The governing board of the Gov. Juan F. Luis Hospital convened Tuesday and discussed progress towards maintaining certification from the U.S. Centers for Medicare and Medicaid – the agency that reimburses the hospital for many patient services.
Discussion revealed that many of the CMS deficiencies need funding to make corrections and that none of the $10.3 million promised by the V.I. government has been scheduled nor received.
Philip Arcidi, chairman of the finance committee, asked what could be done to secure the funds.
Dr. Kendall Griffith, chief executive officer, said he plans another appeal to senators.
One of the major problems at the hospital is hiring and retaining staff, Griffith said, attributing recruitment problems due to low salaries. He said five physicians and three physician assistants are being sought to staff the emergency room.
According to Dr. Mavis Matthew, chief medical officer, two physician assistants were hired for the ER, but two others resigned from the emergency room and intensive care unit.
According to Griffith, recruitment has been ongoing to fill several administration positions. Griffith said the hospital also needs an orthopedic surgeon.
When asked about improving patient wait time or fast tracking, Justa Encarnacion, chief nursing officer, said a nurse is needed to manage the program and improve the workflow. She said a certified nursing assistant/greeter is being trained to help patients register at bedside and that CNAs will be used to break up the bottleneck in the lab.
Encarnacion said fast tracking could be implemented in two weeks. Turn around time and other quality indicators would measure the success of the program, she said.
To help implement the systems improvement agreement with CMS, a third party consultant, has been on site evaluating the hospital, Griffith said, and will have an assessment the first week of January. He said he hoped resources would be in place to streamline the ER by September.
The consultants “have made it very clear they are here to help us – to be part of the team,” Griffith said. “They report to us and then we report to CMS.”
The first report to CMS is due the end of January and then about every three months thereafter.
Dr. Anthony Ricketts, board president, asked Griffith to schedule a presentation from the consultants for the next board meeting.
Other business included discussion of reopening the psychiatric unit when funding is received. Griffith said it is not planned as an inpatient ward but an extension of the ER to stabilize patients. Currently the area is a “construction zone,” he said.
There was a financial report that listed scant information for the month of November. Michael Younger, acting CFO, said the gross income was $10.4 million and the net income was $3.1 million. Expenses for the month were $7 million and there was a loss of $2.6 million, he said.
The action items on the agenda dealt with updating forms, procedures and medical staff bylaws to lay the foundation for improving patient care and CMS compliance. The new forms and procedures included those affecting physician assistants, diagnostic imaging, pediatrics, nursery and physician credentialing. The board approved all motions unanimously.
“We are on our way. We’ve eight months to make sure we have all the improvements necessary” in the systems improvement agreement with CMS, Griffith said.
Ricketts ended the meeting thanking the board and staff for their work during the year.
“There have been a lot of challenges. It will be one or two months to see the initiatives in action,” Ricketts said. “The SIA is our priority. We will get an assessment at the end of January. And then we have seven months to turn around the deficiencies.”
