The Martin Luther King Jr. Outpatient Center, formerly known as Martin Luther King Jr. Multi-Service Ambulatory Care Center, Martin Luther King Jr./Drew Medical Center (King/Drew), and later Martin Luther King Jr.–Harbor Hospital (MLK–Harbor or King–Harbor), was a public urgent care center and outpatient clinic and former hospital in Willowbrook, an unincorporated section of Los Angeles County, California, north of the city of Compton and south of the Watts neighborhood of Los Angeles. It closed in 2007.
Founded as a major public hospital, it was shut down in August 2007 because of its poor record of patient care. The urgent care center and outpatient clinic, however, remained operating on the site. In 2014, a smaller hospital under a partnership between Los Angeles County and the University of California opened as a nonprofit organization governed by a seven-member board of directors.Jennifer Steinhauer, Deal Will Turn a Los Angeles Hospital Private, The New York Times, November 23, 2009, Accessed November 23, 2009.Molly Hennessy-Fiske, UC regents approve partnership with L.A. County to reopen King medical facility, Los Angeles Times, November 20, 2009, Accessed November 23, 2009.
MLK Outpatient Center was operated by the Los Angeles County Department of Health Services.
At the beginning of the 21st century and before its crisis, MLK–MACC (then MLK/Drew) had 537 beds, was the teaching hospital of the adjacent Charles R. Drew University of Medicine and Science, spread over a site, which included a dormitory for medical residents, employed 2,238 full-time personnel, and in 2004 treated 11,000 inpatients and 167,000 outpatients.
Located near high-crime streets, the hospital had a very active trauma unit. In 2003, it handled 2,150 gunshot wounds and other life-threatening injuries. Because of the large number of gunshot wounds the trauma unit saw, the United States Armed Forces sent their trauma teams to MLK/Drew for training.
After 2004, 260 of its staffers, including 41 doctors, had been fired or had resigned as a result of disciplinary proceedings. To alleviate the impact on the community of this large loss of capacity, the Los Angeles County Medical Alert Center contracted ambulances to take approximately 250 patients per month to other local hospitals.Susannah Rosenblatt, Former King/Drew scales down to smallest size, Los Angeles Times, March 1, 2007.
In the 2000s, widely publicized problems related to incompetence and mismanagement caused the hospital to undergo a radical overhaul, which reduced the number of beds from 233 to 42 before it finally closed in 2007.Susannah Rosenblatt, Former King/Drew scales down to smallest size, Los Angeles Times, March 1, 2007. It was replaced by the Martin Luther King Jr. Community Hospital.
History
Founding and early history The facility's founding was spurred by the 1965 Watts Riots. In the aftermath of the unrest, Governor Pat Brown appointed a commission to identify factors that contributed to the unrest. This result was the December 1965 McCone Report. One major finding of the report was the lack of healthcare access near the low-income neighborhoods of South Central Los Angeles. At the time, the closest major public trauma center was Los Angeles County-USC Medical Center, located over 10 miles (16 km) away—a problem heightened by the amount of gang violence in the area.
In 1966, DHS established a task force to develop a full-service community and teaching hospital operated by the County in conjunction with the USC and UCLA Medical Schools as well as the newly formed Charles R. Drew Postgraduate Medical School, a private nonprofit medical school formed to train doctors to work in areas of urban poverty.
Ground was broken on the hospital in April 1968. It was originally named the Los Angeles County Southeast General Hospital but was soon renamed Martin Luther King Jr. General Hospital, days after the namesake's assassination. After a dedication in February, it opened on March 27, 1972, as a full-service medical center. The facility changed its name again, to Martin Luther King Jr./Drew Medical Center, when it became the teaching hospital of the adjacent Charles R. Drew University of Medicine and Science.
In 1981, the hospital expanded into psychiatric care by opening the Augustus F. Hawkins Mental Health Center. In 1998, it expanded its trauma center. By the 1980s, King/Drew was part of the Drew/UCLA Undergraduate Medical Education Program, training physicians through a partnership of UCLA and Drew medical schools, and was a source of pride and jobs in the community.
The fall of King/Drew King/Drew entered the 21st century with an array of problems related to incompetence and mismanagement. A perceived lack of quality at the hospital had earned it the nickname of "Killer King."Charles Ornstein and Rich Connell, , Los Angeles Times, June 22, 2007. The facility employed travel nurses from across the country in an attempt to improve conditions.
Troubles come to light On August 22, 2003, the Los Angeles Times reported that two women connected to cardiac monitors at King/Drew died after their deteriorating vital signs went undetected. In December 2003, DHS closed the cardiac monitoring ward at the hospital after a third patient died under questionable circumstances. A consulting group was hired to help fix issues with the nursing staff; DHS spent nearly $1 million on this effort.
