The Gov. Juan F. Luis Hospital has retained an international law firm following a report from the Centers for Medicare and Medicaid Services, hospital Chief Executive Officer Dr. Kendall Griffith told the governor and 13 members of the 30th Legislature at a meeting Tuesday night on St. Thomas, Government House reported in a news release.
Griffith said the hospital had signed Ropes & Gray, a Boston-based firm with offices in the United States, Asia and Europe. The firm, with more than 1,100 lawyers on its staff, includes among its clients corporations, financial institutions, government agencies, universities and health care organizations.
CMS announced Thursday that it will decertify the St. Croix hospital from participation in the two federal health care programs, threatening an important revenue stream for JFL. The report included a catalog of cases in which the hospital caused harm to patients. (See links below.) The report also highlighted what the inspectors considered administrative problems at the hospital.
Gov. John deJongh Jr. started the meeting by pointing to the potential impact decertification will have on the hospital. While many of the problems highlighted by CMS are directly related to quality of care, policy and procedure, as well as oversight of the hospital’s medical staff and clinicians, the governor said there is also the need for demonstrated governmental support, organizational and structural change, training and additional funding.
“This was an opportunity for the senators to hear directly from Dr. Kendall Griffith about the CMS report, what he agrees with and the portions of the report to which he takes exception," deJongh said. "More importantly, the meeting underscored for everyone the importance of identifying the risks as outlined by CMS and working together to develop a clear path forward to address the issues through a comprehensive corrective action plan that we hope will lead to a reconsideration by CMS of its decision."
DeJongh and members of his senior staff and policy team have been in regular conversations with Griffith, Delegate Donna M. Christensen, Territorial Board Chairwoman and Commissioner Lynn Millin Maduro, Human Services Commissioner Chris Finch, Department of Finance Commissioner Angel Dawson, and Office of Management & Budget Director Debra Gottlieb about the governance and financial challenges facing the JFL Hospital, the release said.
“There was universal agreement that the provision of quality patient care is paramount and that we are prepared to make the decisions that are required in the best interest of the community and health care delivery," the governor said. "The senators were open to suggestions, provided their own observations, voiced their concerns and wanted to ensure that we have a coordinated approach.”
Senators who attended the meeting included Sammuel Sanes, Janette Millin Young, Donald Cole, Alicia “Chucky” Hansen, Tregenza Roach, Clifford Graham, Kenneth Gittens, Myron Jackson, Nereida “Nellie” Rivera-O’Reilly, Clarence Payne, Craig Barshinger and Terrence “Positive” Nelson. Sen. Judi Buckley participated by telephone.
“Our community and especially St. Croix has had to deal with a number of major events over the last several years – the Great Recession, the closing of the oil refinery and now the possible loss of CMS certification at the Luis Hospital,” deJongh said. “In all these instances, we are better than any one of these challenges and, right now, we have to come together and not fall victim to the negative discussions that only serve to hold us down and not advance our collective interests.”
“We will find our way through each of these events, but only if we believe in ourselves and exercise the strength and determination to make the difficult but necessary decisions,” deJongh said.
And what money is JFL going to use to pay this well-heeled Boston law firm? Wouldn’t that money be better spent on making up missing GERS contributions, paying its delinquent IRS and BIR taxes, or WAPA or any other outstanding debt?
VI Watchdog
I have some questions….Did the Source reporter ask deJongh what was his reason for leaving the hospital without a governing board quorum for over a year? Did the senators chide themselves for cutting the hospital budget year after year? Did anyone in attendance recollect that 4 CEO’s Including Jeff Nelson, Calliste, Plaskett, and now Griffith had warned the senate that the budget cuts would threaten the optimal functioning of the hospital?
