ST. CROIX — The Juan F. Luis Hospital and Medical Center’s Chief Executive Officer, Dr. Kendall Griffith, told members of the Committee on Finance at the Frits E. Lawaetz Legislative Conference Room on Friday that the hospital was expecting the Centers for Medicare and Medicaid (CMS) to perform its unannounced inspection of the facility “any day now,” and said that JFL is ready for the surprise visit.
The CEO made his remarks during the hospital’s fiscal year 2016 budget hearing, where it requested an additional $13.41 million upon the Governor Kenneth Mapp administration’s recommended budget of $20.15 million, bringing the government-funded total to $33.6 million. Coupled with the hospital’s own expected revenues of $43 million, JFL’s FY2016 budget totals $77.53 million.
“We are on full alert,” Griffith said in regards to CMS. “We are in a state of readiness and we’re expecting them any day now. And I have to say that we feel very confident that we are ready for the survey.”
JFL was on the brink of losing its certification on Oct. 9, 2014 when CMS said it would withdraw its funding from the hospital due to alarming findings outlined in a damning 112-page report following a CMS audit of the hospital in August of 2014.
The hospital managed to divert disertification on Oct. 9, however, when hospital executives met with CMS officials in Baltimore on Oct. 3 and were given an extension, through November 20, to begin the process of fixing its deficiencies through a Systems Improvement Agreement signed between CMS and JFL. Since then, the facility has undergone a number of changes, including re-establishing quorum on its St. Croix District Board, the body which provides oversight of JFL, and launching a search for top executive staff members.
An SIA is a time-limited contractual arrangement between a Medicare-accredited healthcare organization and CMS. SIAs have been used in nursing homes and organ transplant centers in the past, and recently have been implemented in hospitals.
Entering into an SIA provided JFL more time to fix its deficiencies than is typically allotted from a validation or for-cause survey. In some cases, the timeframe has been extended to as long as 19 months.
The hospital has been making strides to corrected cited deficiencies, installed new units — including a new psychiatric ward — and has updated already functioning segments, including its much-lauded neonatal unit, which was recently enhanced with new equipment worth over $40,000. The hospital has also hired key personnel to aid in carrying out its goal of full CMS compliance.
But areas of improvement still remain. Some employees are overworked — the hospital expends millions of dollars in overtime pay annually as some nurses work 16-hour shifts. The facility recently housed a cancer patient in a room that had no air-conditioning. And it continues to bleed money and remains in constant need of government assistant to stay afloat. Griffith provided information to senators revealing that the hospital is projected to lose over $13 million in fiscal year 2016, compared to a projected loss of $4 million for 2015.
Griffith’s answer to an inquiry from Sen. Graham was, “neither has happened yet, so until we actually start to see cash in hand, I still think we have to demonstrate as accurately as we can what is possible.” The notion being, notwithstanding the improvements and upgrades the facility has made during the SIA time period, and the projected increase in revenue expected to be realized as a result, the hospital must still correctly report its pro.
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