Two rival groups have submitted plans to take over operation of the hemodialysis unit at the Gov. Juan F. Luis Memorial Hospital, and after Wednesday’s board meeting other interested groups may join them.
Hemodialysis services – treating patients whose kidneys can no longer screen blood by taking the blood, filtering it and putting it back in – have been a major topic of concern since 2010. In that year CMS, the agency that certifies hospitals to participate in Medicare and Medicaid, found the unit violated 25 standards and ordered a host of steps be taken.
Since then a total revamping of the system has taken place. The unit now not only qualifies for CMS certification and it has a received a “five-diamond” rating, the highest quality rating awarded by the national organization that oversees the centers.
But all that quality doesn’t come cheap, and hemodialysis is costing the hospital more than $1.6 million a year.
One of Wednesday’s proposals first came to light during a series of talks about the hospital’s precarious financial situation.
The board learned Wednesday the hospital had turned a profit for the third month in a row – the first time anyone on the board could remember it doing that – but in the next breath they learned the profit won’t even begin to deal with the $34 million in debt that threatens to drown JFL in a sea of red ink.
A month ago the board asked Chief Executive Officer Jeff Nelson to report on options for restructuring the hospital or finding other ways to bring in an infusion of cash – at least $10 million is needed – and a series of public meetings and private talks followed, as all parties discussed the hospital’s future and possible joint ventures. Without such an infusion, Nelson warned, the hospital’s very existence could be jeopardized.
During one of those discussions several doctors in the dialysis unit broached their plan to launch their own outpatient clinic, which would include taking over dialysis services from the hospital. Calling themselves the Medical Plessen Group, they presented a formal proposal to the board Wednesday. The group took its name from its plan to build a facility in Estate Plessen. The two doctors presenting the group’s proposal were Jan B. Tawakol and Tasmin Khan.
They were joined by Rudel Chinnery of American Paradise Management Group LLC, who also has a plan for taking over the operation of the dialysis unit both at JFL and at the Schneider Regional Medical Center on St. Thomas.
Wednesday the board heard brief presentations from both groups, asked questions and then discussed the proposals as part of an hour-long executive session that also covered several personnel matters. Details of the proposals were not made available.
Following the executive session, Board Chairman Kye Walker said the board wanted both groups to continue taking part in the discussions at least through August. The board also voted to issue a request for proposals, asking any other interested parties to come forward with similar proposals. The RFP will probably go out next week, Walker said, and would be open for 15 days.
During their presentations, both groups talked about their plans for the dialysis centers and emphasized education and prevention of kidney disease.
“Our No. 1 goal is to take care of the patients before they need dialysis,” said Chinnery, a native of St. Thomas who has been involved in management and ownership of other dialysis centers in Virginia.
Chinnery said he has been in the territory since January working on a proposal, and that he met with a dialysis patient support group Sunday at JFL. While he doesn’t have all the answers yet, particularly on the financial side, he said there is potential.
Chinnery described being able to obtain discounts for equipment and supplies from one of the major companies by using the power of bulk purchasing as one way to lower costs. He said the doctors now working at the unit would have the option of buying stock in the company, and promised that if they worked for the group instead of the hospital, the 8 percent salary reductions they’d taken as government employees would be “a thing of the past.”
Both proposals will eventually involve building new centers, probably more toward the west end of the island, where statistics show the greatest number of potential dialysis patients live.
Walker had said that there are three options – either of the proposals or the status quo – but Khan, speaking for the local Plessen group, disagreed.
“The status quo is not an option,” she said, pointing to the drain of money on the hospital. That can’t be sustained indefinitely, she said, and patient care would inevitably suffer.
Tawakol said that the local doctors already know the population and the problems, and have been dedicated to the health community for years. They provide “great” service to the community, he said, and their plan will allow them to “take it to the next level.”
He said the group would combine dialysis with a range of other clinical outpatient services.