Did Senator Sanes offer an explanation for why he let the two nominees sit in the Rules Committee for so long? Did it have anything to do with his bill to make JFL a satellite of RLS Hospital in STT? Did any of senator who were seated in 2011 like Sanes who voted for the 8% cut and Hansen who dodged the vote, which lost the territory scores of both experienced nurses and teachers, admit that the 8% cut was a mistake? Did the governor remind the senators that he had taken JFL of the payroll in 2012? Did anybody there, especially Governor deJongh seem inclined to connect the loss of educated professionals to early retirement with the Economic Stability Act, which incidentally is also sinking the GERS pension system?
Doesn’t this territory realize that you cannot fix mistakes if you don’t admit them?
What a legacy deJongh has left us, inheriting a funded, certified hospital, with 7 board members. And now this. I guess that 2007 contrast to now was lost on this reporter. It is not however lost on us.
VI Watchdog
Senator Chucky Hansen has a daughter and a son hired by deJongh working at the Dept of Health. He never reports for work, she reports on paydays. They can never be fired or written up because “my mother is Sen. Hansen.” This amounts to thievery against our treasury is is part of the reason our healthcare system has such challenges. Things are not as they appear. If Chucky has her way to place the hospital back under the Dept of Health, CMS will never decertify them, and her daughter who now makes $56,000 per year with a high school diploma will be the next CEO making $500,000 per year.
Until we remove corrupt people from government none of our systems will be functional.
“I am a registered nurse with over 17 years experience in non-profit facilities, corporate owned facilities and state
facilities. I have had the privilege of
working in a variety of settings: all critical care areas,
medical, surgical, OR, recovery unit, high-risk Labor &
Delivery, Ante & Postpartum, and disaster relief
areas such as Florida and New Orleans.
I’ve seen excellent, mediocre and poor health care. Gov Juan
F Luis hospital is the worst I’ve seen; but not because of
lack of supplies or equipment, not because of a run down
facility, but because of the attitude and lack of
accountability our healthcare community has had; because of
the lack of camaraderie with healthcare workers, and the
lack of community involvement.
For these reasons I do not believe it is only the hospital
at fault that we are now in this healthcare crisis. I
strongly believe the following should all be held
accountable: the hospital staff, our local physicians, CMS,
Joint Commission and our local community.
I left the hospital after 3.5 years because my own
conscience would not allow me to continue to turn a blind
eye to the inhumane treatment our patients received. These
are the things I saw with my own eyes: hep-locks
imbedded in a person’s arm, IV tubing and IV sites not
labeled with date, time or initials, dressings that hadn’t
been changed for days, bed sores that could have been
prevented, urine and feces saturated diapers on a person all
day, ignored call bells for assistance, wrong medications
given, no medications given, beating patients, refusal to
feed patients that could not feed themselves and force
feeding patients when they took too long to chew and swallow
the food they were being fed, doctors orders not being
carried out, no policy and procedures and out dated policy
and procedures, doctors not responding to calls, doctors not
coming in when called in, poor working diagnostic machines
(x-Ray, CT Scan and MRI) yet billing for the services,
blankets and pillows along with other supplies being taken
home by staff members for their own use, wrong diagnosis
from doctors, radiology staff sending letters to patients
saying they have cancer when in fact they did not, hospital
walls and ceilings dripping with condensation falling into a
patients open abdomen while on the operating room table, and
more.
While in nursing school I was taught that going to a
hospital is like going to visit someone at their home.
That we should treat each patient as if they were a guest in
our own home; that we should treat ALL patients the way we
would want to be treated and the way we would want our loved
ones to be treated.
Shame on all of you involved in his treatment.
To the clinical hospital staff I ask: How can you
continue to turn a blind eye? How can you document
that an IV is clear of signs and symptoms of infection when
you haven’t even looked at it? How can you document
that you’ve carried out an order and really haven’t ?
How can you not work together as a team when you know full
well that caring for a patient IS TEAM WORK? Why is it
that those nurses that are now in administration cannot put
on a pair of scrubs and help care for patients when there is
a staff shortage? I was told by the Chief Nursing Officer by
the union laws they are not allowed to treat patients once
they’re in administration. Really? Then why did you become a
nurse?
