Jan 28, 2009 – Uninsured patients may be the cause of a deficit in the financial statement of the Schneider Regional Medical Center, the members of the hospital's governing board learned Wednesday at their monthly meeting.
The hospital's financial statement for October and November showed total operating revenue at $9.9 million, with operating expenses for the period standing at just shy of $18 million. The net deficit for the period was $3.2 million.
Cornell Williams, chairman of the St. Thomas-St. John District Governing Board of the V.I. Hospitals and Health Facilities Corp., suggested an increasing number of uninsured patents was at the root of the problem, although he wasn't happy speculating.
To find the cause, the board is procuring a current state analysis. Once the contract is inked, the board will prioritize areas for study, emphasizing patient care and safety as well as financial criteria, Williams said.
To minimize spending, the board has established a cost-containment task force to review the necessity of filling open staff positions. The task force will also take a close look at productivity of existing staff and examine other areas for cost-savings.
One area under particular scrutiny is contracts. and the staff has already reviewed 30 to 40 of them, Harris said. The hospital is seeking to reduce contract terms to shorter periods, said board attorney Karl Purcel.
"We do not think it is in our benefit to have long-term contracts," Purcel said.
The meeting began after board members took an unannounced tour of Schneider, but the visit had to be cut short in time to convene the monthly meeting.
"It was something we had to do as new board," Williams said. "We probably should have done it sooner, but we will complete it before next meeting."
Staff were not informed that the board was touring the facility, according to interim chief executive officer Elizabeth Harris.
In other business, the board:
— Learned that the hospital is pursuing funding for capital improvements from the $819 billion stimulus packaged approved Wednesday evening by the US House and pending U.S. Senate approval. The hospital forwarded a list of about $9 million in projects to Government House for inclusion in the Virgin Islands projects proposed, according to Williams.
"We hope to get a good chunk of it," Williams said. "These are projects that are sorely needed."
Interim Hospital Chief Financial Officer Eugene E. Welsh and Harris will discuss the submissions with the Governor's office on Friday.
— Heard about progress in finding a new chief executive officer. After the last CEO was fired during a financial scandal, the search process for a new CEO has staff reviewing proposals from seven executive search firms. One of those firms will be brought in for face-to-face discussions. Once the contract is awarded, the process of finding a new CEO is expected to take about six to seven months.
— Was told that red tape from the Office of Management and Budget has prevented the hospital from hiring for some critical positions, which could lead to trouble with accreditations, Williams said.
Harris said the OMB hurdles are forcing the hospital to look at other ways to bring needed staff on board, including putting them under contract, which in turn increases the hospital's use of revolving funds.
— Had a brief but welcome interlude when visitors Charlotte and Henry Kimelman sat down with the board for a few minutes. The Kimelmans are the driving force behind the Charlotte Kimelman Cancer Institute. The Kimelmans were on-island visiting friends and family.
Former U.S. Ambassador Henry Kimelman said, "We want our grandchildren and our great-grandchildren to come here and say that their grandmother and great grandmother was responsible for this."
The Institute's revenues are down by about 50 percent, and this is attributable in part to a lower number of patients as well as fewer Intensity Modulated Radiation Therapy treatments administered, according to the Institutes administrator, Edward Arbisala, MD.
"It depends on how a physician practices," Aribasala said. "Some physicians that we have here are not using that technology."
The reimbursement from insurance companies for IMRT is higher than for other therapies, but if a physician is unfamiliar with the treatment an alternative therapy, with a lower reimbursement, might be employed, Aribasala said.
Aribasala also said "out migrations" of patients going off-island for treatment contributed to the Institutes financial troubles.
"It is unfortunate that people don't appreciate what we have [at CKCI]," Aribasala lamented. "We have a gem here."
— Discussed St. John's Myrah Keating Smith Community Health Center. The center is still in talks with the Veterans Administration to provide care to its constituents on that island, said Harold Wallace, administrator of the center said.
The center's telemedicine project is now in legal discussions with the Cleveland Clinic. Funding is coming from a private individual through the St. John Rotary, Wallace said.
In a course sponsored by the Community Foundation of the Virgin Islands, staff were trained on the new portable ultrasound Wednesday, Medical director Thelma R. Watson, MD reported.
Next month the board will have an officially presented report from the hospital's nursing staff. However, there was news from the nursing staff, who in January received Sexual Assault Nurse Examiner's Training, said Blondell Williams, vice president of Nursing and Patient Care services. The seven-day training teaches nurses how to conduct a sexual assault examination, as well as prepares them to testify in court about their findings in support of sexual assault victims. The program, which was funded by a grant from the Law Enforcement Planning Foundation, had both adult and pediatric components, Blondell Williams said.
"For women victims it will make the process a little more tolerable if the examiner is also female," Blondell Williams said
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