here ya go. jalby, hope your last exam went well. bet your happy! now you have to study for step 1. good luck!
King/ Drew Funds Are at Risk
U.S. officials warn they will cut off Medicare and Medi-Cal payments if the county hospital fails to correct lapses in dispensing medication.
By Tracy Weber and Charles Ornstein, Times Staff Writers
Federal health officials said Thursday that they would cut off funds to Martin Luther King Jr./ Drew Medical Center unless the hospital corrected serious flaws in the way it handled prescription drugs within two weeks.
"The findings, in our opinion, rose to the level of immediate jeopardy to the health and safety of patients," said Steven Chickering, a manager for the federal Centers for Medicare and Medicaid Services in San Francisco. "They have some serious issues to address, and this particular situation. They need to address them quickly."
The threat and its tight deadline were outlined in a letter Wednesday to King/Drew that was obtained by The Times. The letter marks an escalation in the U.S. government's attempts to force Los Angeles County, which owns the hospital, to fix the problems there. Other recent inspections that found deficiencies simply required hospital officials to submit a plan of correction.
Fewer than 10 hospitals in the four-state region that includes California receive "immediate jeopardy" termination notices each year, Chickering said.
The government inspection at the Willowbrook hospital was triggered by an error last month in which a meningitis patient was mistakenly given a potent anti-cancer drug for four days. The patient does not appear to have suffered long-term harm.
The letter Wednesday came with an inspection report detailing a chain of deficiencies in the way drugs are managed at the 233-bed hospital. But federal and county health officials declined to release the report to The Times, saying it was not public information until the hospital submitted a response.
A summary prepared by county health officials after the inspectors' visit March 3 indicates that King/Drew was cited for failing to administer medication accurately, delaying care and services for a patient, failing to investigate medication errors and lacking "general oversight" over pharmacy services.
The county has until March 23 to prove to inspectors that these problems have been corrected or it risks losing more than $200 million to cover Medicare and Medi-Cal patients. The funding accounts for more than half of the hospital's annual budget.
The county intends to submit its plan of correction by Monday, which would trigger a second visit by federal inspectors to ensure that the hospital had complied.
Chickering said most hospitals "understand the seriousness of the situation and what would happen if they would lose their Medicare certification, so they usually take the necessary steps to remove the immediate jeopardy."
King/Drew was cited this month by the California Board of Pharmacy for the cancer drug error.
County health officials say they have already tightened controls. For instance, they now require medication records to be reviewed daily by the treating physician and a pharmacist.
In addition, two nurses must now check orders for high-risk drugs, which they can research further on a computer database. A nursing supervisor also must review drug orders each shift.
"We want to get this fixed and have them come back in and say you did a good job," said Dr. Thomas Garthwaite, director of the county Department of Health Services.
The pharmacy is only one area in which federal inspectors have recently found serious flaws. In a Jan. 13 report, they found that King/Drew nurses had been ordered to lie about patients' conditions, failed to give crucial medications prescribed by doctors and left seriously ill patients unattended for hours. The report also said hospital officials failed to fix dangerous lapses after promising to do so.
Federal authorities have accepted the hospital's plan to correct those problems.
"The threat has always been there that the consequence of the hospital not getting its act together could be the loss of federal funding," said county Supervisor Zev Yaroslavsky. "Obviously, there's a lot of work being done to try to avoid that and to fix the problems."
County Supervisor Yvonne Brathwaite Burke, whose district includes the hospital, said she worried "constantly" that something new would go wrong at King/Drew.
Burke said she believed that managers had corrected the pharmacy problems. But she said she wasn't confident that top county health officials, who are temporarily running King/Drew's day-to-day operations, would be able to prevent future lapses.
"I'm not sure they're managing it OK," she said.
Burke said the hospital needed a full-time administrator to go department by department, meeting with staff to ferret out brewing problems.
Garthwaite said he hoped to announce an interim chief executive for King/Drew in the next few days. He added, however, that he would not be comfortable until "we sustain a period of time when we do not have bad events?. I won't relax until that happens."
That's too cute! Thanks for the support Mike! Although I wish that were the case...I'm not countin' on it. 
Where on where did the time go? Luckly I have already been accepted somewhere.