To the physicians I ask: Is it really about the
money? Because that’s what it looks like. Caring for a
patient in a hospital is a “Privilege” for services that you
can charge for. By getting a salary from the hospital as
well as charging for your services is double dipping.
Is it really because a doctor isn’t born here on St Croix
that you cannot accept them as colleagues and work together
as comrades? That question is for nurses as
well.
To the administrators I ask: Why is having a title of
CEO, Chief Nursing Officer, Nurse Manager, Assistant Nurse
Manager, Clinical Coordinator, etc more important than
“Quality Patient Care”? How is it that at the end of
2013 we still do not have a Scope of Practice for Nurses,
Nurse Practitioners, Physician Assistants, etc? How is
it that we don’t have updated policy and procedures for
things like Blood Transfusions? How is it that we
still have inexperienced nurses working triage? How is it
that we still have nursing assistants working as emergency
room technicians without the proper training? How is
that we do not have cardiac monitors in every ER exam
room? Where are we supposed to get our patients for
the new Cardiac Care Center if our front door (the Emergency
Room) is not prepared? Do we really need sooooo many
administrators when we have such a “global” shortage of
nurses? What about overseeing the housekeeping
staff? Surely this small facility could be a little
cleaner. What is it that you are
“Administering”?
To the community I ask: How is it that the community
hasn’t come together to address these issues as well?
Why is the community going off island for healthcare
treatment? Including the same doctors that were born
here and live and their family members? Why is the
community not actively protesting to have better
healthcare? Why aren’t asking questions and demanding
answers? Why is the community NOT
OUTRAGED!!!!!! at our healthcare here in the
territory? It is your body, the body of your friends
and family that are being neglected, mistreated and
misdiagnosed. Do you not care about yourself and loved
ones? And lastly you need to know that most of us got
into healthcare because we really do care. We’re not here to
give you a hard time; we’re here to take care of you and
your loved ones. So when we ask something of you please
remember that. It doesn’t help when you treat us badly
like cussing at us or threatening us with harm. You
cannot put a price on saving someone’s life. We don’t get
paid that much!
To Joint Commission and CMS (Center for Medicare &
Medicaid Services) I ask: If a hospital is to report
to both agencies as governing bodies then surely you should
be held accountable as well. Clearly the hospital did
not get to this point over night? Both agencies also
turned a blind eye. If you hadn’t our hospital would not be
in the situation it is in today.
CMS is the agency that governs Medicare and Medicaid
services. It sets the rules and regulations hospitals,
long-term facilities and laboratories must follow and meet.
“Founded in 1951, The Joint Commission seeks to continuously
improve health care for the public, in collaboration with
other stakeholders, by evaluating health care organizations
and inspiring them to excel in providing safe and effective
care of the highest quality and value. The Joint Commission
evaluates and accredits more than 20,000 health care
organizations and programs in the United States. An
independent, not-for-profit organization, The Joint
Commission is the nation’s oldest and largest
standards-setting and accrediting body in health care. To
earn and maintain The Joint Commission’s Gold Seal of
Approval™, an organization must undergo an on-site survey
by a Joint Commission survey team at least every three
years. (Laboratories must be surveyed every two
years.)”—copied from http://www.jointcommission.org.
—-did you hear that—–every 3 years for the facility and
every 2 years for the laboratory!!! Where were these
guys? Not here, or maybe they were paid
off.
I’ve often wondered why the United States needs two agencies
to oversee the requirements that are mandated by “one”
CMS. It just sounds like more money for us tax payers
to pay.
And lastly to our local government I ask: All of this
starts with you, the government. What are you thinking
of? These are your people you are representing, yet
you too leave the territory for better healthcare. Why
aren’t you taking stronger actions for us regarding
healthcare? Why is it that individuals still cannot
get health insurance here? It’s been over 3 years now.
How much longer are you going to negate what is rightfully
ours? This community trusted you and the education you
received to do better for us. You have
failed us as well. You should be setting the example for
those of us in the community and yet you shame us.
