Douglas Koch, chief executive officer of the Gov. Juan F. Luis Hospital, proposed a budget of $88 million to the Senate Committee on Budget, Appropriations, and Finance Friday.
He described it as “a conservative balanced budget projection.” He added that the St. Croix hospital was currently on track to end the fiscal year 2023 at $83 million.
The hospital moved into a temporary home, referred to as JFL North, three months ago. He testified, “We are watching with eagerness the construction of the Critical Administrative Building and the continued progress to reach the ultimate goal of a rebuilt permanent hospital.”
Sen. Novelle Francis said the hospital was going through around $100 million a year. He asked, “Where are you bleeding money?”
Koch touched on three areas that sucked money out of the hospital coffers — the cost of boarders, legacy debt, and the cost of hiring visiting nurses.
Borders are residents who remain in the hospital because they have no place to go. The hospital does not get reimbursed for their care because no medical problems necessitate their stay. Koch testified, “Neither Medicare, Medicaid nor private insurance carriers pay for their continued stay after they have been medically discharged. Boarders come at a cost to the hospital and add to the issue of long wait times in the Emergency Room. This is because the boarders are unnecessarily occupying inpatient beds forcing our inpatients with legitimate diagnoses to be housed in our Emergency Department. We have also had to cancel elective surgeries because of the lack of bed space.”
He gave this example. “In May 2023, there were eight boarders. The cost to keep those boarders for that month alone was approximately $402,527.”
He added patient beds being occupied by boarders is the primary reason people leave without being seen in the Emergency Room. During the month cited as an example above, Koch said 156 people left the ER without being seen.
The paying down of old debts, according to Koch’s testimony, is a diminishing problem.
JFL’s payables decreased from $25.3M in May 2022 to $17.6M as of the end of May 2023. Koch added, “We have decreased our accounts payable from $54 million to $17.6 million over the past five years.”
Included in the debt payoff was money the hospital owed to the Government Employment Retirement System. Koch said JFL was now current on all payments to GERS.
The fact that the hospital has 41 vacant positions oddly contributes to the hospital’s bleeding of funds. To keep adequate staffing at the hospital, JFL must hire visiting nurses. The costs associated with that process are, according to Koch, double what it would be to have nurses on staff. Koch said it was “all hands on deck” concerning the effort to hire permanent nurses.
According to testimony, the salary for next fiscal is $36 million, with fringe benefits costing an additional $25 million. The budget for supplies is $11 million, other services are also $11 million, and utility costs are projected at $5 million.
The requested General Fund appropriation is $29 million.
Sens. Donna Frett-Gregory, Novelle Francis Jr., Angel Bolques Jr., Marvin Blyden, Diane Capehart, Samuel Carrión, Dwayne DeGraff, Ray Fonseca, Kenneth Gittens, Javan James Sr., Franklin Johnson, and Carla Joseph attended Friday’s hearing.
