An unexpectedly frank and open discussion by the board and executive staff of the Gov. Juan Luis Hospital Monday was sparked, in part, by a critical committee report and pointed questions from a representative from the governor’s office.
Vera Falu, chairwoman of performance improvement, reported that her committee found that systematic changes are needed at the hospital, better communication by management and “everybody needs” staffing, among other recommendations.
At the end of her report, Juel Molloy, special advisor to Gov. Kenneth Mapp, asked why more staff is needed when there are currently 600 employees to care for about 65 patients. She said the hospital should look at downsizing and “live within its means.”
“Some staff are misplaced and can’t fulfill their roles efficiently and effectively,” board chair Troy de Chabert-Schuster admitted. He said the board is aware it must cut expenses and build patient volume.
Falu added that a reorganization plan by the chief executive officer is in the works to evaluate staff’s skills and competencies and if an employee doesn’t fit, he or she will be moved elsewhere.
CEO Ken Okolo said the reorganization plan will improve operations and the extra staff means more outpatient services can be performed, adding to the hospital’s revenue. He pointed out the hospital has already replaced some of the declining government appropriations with earned income.
Also speaking in defense of the employee to patient ratio, board treasurer Philip Arcidi pointed out that there are more outpatients and emergency room patients than in the past, who are not included in the patient census.
During his report, Okolo said the hospital is no longer working under a systems improvement agreement and is now in compliance with the Center for Medicare and Medicaid Services “in the same standing as any hospital in the country.”
While seven nurses were hired in March, more nurses are needed to build outpatient surgery volume, in the emergency room and as the census grows, he said.
Okolo reported that improvements have been made to the dietary and laundry areas, the CT scan is the “best in the region” and new chillers were installed for the air-conditioning system.
Progress has been made in two of Arcidi’s pet projects, he reported: Patients who enter the hospital are being interviewed for presumptive eligibility with Medicare and Medicaid, but they still need cards issued by the Department of Human Services. And, a meeting has been set in Washington D.C., to discuss rebasing JFL’s reimbursement by CMS for patient services. An adjustment to 2013 prices instead of 1996 rates would add $8 to $10 million to the hospital’s coffers every year, Arcidi said.
During the financial report, Tim Lessing, chief financial officer, said statistics show there are about the same number of inpatients as last year. They are sicker but their stay is almost a full day shorter, he added.
Lessing also confirmed that JFL has improved its financial status slightly. Although a loss was posted for February’s income to expenses of $1.1 million, year-to-date, the hospital has gained $258,816, instead of a predicted loss of $1.7 million.
The board heard Robert Shuman of Boston Children’s Hospital and Linda Moulton of Lahey Hospital Executive International Health Program talk about building partnerships with JFL by providing specialized physicians who would consult at the request of local physicians.
De Chabert-Schuster said they hope to start the program with visits by rheumatoid and vascular physicians in the summer or fall.
“It will extend the scope and reach of JFL. We cannot operate in isolation any longer,” Okolo said.
The board approved four reappointment applications and one initial appointment for medical staff and voted to request approval from the Territorial Board for a $5 million line of credit to pay up-front for items funded by grants. The credit line would be repaid when the grant was received.
Also attending the meeting were board members Joyce Heyliger and new members Aracelis de Hendry-Walcott and Theresa Frofup-Alie.
