Closing the Behavioral Health Unit at Juan F. Luis Memorial Hospital for 90 days to renovate and expand it was an internal decision by the hospital administration to prepare for an inspection by the federal agency that regulates Medicare and Medicaid services, not a fiat dictated from an outside agency, a hospital spokeswoman said Monday.
The renovation will cost about $300,000, which the hospital expects it will be able to pay from its collections, according to Xaulanda H. Simmonds-Emmanuel, chief of communications at St. Croix’s hospital.
JFL announced Friday that it was closing the unit temporarily, with the expected re-opening in time for the Feb. 13 inspection by The Center for Medicare and Medicaid Services next year.
In summer 2011, JFL failed to meet 11 of 23 CMS standards, endangering its ability to participate in the two federal programs. Since then the hospital has engaged in a concerted effort to meet all the shortcomings, and entered into an improvement agreement with CMS in November 2011.
Under that agreement hospital staff has to make continuous improvement for the next three years, meeting the standards and maintaining those improvements.
Under the plan, the hospital immediately stopped accepting new admissions to the unit and began arranging with patients to be relocated to other facilities, either Roy. L. Schneider Regional Medical Center on St. Thomas or a stateside hospital.
The unit has six beds and averages about 15 admissions a month, according to the statement announcing the closure. Under the planned renovation, the unit will add beds and staff.
In anticipation of the February CMS deadline, the hospital was looking at every area of patient care, Simmonds-Emmanuel said, and the Behavioral Health Unit, colloquially known as the "psych ward," was a good target for improvement. The decision to close it for renovation was "pre-emptive," she said, taking care of a potential problem before the federal officials came in.
"It’s an opportunity to really improve patients’ safety and the care we provide," she said.
St. Croix is facing a harsh economic climate in the wake of the closure of Hovensa, she said, and more families are under stress and in need of the kinds of services provided by the unit.
"We anticipate increasing the number of patients," she said, agreeing that it won’t come cheap. "We’re trying to look at it as an investment," she said.
The more patients the hospital is able to serve, the more revenue it will generate from insurance and Medicare – assuming it meets CMS standards.
Money for the renovation will come from the hospital’s stepped-up collections effort. The hospital has been showing an increased bottom line this year, taking in more in revenues than it pays out in expenses for six months in a row. Simmonds-Emmanuel said the increased collections effort has been generating about an additional $100,000 a month, so that in the three months the works is scheduled for JFL will be able to pay for it out of existing funds, rather than going “hat in hand” to the Legislature.
The increased collections and black ink in the financial statement is a huge improvement over recent years, but doesn’t begin to touch the hospital’s $30-plus million in debt to creditors and suppliers, Simmonds-Emmanuel said. That will still require an infusion of cash.
Hospital Chief Executive Officer Jeff Nelson has been warning for more than a year that, without such an infusion, the hospital could still end up failing, being forced to close its doors and leaving St. Croix with no major medical facility.
Nelson was off island Monday, Simmonds-Emmanuel said, and could not be reached for this story.
