DeJongh's legacy: JFL shuttered

Thanks, Alana, for your question. I have voted here every election of my adult life since the age of 19.

I am self employed and I have health insurance for myself and all of my employees, except one who uses his spouse's insurance. I pay a lot for it. I use the Obamacare tax credit for small employers in addition to deducting the costs on my Schedule C.

I am terrified of revealing my true identity both for myself and my loved ones who work for the government in unionized jobs. When you speak out, you get harassed, they get harassed, you get moved around as a teacher to a school opposite your home on the other end of the island. Stt-STJ policemen get transferred to St. John to work hours that don't don't reasonably include a ferry if you live in Bovoni. Or you don't get your tax return.
Or someone in the Lt Gov office sells your property.

I don't hate the administration, but I hate what they have done and are still doing to the VI. I don't know about you, but are you better off? When last have you driven on STX roads?
Did you know that 80% of ARRA funding was spent in STT? Did you know that millions in ARRA funding to change light bulbs in schools was awarded to a cousin of dejongh in the states? Or that a federal court in DC found that he improperly exerted his influence to give a road contact to the higher bidder?
And I don't have to tell you about Diageo. You can count. And apparently so can Congress who is too pissed to give us the extender back and are talking about canceling the whole program.
Alana, did you forget the the Daily News breaking the story of the 3 federal convicts who were about to enter a $$$ deal with deJongh to repair the Paul E. Joseph Stadium. (Chucky still voted yes after the news broke).
What would I do differently? In a word, I would not vote for anyone who campaigned with or for Dejongh. And I will not vote for his senate pawns, Chucky or Sanes.
If you can't stomach Mapp, then Diase Coffelt is a fine woman of honor and integrity and courage to fight. She will fight for to get EQUAL Medicaid money, SSI, and Obamacare,

Yep I watched you guys quietly while you hurled when DeJongh pardoned her. I heard you commiserate as it started to dawn on you what corruption is going in her and with whom.

Start with voting out Rupert Ross who is trying to get Chucky back on the ballot at the board of elections. And Raymond Williams who is Chief of Staff with the Lt Gov at that fraud ridden office.

No one,
Even the beaurocratic Feds would be better. But they are not interested. They neither care to prosecute corruption nor take over the jail.

If I were JFL, I would tell the Feds "you run the hospital yourself! With the limited Medicaid funding and no Obamacare, I would love to see them still require stateside standards with territory funding. It would be like letting a slum lord live in his own building.

I am terrified of revealing my true identity both for myself and my loved ones who work for the government in unionized jobs. When you speak out, you get harassed, they get harassed, you get moved around as a teacher to a school opposite your home on the other end of the island. Stt-STJ policemen get transferred to St. John to work hours that don't don't reasonably include a ferry if you live in Bovoni. Or you don't get your tax return. Or someone in the Lt Gov office sells your property.

wikipedia VI Daily News

In 1994, the paper had a circulation of 16,400 and a staff of 18 full-time editors and reporters. In June 1994 the newspaper began to inquire about why there had been little investigation into the death of a policeman known for his integrity. The reports resulted in a 10-part series "Virgin Island Crime: Who's to Blame?" The series determined that the police were catching too few criminals, that prosecutors were losing too many cases, and that judges were handing out light sentences. The sole reporter of the series, Melvin Claxton, received such severe threats that he relocated his family to the U.S. mainland.

Read more at the Pulitzer web site:

http://www.pulitzer.org/works/1995-Public-Service

http://www.youtube.com/watch?v=yIYKErCv6Qc

1. I understand getting threats from criminals. After all, threats are a crime. So if in fact threats were the reason Melvin relocated and it was not because of a job offer, or a marital issue, then I condemn that.
Since you mention Claxton...
Last Xmas festival, a calypsonian named Generic sang a song criticizing the governor. His wife was fired two weeks later from the government. Mind you, it is tradition for the calypso shows throughout the Caribbean to use song to air political discontent. It's never personal. Except here.
2. But when threats and retaliation come from a governor who is sitting in office with the color of law,......
People like me either blog anonymously, close my business and leave the territory, or suck it up until the next election, and hope to convince a few reasonable people not to vote the same way again. We also file police reports and call the FBI who never call back.

I feel like we live in North Korea.

On a brighter note. I see opportunity here. I would like to embarrass the US internationally for treating its colonies (all nonwhite by the way) differently when it comes to healthcare resources. How can you tout the success of Obamacare when there are 5 million Americans on US soil who are not entitled to it? After those same colonies were chronically denied equal Medicaid since the inception of the program?

