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Ward 8 Councilmember Sandy Allen recently confessed to LL and the rest of the local press corps that she had trouble sleeping last week.

Had the council’s two-month summer recess wreaked havoc on her circadian clock? Or, perhaps, had she seen a sneak preview of Freddy vs. Jason?

As it turns out, her insomnia had a lot to do with her job. “I can go to sleep tonight because…the night before last I was not sure whether we were going to have a licensed hospital in Ward 8, the area of the city most needing a hospital,” Allen told reporters Aug. 13. “It is the only [hospital] east of the Anacostia river.” Moments before, Mayor Anthony A. Williams had announced a consent agreement between Greater Southeast Community Hospital and the city’s Department of Health, which monitors and licenses the city’s health-care facilities. The legalese keeps the hospital on Southern Avenue SE open another 60 days, at least.

“It is important that we keep the largest employer in Ward 8 open, and it is more important that we give quality health care,” Allen added that Wednesday morning.

Another near-death save. The hospital’s symptoms, however, had been observed by D.C. government for months. In early spring, the Department of Health’s regulatory arm knew that Greater Southeast wasn’t up to snuff. The recent consent agreement concentrates on five areas: increasing physician coverage in the ER, ensuring a reliable nursing staff, meeting fire-safety requirements, especially emergency generators, implementing a performance-improvement program, and bolstering the hospital’s medical executive committee.

The agreement buoyed the hospital’s prospects for exactly five days. Then, on Aug. 18, came an announcement from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which yanked Greater Southeast’s accreditation after site visits revealed problems with blood transfusions, infection control, and screening of workers and physicians. JCAHO’s vote of no confidence doesn’t shut the hospital down, but it hardly reassures the city’s ailing population.

In other words, Allen has had more than humidity to keep her tossing and turning at night.

Let’s review the chart: In less than a month, Greater Southeast has been admitted twice to the Wilson Building’s Intensive Care Unit, where it struggles for survival along with community policing and the summer feeding program. Yet D.C. politicos don’t seem interested in long-term solutions for keeping a hospital east of the Anacostia. Instead, they merely ape the behavior of patients in a dysfunctional health-care system, forgoing treatment until the next crisis.

And at that point, the costs are much higher.

The hospital’s current stretch of misery dates back to 1999, when it filed for Chapter 11 bankruptcy. After lending $8.5 million to keep Greater Southeast’s doors open, the city closed its checkbook. “The taxpayers should not be expected to foot the bill for a private hospital’s management run awry,” Williams told Ward 8 residents. In terms of spreadsheets, the mayor was right; in terms of politics, he was telling a quarter of the city to take a hike—to Georgetown, Howard University Hospital, or Washington Hospital Center.

Instead, Greater Southeast found an interested buyer: Doctors Community Healthcare Corp., an Arizona-based company that had been buying up urban hospitals, including Ward 8’s own Hadley Memorial Hospital. Some local officials hailed Doctors as Mother Teresa. A few officials, most notably At-Large Councilmember David A. Catania, expressed grave concerns about Doctors’ financial stability.

He turned out to be prescient: In November 2002, Doctors filed for bankruptcy after its prime money supplier, National Century Financial Corp., collapsed amid questionable financial dealings. Doctors and Greater Southeast remain in bankruptcy.

This time around, though, the mayor isn’t so cavalier about the Ward 8 institution. After four-and-a-half years, the finances are just as messy and the management just as haphazard but the hospital has raised its profile in one area: geography. With the closure of D.C. General Hospital, the public hospital that Williams and the financial control board shuttered in 2001, Greater Southeast has become the safety net for the city’s poorest and sickest. In place of D.C. General’s charity care, Williams created a privatized health-care network for the poor anchored by Greater Southeast.

Not too long ago, that was a role Greater Southeast embraced. In 1989, the American Hospital Association and the Baxter Foundation awarded the hospital the Foster G. McGaw prize for distinguished community service. Greater Southeast received $75,000 for its role as a national leader in addressing health care and economic development in a distressed urban community. “Greater Southeast is known around the country for effective management that makes resources go as far as they can possibly go,” said JCAHO president Dennis O’Leary at the time. “Any hospital that says times are tough and they’re in the wrong location needs to look at Greater Southeast.”

O’Leary, a former dean of the George Washington University Medical Center and former president of the District of Columbia Medical Society, had quite a different take on Greater Southeast this year. Back in March, JCAHO recommended revoking Greater Southeast’s accreditation over various operating deficiencies.

O’Leary appealed to the city’s leadership. “I would respectfully suggest that the District government also seriously consider appropriate constructive interventions that might help this hospital again achieve the community standard of performance maintained by other District hospitals,” O’Leary wrote to Mayor Williams. “That, in my view, would be an enormous service to the most vulnerable citizens in the District.”

Yet the drumbeat to save the lone hospital east of the river didn’t start then.

