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JFL Hospital Faces its Second CMS Decertification

For the second time in just more than two years, the Gov. Juan F. Luis Hospital on St. Croix faces decertification by the Centers for Medicare and Medicaid, the federal agency that reimburses hospitals millions of dollars for services to Medicare and Medicaid patients.

At Tuesday’s hospital board meeting, acting Chief Executive Officer Richard Evangelista said CMS conducted a one-day survey in November based on a “for cause” complaint but said the results of the visit were unknown at that time. The results were conveyed to Evangelista through a letter dated Tuesday, stating that JFL no longer was deemed in compliance with the agency and would be terminated Feb. 27, 2017, unless a plan of correction is received by Dec. 9 and approved by CMS.

The “for cause” complaint that brought CMS to St. Croix was lodged by employees, according to Troy de Chabert-Schuster, who until Tuesday night was president of the JFL board, and the 12 pages of deficiencies centered on problems with the facility and the “environment of care.”

Leaking air conditioning ducts were cited, as were wet ceiling tiles, pools of water on floors and mold – all familiar problems to board members, administrators and staff at St. Croix’s only hospital. The deficiencies require millions of dollars to correct.

CMS noted soiled vents, or mold, and wet ceiling tiles in the surgical, medical, post partum and pediatric units as well as the emergency department and main entry hall.

De Chabert-Schuster said there have been meetings with Gov. Kenneth Mapp, Delegate Stacey Plaskett and the hospital board to discuss the need for immediate funding and $5 million “was on its way.”

 “We’ve known the issue was mounting and discussed with the governor many times that we need money,” he said. “Gov. Mapp was doing his best but it was not fast enough.”

On Wednesday night, Government House released a statement asking the Legislature to act on Mapp’s request for the capital projects plan and increase the amount for hospital repairs from $10 million to as much as $20 million.

“I know there is no need for me to explain the catastrophic result of any of our hospitals losing their certification by the Centers for Medicare and Medicaid Services,” the statement concluded.

In his capacity as board chairman, de Chabert-Schuster said he worked on the hospital’s strategic plan and the committee determined that the facility should be renovated to the tune of about $50 million. The foundation and structure is solid but the rooms need to be “gutted,” he said.

CMS also found the hospital deficient for not submitting a three-year capital improvement budget. De Chabert-Schuster said the hospital has not prepared such a document in the past, nor did CMS request one to his knowledge.

CMS specified that the following components must be part of the plan of correction:

1.         The plan for correcting each specific deficiency;

2.         The plan for improving the processes that led to the deficiency;

3.         The procedure for implementing the POC, if approved;

4.         The completion date for correcting the deficiencies;

5.         The monitoring and tracking procedures to ensure the POC is effective;

6.         The title of the person responsible for implementing the POC.          

In September 2014, CMS decertified the hospital with a list of deficiencies and cited everything from insufficient patient care to poor oversight by the board.

“This time, it will be easier to remedy, provided we get money from the government,” de Chabert-Schuster said.

Calls and emails to Evangelista were not retuned Thursday.

Late afternoon Thursday, JFL released a statement confirming the issues with CMS were related to the physical plant – air conditioning, heating and circulating systems.

“There were no immediate jeopardy violations found or cited from the survey last month,” Evangelista said in the statement. “CMS has asked us to provide a plan of correction to address the deficiencies that were identified and our team is working aggressively to address the issue,” including collaborating with the governor and Senate president to “identify funding to correct the deficiency identified by CMS.”

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