Does anyone reading have the balls to make a case for equal protection to the Supreme Court? I know that delegate Christian doesn't. She is more worried about being able to say that Hillary and Barack are her buddies than acting in our best interests.

cruzaniron is it itemized? make sure you get itemized

A must read... The reality and possible TRUTH behind the decertification is a lot worse than I ever imagined...

I can't get the embed to work for the link... but, click on the source http://stcroixsource.com/? and read:

"CMS Report Details Patient-Harm Issues at JFL, Says Griffith Did Not Report Incidents To Board"

I am not going to get into politics, but Chucky Hansen insisted it be Griffith to fix this hospital... What a disgrace...

As the old saying goes................"We are all going to hell in a hand-basket."

It's quite demoralizing when you look around, see all that is wrong, know how great things could be if our elected leaders acted with truth, honor and intergity. I doubt any know the meaning of those words and it's quite depressing. Hell, they don't even end up in jail for stealing or fraud and bad behaviour is the norm. Good Luck to us all.

Miss Justice - I apologize for my mini meltdown.

Alana, I have been melting down for 6 years. Welcome to my world.

Again I say, the report is embarrassing if true. (Griffith says he believes otherwise.) the appeal will tell.

But something stands out. One of the many criticisms that CMS contends is that there is no governing board quorum to report stuff to! Dejongh is directly responsible for that violation.

Of the 7 governing board slots, deJongh has only filled one. Two other members are selected by nurses and doctors. Those two nurse and doctor slots are filled.

So, in terms of action, do this. Call deJonhj and ask him to fill the slots. Or ask your senators to grow some Cohones and change the law so that other mechanisms can play into filling the voids.

If you can't stomach Mapp, then Diase Coffelt is a fine woman of honor and integrity and courage to fight. She will fight for to get EQUAL Medicaid money, SSI, and Obamacare,

I see Diase Coffelt as about the only one I would consider voting for at this point. Mapp is just another "same old, same old". Christiansen has done nothing but party on at our expense.

I have to agree. I feel Mapp is just another one of the good ol' boys (not so good).
The one idea I did like of Christiansen's was having a CFO which DIJON was totally against. We really need some integrity in our leadership.

A must read... The reality and possible TRUTH behind the decertification is a lot worse than I ever imagined...

I can't get the embed to work for the link... but, click on the source http://stcroixsource.com/? and read:

"CMS Report Details Patient-Harm Issues at JFL, Says Griffith Did Not Report Incidents To Board"

Dude, you have no idea. I have been so sick lately I haven't been able to follow the local news well. This report makes me weep. I have no doubt my case is on that list. There is no question in my mind, none whatsoever, that the mistreatment I received at JFL on more than one occasion contributed to my current state of deterioration and likely premature death. I can no longer work, have no insurance, and few resources other than a plane ticket that will get me to the mainland in a week. There is treatment for what I have, but it will eventually kill me.

I weep for those poor patients who were treated as cruelly and dangerously as I was, all the while being admonished to appreciate that they were doing the best with what they had. I weep for the people who don't have advocates like MissJustice, who writes with such strength, but who also sounds as sh!tscared as I am of what the administration has done to JFL and to anyone who dares complain. Most of all I weep for this island. I love this place and its people, and your elected officials have done you a grave disservice. YOU DESERVE BETTER.

Why doesn't someone run on THAT campaign slogan? Someone, PLEASE, go print off stickers and plaster that phrase on every freaking campaign poster out there today.

IT

To answer the questions posed:
.. registered to vote in the VI? Yes (independent), and I vote.
Do you speak out except for this forum? Yes
Do you call or write Senators? Yes
Do you fight for what is right? I like to think so
Do you actually make a difference? Maybe, but it's like pissing in the ocean, it may feel good but no one really notices a difference.

I have some IS/IT experience in health systems (from the plan side) and a ton in process improvement. I offered my services on more than one occasion - no formal response. I believe that a healthy functional hospital is key to a successful community. As I couldn't help as an employee, I considered applying for a position on the board and spoke briefly with the LT gov about it, but I've lost respect for the gov over the chucky debacle. This is in addition to the gov dropping the ball on the affordable health care act, and failing to establish and exchange. The fact that there is no option for individual health insurance in the territory is a crime.

The government is paying a small fortune in premiums to cover it's employees/retirees. If they instead became self insured, administering their own simple plan that restricts coverage to use local doctors/facilities, then this would 1) save money, and 2) very quickly result in improvements to our facilities. The plan, once established, could be opened up to individuals.