“The proactiveness of this administration in many instances has been lacking,” says Allen. Sure, the administration dispatched City Administrator John A. Koskinen in May to meet with JCAHO officials. But Koskinen’s good-government schtick didn’t move the health-care arbiters, who must base their decisions on what they see at a facility, not on what an optimistic bureaucrat tells them about the future.

The hospital still serves some of the city’s most vulnerable, however, because the Health Department, which ultimately decides which institutions can legally treat patients, has yet to close it down. At the moment, hospital and city officials, pursuant to the Aug. 12 consent decree, are rushing to upgrade the hospital’s quality of care and management. If they succeed, the Health Department will let the place stay in business, and maybe JCAHO will come back and find at least two doctors staffing the ER.

Once those organizations give Greater Southeast a clean bill of health, you can bet that D.C. politicos will move on to other issues. Soon enough, the hospital will fall apart again, and the whole drama will run on a loop.

Whenever they discuss the Greater Southeast disaster, politicians like Allen and Ward 7 Councilmember Kevin P. Chavous point to the need for a public hospital, like D.C. General. It’s hard to see how a new institution would solve the core problem, which is how to craft a quality indigent-care system that doesn’t drain the D.C. treasury.

So if Allen and Chavous were to get their way, the city would have two lousy hospitals in Southeast, not one.

POLITICAL POTPOURRI

On the evening of Aug.12, the city’s Department of Public Works faced a daunting challenge: a double-header against softball teams from the Correctional Treatment Facility and Randall Recreation Center. DPW’s team Triple Threat, or TTT—Trash, Tickets, and Towing—plays in the Department of Parks and Recreation adult league along with the H Street Warriors, from the Department of Human Services; Air Lorton, made up of former Lorton prison contractors; and teams from the D.C. Pretrial Services Agency and the Washington Post.

Triple Threat had its star-studded lineup in place that Tuesday, including agency director Leslie Hotaling batting in the No. 2 slot. “She plays a mean second base,” says Triple Threat coach and third-baseman Andre Lee, who daylights as a solid-waste inspector.

Ward 4 residents, though, concerned about escalating gang-related violence, wanted Hotaling to go to bat for their neighborhood that night: In a meeting attended by Metropolitan Police Chief Charles H. Ramsey and Mayor Williams, neighbors expressed concerns about DPW issues such as graffiti and abandoned cars. DPW spokesperson Mary Myers says the department had the meeting covered: Dennis Butler, chief of nuisance abatement, and Sybil Hammond, deputy solid waste administrator and a Ward 4 resident, both pinch-hit for Hotaling at the meeting.

City government officials say Hotaling has skipped out on or rescheduled other meetings during the softball season.

“Leslie was happy to play softball with DPW employees because she felt the meeting was well-covered,” responds Myers, who doesn’t play for Triple Threat, but often cheers her colleagues on. “We don’t take much time to do things for them. This is one way she shows her appreciation.”

Recently, Mayor Williams has taken notes from Post Ombudsman Michael Getler, critiquing the newspaper’s reporting and editorials as well as other pieces of local journalism.

Apparently, though, the mayor is less critical of his own publications. In the Aug. 15 edition of In the News, a newsletter produced by the mayor’s office, the mayor writes about National Night Out Against Crime and offers a few numbers to back up his thesis.

“The facts are simple,” writes the mayor. “Although our city’s homicide rate is up about 9 percent from this time last year, the homicide closure rate is 51 percent. At this time last year it was 48.9.” That’s a difference of 2.1 percentage points.

“This is a testament to the progress our Metropolitan Police Department is making,” writes Williams.

It also sounds statistically insignificant. CP

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DEAD AGAIN

Every time Greater Southeast

Community Hospital enters crisis mode, city officials deliver the same quality of care that the struggling hospital offers its own patients.

Crisis:

May 1999—Greater Southeast files for bankruptcy.

Response:

Cross fingers and pray that someone buys struggling hospital.

Happy Talk:

“If owners of Hadley purchase Greater Southeast, that would obviously be wonderful,” says Council Chair Linda W. Cropp.

Crisis:

November 2002—New owner Doctors Community Healthcare Corp. and Greater Southeast file for bankruptcy.

Response:

Holy shit! David Catania is right for once!

Happy Talk:

“We’re in a suboptimal world. The only optimal world is heaven, and none of us are there yet,” says Mayor Anthony A. Williams.

Crisis:

March 2003—JCAHO issues preliminary denial of Greater Southeast’s accreditation.

Response:

Focus on bringing the Montreal Expos to Washington.

Happy Talk:

“Their business isn’t to shut down hospitals; it’s to ensure quality of care,” says City Administrator John A. Koskinen.

Crisis:

July 2003—D.C. Department of Health threatens to revoke Greater Southeast’s license.

Response:

Assemble band-aid solutions to get to next crisis point.

Happy Talk:

“Our priority is and has always been quality health care for all citizens and residents of the city,” says Williams.