

Blanco was off work for months. But he, at least, had a medical excuse.

To continue reading this article, click here


Charles Ornstein, Tracy Weber and Steve Hymon are LA Times Staff Writers.


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