Gov. Juan F. Luis Hospital will soon post the hospital’s monthly financial statements on its website to let the public see for itself the hospital’s financial shape in the wake of declaring a financial emergency two weeks ago.

Juan Luis’ new Chief Executive Officer Jeff Nelson asked the hospital’s governing board for permission during its regular monthly meeting Wednesday and, after a few questions, the board voted in favor.

"Is there any way publishing the information might affect negotiations with vendors?" asked board member Carmelo Rivera.

"The reality is the information is already available for a fee from Dunn and Bradstreet, so it’s already semi-public," Nelson said. "But more importantly, this is a public institution, we have nothing to hide and it is already out there anyway." Broad, hospital-wide figures will be posted on a monthly basis to the hospital’s website, along with some explanation of what the numbers mean, he said.

The board selected Nelson, a turnaround specialist, as hospital CEO in January and gave him broad powers over the hospital with the goal of putting the hospital on a more solid financial footing and improving customer care.

In early March, the hospital declared it was facing a financial emergency and was having trouble paying its vendors. The hospital lost $3.7 million during the current fiscal year through January, slightly worse than the $3.5 million loss for the same period in 2010, Nelson said at that meeting. It owes its vendors $22.7 million, of which 90 percent is owed to 23 vendors, including Advanced Radiology, the V.I. Water and Power Authority, and Worldwide Travel Staffing.

The hospital owes the V.I. government $2.9 million for health benefits and internal revenue payments, while WAPA is owed more than $3 million.

Looking at the hospital’s finances in detail helps point to where the most improvement can be made, Nelson said. For February, the hospital had $6.7 million in revenues, which was $390,000 less than budgeted, he said. But in the details, it seems the hospital is coming under budget on some items; spending almost half a million less on supplies than expected. Meanwhile, labor costs: salaries wages and benefits, cost $3.4 million in February, $1.1 million over the $2.3 million budgeted.

Some of those labor costs might be cut by handling the hospital’s patient load more efficiently, he said.

From an admissions standpoint, Juan Luis had slightly fewer outpatient procedures and slightly more inpatient procedures than expected, he said. Inpatient work is more costly than outpatient, so each patient should stay exactly as long as necessary and no longer he said. Also, the average length of patient stays at the hospital was just over 6 days—more than two days in excess of national norms.

"There are many reasons for this, from the disposition of the patients to some boarder patients," he said.

Managing the volume of patients more appropriately would reduce the length of stays, saving money, he said. Also, a disproportionate share of patients had discounted bills or are not expected to pay, he said.

Meanwhile, Nelson and hospital staff have been working on increasing collections, meeting with vendors who are owed money and revamping the hospital’s chargemaster schedule of prices for service—something that has not happened for five years, he said.

One of the biggest debts is to WAPA, which has issued a demand letter, Nelson said.
"We will meet with them, as well as other vendors, to try to work out a plan to pay," he said. "And although there are already payment plans we have not historically met, we will work to restore trust going forward," he said.

He is speaking with Gov. John deJongh Jr. about how to more quickly get funds the federal and local government may owe the hospital, he said.

"In particular, we are looking at how the central government can help with the federal government on Medicare funding we think is owed to us," Nelson said.

Nelson has set up a team of volunteers from all parts of the hospital and tasked them with submitting ideas for improving care and better serving the public. The team gave the board an upbeat presentation Wednesday, laying out broad goals.

The team would like to see Juan Luis become "the most trusted patient-family centered health system in the Caribbean by 2020," said Ellenor Paul-O’Neil, who narrated a short Power Point presentation for the group.

Ultimately, the team will work out a series of proposals to help reach that goal, focusing on suggestions that are: specific, measurable, actionable, realistic and timely, Paul-O’Neil said.

"We ask you for your support and we will support you as well," she said.

The team’s proposals will go to the hospital’s governing board for consideration and approval, Nelson said.

Present at the meeting were board members Rivera, Chairman Valdemar Hill, Joyce Heyliger, Wallace Phaire and Kye Walker. Absent were Imelda Dizon and Deepak Bansal.