Cash-Poor Hospital for Women Closes Doors
With a mere 86 beds but a loyal clientele, drawn from the capital's political elite and its indigent and powerless, the hospital shut down because of a lack of cash that its managers and outside experts attributed to inadequate and tardy insurance payments.

It's an example of the financial stresses hospitals face across America," said Carmela Coyle, senior vice president for policy at the American Hospital Association. Medicare, the insurance program for the elderly, and Medicaid, the insurance program for the poor, both reimburse hospitals less than the cost of care, Ms. Coyle said.

Columbia declared bankruptcy in 1998 and emerged from court protection a year later. In 2000 it received a $5 million federal grant to develop outreach programs, which included three clinics — the Betty Ford Comprehensive Breast Cancer Center, a center for sexually active and pregnant young adults, and a primary care center.

But the hospital's debt continued to grow, in part because the programs drew many poor patients. Columbia's costs, especially for malpractice insurance, which is particularly expensive for obstetricians, continued to grow.

Some health care officials here saw the private, specialized, nonprofit care that Columbia Hospital for Women offered as an obsolete approach.

"People are looking for more consolidated services now, one-stop shopping," Dr. Ivan Walks, the former chief health officer for Washington said in an interview.

Even so, the closure shocked some. Al Gore's spokeswoman, Kiki McLean, went into labor and checked in on Monday. By the time her son was born, the hospital had stopped admitting patients.

The baby, Joseph Woodfen McLean, was one of the last three discharged from Columbia Hospital for Women. Ms. McLean said she would treasure the certificate bearing his footprints not just as a mother's keepsake but as a historical document.
http://www.nytimes.com/2002/05/12/health/12COLU.html?todaysheadlines