A severe shortage of registered nurses at Gov. Juan F. Luis Hospital led the board of directors unanimously to implement significant pay increases for its nurses, becoming the first of the three bargaining units involved to act on the raises.
The salary increases were approved Friday at the board’s regularly scheduled monthly meeting. The pay hikes range from a 31.3 to 39.3 percent over RN’s current wages, depending on years of experience, and took effect at the beginning of JFL’s current pay period.
The new salaries were proposed by the Virgin Islands Nursing State Association and were negotiated in June 2012 between JFL, the Schneider Regional Medical Center and the territory’s Department of Health. VISNA represents the registered nurses employed by the institutions under a single collective bargaining agreement, but the changes had not been approved yet by the department or SRMC. JFL CEO Jeff Nelson said failure to act would increase the risk of unsafe patient care and cost the hospital a lot of money spent on traveling RN’s.
Dr. Anthony Ricketts, the board’s new vice chairman, said it was time for JFL to do what it needed to do.
“Three different institutions came together and agreed to increasing salaries,” Ricketts said. “If any other members cannot fulfill their obligations, then they’re the ones who need to be sued, not us. If we’re going to be sued, well, I think we move forward with that, knowing full well what the ramifications are. I implore everyone to put on their logical hats and let’s move forward to take care of the patients that come to us.”
In a prepared statement Nelson said, “JFL is facing a critical shortage of experienced RN’s to adequately staff the emergency department, staff enough inpatient beds to adequately serve the St. Croix community and to deliver safe patient care.”
The average wait time for ER care exceeds six hours, Nelson said, almost double that of most other hospitals. JFL also has had to reduce the number of inpatient beds by 13 over the last year. When this happens, very sick patients are admitted and housed in an already understaffed and overcrowded emergency department, he said.
He added that during the last seven months, 21 local RN’s had left the hospital due to low pay, the closing of Hovensa and because of the shortage of nurses in the care units. With not enough nurses on staff, the nurses that are working are worked harder, burn out quicker and because of all this the hospital has had to rely on RN travel agencies, which are paid at a rate of about $55 per hour per RN.
JFL employs 173 RN’s, with 40 of those coming from travel agencies. Nelson said an additional 40 nurses is necessary in order to serve St. Croix patients adequately. He said paying local RN’s the higher new salaries will reduce its dependency on hiring travel RN’s, reduce overtime costs by at least $1 million annually, and ultimately, save the hospital money so that it can buy needed supplies and equipment.
“By paying local RN’s the higher new salaries, JFL will be able to recruit and retain more permanent local RN’s,” Nelson said, adding that at least five and possibly more than 10 local RN’s have expressed interest in returning to work full time within weeks of the new salaries going into effect.
The new salaries are retroactive to Oct. 1, 2011, but no one-time, lump-sum payouts will be made as the hospital simply doesn’t have the money. Instead, the hospital will make gradual retroactive payments from Oct. 1, 2012, until the present over the next six months. At that time, the hospital will address how to pay nurses their retroactive increases from Oct. 1, 2011, to Oct. 1, 2012.
On another important front, board Chairman Kye Walker said a Feb. 13 deadline to become compliant with the Center for Medicare and Medicaid Services did have the possibility of being extended, the caveat being JFL finds a new chief operating officer with a clinical background so that this person could lead the hospital forward as it tries to become compliant with the system’s improvement agreement required by CMS. Walker said the brief search was largely an in-house one where JFL was looking for someone with a “history at JFL.” She said the board hopes to have the position filled by the end of the month.
“I know there have been some changes in the (organizational) structure but it’s with the goal of becoming compliant,” Walker said, referring to CEO Nelson no longer leading the CMS compliance charge. “We need to understand that we cannot afford to lose accreditation and the patients can’t afford us to lose accreditation.”
Also Friday, Peter Abrahams, the director of the hospital’s Cornerstone Services, which maintains the hospital’s physical plant, told the board the Behavioral Health Unit would not open within the 90 day schedule originally planned when it was closed Nov. 2. He gave no timetable on how long the delay would last.
The board meets next Jan. 30.
