Two days after its regularly scheduled meeting, the Territorial Hospital Board met again Friday to resume discussion on a vendor agreement that would help Gov. Juan Luis Hospital sort out its revenue cycle, but little progress was made due to inadequate paperwork and lack of a quorum.
Friday’s brief meeting was meant to lay to rest board members’ concerns about JFL Hospital’s “revenue cycle optimization project,” which would bring onsite an outside company, Advisory Board, to improve its revenue stream while training the hospital’s own staff on the best practices to improve and generate revenue.
The contract with Advisory Board, however, would cost $250,000 initially for the first four months and a total of $1.27 million for one year. With Advisory Board’s services, JFL administrators estimate up to $6 million in returns, or an additional $62,000 in monthly invoices.
The hospital’s chief financial officer, Nelson Bowry, presented the proposal to the territorial board on Wednesday but was met with objections from a majority of board members who were concerned that JFL might be overpaying for the service. In comparison, Schneider Regional Medical Center on St. Thomas is receiving a similar service from Advisory Board, but for only $300,000 for eight months.
While the territorial board lost its quorum at Wednesday’s meeting and was, therefore, unable to officially act, JFL Chief Executive Officer Kendall Griffith and other officials of the hospital were tasked to ask Advisory Board representatives if they would agree to JFL pursuing only the four-month contract and then revisit the one-year option if the project moves in a positive direction.
Wednesday’s meeting, which was teleconferenced, continued in spite of lacking a quorum and Territorial Board Chairwoman Lynn Millin-Maduro reiterated the lack of a draft contract from Advisory Board, only a proposal with none of the needed specifics.
“Trust me, I know what a contract looks like and I have not seen contract,” said Millin-Maduro. “I’ve seen two variations of a proposal…There are none of those provisions that you would see in a contract and there is nothing that gives you the guarantees that you would have in a contract.”
According to Bowry, past practice did not require the board to actually sign off on the contract.
“The way I’ve seen it done in the past is that we get approval from the board to enter into a specific contract pursuant to some terms that have been outlined,” said Bowry. “The board itself doesn’t sign the contract.”
Millin-Maduro disagreed, saying, “The board does sign off on contracts over certain amounts. I would sign it as territorial board chair, and definitely, as territorial board chair, would require to see the contract in advance.”
According to Millin-Maduro, even after the board approves the terms, scope and compensation relating to the contract, the board’s counsel and the chairwoman would still have to review the final contract before it can be signed.
JFL Hospital officials reassured the territorial board that they understand the need for strict procurement procedures but are pressed by immediate financial concerns.
“I think our biggest problem now is that our cash flow and financial stability depends on bringing in this group,” said St. Croix District Board Chairman Anthony Ricketts. “We have determined that the presence of this group in the hospital is going to alleviate our cash flow problem come May,” he said.
Millin-Maduro insisted that the best way to protect the hospital’s interests is to make sure the board gets “an iron-clad contract.” She sent a copy of a similar contract between Schneider Hospital and Advisory Board to JFL’s legal department to serve as a guide. A meeting between the legal counsels of both the board and Juan Luis Hospital is set to take place.
The meeting ended without achieving quorum. Present were Millin-Maduro, Ricketts, Miles Stair and Joyce Heyliger. The board is scheduled to reconvene on May 7.