This hospital was set up to fail from the beginning it was
just a matter of time before it finally was brought to the
forefront. An organization that has so many people in
high paying positions cannot sustain without falling at some
point. An organization that has no inventory control cannot
sustain with falling. An organization that continues to turn
a blind eye at the inhumane treatment of another human being
cannot sustain without falling! An organization that
does not hold itself or it’s governing body accountable
cannot sustain without falling. There are too many variables
to deal with on a daily basis, including but not limited to
the constant changes and demands from CMS and our local
government.
So now for some solutions:
–This community MUST!!!!!!!! Get REALLY, REALLY ANGRY!!!
–This community MUST!!!!! Get INVOLVED and EDUCATED in
basic healthcare current events.
–This community MUST!!!!!! Raise it’s standards and stop
accepting mediocre at best.
–This community MUST!!!!! Pay attention to their own
healthcare as a whole and STOP blaming the healthcare
professionals. Ask your nurses and doctors questions
so that YOU understand what exactly is happening to you and
what exactly are YOU being treated
for. Keep a list of your medications, past
medical and surgical history and your doctors names and
phone numbers in your wallet. Know what each
medication is and why you are taking it; not just its color
and size. These are your responsibilities not
ours. The same way healthcare professionals have
responsibilities, so do you.
–This community MUST!!!! Ask CMS and Joint Commission for
an explanation of why they have continued to give the
hospital here accreditation when clearly they shouldn’t
have. Also to possibly work a little closer with the
hospital to get it to be where it needs to be to meet the
standard of quality patient care we all deserve.
–This community MUST!!!! Hold the government to their word.
Next:
Create a financial analysis. A lot of the money that
is needed is within the hospital.
Create an IT analysis so that we do not continue to spend
money on electronic equipment we do not need. Remember
CMS is constantly changing their requirements. They now want
all electronic health record systems to be web based. I hear
no one talking about the exorbitant amount of money that has
already been spent on these systems.
Create a bartering system where patients that owe money can
work off part of their debt. I.e. Electrical, plumbing,
painting, IT etc., services the hospital needs to maintain
its facility can be done by our own community.
Then:
–Get rid of administrators that are clearly NOT really
needed. This is part of the financial analysis.
I’m not saying to fire them, but maybe demote them or
cross-train them to do other needed services. Those who are
nurses should assist as needed when their is a nursing
shortage.
–Take away doctors salaries from the hospital and allow
them to charge for their “privileges” / services.
–Create up-dated policy and procedures and keep them
updated yearly or as needed.
–Have regularly scheduled in-services for the staff re: the
policy and procedures.
–Create standing orders for the emergency room (ER) for
various common symptoms I.e. Urinary tract infections,
chest pain, shortness of breath, asthma, etc
–Place cardiac monitors in every ER, intensive care unit
(ICU), progressive care unit (PCU) room and have a monitor
tech monitoring them.
–Have only seasoned experienced nurses working triage.
–Have only ER techs assisting Registered Nurses in the ER,
not licensed practical nurses (LPN’s) nor certified nursing
assistance (CNA’s)/patient care technicians (PCT’s).
ER techs can: draw blood, star IV’s, get EKG’s done,
transport patients, do glucose finger sticks.
–Have CNA’s/PCT’s assisting LPN’S and RN’s on the medical
and surgical wards.
–Have only RN’s working in the other critical areas with
CNA’s/PCT’s assisting.
–Hire a Nurse Educator to offer in-house Continuing
Education classes such as Basic Life Support (BLS), Advanced
Cardiac Life Support (ACLS), Pediatric Advanced Life Support
(PALS), and Neonatal Advanced Life Support (NALS),
medication errors, HIV and Aids, EKG monitoring and reading,
infectious disease etc keeping everyone current and up to
date with their licensure requirements.
–Cut back on paid holidays.
–Continually educate staff on the diversified culture we
have in our community. By doing this it can decrease a
lot of the frustration both nurses and patients have
–Hold ALL staff accountable for their actions by doing
regularly scheduled reviews, addressing insubordination
issues and medical errors, etc
–Obtain an inventory supply system such as an Omnicell and
a small staff that monitors inventory control.