In a January 13, 2004, report, the federal Centers for Medicare and Medicaid Services determined that King/Drew was out of compliance with minimum requirements for receiving federal funding, citing the work of government inspectors who identified three patients who died at King/Drew after what were determined to have been grave errors by staff members. By March, CMS declared King/Drew patients were in "immediate jeopardy" of harm or death because of medication errors at the hospital, citing numerous mistakes and threatening to pull federal government funding from the public hospital.
In June, 2004 CMS again stated that patients were in jeopardy, citing the use of Taser stun guns to subdue psychiatric patients. Yet again, it threatened to pull federal funding but backed away; federal funding made up over half of King/Drew's $400 million operating budget.
Closure of the trauma center On September 13, 2004, DHS recommended the closure of King/Drew's busy trauma unit, saying the hospital needed to put its full energy into fixing problems in other areas. Soon after, the Los Angeles Times revealed that the American College of Surgeons had revoked its approval of the quality of King/Drew's trauma unit in 1999 and 2003 because it failed to properly investigate questionable patient deaths, and that doctors routinely skipped meetings held to discuss treatment problems. Also in September, the Los Angeles County Board of Supervisors agreed with CMS to hire a new consulting firm to take over operations at the hospital.
By November 2004, neighborhood resistance to the proposed closures (particularly the trauma center) formed, led by U.S. Representative Maxine Waters and joined by the Rev. Jesse Jackson, Los Angeles Mayor James K. Hahn, actress Angela Bassett, and children of the Rev. Dr. Martin Luther King, Jr. In December 2004, CMS declared King/Drew patients were in "immediate jeopardy" for a third time. This time it cited the staff's heavy reliance on Los Angeles County Police personnel to deploy Tasers to subdue combative and violent psychiatric patients. Federal funds were again threatened, but as in previous times, action was not taken.
Despite protests, negative media and the near-unanimous opposition of city political leaders, the five-member Board of Supervisors voted four to zero, with one abstention, to move forward with closure of the trauma center. A temporary restraining order was filed by a group of doctors and residents, but was denied. The trauma unit was closed in early 2005. Patients were diverted to three other hospitals, both public and private (with county subsidy).
A few days later, the Joint Commission on Accreditation of Healthcare Organizations (now simply the Joint Commission), citing the medical center for failing to correct severe lapses in patient care, threatened to pull its seal of approval, jeopardizing over $14 million in physician training funds. King/Drew's seal of approval was revoked in February 2005.Charles Ornstein, , Los Angeles Times, June 12, 2007
This move gained national attention after the Los Angeles Times ran a Pulitzer Prize–winning five-part series reporting on "The Troubles at King/Drew." The series found that the problems at the hospital were far deeper than the public already knew and faulted the Board of Supervisors for shying away from making needed changes, often because of racial politics. Among the other findings was that King/Drew spent more per patient than any of the three other general hospitals run by Los Angeles County, the opposite of what many hospital supporters had assumed.
Problems for King/Drew became even worse over a period of four days in March 2005, when three patients died as a result of mistakes and lapses in medical care. The Board of Supervisors considered severing the hospital's relationship with Charles R. Drew University of Medicine and Science and partnering with another medical school such as UCLA, USC, or Loma Linda University.
In April, the Los Angeles Times reported a seventh death attributed to lapses in care by the hospital. This time, nurses and staff virtually ignored the audio and visual cues of vital-sign monitors over a period of hours.
"Make-or-break" inspection After the three previous warnings holding King/Drew out of compliance with federal guidelines since January 2004, CMS and federal authorities held an unannounced last-chance inspection of the hospital that began on July 31, 2006, and was finished on August 10. On September 22, CMS informed King/Drew that the hospital still did not meet minimum patient-care standards, failing nine of the government's 23 conditions for federal funding, and thus failing the final "make-or-break" inspection. Federal regulators identified problems in nursing, pharmacy, infection control, surgical services, rehabilitation services, quality control, patients' rights, and the hospital's governing body and physical plant. Inspectors found more problems during the final inspection than they had at any time in the previous three years.
King/Drew becomes King–Harbor Radical restructuring DHS elected to move forward with a radical restructuring plan that eliminated the hospital's specialty services, severed its relationship with the Drew medical school, and proposed to place it under the management of Harbor–UCLA Medical Center (Harbor–UCLA). The plan downsized and refocused the hospital on community medical care, including emergency department and outpatient services; the two central pillars of the plan were identifying and removing under-performing staff and integrating the two hospitals "under one medical management and administrative leadership team at Harbor–UCLA."Rich Connell, Robert J. Lopez and Susannah Rosenblatt, King–Harbor efforts faltering, Los Angeles Times, June 19, 2007. King/Drew became King–Harbor to reflect the change.