(Updated) As Gov. Juan F. Luis Hospital sinks further into a severe cash flow crisis affecting patient care, several senators are promising to change the law to abolish the hospital’s governing board and legislatively reinstate interim Chief Executive Officer Kendall Griffith, who resigned a week ago.
The hospital has been struggling financially for a number of years, in part due to a large proportion of patients who are uninsured and do not pay for their care, among other, more complex and subtle issues.
The hospital’s governing board first hired previous CEO Jeff Nelson, a specialist in turning around financially troubled hospitals, in 2011, on a three-year contract, with the express intention of having him take unpopular measures to turn the hospital around.
When Nelson laid off a large number of certified nursing assistants, with the goal of saving money and moving toward a better qualified nursing staff, some hospital staff, along with local talk radio shows and Sen. Alicia "Chucky" Hansen, began demanding Nelson’s ouster. Nelson resigned in January of this year, saying in his letter that he was asked to resign. The board then selected Griffith, a cardiologist who headed the V.I. Cardiac Center, as interim CEO.
Meanwhile the financial situation at the hospital deteriorated further and Griffith laid off 24 more employees in April. (see related links below)
After several months with small profits last year, the hospital slid into ever increasing cash shortfalls this year. Board Chairwoman Kye Walker said Thursday that no one policy or action is to blame for the change, and in fact revenues at the hospital are up dramatically. But not enough to counterbalance the closure of Hovensa, the overall bad economy and increasing amounts of uncompensated care, Walker said.
Griffith resigned July 7, citing the difficulty of maintaining his active medical practice while also managing the hospital. “I knew that accepting the position of interim chief executive officer while also practicing as a physician would be a challenge," Griffith said.
On Thursday, Sens. Kenneth Gittens, Sammuel Sanes, Diane Capehart and Hansen visited Griffith at the hospital, and afterwards several of the senators said the Legislature would meet in session next week to address the situation with the hospital.
Reached by phone, Capehart said the meeting was to discuss all the hospital’s issues and the challenges Griffith dealt with as CEO.
"So Hansen, Gittens and I, we came back and started working on a plan" to help the hospital, Capehart said, adding that she saw people at the hospital "encouraging Dr. Griffith not to resign and to come back to work as CEO. You had people who felt he was the best person for the job."
In a statement to the press, Gittens said "constituents across the island of St. Croix have flooded my office and cell phone with calls to reinstate Dr. Griffith and implement a plan that helps the executive branch and the hospital board select and retain qualified leaders capable of managing the hospital and its human resources to success."
Gittens asserted that JFL staff also wanted Griffith to be reinstated, saying he saw "overwhelming support" for Griffith to be reinstated. “Their message was loud and clear as they chanted continuously and with increasing volume: Reinstate Dr. Griffith! You’re still our leader,” Gittens said.
Gittens said he would submit legislation to abolish the hospital’s governing board and mandate the formerly semi-autonomous hospital reinstate Griffith.
Asked whether the board would consider reinstating Griffith, Walker said Thursday that no one had contacted the board to request he be reinstated. She would not comment on any proposals, saying she had not seen them, but expressed optimism that having the Legislature enter the discussion would help.
"If they are discussing funding for the hospital, that is definitely a good thing," Walker said.
Meanwhile, despite the senators’ impressions, some at the hospital are not happy with Griffith and not happy with senators getting directly involved in political infighting within the hospital.
"While the senators are talking to doctors and making a scene sadly we just had another gun shot victim," said Helen Danielson, executive assistant to the hospital’s governing board. "Our staff is overworked and stressed and this infighting and senators getting involved is very sad," she said.
Danielson said the hospital’s environment has become punitive and hostile. "As an example, a Uniform Policy was established and monies were spent to buy white shirts with hospital logo, when in fact each collective bargaining agreement of Juan Luis’ unionized employees calls for uniform allowance to be paid to them annually. Before hospital employees had a voice and could purchase what appropriate uniforms they would wear by department. So, we spent funds that could have paid a vendor or purchased much needed supplies for the units," she said.
On July 7, three days before Griffith’s abrupt resignation, JFL Chief Financial Officer Deepak Bansal and two assistant CFOs penned a letter complaining that Griffith had created a "hostile work environment” against the financial division.
Bansal claimed he and subordinates had been given an "unwarranted disciplinary letter" and subjected to "intimidation practices” by Griffith and his wife and a “general oppressive atmosphere," in which Griffith’s wife improperly tried to get Griffith’s pay increased.
"Your wife, Dr. Mannings, came to my office to see me regarding your pay," Bansal said in the letter. According to Bansal, Mannings told Assistant CFO Aishe Nisbett that she "will go postal if (Griffith’s) salary is not changed and retro paid."
"This bullying type of tactic just because she is the wife of the (CEO) is not conducive to a good working environment. … It is difficult to work and I feel I am being set up for failure as retaliation," Bansal said, demanding that Griffith retract the letter of reprimand and "cease and desist," regarding the hostile working environment.
Bansal also pointed to the hospital’s rapidly worsening financial situation, and said he has not been able to get cooperation on a number of items important to hospital revenues. He said he has tried and failed to get cooperation to help get clinical staff to fill out reports in a way that will enable the financial staff to submit it for outpatient billing. And that large numbers of products and pharmaceuticals are being tediously recorded by hand or not billed at all, because the hospital has not paid the vendor: Omnicell. As a result, the company is still dispensing the products, but not automatically generating bills, according to hospital staff.
This costs the hospital lost revenues and extra employee work hours, while creating more opportunity for human error in treatment and billing, according to hospital staff familiar with the system
It cannot be readily determined whether or which of these complaints is true, or what the underlying facts are. And Griffith has not had an opportunity to respond in this forum to the claims made by Bansal and others. But that this letter exists, and that some hospital employees are speaking publicly against senatorial plans to reinstate Griffith by legislative fiat, indicate that the image of employees chanting Griffith’s name that Gittens’ depicts in his press release is not a complete picture of the reality at the troubled hospital.
Update: A legislative session to address the crisis at Luis Hospital will be held during the week of July 15-19, Senate President Shawn-Michael Malone confirmed Friday morning in an email. Malone declined to comment on Griffith’s resignation and whether the Senate had a role to play. "I need more information first," Malone said.
Editor’s Note: This story has been edited to change a reference to 24 employees to eliminate reference to their job title, in response to a reader indicating not all were nursing employees.