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Monday, January 30, 2023
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Schneider Hospital Trying to Expand Dialysis Unit

Schneider Regional Medical Center is negotiating with a contractor to run or help run its kidney dialysis unit, which is at capacity and losing money, hospital staff told the Senate Committee on Health, Hospitals, Human Services and Veteran’s Affairs on Friday.

As they have in the past, hospital and Health Department officials raised the alarm that the number of Virgin Islanders with severe kidney disease is growing faster than the capacity of the hospital to provide dialysis.

In 2010 Schneider had an average of 76 dialysis patients and now it has 101, said Bernard Wheatley, the hospital’s acting chief executive officer.

Not only is the dialysis unit at capacity, but a few patients who come in for treatment through the Emergency Department get less time on dialysis than medically recommended.

"The patients who receive treatment in the ED should be receiving treatment at least three times a week, an average of 12 hours of treatment each week/per patient. However, due to capacity issues, they can only receive an average of seven hours of treatment each week," Wheatley said.

To give those patients their three four-hour treatments per week would "require additional full time employees," for which there is no funding, he said.

Because of low reimbursement rates from Medicare and Medicaid, and because of high costs for contract nurses, the unit "has incurred an annual operating loss in excess of $2 million" and loses about $146 per dialysis treatment, he said.

"Given these facts, it is not financially viable to continue to operate the unit," Wheatley testified.

The hospital is working with the Centers for Medicare and Medicaid Services to meet its requirements, he said, but the hospital "still lacks the adequate resources" to set up required dialysis modules in the hospital’s electronic medical records system to comply with a January 2014 deadline set by CMS.

To try to get around these difficulties, last year the hospital issued a request for proposals for a private contractor that is in a position to make a capital investment to either take over the kidney unit or partner with the hospital.

American Renal Associates and DaVita Inc. submitted formal proposals and the hospital is now in talks with DaVita, Wheatley told senators.

"Barring any concerns … it could take maybe another five or four months to hammer everything out," he said.

No votes were taken at the information gathering hearing.

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