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Thursday, August 18, 2022
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JFL Board Reaches Quorum with New Members

The newly reconstructed governing board of the Gov. Juan F. Luis Hospital met Monday and outlined corrections being made to problems that resulted in the hospital’s decertification by the Centers for Medicare and Medicaid Services.

After more than a year of resignations and vacancies, the nine-member board has lacked a quorum since July 2013.

Two new members – Kimberly Jones and Troy DeChabert Schuster – were named by Gov. John deJongh Jr. and approved last week by the Legislature, bringing the total to five.

A quorum allows the body to oversee the hospital, make policy and approve financial expenditures. One of the deficiencies noted by CMS was lack of oversight by the board.

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Board Chairman Anthony Ricketts quickly launched into business Monday and called for the election of officers. After the voting, Ricketts retains the chairmanship and Schuster was named vice chairman. Philip Arcidi will serve as treasurer and Jones will replace Joyce Heyliger as secretary.

Ricketts then asked the board to approve more than two dozen policies and procedures crafted or rewritten in time for a meeting with CMS this week. The rules cover wound care, emergency management, patient safety, case management, patient rights, the Americans with Disabilities Act policy, nutrition procedures, patient discharge, nursing, discipline and other areas deemed deficient by CMS.

Dr. Kendall Griffith was approved as chief executive officer, a position he has held for the last 18 months on an interim basis. His contract is for one year and his salary remains at $300,000.

“CMS doesn’t like ‘interim.’ That says indecision,” Jones said after the vote was taken.

According to Griffith, by midweek the hospital will have a corrective action plan for a Friday meeting with CMS in Washington, D.C.

To be in compliance with CMS, Griffith said he needs $2.3 million in “tools and consultants” beginning with $175,000 for legal fees, $75,000 for Micromedics software and up to $900,000 for scheduling, inventory management and budgeting software. Another software package, PatientKeeper, and a merchant service contract would help improve collections, he said.

Arcidi asked about the source of funding and Michael Younger, assistant chief financial officer, said there is $1 million set aside for IT upgrades last year and Griffith hopes the Legislature will provide the remaining $1.3 million.

“The Legislature discussions included IT funds,” Griffith said. “I hope they will find some of that funding.”

Last week JFL hired Ropes & Gray, an international law firm based in Boston “not to fight CMS” but to help the hospital avoid decertification, Griffith said.

Deborah Gardner, one of three Ropes & Gray attorneys, said their goal is “to resolve many deficiencies” and avoid the “dire impact” of decertification. She stressed that CMS will want to see what is being done differently this time to correct matters at the hospital.

Sammy King, new chief financial officer at the hospital, talked about “Medicare what-ifs” and said roughly $2.2 million is collected from CMS every month. He said that would disappear if the hospital is decertified and, if private insurance companies follow suit, even more would be lost.

CMS reimbursement is 80 percent of JFL’s cash flow, King pointed out. Decertification would be “horrific for the hospital and the community.”

Griffith said it could be as much as a $32 million shortfall annually.

“It would be better to pay $10 million for getting recertified than $32 million to keep us afloat,” Griffith said. “It’s very important to show the investment and commitment of the government in this process.”

Gardner and Griffith met last weekend with senators and requested $10 million “integral to the corrective action plan” for CMS.

In addition to $1 million for PatientKeeper, $5 million would pay for medications and supplies. Delinquent accounts could be brought up to date with $400,000 and $1.6 million would be held in escrow for third-party consultant payments.

King, on the job for two weeks, gave a brief financial report. He pointed out that in October 2013, operating revenue was $51 million, $10 million more than this year to date. Although expenses are down $13 million over last year, the margin – revenue minus expenses – is 54 percent instead of the accepted 4 to 15 percent. Cash on hand is $2.1 million, but there should be $5-6 million in the bank.

“The money that comes in goes right out the door” in salaries, wages and benefits, King said.

Good news was delivered to the board by Karl Knight, director of the V.I. Energy Office. An energy audit by Florida Power Light Energy Services will allow $12.5 million in energy saving improvements to be made with no cost to the hospital. Light controls and fixtures, meters, new toilets and showerheads will be installed throughout the facility. Two water heaters, three chillers and one air handling unit will be replaced. The kitchen and laundry will be revamped, Knight said, and 30 transformers will be replaced.

Knight said the changes will save $2.5 million a year. Electricity use will decrease 27 percent and water usage by 22 percent. Gardner asked when the air-handling unit would be replaced. The whole project should take about 18 months, Knight said.

Throughout the four-hour meeting, Griffith spoke about the need for increasing patient satisfaction, “high standards and level of care” and more hard work by the staff and administrators. He also complimented his staff and administrators.

“I want to assure the community we are ready and willing to care for our community,” Griffith said. “The present state of operations at JFL doesn’t reflect what is in the report.”

Time will tell if his optimism is justified.

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