This is about the private
do indigent care after the City closed D. C. General Hospital. For a
background story, read the 11-21-02 Washington Post story:
http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&node=&contentId=A18003-2002Nov20¬Found=true
Washington Post, February 27, 2003; Page B08
Greater Southeast Hospital's Accreditation at Risk
Continuing Problems Present a Threat to
District Officials' Plans for Delivering Health Services
By Avram Goldstein Washington Post Staff Writer Thursday,
Financial strains at Greater Southeast Community Hospital have led to
so many problems in care -- including blood transfusion errors and
inadequate screening of physician credentials -- that the hospital
faces the loss of its national accreditation within months.
That would present a serious threat to District plans to save health
services in
would send patients to hospitals elsewhere in the city that say they
could not handle them.
A recommendation to withdraw the hospital's accreditation is
scheduled
to go before the Joint Commission on Accreditation of Healthcare
Organizations in
action for months. Loss of accreditation can strangle a hospital
financially. Most private health plans refuse to pay unaccredited
hospitals, and public programs such as Medicare and Medicaid subject
them to heightened scrutiny and possible expulsion.
Greater Southeast Chief Executive Karen Dale, who got the news in a
letter from the commission, briefed city officials Tuesday and shared
the particulars yesterday with 1,100 hospital employees.
"People are very concerned," she said. "The worst-case scenario
isn't
here yet. We focus on the fight."
Dale said the hospital's problems are a result of years of
inattention. "I believe that there was not adequate focus and
investment in quality improvement," she said.
In its letter, the joint commission reported on a surprise inspection
two weeks ago. The letter said Greater Southeast had not made adequate
progress in the last year and that new problems had arisen.
Inspectors cited Greater Southeast for inadequate training,
leadership, planning, quality control, documentation, cleanliness and
building maintenance. Also cited were serious errors in giving blood
transfusions.
"We added several more checks and balances to ensure at every point
that we would catch an error," Dale said. "We have seen that process
work over the past few weeks where we caught things."
The commission "vehemently" objected to the stand-alone D.C. General
emergency room being run far from any hospital, Dale
said. Patients
who arrive there needing inpatient care are transferred to Greater
Southeast's emergency room -- where they might have to wait again for
admission.
"The emergency department can be mistaken [by the public] as being a
part of a hospital with the capability of providing, for example, a
functioning operating suite, including anesthesiology services, on
site," the inspectors wrote.
The hospital's parent company, Doctors Community HealthCare Corp. of
November, when its main lender, National Century Financial Enterprises
of
scandal.
Now city officials are trying to figure out how to save the only
hospital that serves the city's southeastern quadrant. District
hospital leaders contend the loss of Greater Southeast would deal a
devastating blow to inpatient and emergency care citywide. In
addition, confidence in the District's privatized indigent health care
system has been shaken because Greater Southeast is
the prime
contractor.
"I'm extremely distressed," said Daniel P. McLean, chief executive of
Williams (D) to convert the D.C. General emergency room, which is run
by Greater Southeast, into an urgent care center.
D.C. Health Department Director James A. Buford was unavailable for
comment.