The 90-day license restriction imposed on obstetric services at United Medical Center (UMC) nears its end, but the future of obstetric services at the District’s only full-service hospital East of the Anacostia River remains uncertain.
On Aug. 7, Department of Health Director LaQuandra Nesbitt ordered the suspension of UMC’s obstetric services for up to 90 days due to patient safety concerns, but very few questions about what has been done to improve the issues that led to the suspension have been answered.
“It appeared that very little discernable progress had been made in the nearly seven weeks since the suspension of services began,” said D.C. Council member Vincent Gray, who chairs the council’s Health Committee. “I expected to see a sense of urgency, and instead, I saw nothing that made me feel like things were moving in the right direction. Even more concerning, it was suggested that [obstetric] services may never return to UMC.”
Though admitting to never having restricted the license of any other hospital in her roughly two years at the health department, Nesbitt refused to testify to the specific issues that led to the suspension, saying doing so would violate the confidentiality of the patients involved.
In a letter written by Nesbitt, she cited specific cases of dangerous mistakes in patient care that led to the license restriction, including failing to follow procedures to prevent HIV transmission from an infected mother to a newborn.
It is not clear whether the hospital will ask for an extension to address the issues, but they say there are financial implications that may keep the department closed.
UMC representatives said they are still developing a plan of action to address the issues and do not want to rush to restore obstetric services at the cost of quality patient care.
“We’ve got to do this right,” said David Boucree, UMC executive vice president of planning and analysis. “Ensuring high quality medical care is an ongoing process.”
In the meantime, Howard University Hospital and several other District hospitals have transfer agreements with UMC to automatically transfer any obstetrics patients out of the hospital.
University of Maryland Prince George’s Hospital Center has also begun the process to take D.C. Medicaid and fill the gaps in the District’s obstetrics care.
Wayne Turnage, director of the D.C. Department of Health Care Finance, said the hospital’s structure does not support reopening of labor and delivery services and that there are financial implications to keeping the department closed.
“If there is any hope for a reopening of the [obstetric] services at UMC, there will have to be a commitment to funding the cost of such because the revenue won’t pay for it,” Turnage said, said citing low volume of babies delivered at the hospital and the high expenses of the services as financial barriers.
Earlier this month, nearly half of the Council filed a disapproval resolution on a proposed $4.2 million contract for Veritas of Washington LLC to continue its hospital management next year.
The consulting firm’s charge when hired in April 2016 was to stabilize the District’s only hospital and only full-service hospital on the city’s east end, which has long been troubled with financial and patient care quality issues.
Despite millions of dollars in investments from the city, the hospital continues to struggle, with little noticeable change.
The D.C. Nurses Association gave a no-confidence vote in the UMC leadership earlier this month. Days later, Vertias moved to replace current UMC CEO Luis Hernandez, the hospital’s third chief executive since the firm took over its operations.
Gray scheduled a Committee on Health public oversight roundtable on the Veritas contract extension for Oct. 30 at 11 a.m.
“There needs to be significant additional progress demonstrated at the roundtable to make me believe an extension is warranted,” he said. “Absent that, I will move to disapprove this contract on Nov. 7, 2017, and I will encourage my Council colleagues to support the disapproval.”