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Health Commissioner and Hospital CEO at Odds Over License Procedure

July 18, 2006 – Health Commissioner Darlene Carty is holding up Medicare and Medicaid payments to Schneider Regional Medical Center until the facility files an annual report with the Health Department in order to renew its license, which expired June 30.
According to V.I. Code, the Health commissioner is charged with issuing licenses for the territory's hospitals and health care providers.
In a letter sent July 14 to Rodney Miller Sr., SRMC chief executive officer, Carty said, "I am now compelled to assert my regulatory authority and insist that Roy Lester Schneider Hospital and Myrah Keating Smith Community Health Center submit the documentation necessary for licensing renewal."
Carty's letter was in response to one written to her by Miller on July 10 asking for the specific statutes that uphold her request for detailed financial information.
Miller said Wednesday that what Carty is asking for — which includes profit and loss statements, cash flow statements, income statements, staff credentials, and 15 other items — is far more than what is required in any other jurisdiction in the United States.
Miller said, "Since when does a licensing agency want financial reports?"
A check with Charlene Hill, public information officer at the Joint Commission on Accreditation of Healthcare Organizations, confirmed Miller's contention that JCAHO does not ask for any kind of financial information when conducting accreditation surveys.
Furthermore, Miller said since he and the Health Department are involved in a lawsuit, it is inappropriate for Carty to ask for such sensitive information.
"We don't have a problem giving the Health Department what the regulations require." But, he added, "Don't expect us to give critical information that is not warranted." He said he's done that before and "it's ended up in the wrong hands."
He also questioned some of Carty's other requirements. "Credentials of staff? We have 700 staff members," Miller said.
The code is not specific and nowhere mentions financial reports, but Carty said Wednesday afternoon that the department has always asked for financials. And she said she never received them last year.
"It is our duty to protect the community's health," Carty said.
In his July 10 letter, Miller said he had submitted an annual report to Gov. Charles W. Turnbull.
"We suggest you contact the governor's office to obtain a copy," Miller wrote.
Miller said he hopes to have a meeting with the governor this week to resolve the matter.
Meanwhile, Carty has given Miller until July 31 to come up with the items she has requested.
"Your license renewal … remains contingent on your submittal of an annual and financial report in statistical and narrative form … by 3 p.m. on July 31. "
She goes on to quote the code, saying that any health provider who operates without a license is subject to a fine of $500 for the first offense and not more than $1,000 for each subsequent expense. Carty wrote: "Each day of a continuing violation after conviction shall be considered a separate offense." She said the department will not issue the hospital's license retroactively. Therefore, she wrote, "Roy L. Schneider Hospital will be fined $500 and MKSHC $500 for July 1, 2006; on July 2, 2006, fines will increase to $1000 per day for each facility … until the license is reinstated."
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