In 2014, a smaller hospital under a partnership between Los Angeles County and the University of California opened as a nonprofit organization governed by a seven-member board of directors.

At the beginning of the 21st century and before its crisis, MLK–MACC (then MLK/Drew) had 537 beds, was the teaching hospital of the adjacent Charles R. Drew University of Medicine and Science, spread over a 38.5-acre (156,000 m2) site, which included a dormitory for medical residents, employed 2,238 full-time personnel, and in 2004 treated 11,000 inpatients and 167,000 outpatients.

To alleviate the impact on the community of this large loss of capacity, the Los Angeles County Medical Alert Center contracted ambulances to take approximately 250 patients per month to other local hospitals.

[3] In the 2000s, widely publicized problems related to incompetence and mismanagement caused the hospital to undergo a radical overhaul, which reduced the number of beds from 233 to 42 before it finally closed in 2007.

One major finding of the report was the lack of healthcare access near the low-income neighborhoods of South Central Los Angeles.

The facility changed its name again, to Martin Luther King Jr./Drew Medical Center, when it became the teaching hospital of the adjacent Charles R. Drew University of Medicine and Science.

On August 22, 2003, the Los Angeles Times reported that two women connected to cardiac monitors at King/Drew died after their deteriorating vital signs went undetected.

On September 13, 2004, DHS recommended the closure of King/Drew's busy trauma unit, saying the hospital needed to put its full energy into fixing problems in other areas.

Soon after, the Los Angeles Times revealed that the American College of Surgeons had revoked its approval of the quality of King/Drew's trauma unit in 1999 and 2003 because it failed to properly investigate questionable patient deaths, and that doctors routinely skipped meetings held to discuss treatment problems.

Also in September, the Los Angeles County Board of Supervisors agreed with CMS to hire a new consulting firm to take over operations at the hospital.

By November 2004, neighborhood resistance to the proposed closures (particularly the trauma center) formed, led by U.S. Representative Maxine Waters and joined by the Rev.

Jesse Jackson, Los Angeles Mayor James K. Hahn, actress Angela Bassett, and children of the Rev.

This time it cited the staff's heavy reliance on Los Angeles County Police personnel to deploy Tasers to subdue combative and violent psychiatric patients.

Despite protests, negative media and the near-unanimous opposition of city political leaders, the five-member Board of Supervisors voted four to zero, with one abstention, to move forward with closure of the trauma center.

[7] This move gained national attention after the Los Angeles Times ran a Pulitzer Prize–winning[8] five-part series reporting on "The Troubles at King/Drew."

The series found that the problems at the hospital were far deeper than the public already knew and faulted the Board of Supervisors for shying away from making needed changes, often because of racial politics.

[10] If federal funding ended, among other problems, MLK–Harbor would permanently lose 250 medical resident slots, 15% of the 1,700 in Los Angeles County.

In particular, the case of patient Edith Isabel Rodriguez, who bled to death on the emergency room floor after being ignored for 45 minutes, became a cause célèbre of the failures and bureaucratic indifference of King–Harbor as well as political and health leaders in Los Angeles, creating or reinforcing fears that the healthcare system could not take care of people in a time of dire need.

[19] If the problems were resolved in that timeline, the hospital still could have lost its federal certification because it had failed to meet the terms of a March agreement with the U.S. Centers for Medicare and Medicaid Services.

[7] On June 12, 2007, the Los Angeles Times reported that King–Harbor had replaced its chief medical officer, Dr. Roger Peeks, who had been brought in to fix problems three years earlier.

[22] There remained serious concerns over how King–Harbor's 47,000 annual emergency department visits might be spread across the system with minimum disruption if the hospital were to close.

[25] On August 10, 2007, after the hospital failed a comprehensive review by the U.S. Centers for Medicare and Medicaid Services, federal officials decided to revoke $200 million in funding.

[26] On August 13, at a specially convened board meeting, county supervisors voted unanimously to shut inpatient services and promised to pay up to $16.3 million to nearby private hospitals and doctors bracing for a deluge of patients from the closed facility.

Meanwhile, the remaining outpatient clinic at King–Harbor saw patient totals fall well below the target of 190,000 visits a year, due to the poor reputation of the facility.

[1] Civil service rules and labor contracts would have required former MLK–Harbor employees to be given first chance at a replacement hospital if it were directly owned and operated by Los Angeles County.

Chartering the replacement hospital under a Section 501(c)(3) nonprofit organization made it a distinct entity from the county, unencumbered by legacy hiring rules.

Other improvements are an upgraded central plant, new emergency generators, and two new buildings, one with six out-patient surgeries and a dental clinic, with an estimated total cost of more than $350 million.