The revamped governing board of the Gov. Juan F. Luis Hospital held its first meeting Thursday and, as to be expected, the main topic was the recent reprieve granted by the Centers for Medicare and Medicaid Services instead of decertification of St. Croix’s only hospital.
Dr. Anthony Ricketts, board president, called the meeting to order and roll was called by Kim Jones, the new secretary. Other members present were Troy Schuster, vice chairman, and Joyce Heyliger and Philip Arcidi, treasurer, through audio conferencing.
The first order of business was approving a resolution to authorize the following as signatories on the hospital’s checking account: Dr. Kendall Griffith, chief executive officer, Justa Encarnacion, chief nursing officer, Ellenor Paul O’Neill, vice president of human resources, and Michael Younger, assistant chief financial officer. They can now approve payments, agreements and contracts up to $100,000. Anything in excess will require board approval.
Griffith’s CEO report covered the details of the last week’s meeting to avoid termination by CMS. Along Ricketts and attorney Deborah Gardner, Griffith met with two senior administrators.
On Monday, Griffith received a letter from CMS that gives the hospital until Nov. 20 to prepare a systems improvement agreement and execute the plan within nine months. If the hospital does not meet CMS criteria within that time, it waives its right to appeal and JFL will no longer receive reimbursement for Medicare and Medicaid patients.
The federal agency wants to see improvements at the hospital, not just a written plan, Griffith said. The letter said CMS doesn’t “discount the importance of such written material” but the problem in the past has been “implementation and execution of policies.”
“Therefore, we do not accept the submitted plan of correction as representing a credible allegation of compliance,” the letter from CMS reads.
The systems improvement agreement will need signatures or letters of approval from the executive and legislative branches, the CEO and the hospital board.
Griffith said he met with Gardner on Wednesday to begin outlining the contents of the agreement – how JFL will demonstrate improvements are taking place. CMS will survey the hospital towards the end or after nine months to see for themselves what has been accomplished.
“We have already begun discussions on what should be in the systems improvement agreement and we will have it by that date,” Griffith said.
In addition to changes and improvements, the agreement will list how the hospital will achieve financially compliance with CMS. Griffith said he met with senators this week to ask for $10 million.
Half of that sum, $5 million, would be used for supplies and medications, $1 million each to reopen the psychiatric unit and upgrade medical records software. To enable tele-radiology will take $450,000 and $175,000 will pay Ropes and Gray for legal services. An escrow account of $1.6 million will be set up to pay a third-party consultant to help bring the hospital into compliance.
Arcidi pointed out the hospital requested $37 million from the government for next year, based on past revenues, but was budgeted $20 million. With a similar budget last year, JFL was asking for advances on allotments and finally “pleading for money” at the end of the year, he said.
Younger added that the V.I. government has owed the hospital $7 million for years. Finally the debt has been written off because there is no hope of collecting it, he said.
“We’re not getting the true funding we should be receiving,” Arcidi said.
Several board members wondered what the financial situation would be in nine months, given the current government budget.
On an optimistic note, Jones said the newly constructed psychiatric unit and tele-radiology (remote reading of x-rays) will produce income and the Patient Keeper software will help billing and collections.
Also during the meeting, Ricketts assigned board members to various committees. All five members will comprise the finance, executive, performance improvement and bylaws committees. The joint conference committee will consist of Ricketts, Jones, Schuster and Arcidi. Jones, Schuster, Arcidi and Heyliger will make up the human resources committee and the planning committee will comprise Schuster, Heyliger, Jones and Arcidi. Heyliger will chair the End Stage Renal Disease oversight committee and staff will be included on the committee.