On the subject of medicaid, the federal portion is paid from federal tax dollars, right?
As we (USVI) don't pay taxes to the federal government how can we possibly state that we aren't getting our 'fair share'. We're bloody lucky to get the ton's of federal aid, subsidies, and grants that we do. Yes the fed's do throw money around the states, and other countries, like drunken sailors at a regatta, yet we can't complain if we are not the ones footing the bill. Something to keep in mind.

Oh, Acting CEO Griffith, appealing the decertification in court is not the answer, that's just pulling a chucky. It's time to stop acting and step down - Take one for the team. A new CEO might just pacify CMS in the short term, while a real plan can be put into action.

"Now the Joint Commission, as I said before is not higher than CMS. They accredit on behalf of CMS, which is the agency with the power to pay. CMS has the power to reject the Joint's assessment for accreditation up or down. And CMS can do their own survey which they did.

Clarification: And regarding Medicaid money... We get M.A.P. To individual patients. People here do not have "Medicaid" cards. The point I am making here is that we are getting Medicaid funding that is capped. We get cents on the dollar compared to Mississippi. Ten cents to be exact. Until recently, the poverty line was $5,500 per year. Meaning that someone earning $6,000 per year is not indigent and can afford to pay for their care and pay their hospital bill. In Florida, a pregnant woman earning $17,000 per year is eligible and therefore, the hospitals in Florida are getting competent reimbursement and have enough money to function better. My fellow bloggers, people earning $5,500 will not pay their hospital bills.
So I maintain, ten cents on the dollar for capped Medicaid is no real Medicaid money."

I did not say Joint Commission is "higher", just that passing their certification indicates that certain quality standards have been met. These standards are more stringent than CMS standards. Sure, CMS could come decertify a Joint Commission-accredited hospital, but chances are very slim. They are two separate things. I do not know, has JFL ever applied for Joint Commission accreditation? My point on this one is that the hospital on St. Thomas does not face the same dire future that the one on St. Croix seems to be facing.

People here DO have Medicaid cards. Here they are called Medical Assistance Program cards: http://ltg.gov.vi/what-is-medicaid.html
As I said, we have, what a 50% match? Mississsippi has maybe a 75/25% match. Mississippians actually pay taxes into the Federal system, while we do not. If the Feds give us $10 million, do you think we put up $10 million? Yes, it is capped on their end. It doesn't have to be capped on our end. Oh, wait! We are spending money on horse racing tracks, oversight of one casino, cars for a bunch of government employees, public defender for Rosemary Sauter, an election system that can't get ballots out, a legislature that has some of the highest paid "senators" in the country and huge budgets for their friends and family..Well, you get my drift. There are priorities that could be made, but aren't.

I'm taking your poverty line for a single person at $5500, EE. Personally, I enjoy Medicare and Medicaid that pay for nearly 100% of my medical costs, including a $1400 once-a-month shot. I receive a total of $8892 a year, with no WIC (I might qualify like I used to for $50 a month and probably should go through the work) and I live at bare minimum. I rent a room, buy groceries from Costco and Food Lion, am carless now, have my computer and TV from 2008, a small refrigerator, some furniture including a bed, and play a free to play video game besides doing curious research on the internet, mostly news.

Maybe the rules are different down there? I am unsure.

//Oh yeah I can't forget my approximately 3' long cannon my dad bought me when I was three

As with others, I am highly concerned about JFL’s pending loss of CMS accreditation.

But, folks, it’s a small rural hospital that has tried to meet the big city hospital expectations. For instance, though I felt horribly about Iris Tramm’s medical issues, she was correct to leave for treatment elsewhere given a difficult diagnosis and JFL’s resources as a rural hospital.

It’s time for JFL/VI to re-define what health care services are most important to island residents and visitors. From understanding this a local standard of diagnosis and care with corresponding policies can be developed and then implemented.

If the diagnosis is outside the standard – refer on to STT, PR or FL specialists once a patient is stabilized. BTW the University of Miami has a telemedicine practice where you can be treated by its physicians remotely. A local physician can work with offsite specialists in implementing treatment plans.

The business model for all hospitals is changing and the need to respond to change is accelerating with ACA requirements. It’s now all about quality of care and how the health care system best delivers that. JFL will need to catch up or go out of business. VI politics, in the end, will not stop this progression without re-visioning.

JFL revenues are bound to drop and its need for hospital workers will be reduced. Then you look at employment issues that could affect a lot of families. However, this is going to happen regardless.

The world of health care is changing and I hope it’s not too late for JFL – and Schneider for that matter.

