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The District’s D.C. Superior Court filing also stated that the city had provided more than $100 million for patient care since the fall of 2007. That’s when city officials, using $79 million, approved a public/private partnership with Specialty Hospital of Washington, a subsidiary of Specialty Hospitals of America.

Under the deal, the city used the money to back the sale of the hospital from Envision Hospital Corp. to Capitol Medical Center — a subsidiary of Specialty Hospital of Washington, court filings show.

While the city’s court filing notes “dramatically improved” quality of care at United Medical Center since 2007, including a pediatric unit, city officials said their investment now was “at risk” because of the worsening finances.

“Despite these investments, however, either through mismanagement or lack of good faith, [Specialty Hospitals of America] misrepresented UMC’s financial outlook until the end of 2009 and failed to disclose the existence of pertinent information. … Today, despite nearly 12 months of rosy projections and assurances from [Specialty Hospitals of America], UMC stands on the brink of financial insolvency,” the court filing stated.

D.C. officials later withdrew their move to take over the hospital by way of the courts, and instead recently said United Medical Center could be sold to the highest bidder next month at an auction, barring an agreement with Specialty Hospitals of America.

The company has sharply disputed the city’s accusations and has laid blame on D.C. government officials for not reimbursing the hospital for all of the services it has provided to patients.

In an e-mail to The Washington Times, Mr. Rappaport called the hospital’s financial troubles “very simple.”

“For the better part of two years, the District through its Medicaid program and its Alliance (city-funded health plan) program was paying 68 percent of actual costs for services provided to those patients,” he said. “This led to a shortfall of almost $10 million in revenue for those services.”

In addition, he said, the hospital should have been receiving at least $12 million for providing uncompensated care, instead of the $4.2 million to $4.8 million it received in 2008 and 2009, respectively.

“If the hospital had been compensated … the hospital would have had no financial problems,” Mr. Rappaport said.

As for the construction bills, Mr. Rappaport said estimates for renovation work at the hospital ended up costing nearly $5 million when estimates originally were around $2 million.

The added work also meant that some beds at the hospital were taken out of service and that major expansion of services was delayed nearly a year, according to Mr. Rappaport.

“The loss of beds was extreme disruptive,” he said, though adding that officials were still able to obtain approvals by the Joint Commission, the nation’s largest hospital-accreditation organization.

Herman Brown, executive director of the D.C. Nurses Association, whose membership includes United Medical Center nurses, said the organization is concerned about the hospital’s finances. Unsure of the future of the hospital ownership, he said he doesn’t think D.C. officials will allow it to close.

“They can’t let it fold,” Mr. Brown said. Whether the current owners stay or go, he added, the nursing staff “just would like some stability.”