The territorial hospital board Friday again found itself making decisions on St. Croix district board matters that could not be addressed on the district level because of the lack of quorum, including the approval of policy manuals and tabling a major vendor contract.
Present on the Schneider Regional Medical Center board room were board chairperson Lynn Millin-Maduro, members Maria Tankenson-Hodge, Cornel Williams, Debra Gottlieb, Anthony Ricketts, Angel Dawson, Wilbur Callendar, and Aldria Harley-Wade. Joyce Heyliger attended via telephone. Juan Luis chief executive officer Kendall Griffith was also present.
Hodge read to the board the Juan F. Luis Memorial Hospital’s executive committee’s recommendation to deny surgeon Dr. Albert Titus’ application for reappointment of clinical privileges, an item tabled from the board’s Oct. 31 meeting. Voting to deny Titus’ reappointment were Millin-Maduro, Tankenson-Hodge, Williams, Gottlieb, Heyliger, Ricketts and Callendar, while Dawson and Harley-Wade abstained.
The board also reviewed Juan Luis policy and procedure manuals for medical staff and peer review, the pharmacy department, advanced radiology, VI Cardiac Center, the cashier’s department and housekeeping.
Callendar raised concerns about the medical staff peer review policy, which he called “quite restricting” as written.
“It didn’t seem as though the policy encouraged other physicians to participate in the center,” Callendar said. “It seems to prioritize physicians who finished their training in the last 12-month period.”
Griffith said that was not the case.
“Any sort of credentialing process for physicians, you have to ensure that they have the requisite number of procedures under their belt to be able to do the procedures,” he explained, adding that years of experience does not mean a physician has the required amount of procedures per year. “You cannot make any assumptions.”
Hodge was concerned that the policies being reviewed were not finalized, citing pagination errors and references to King’s County, which she said, must have been used by Juan Luis as a model for drafting the policies.
Millin-Maduro reminded the territorial board does not normally deal with district level policies.
“We’re seeing works in progress,” she said about the policies currently being reviewed. “I just want to make sure that what we are approving has something that determines that this is the day it was approved, and the requirement of having them approved annually.”
Griffith assured the board that a Juan Luis policy manager responsible for keeping a library of all manuals would make them easily accessible to hospital staff.
Harley-Wade insisted that the chief of nursing should sign off on the housekeeping policy, which largely affects nursing staff, so the board decided to vote on housekeeping separately.
All the other manuals were approved, with Millin-Maduro, Hodge, Dawson, Gottlieb, Ricketts, Heyliger and Callendar voting yes. Williams and Harley-Wade abstained.
The board also conditionally approved the housekeeping manual. Millin-Maduro, Hodge, Dawson, Gottlieb, Ricketts, Heyliger, Callendar and Harley-Wade voted yes on the condition that Millin-Maduro reserve her signature until the chief of nursing has approved the document, with Millin-Maduro withholding her signature until the chief of nursing has signed off on the document. Williams and Harley-Wade abstained.
JFL chief financial officer Deepak Bansal presented for approval an agreement with equipment solutions provider Varilease, which would allow the hospital to wean itself from reliance on Advanced Radiology for the hospital’s radiology needs.
According to Bansal, JFL is currently obligated to pay Advanced Radiology $60,000 per month for servicing the hospital’s outpatient cases. An agreement with Varilease would mean a 24-month lease of a bundle of equipment at $57,677.64 per month, roughly the same amount as Advanced Radiology payments. It would, however, allow JFL to handle all radiology services in-house, receive the outpatient revenue that currently goes to Advanced Radiology, and possibly buy out the equipment at the end of the two-year lease.
The Varilease discussion raised other concerns with JFL’s relationship with Advanced Radiology, including $7 million owed by the hospital.
Both parties are enjoying a 60-40 split of Advanced Radiology revenues – a split questioned by the board – with the hospital receiving the smaller share. However, an accumulation of years of uncompensated care given by Advanced Radiology not only cost the hospital its 40 percent share, but resulted in a $7 million debt that continues to increase monthly.
The board decided to table the Varilease agreement until a Nov. 15 meeting, pending clarification of issues, including the actual equipment delivery date, installation fees involved, responsibility for maintenance, the date when payments actually commence, and whether the one-page letter from Varilease presented to the territorial board is the actual lease agreement.
Bansal also presented an amended contract with Omnicell, a technological automation company, for purchase of a system that controls the amount of pharmaceuticals and other supplies in JFL’s dispensing system.
According to Bansal, the system is needed for CMS-compliance, and the software they used previously could no longer be repaired, causing a drop in recorded revenues.
“One month period that it was down, you could see the revenue drop,” he explained. “All those charges, we tried to manually charge, but we have a cut-off date which, if we don’t make, we would not be able to charge for them.”
According to Bansal, Omnicell agreed to write off $117,787 of the original $272,466, leaving the hospital with a $150,000 bill that would be paid by a grant.
After assurances that the Omnicell write-off was done in writing, the board unanimously approved the Omnicell contract amendment.
The territorial board agreed to meet again on Nov. 15 to address tabled matters.