DOH Discusses Medical Waste, Sewage Crisis With JFL

Gov. Juan F. Luis Hospital
Gov. Juan F. Luis Hospital

Health Commissioner Michelle Davis met this week with Richard Evangelista, acting CEO of the Juan F. Luis Memorial Hospital, to discuss the hospital’s critical sewer line collapse and other problems the hospital has been struggling with lately.

The difficulties include a buildup of hazardous medical waste, leaky roofs, mold and ventilation issues in the morgue.

“We are focusing on addressing the health and safety of the V.I. community that utilizes JFL for health care. The Department of Health will be convening with other agencies to get JFL back up to speed,” Davis said.

The issues have been building for some time. The sewer system underneath part of the hospital collapsed in May, leading to a $3 million Senate emergency appropriation for repairs, the use of a pump truck to bypass part of the system and as-yet-unfulfilled plans to move the Emergency Room.

Conditions at the morgue and the accumulation of hazardous waste came up during a July 30 Senate hearing. Hospital officials said the hospital was struggling to deal with accumulating piles of hazardous waste behind the hospital because the waste hauler doesn’t have the right equipment.

Regarding the morgue, Sen. Alicia “Chucky Hansen (I-STX) alleged a family was denied entrance and forced to wait in the parking lot by the trash bins to identify their loved one.

JFL officials looked into the claim and reported much of the claim was not accurate and no family was denied entrance or forced to identify a body outside.

In a statement from the hospital, Evangelista said the V.I. Department of Justice had provided a report on the incident in question.

“The medical examiner had picked up the deceased from an accident scene and was transporting the deceased to the morgue for preparation. While the ME was unloading the body, a number of Virgin Islands Police Department vehicles drove into the restricted area, one of them carrying the mother of the deceased, and demanded the mother see the body,” Evangelista said, summarizing the DOJ report.

“The police officers were repeatedly advised by the DOJ staff that it was not appropriate to view the body at that time, but the VIPD officers still insisted. To avoid further confrontation, the decision was made by DOJ staff to allow the mother to identify the body at the rear of the morgue on the hospital’s loading dock. At no point was the deceased in the morgue or removed from the morgue, to be viewed on the dock,” Evangelista said.

More recently, Sen. Nereida Rivera-O’Reilly and others have expressed concern about reports of mold and structural damage due to leaks in the roof. O’Reilly reportedly contacted the Centers for Medicare and Medicaid Services after not getting a sufficient response from hospital officials.

Hansen attacked O’Reilly for what Hansen called “betraying” the hospital.

“The risk of losing accreditation because of Sen. O’Reilly personally calling CMS to come in can only result in the loss of Medical Assistance Programs and Government Insurance benefits to thousands of Virgin Islanders and this is downright disgusting. As a matter of fact, I have informed the governor so he would be aware as well,” Hansen said in a statement.

Calls to O’Reilly’s office for comment were not returned. O’Reilly was quoted elsewhere saying she contacted CMS because the concerns were not being addressed.

Since then, Hansen sent a letter to the hospital repeating a claim that there was a stench near the morgue. Evangelista has denied that claim.

According to this week’s statement from the Health Department, DOH has reviewed JFL’s plans to address these concerns and finds them to be satisfactory and will be monitoring progress with their plan of correction, on a weekly basis. The DOH is also in contact with Centers for Medicaid and Medicare Services to assure that JFL is adhering to CMS regulations.

While Hansen has expressed concern that contacting CMS risks decertification, her past actions contributed to CMS decertifying the hospital temporarily in 2014. (See: Hansen, Griffith to Blame for the JFL Decertification in Related Links below)

She used her Senate seat to lead efforts to oust former CEO Jeff Nelson after Nelson tried to cut costs and reorganize nurse staffing at the hospital.

“JFL is making more money than ever,” Hansen said in a July 12, 2012, press release. “Although Nelson is spreading doomsday predictions about the hospital’s finances, JFL’s financial statements show otherwise.”

Those “doomsday predictions” all came true, as the hospital ceased paying electric bills, employee taxes, employee pension contributions, tens of millions in vendors bills and has needed repeated infusions of cash just to meet payroll.

Hansen spearheaded efforts to dismantle the JFL governing board in 2013, to consolidate power under then-acting CEO Kendall Griffith. With the help of other senators, Hansen and Griffith forced Kye Walker and Imelda Dizon off the board by threatening a legislative dismantling of the hospital’s board to make it more amenable to the interim CEO.

“Senators Sanes, Capehart, Hansen and I worked feverishly today to draft legislation to dismantle the St. Croix Hospital Board,” Sen. Kenneth Gittens said in a July 11, 2013, press release.

CMS’ report threatening decertification mentioned the lack of a quorum on the board five separate times. It spoke of a “lack of oversight” and “the Governing Body’s ineffectiveness.” It listed terrifying patient-harm incidents that should have been reviewed by the St. Croix board or, if not, by the territorial board so preventative measures could be put in place.

Conditions have slightly improved in the several years since. The board now has a quorum and billing is more effective than previously. However structural problems, especially the collapsed sewer system beneath the hospital, are becoming dire. And the hospital still struggles to pay its bills. A mandate to provide care regardless of ability to pay combined with declining annual government appropriations have exacerbated its financial ills.

In her statement this week, Davis said the Health Department “will be convening with other agencies to get JFL back up to speed.”

She said the Health Department has reviewed JFL’s plans to address the concerns about hazardous waste, mold and the other problems it is facing and “finds them to be satisfactory and will be monitoring progress with their plan of correction, on a weekly basis.”

DOH is also in contact with CMS to assure that JFL is adhering to CMS regulations, according to the DOH statement. As a member of the territorial hospital board, Davis will meet with the board to discuss these issues and help find money to support JFL’s plan of action. She said she plans to bring the JFL team, other agencies and the territorial board together to make sure that the hospital continues to make rapid improvements.

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