Somehow the hospital has remained compliant with the U.S. Centers for Medicare and Medicaid, despite significant destruction from Hurricane Maria, but acting chair Dr. Anne Treasure said without a full board that may not last.
Lack of quorum and a resulting lack of board oversight were among the factors that led CMS to briefly decertify the hospital twice in the past decade. Poor management practices and political interference in the board played major roles as well. The board was without a quorum for 2013 and 2014, achieved a quorum for awhile, then lost its quorum again in 2018.
The governor appoints board members and the St. Croix board should have nine trustees. According to CMS, their responsibility is oversight of the hospital. With Treasure, Christopher Finch and Faye John-Baptiste, there are only three trustees. John-Baptiste, the nurse representative to the board, was with patients and arrived at the early evening meeting as it was already in progress.
Gov. Albert Bryan, Jr. has said the boards of the two hospitals should be combined, but there has been no official action to put the combined board in charge. Until then, Luis hospital can’t make any significant financial decisions without the St. Thomas members. The JFL acting chief executive officer, Dyma Williams, can approve expenditures for as much as $100,000.
The joint hospital board – the V.I. Government Hospital and Health Facilities Corporation – currently has nine of 15 possible members.
“Right now, we are out of compliance which means the certifications of both hospitals are in jeopardy,” Treasure said.
The acting chief financial officer, Christopher Lewis, gave a brief financial summary and reported that payments have been made for taxes, the employees’ retirement plan and unemployment insurance but current payables amount to $35.6 million. The St. Croix hospital owes the V.I. Bureau of Internal Revenue, $19.8 million, most due to nonpayment of employees’ local taxes that were deducted from paychecks from 2012 to 2015. The Department of Labor is owed $674,000 due to the layoffs of 80 people in 2017, according to Lewis, and payments are current from 2017 to the present with the Government Employees Retirement System.
He also reported that yearly losses for fiscal years 2014 to 2018 amounted annually to $17.6 million on uncompensated care – bills unpaid by insurance or the patient.
Adding stress to the financial capacity of the medical center, JFL is obligated to contribute its share of a matching grant and will be required to pay $4.7 million for the hardened structures of the temporary hospital. They also will pay $2.5 million for furniture, fixtures and equipment and another $17 million to build a new hospital.
Williams said the installation of the hardened structures would probably be delayed past the May 2020 deadline because some requirements won’t be met in time.
She talked about what will be needed to transform the current 46-bed facility into one with 118 beds. Currently, arrangements are being made to hire personnel through training programs at the University of the Virgin Islands, V.I. Labor Department, V.I. Waste Management Authority and U.S. Department of Energy, for staff to help reduce energy bills.
The critical positions will include a chief of information, respiratory technicians, radiology physicians and technicians, a facilities director, a certified project manager, a paralegal and clinical staff in all areas, Williams said.
During the last few minutes of the meeting, two members of the audience aired grievances about the dialysis unit and Angel Rivera accused Luis administrators of lying in a recent news article about the number of chairs in service. There are seven, not 12, he said. He listed a number of deficiencies that included tie downs not sufficient to hold the trailer in place during a hurricane, the lack of a television or outlet to charge devices and weak air conditioning. He said there is no cover over the ramp to protect it from rain and the door to the bathroom is unmarked. It could be an exit, which could cause problems because there is one way in and one way out, he said. Security personnel have not been seen in the area despite, “shady people out there,” according to Wallace Phaire, a former Luis board member.
Treasure and Angeline Ravariere, acting chief operations officer, told Rivera and Phaire their complaints will be addressed. Treasure said there is a dialysis committee with a physician chair and she promised that two dialysis patients will be invited to their next meeting.
*Editor’s Note: The story initially reported two members were present. After the meeting began, a third member: Faye John-Baptiste arrived.