The Territorial Hospital Board voted to accept the resignation of Dr. Luis Amaro as acting CEO of St. Thomas’ Schneider Regional Medical Center on Thursday. The Board thanked him for his service. It installed hospital legal counsel Tina Comissiong to the post until the permanent CEO is named. Dyma Williams continues to serve as acting CEO of St. Croix’s Juan F. Luis Hospital. The Board expects to name new CEOs within a few weeks, officials said in a statement.
During the meeting, Board members heard about overtime woes, staff vaccination and plans for a new St. Croix hospital at the monthly Territorial Hospital Board meeting Wednesday evening. In addition to reports from the interim chief executive officers, a representative from Flad Architects presented a slide show on rebuilding the Gov. Juan F. Luis Hospital.
The board had a quorum and voted on several items including new hires and renewal contracts. Present were Christopher Finch, chair, Jerry Smith, Jenifer O’Neal, Justa Encarnacion, Dr. Anne Treasure, Dr. Frank Odlum, Greta Hart-Hyndman, Faye John-Baptiste, Marise James and Bosede Bruce.
During their reports, the chief executives lamented short staffing issues, including the loss of several employees to the board’s vaccine mandate.
JFL acting CEO Dyma Williams said overtime expenses were $3 million for fiscal year 2020 due to the low staffing numbers. She requested board approval for an incentive package to help with recruitment and retention of critical staff. She also asked the board to approve a discount payment program. Neither was approved at the Wednesday meeting.
Amaro said Schneider Hospital has already submitted a proposal to the governor and the Office of Management and Budget to implement a recruitment/retention program at the St. Thomas hospital. Amaro said they still rely on Pafford employees through the V.I. Health Department to fill some critical staff shortages. Pafford is a staffing agency that provides nurses who travel to the territory to work for set periods of time. These traveling nurses are more expensive than permanently hired nurses but they allow for easier adjustment of staffing as needed. Additional personnel are needed especially in the behavioral health unit, hemodialysis, anesthesia service, OB/GYN and surgery, Amaro said.
The administrators talked about the vaccination rates at their facility. Williams said 74 percent of employees have had two doses of the COVID-19 vaccine but at least seven registered nurses have resigned, resulting in staff shortages in critical areas. Overall, there have been 20 resignations or employees who have elected to work part instead of full time. An additional 80 staff members have filed for exemptions for religious and medical reasons.
Amaro reported that 574 vaccines have been administered at Schneider and 85.6 percent of employees have been immunized. Two people were given exemptions and one left the job for non-compliance. So far, 57 employees have tested positive for COVID-19 and one employee succumbed to the virus.
Williams said additional staff will be needed as the temporary hospital, called JFL North, opens. There will be 105 inpatient beds instead of the current 46, increasing the need substantially for more licensed healthcare professionals.
Amaro announced the St. Thomas hospital has signed agreements with the UVI Medical School to serve as the host agency for medical students’ future training programs. Buildings on St. Croix and St. Thomas are nearly complete, but the school was rejected on its first attempt to become accredited.
Almost an hour of the meeting was devoted to presenting new information, drawings and photos of what a new St. Croix hospital will look like. Daryl Smalls, executive director of the Hospital Redevelopment Team, and Steve Jackson, of Flad Architects, talked about the processes used for decisions on the final plans.
Jackson said the size of the new facility was based on patient data prior to the 2017 hurricanes, the U.S. Census, target occupancy rates and numbers of lost opportunities when patients go off-island for health care. Based on those statistics, the hospital will be about 450,000 square feet with a 25,000-27,000 square foot emergency plant.
“The last thing we want to do is overbuild,” Jackson said.
The new hospital will have 116 patient care spaces and six surgical units. Two rooms will be for behavioral health patients and 24 for intensive care patients. There will be 10 rooms for labor and delivery patients and six rooms for postpartum and Caesarean Section inpatients. The Emergency Department will hold two triage rooms, four fast-track areas, three trauma rooms and 14 exam rooms.
The third floor will contain a mechanical area, air handlers as well as rehabilitation and conference rooms. The mechanical and electrical equipment will be protected against hurricane damage by the top floors.
The construction materials for the hospital will be rated for category five hurricanes, including the window glass. The roof will be built with pavers laid on top of a membrane to prevent wind damage, and there will be two generators for redundancy. Jackson said the cost will be higher, but maintenance will cost less, and equipment will last longer.
“This will perform better than the current hospital,” Jackson said.
For the final plan, Jackson said three designs were taken into consideration, and the best plan is based on the site, functionality and staffing efficiency. There will be a tower for patient beds above the surgeries, an arcade for easy entrance and access to rooms and elevators.
The grand opening of the new hospital is projected for spring of 2027, depending on the JFL North installation and removal and demolition of the old hospital. The JFL demolition is forecast for 2022 into the first part of 2023. The completed design of the new hospital is expected in late 2022, including bids and permits.
Smalls also updated the board on plans for the medical facilities on St. Thomas and St. John. There are no final numbers from FEMA on what exactly will be covered. The St. Croix Hospital cost has not been finalized either.