–Modify radiology, dialysis and rehabilitation units
——-I’m sure there are many other solutions out
there——-
And finally, we all need to look at our own attitude and
make the changes within ourselves. As healthcare
professionals we are taught to improvise when we do not have
the supplies we need. This is a small town where
people working together as human beings can make it a great
town. Not more, better, bigger or faster; just working
with what we already have. Maybe improvising a little
when needed.
This is not a “state side or corporate America” way of doing
things; I believe it’s just a humane way of doing
things. It doesn’t cost a cent to be kind to one
another.
After putting opinion to paper why do I feel like I’ve just
wasted my breath? How discouraging …..”
Things may well be imploding for the V.I. ruling class. They will kill their cash cows instead of suring them up. The corruption cannot march on in perpetuity. Now if Congress would just stop feeding the animals things may finally get to democracy.
Mapp, you are very desperate to be governor! Why don’t you come out the closet? You can’t hide your identity and orientation!
Instead of continuing to throw money away by hiring an international law firm, JFL, Griffith and our illustrious leaders should be tackling this problem head on and fixing the deficiencies that caused the decertification. “You cannot appeal decertification, you can only apply to be recertified.” More wasteful and unfounded spending but what else is new with our so-called leaders.
The leadership in the Virgin Islands has become a joke with continued nepotism and cronyism replacing individuals that have actual qualifications for the jobs they are given and that actually do the work they are hired and paid to do.
This unfortunately is nothing new but it needs to be stopped, now.
DeJongh, I am sorry to say, is full of BS. That goes for the majority of our Senators as well.
Every single entity this Government touches and has oversight for goes to hell in the proverbial hand basket and there is absolutely NO ACCOUNTABILITY.
We have been bailing out the hospitals both on STT & STX for years and nothing changes except the amount of money it costs us to do so.
Is it surprising that JFL was decertified given the glaring and ongoing deficiencies? NO!
The Virgin Islands needs to privatize:
both Hospitals, WAPA,VIWMA to name a few and get rid of all the blood sucking parasites that operate them and operate without consequences within them. That goes for all those elected leaders within our Government as well.
Vote Wisely!
WOW, Ok, so i vote for you to be CEO.
I am a Clinical Psychologist – off island most of the time but licensed in the VI. I cannot believe what I have watched over 10 years as the hospital struggles along. This was only a matter of time. The situation must be REALLY bad because, in my experience, it is actually quite difficult to LOSE certification. I have seen hospitals threatened, but they never really do it…so again, this situation must actually be very bad!
Money is no problem but the problem is no money…tell me again? No money to do what you professionals know needs to be done but you want to pass on the job to Ropes & Gray. You have had CMS certification for years and now that you don’t, you panic and run to a high priced law firm up in Boston. Idiots!
The hospital is currently a caca hole. 911 mentioned condensation dripping from the overhead ceilings. The place was raining 24/7, inside the hospital. What a mess! Imagine, they are planning to build a medical school soon. Will JFL be the new training hospital for these future doctors? I feel a nightmare coming on.
Is there a bureau in the government that investigates employee attendance? These loofs should be fired immediately. If it is found that Chucky’s son and daughter are a set of payroll parasites, they should be sent packing. Let them go and clean the land around the mother’s house as a job. That should keep them gainfully employed for years. The governor needs to clean house.
VI Watchdog
The harm is done. Your most qualified nurses and teachers are leaving in droves and will not come back. And whoever has a fantasy that doctors in the emergency room will see patients with no salary has no idea what they are talking about. Griffith was warned not to take over JFL while it was on probation. It was a suicide mission.
And the other fantasy is that a private company would want to touch the hospital or WAPA. Almost half the people in the territory cannot pay their bills and cannot be denied service. What a ridiculous business model that is! So keep dreaming.
The buck stops with deJongh. He purposely left the hospital without an oversight board so he could make JFL an RLS satellite clinic.