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Hospital Needs More Money to Maintain Service

Aug. 25, 2005 – Gregory Calliste, chief executive officer of the Gov. Juan F. Luis Hospital and Medical Center, told the Senate Finance Committee the hospital would have to cut services with the budget being proposed by the Office of Management and Budget.
The OMB is recommending the general fund contribute $18.9 million to the St. Croix hospital. Calliste is asking for $20.7 million.
Calliste said fiscal viability was a top goal at the hospital. He added, "Short-term objectives include increasing revenue by 10 percent and decreasing costs by 10 percent, and a long-term fiscal objective is to break even within five years."
But he pointed out to senators that it would not be an easy job for the hospital, which is under collecting by about $3 million this year.
The 13 patients at the hospital who have been abandoned by their relatives play a big part in the under collecting. Calliste said these patients generally don't need acute care "but have no place to go, so we seem to be stuck with them."
The hospital is receiving Social Security payments for seven of them, but according to Calliste, "Those amounts are insignificant compared to the cost of having them in an acute care bed. For example, average Social Security payment per individual is about $250 per month versus the $1,400 per-day cost per acute care bed."
Sen. Norman Jn Baptiste, chairman of the Finance Committee, asked, "Is this a contributing factor to why people are kept in the emergency room?"
Calliste answered, "Yes, it contributes to the backlog." He said if those 13 beds were open, the hospital would have enough beds.
The hospital has 130 beds now. According to testimony, it was built in 1982 with the goal of having a 250-bed capacity.
Sen. Usie Richards said, "I am particularly concerned about the use of the funds you have."
He turned the discussion to loans that the hospital made to employees.
Calliste said loans are no longer given to employees. He said they were given to employees who were waiting through the long process of getting on the government payroll or waiting for raises to be implemented "with the understanding that the money would be paid back." Calliste said the hospital had lost $200,000 through these loans.
A lengthy discussion was entered into between the senators and hospital officials about the shortage of nurses in the Virgin Islands.
Jn Baptiste asked if enough was being done to steer students at the high school level into the nursing field and whether those who became nurses and left to the States were given incentives to come back.
Dr. Kendall Griffith, medical director, said the lower pay scale in the Virgin Islands, where nurses earn $10,000 to $15,000 a year less than those working stateside, was a disincentive. He added that it was generally seen as "easier" to work in the States. V.I. nurses had to be more "creative," he said.
However, Calliste did mention some hope. He said V.I. nurses were paid more than nurses in Puerto Rico, and the hospital was working to put in mechanisms so recruitment from there could be accomplished.
The hospital's general fund allotment has been decreasing since fiscal year 2003, when it reached its high of $20.9 million. The allotment was $18.7 million in 2004.
Calliste's list of proposed improvements included upgrading the emergency room for $500,000 and $150,000 for the ambulatory surgery pre-operative unit.
Jn Baptiste asked what services would be cut if the full budget request was not granted.
Calliste answered, "We would have to cut from all services. It would be done piece meal."
He added the hospital's accreditation from the Joint Commission on Accreditation on Healthcare Organizations might be jeopardized. He pointed out that the hospital's Clinical Laboratory had recently been re-accredited for another two years. (See "Hospital Laboratory Gets Re-accredited").

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