THE WORST PUBLIC HOSPITAL IN L.A. IS OVER-FUNDED

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.

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.....

On Friday morning, Aug. 13, 2004, patients filed into King/Drew's orthopedic clinic seeking treatment for their broken bones and aching joints. Help was not to be had. The medical staff — doctors, doctor trainees and physician assistants — was inexplicably absent. It took three hours or more to find fill-in doctors, county auditors later found. That Friday the 13th was merely the beginning of a bad weekend for King/Drew. Later that day, officials were forced to close the emergency room to ambulances until Monday morning because nearly half the nurses on some shifts had either called in sick or failed to show up.

Every hospital must contend with the national nursing shortage — and King/Drew's shortfall, given the county's relatively low pay and its ongoing problems, may be worse than most. More than 35% of its nursing positions are vacant. But the hospital also is thrown into chaos when nurses, doctors and others on the payroll simply don't come to work......

Another cost, less easily tallied, results from employees who show up but don't do their jobs. A nursing supervisor found nurse Nopawan Mahasuwan "asleep in a lounge chair, mouth open, snoring and drooling," in February 2000, according to an internal hospital memo. Supervisor Liberty Pascual said she watched Mahasuwan sleep for at least three minutes before trying to wake her. Mahasuwan, however, said she was watching a monitor — not sleeping. And, she added, Pascual didn't simply nudge her, but delivered a smack that caused pain and swelling, according to the memo......

Dr. George Locke is a member of King/Drew's ruling class. When he pulls his 2002 Mercedes-Benz coupe into his reserved spot at the hospital, he routinely stands beside it until a female assistant arrives to carry some of his belongings inside. On his way out, someone is on hand to tote them back. When political leaders, such as Rep. Maxine Waters (D-Los Angeles), arrive at King/Drew, Locke often is there to greet them with a hug. As neurosciences chief, Locke made a total of more than $1 million over the last two fiscal years. That includes his hospital salary and a stipend he receives from King/Drew's affiliated medical school, records show. Top county officials can't say what Locke does for all the money he earns......

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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