The Gov. Juan F. Luis Hospital, chronically at risk in recent years of losing Medicare reimbursement for patient services, received an unannounced visit from the Centers for Medicare and Medicaid Services to inspect the medical center and investigate an undisclosed complaint.
“Upon their arrival CMS informed the hospital that their purpose for visiting was twofold,” according to Samuel Baptiste, special assistant to the interim chief executive officer, in written response to questions from the Source.
CMS was “conducting a follow-up to their previous inspections and they were conducting an inspection based on a complaint they had received,” Baptiste said, adding that CMS did not disclose the nature of the complaint nor did they provide information on who lodged the complaint.
CMS is the federal agency within the U.S. Department of Health and Human Services that reimburses hospitals for services to Medicare patients. When CMS evaluates health care facilities, it grades them on medical service, safety, patient care, record keeping and staff.
According to Baptiste, CMS visited the entire facility during the week-long inspection, including clinical areas.
CMS has a vested interest in the financial health of the institutions they sponsor. The St. Croix hospital has been crippled financially not only by the lack of funds but by a governing board that lacked a quorum to approve payments and a lack of sufficient accounting personnel. Since July, JFL had only two check signers – Griffith and Wallace Phaire, chairman of the board’s finance committee. Two signatures are needed on most checks.
Finances were not mentioned, the hospital’s interim chief executive officer, Dr. Kendall Griffith, said Wednesday. “They always want to make sure we pay our vendors. It’s always a concern of theirs.”
Griffith said that CMS “noted some findings in the physical plant and clinical areas,” adding that they told JFL staff that “not all the findings are deficiencies.”
“Some are simply observations.” Griffith said improvements made to “environment of care,” the facilities and nursing areas were mentioned by CMS inspectors.
“So that is what we wanted to show them. We are making improvements. They saw evidence of that,” Griffith said.
Griffith said CMS will formally report their findings in two weeks.
In September 2012, a CMS inspection of Juan Luis Hospital resulted in a 79 page report of deficiencies that included deficiencies in medical staff, infection control, equipment, quality control and patient rights. The report listed infractions that included everything from a lack of communication that may have led to a drug overdose to missing light bulbs.
There were no accusations of wrongdoing or neglect by hospital staff, in the 2012 report; CMS simply pointed out deficiencies. But at the end of each section of the report, the governing board and administration were held accountable for all deficiencies.
This week at the hospital, Phaire resigned, leaving only Griffith with the authority to sign checks. By Wednesday, the names of two hospital administrators had been forwarded to the territorial board for approval as “certifiers.”
Griffith said Elleanor Paul-O’Neil, vice president of human resources, and Justa Encarnacion, chief nursing officer, will be allowed to sign checks “immediately.”
To fill the void in the accounting department, Griffith said he has been speaking with Nellon Bowry to fill the chief financial officer vacancy and other financial experts to work in the fiscal department.
One prospective board member, Pastor Derek Skepple, who was nominated by Gov. John deJongh Jr., is making his way through the legislative process for approval.
Griffith has been under fire lately for laying off personnel including 24 employees in April and 15 in November. The correct staff level seems to be elusive.
“According to Premier, we are understaffed in clinical and overstaffed in nonclinical areas. This prompted the layoff,” Griffith said. “We need to make room on the nonclinical side to make room for more clinical staff,” he said but stressed, “There are no intensions to lay off.”
Since staffing is a major concern to CMS, they required JFL hospital to contract with Premier Services to monitor policies, the facility and patient care until deficiencies have been corrected.
CMS ended the surprise visit on Friday with an oral report to approximately 75 JFL administrators and medical staff members. The report coming in two weeks will reconcile the most recent observations of CMS with the official plan of correction approved by the federal agency coming in March.
