Territorial Hospital Board Approves Millions of Dollars and Budgets for St. Thomas and St. Croix Medical Centers

Douglas Koch, CEO, told the V.I. Territorial Board that $4 million is needed by the Juan F. Luis Hospital for temporary medical staffing – traveling nurses – over the next three years. An additional $800,000 will be necessary to cover a contract lease for printer/scanner/copiers over the next three years. They will save money in the long run, he added. Funding sources for both items were identified during the monthly meeting.

To purchase IT equipment for the temporary hospital – so-called Juan Luis North – the board approved $488,950 for Universal Business Supplies adding that a previous contract with Office Cart Supply, LLC will be canceled.

At the same time, a change order – not to exceed $1.6 million – was approved for LEMARTEC USVI, Inc. for rerouting pipes from the JFL central mechanical building and the V.I. Cardiac Center temporary structure. The amount will cover the removal of existing and the installation of new propane tanks to the St. Croix facility.

For the Schneider Regional Medical Center, $415,000 was approved for Dependable Roofers, LLC to complete emergency repairs to 90,000 square feet of roofing at the St. Thomas hospital.

Finally, the board ratified the release of $20 million of the $27 million ABTIM bond for completed work.

All of the financial transactions had been pre-approved by the finance committee before the full board voted unanimously Wednesday night during the monthly meeting.

Without discussion, the board approved fiscal year budgets for 2023-2024. The CEOs will present the numbers to the 34th Legislature on July 12, requesting $77,889,083 for JFL and $88,565,322 for SRMC on Aug.14.

“This is a balanced budget. It is the result of many hours of identifying opportunities where JFL can improve our revenue while identifying several opportunities for cost savings,” Koch said. “We expect to have a vibrant dialogue with the legislative body.”

Koch discussed some of the information he plans to present during the July 12 hearing. The hospital will continue to monitor COVID infections, although they are declining, he said, and encourage social distancing, masks, and vaccinations.

He will highlight the graduate nursing program, new procedures at the hospital and show how they are using government funding properly.

The board also approved 10 physicians for new or renewed appointments at SRMC, including a pulmonologist, five radiologists, a pathologist, a general surgeon, and an internist/Nephrologist. On St. Croix, four physicians were certified or re-certified with specialties in critical care, podiatry, OB-GYN, and orthopedic surgery. Thirteen individuals were approved for one-year of teleradiology services.

In addition to the financial and staffing discussions, information was presented to the board on a new V.I. governmental division and an outline of federal compliance requirements from the Centers for Medicare and Medicaid and the Joint Commission.

Centers for Medicare and Medicaid Services areas of compliance for inspecting local hospitals. (Webex screenshot)

Michele Francis, director of the Office of Health Information Exchange, introduced the work of the HIE office, formed in October 2021, under the Office of the Governor. Working with Medicaid patients and providers especially, but also the general population will benefit from shared information, records, images, data, and telehealth options for better overall health care.

Michelle Francis, director of the Office of Health Information Exchange, introduced the work of the newly formed office in October 2021, under the Office of the Governor. (Webex screenshot)

“It’s driving modernization and implementation of health technology,” she said of the HIE.

Francis said the HIE has applied for $2 million to help the hospitals update the Meditech data system so that they can share data with other health care organizations.

Dr. Delphine Olivacce, vice president of Quality at Schneider Regional, and Hazel Philbert, JFL’s chief operating officer, reminded board members of their responsibilities to federal agencies. They include strategic planning, quality of care and patient safety, financial oversight, risk management/corporate compliance, and legal and regulatory compliance. Risk management includes conflict of interests and review of safety/sentinel events.

The board is required also to maintain financial solvency of the facilities, oversee quality of care and performance and comply with the federal agencies and the V.I. Code.

“The governing body is ultimately responsible for safety and patient care at JFL but not the day-to-day operations of the facility,” Dr. Olivacce said, adding that is up to the medical staff, the chief nursing officer, and chief medical officer.

Olivacce then listed challenges to compliance for SRMC: capital budgeting, physical environment, staffing, documentation, patient flow, environment of care (roof repairs and HVAC systems), and life safety.

JFL’s challenges are: safe staffing levels, physical infrastructure, limited financial and community resources, hybrid electronic health record documentation, limited bed capacity, preventative maintenance agreements, and equipment reliability and life safety code compliance – maintaining the environment of care.

Philbert warned that CMS and the Joint Commission will first ask for board minutes for the last 12 months when they arrive for a survey to determine what role the governing board has played. A visit from the Joint Commission is expected in the near future.

Board members attending the virtual meeting were: Christopher Finch, Dr. Jerry Smith, Jenifer O’Neal, Justa Encarnacion, Dr. Anne Treasure, Greta Hart-Hyndman, Faye John-Baptiste, Marise James, Bosede Bruce, and Dr. Frank Odlum.