CMS Report Details Patient-Harm Issues at JFL, Says Griffith Did Not Report Incidents To Board

The 112-page report [CMS Report on JFL Decertification] explaining the decision cites a litany of issues in cases where patient care was compromised and patients were harmed that should have been reviewed. CMS cites issues including:

– Lack of quality control improvement;

– Lack of response to patient grievances;

– Violations of patients rights by use of chemical and physical restraints;

– Improper disinfection procedures;

– Mandatory surgical checklists being skipped, and

– Mislabeled medicines in the hospital pharmacy.

The report details incidents in which the actions of hospital staff led to "patient harm" on April 3, April 10, April 27, May 11, May 19, June 4, June 17, July 28 and July 30 of 2014. In several of these incidents, CMS suggests mistakes and improperly performed procedures may have contributed to the patient's death and should have been reviewed by the governing board. In several others, the patients were sent off island for treatment for injuries sustained at the hospital.

It also cites five deaths that could be related to care issues in 2013.

Among the recent nonfatal mishaps that should have been reviewed, according to CMS were cases where:

– A patient had a partially collapsed right lung, but the doctor misread the X-ray and initially put a tube into the patient's chest cavity on the wrong side – after the patient tried to stop him "I should have listened to the patient," the doctor, who was exhausted from working a 16-hour shift, told the CMS official.

– A patient was prescribed powerful anti-coagulants, which pose a serious risk of bleeding. The patient fell out of bed and injured his or her head. Despite seeing swelling and warnings about bleeding, staff did not treat the injury or raise any alarms until the patient worsened, with bleeding in the brain. The report says the patient was in a "persistent vegetative state," with "less than 2 percent chance of survival."

– An infant was accidentally exposed to antibiotics that caused vascular damage to its arm, leading it to be sent off island to treat the injuries caused at the hospital.

All hospitals have patient deaths, some of which may be related to actions or inactions of staff. CMS criticized Juan Luis and CEO Kendall Griffith for not reporting the incidents for review and for not having any system to prevent the same type of mistake from happening again.

CMS is also unhappy that the hospital's governing board continues to be inoperative.

I would suggest reading the whole article.

At least we have a World Class Cardiac Center. How many millions did that cost?

What I see is that none of these occurrences were caused by lack of funding, but my mismanaged operations.

Throwing money at this problem is not going to help.

Have you seen the most recent published independent audit (2012)? The auditors state that the JFL's fiscal condition is so dire that they cannot determine how it will continue. The hospital owes over $40 million to various vendors in the most recent report to the VI government.

JFL will not stay in business without CMS funding.

I understand the money needed to provide services and pay bills.
What I said was that the errors that caused the pulling of the certification
were not caused by a shortage of money, and that throwing money at the hospital will not suddenly cause procedures to be written and followed.

I understand the money needed to provide services and pay bills.
What I said was that the errors that caused the pulling of the certification
were not caused by a shortage of money, and that throwing money at the hospital will not suddenly cause procedures to be written and followed.

Hence the need for re-vamped management, a plan, and then the needed capital to execute.

We may have a 'small rural hospital' but the deficiencies contained in the report are inexcusable for any facility. It's not about the scope of services, it's about how those services are delivered. Anecdotal evidence has it that in the past any doctor who encouraged review/reporting of issues was summarily 'encouraged to depart' - dead chickens optional.

There are many instances of wonderful care provided by dedicated staff at JFL, but when you speak to folks who work on the front lines and the common refrain is "just don't get sick", something needs to change.

Dear noOne:

"Personally, I enjoy Medicare and Medicaid that pay for nearly 100% of my medical costs, including a $1400 once-a-month shot."

Well, that is nice for you. Most of us with private insurance get to pay a deductible and a co-pay for our health care needs. And many people here in the VI aren't able to purchase insurance. It is nice that you should have it all paid for.

Ideas anyone?

1. Let CMS run it themselves with territorial level of funding that they expect us to run it with.
2. Have the governor found in contempt of court for purposely not replacing board members. Sanes had a bill to combine both hospitals. The plan was to dessimate the board, so that Stx hospital would be a satellite of Stt. Then just like Stx roads compare to Stt, our hospital would be one big pothole.
CMS's first criticism is that there is no quorum of the governing board to provide oversight. John Percy deJongh Jr. Is the only executive who can nominate board members.
3. Vote out all the sitting senators who cut the JFL budget every year. You need money to hire competent staff. Start with Chucky.
4. Consider that CMS is not completely accurate. I know for a fact that a doctor was terminated over a patient death, for example. And that the dead chickens story may have been completely made up.
5. Get another CEO. Oh but you would need a full board quorum to do that. See idea #2

How do you lose a dead baby?

Just sell the hospital to a private sector operator and get it over with.