Greater Southeast Community Hospital and the District of Columbia Department of Health neared approval of an agreement last week allowing the hospital to stay open temporarily while it addresses patient-care issues.
At deadline , the specifics of the consent order had not been released, but in an earlier interview, James Buford, director of the health department, said it would include addressing staffing and safety concerns in the emergency room and the hospital's infection control program, as well as improving record-keeping. Since late last year, Greater Southeast has been operating on a provisional license.
The expected agreement put an end to the latest crisis at the hospital, which has been fighting for its survival for much of the past year. Its parent company, Doctors Community Healthcare Corp., Scottsdale, Ariz., is in bankruptcy proceedings, and the hospital faces the possible revocation of its accreditation by the Joint Commission on Accreditation of Healthcare Organizations.
Its problems with the Washington health department stem from findings by health inspectors that at least six deaths there had been preventable and that the facility fell short of 17 required quality goals. As a result, the department threatened to pull Greater Southeast's operating license unless it allowed the health department to make necessary changes to the hospital's operations.
Even after agreeing to the order, the hospital can still lose its license if the department determines it has not taken meaningful steps toward improving conditions by Oct. 6.
John Ray, an attorney representing the hospital, said last week that though there were still major hurdles to be cleared, "everything went well ... tremendous progress has been made."
Though Greater Southeast, which has 303 beds, is still not out of the woods, news of the most recent development had other hospital officials in Washington collectively exhaling. Already struggling with an overstressed system, local officials said another hospital closure would precipitate a crisis.
Two years ago, the District of Columbia General Hospital closed, leaving the southeast section of Washington with Greater Southeast as its only acute-care hospital. The hospital is also a primary provider of healthcare services for the indigent.
"Everyone sees this as an incredibly anxiety-provoking situation," said James Caldas, president of Washington Hospital Center, an 869-bed facility about nine miles from Greater Southeast, adding that other facilities in Washington might not be able to fully absorb the additional patient load if the hospital were to close.
"In the fall, if we have a heavy flu season, if we have a SARS outbreak, or if we have a terrorist attack, we would be in serious trouble," said Dan McLean, chairman of the District of Columbia Hospital Association and chief executive officer of 300-bed George Washington University Hospital
In recent talks with local government officials, the association has recommended approaching the federal government for help. While Washington officials would support federal help, because of its own budget constraints, the district is limited in what it can do to prop up Greater Southeast, said Deputy Mayor John Koskinen. The association also has discussed building an additional facility, possibly as a replacement for Greater Southeast.
The hospital faces another major hurdle on Aug. 18, when the JCAHO is expected to announce its decision on whether it will pull the hospital's accreditation. The JCAHO found the hospital not to be in compliance with 11 of the 45 measures it uses for accreditation.
Revocation of accreditation carries less weight than having its operating license pulled, but such a move could still severely undermine Greater Southeast's ability to operate. Most private health plans likely would not continue to do business with the hospital and its ability to conduct Medicare and Medicaid business would be jeopardized.