- The Washington Times - Thursday, November 21, 2002

The future of indigent health care in Southeast became uncertain yesterday after the company that took over D.C. General Hospital in a plan heralded by Mayor Anthony A. Williams to revitalize medical services filed for bankruptcy.
Doctors Community HealthCare Corp., the Scottsdale, Ariz.-based hospital company filed for protection after its lender, National Century Financial Enterprises, of Dublin, Ohio, filed for bankruptcy Monday. Doctors own Greater Southeast Community Hospital and Hadley Memorial Hospital in the District and three others around the country.
"[This] enables the company to get relief from its creditors while it restructures its business and improves its financial stability," a spokesman for the hospital said. "Once in Chapter 11, the company will continue to operate its day-to-day business "
So far, Greater Southeast says it will be able to provide the same level of health care it has since it took over outpatient and trauma care from D.C. General Hospital in May 2001. Hospital Chief Executive Officer Karen Dale said the emergency room remains open even as some patients are being diverted to other hospitals.
But Greater Southeast shut its emergency room this weekend, diverting ambulances to Howard University Hospital and Washington Hospital Center because of a nursing shortage, causing fear of a looming financial crisis.
Washington Hospital Center officials yesterday said they will stop accepting elective patients from Greater Southeast by Dec. 1 because more than $4 million is owed in reimbursements and 1,200 patients' claims were denied on Monday.
And they said their emergency room, which has seen an 87 percent increase in patients since last year, is operating at capacity and could easily be overwhelmed by an influx of patients from Greater Southeast.
"The city needs a new system," said Dr. W.M. James, medical director for the hospital. "This one isn't adequate."
And yesterday the hospital served termination notices to dozens of Greater Southeast and D.C. General emergency room doctors, effective Nov. 30, according to their attorney, Bobby Henry. The action follows a bankruptcy filed by PhyAmerica, a contractor employing those doctors, which says it hasn't been paid by Greater Southeast for services.
Mr. Henry said about 90 percent of Greater Southeast's patients come through the emergency room.
Miss Dale said she has been trying to negotiate an extension, but the contractor for the doctors has decided to let the deal expire. If that happens, the hospital could find another contractor, hire the doctors themselves or extend the contract month-to-month.
"We intend to honor our commitment to our employees," she said, adding that the possibility of closing the emergency room is "remote," but that layoffs are possible.
There is no other emergency room east of the river. The closest emergency room is at Howard University Hospital, nine miles away in Northwest.
Even as the future of the emergency room at Greater Southeast is in question, its parent company has failed to live up to its contractual obligation to upgrade emergency services to Level 1, something it promised to do within a year of receiving the contract in spring 2001.
Mr. Williams said yesterday that he will take a closer look at the situation but doesn't believe the hospital will be shut down.
"I don't see that happening," he said. Still, he added, the "city may have to write a check to solve the problem" even as the District is facing a tight budget due to recession.
But D.C. Council Chairman Linda Cropp, at-large Democrat, has called on the mayor to withhold any future payments to the hospital until the city can ensure that the money won't be going "down a bankruptcy hole."
The council was nearly unanimous in trying to pre-empt the D.C. General takeover last year.
"I don't want this to be an 'I told you so,'" said Mrs. Cropp. "I want us to come together to see how we can keep this from falling apart."
The bankruptcy is a slap in the face to Mr. Williams, who was slammed by city leaders, activists, doctors and residents east of the river for his plan to close D.C. General Hospital in spring 2001 in what was one of the most expensive city contracts in D.C. history.
The 2-centuries-old hospital, which had been financially ailing for many years, was the only public hospital in the District. The plan put Greater Southeast at the center of a consortium of health providers called the D.C. Healthcare Alliance.
Opponents were concerned the deal would jeopardize health care and be financially unstable. The D.C. financial control board refused to release a study by a private auditing company that reportedly showed financial instability in the plan, leading to additional safeguards.
Still, if the city refuses to fund the hospital further, the facility will essentially have to shut down from a lack of cash.
There was a risk in going this route, the mayor said on WUSA-9 yesterday. But there was risk in anything the city did, and the risk was worth taking, he said.

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