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JFL Hospital Financial Problems Worsen

Meeting payroll next week is the latest challenge facing the Gov. Juan F. Luis Hospital and its chief executive officer, Dr. Kendall Griffith. In addition to a continuing financial crisis and insufficient nursing staff, there have been several recent administrative resignations and an unknown number of physicians are planning to resign.

Also the hospital’s board of directors, with only three of nine required members, is not meeting regularly to advise and govern the facility.

Three pay periods in October have put more stress on the hospital’s meager cash flow. According to Wallace Phaire, co-chairman of the board’s finance committee, there won’t be enough cash to pay the entire staff next week without an early appropriation from the Legislature.

The Senate Finance Committee requested the advance last week but has not yet received a reply, Phaire said Wednesday.

“It’s been a stretch. Payroll will be a stretch if we don’t get the allotment early,” he said.

The St. Croix hospital has been in financial distress for years and the V.I. government continues to cut the hospital budget from year to year. Appropriations declined from $26.4 million in 2008 to $19.3 million for Fiscal Year 2014. The hospital absorbs more than $25 million alone in uncompensated, unpaid care each year.

With the closing of the Hovensa refinery a year and a half ago, Griffith said at a Senate hearing in May, he projected an additional loss of as much as $5 million as a result of employees and their families moving off island.

Describing the overall financial picture, Phaire said, “It’s the eighth month of negative EBIDA, so it’s getting worse.” EBIDA is earnings before interest, depreciation and amortization, and a negative number means there were more expenses than operating income.

Phaire confirmed that the hospital is behind again on its obligations to the V.I. Water and Power Authority, the Government Employees Retirement System and several vendors.

Since July, when the board lost its quorum, the finance and the human resources committees have continued to meet monthly, according to finance committee co-chair Joyce Heyliger.

Committee reports will be available Friday, Phaire said, disclosing the current financial situation, as well as the current number of staff. Although Phaire acknowledged there have been number of top level resignations, he said he doesn’t how many have left or how many have been hired.

“Some doctors are in the process” of resigning, he added.

Until there is a quorum, the current three board members cannot approve payments beyond $250,000 or approve physicians to work in the hospital. Gov. John deJongh Jr., in July, asked the territorial hospital board to increase oversight of the St. Croix board but there has not been a meeting since then to deal with the St. Croix issues.

According to Helen Danielson, the St. Croix board secretary, a meeting is being planned for next week, but the date has not been set.

Oversight should stay with the St. Croix board, Phaire said, but “90 percent of the decisions are made by Dr. Griffith” and the board doesn’t hear about them until afterwards. Meetings with the CEO are rare, Phaire said, and there have been complaints that Griffith is not available when signatures are needed.

The Source was unable to contact Griffith, who was reportedly off-island all week and didn’t respond to phone messages.

“Maybe we ought to start looking at different roles for administrators and start looking at the time and attendance of people,” Phaire said.

Griffith is a cardiologist and the executive director of the Virgin Islands Cardiac Center. He was named interim CEO in January after the resignation of Jeff Nelson, who ran the facility for two years. In July, Griffith resigned and was reinstated five days later in a flurry of activity that included the resignation of two board members who broke the board’s quorum.

According to deJongh’s spokesman, Jean Greaux, the governor is actively searching for new board members. So far, one potential candidate has agreed to serve and the name will be announced when the nomination is sent to the Senate, Greaux said.

Over the last few months, the governor has vetted a list of 25 candidates submitted by a member of the Legislature, Greaux added. Many of those individuals did not know they were on the list and others declined to serve because they did not want to go through the Senate confirmation process or reveal their financial information.

“The governor is very supportive of a consolidated territorial hospital board with some elements of unified joint leadership which would provide stability, uniformity, leverage staffing and financial resources as well as tangible assets,” Greaux wrote in an email. “Other benefits of consolidation include joint IT system purchases and value-based purchasing in areas of supplies and pharmaceuticals.”

Normally board members keep current on the progress being made to correct deficiencies outlined by the Centers for Medicare and Medicaid in 2012. CMS is the federal agency that reimburses the hospital for treating Medicaid and Medicare patients. Not complying with CMS risks losing reimbursements to the hospital.

In the report, CMS stated deficiencies were the ultimately the responsibility of the board. CMS representative Danielle Liss said the agency is working closely with the hospital and is “keenly aware of the issues.” She said CMS would not comment on the “specific issues.”

The hospital has been short-staffed for months and recently there have been top level resignations. There are openings for registered nurses, medical technicians, and legal and administrative personnel, according to an employee posting. At least two directors and an executive secretary have resigned recently.

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