- The Washington Times - Tuesday, December 24, 2002

An independent organization that evaluates hospitals says problems at Greater Southeast Community Hospital found 10 months ago remain uncorrected and declined to upgrade the hospital's accreditation status from conditional to full standards compliance.
"The accreditation decision means that the hospital still has requirements for improvements," said Charlene Hill, spokeswoman for the Joint Commission on Accreditation of Healthcare Organizations. "We initially do an assessment. If conditional status is given, a team goes in to makes sure they are in compliance."
She said the commission's team will do another follow-up.
Conditional accreditation is a decision made when "a health care organization fails to demonstrate compliance with the standards in multiple performance areas," according to commission officials. The commission also bestows accreditation with full standards compliance and accreditation with requirements for improvement for those compliant in most performance areas.
And though the commission gave Greater Southeast a "conditional" status, hospital sources say the commission would have declined to bestow any accreditation except for a "special set of circumstances" that is, the hospital's filing for bankruptcy protection late last month. Sources also added that commis sion investigators were not pleasedwith the conditions they found in the hospital.
The commission is one of two ways hospitals must be examined to qualify for federal reimbursements for Medicare and Medicaid, and reimbursements from many other, private insurers. Without full accreditation, a hospital's money flow would be jeopardized, possibly forcing it to close.
The commission initially reviewed the hospital in February. Then, investigators found flaws in 12 categories, gave the hospital conditional status and issued a private report.
In late November, after a six-week extension, commission investigators returned to the hospital for a follow-up.
Nothing had changed. Investigators found:
Emergency-room patients not being seen or moved to a bed in a timely manner because of backups in the intensive-care unit and the emergency room.
Updated information not being put into patients' charts in a timely manner for doctors to review them.
A lack of medical supplies. Earlier this year, emergency-room doctors complained publicly that the hospital is not spending money on medicine and equipment.
Patients restrained inappropriately and doctors not checking on them in a timely manner.
Other issues include the lack of a plan to address problems, no effective infection-control program and late or absent verification of physicians' credentials.
Investigators also found that the hospital's safety plan has not been updated and that preventative safety maintenance is not being performed.
Last week, the hospital had a 45-minute blackout and two generators did not switch on, sources say, because they had not been properly maintained.
"That should never have happened," a source close to the situation said. "But the hospital is not spending the money. That puts the patients at risk."
Doctors Community Healthcare Corp. of Scottsdale, Ariz., which owns Greater Southeast, filed for bankruptcy protection in November, two days after its financier, National Century Financial Enterprises.
Greater Southeast led the D.C. Healthcare Alliance and took over and partially closed D.C. General Hospital in a plan by D.C. Mayor Anthony A. Williams to provide health care to 28,000 residents who do not have health insurance through a network of hospitals, clinics and providers.
The problem is that Greater Southeast needs financing to improve operations, but has been slow to receive it because of the ratio of its debt burden to its income.
Temporarily, a bankruptcy court judge allows the hospital to use anticipated earnings every few weeks for operations costs. But the kind of money the hospital needs to make substantial improvements in operations has not materialized.
And if the hospital doesn't make the improvements, the commission may not be so understanding next time, sources say.
"I am surprised they gave them the conditional accreditation at all," said a veteran Greater Southeast physician.
Another Greater Southeast doctor said the hospital will try to blame the bankruptcy filing for the assessment even though the issues began long before November.
"Greater Southeast is in serious trouble," the doctor said.
"It does appear that money given from the city is not being put back into the hospital for supplies and support staff. I am sure the [bankruptcy] excuse will be accepted by city [leaders]. But the problems have existed since their takeover of Greater Southeast."
Greater Southeast and D.C. health officials were not available for comment yesterday.


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