Dialysis patients and their caregivers, along with the Dialysis Support Group at JFL conveyed their frustration to Territorial Board members on Sunday, Sept. 26 in a JFL conference room. Photo Credit: ERNICE GILBERT/VI CONSORTIUM
ST. CROIX — Nearly 50 dialysis patients currently receiving what has been universally expressed as pristine dialysis treatment at the Juan F. Luis Hospital, conveyed raw frustration and anger during a meeting Sunday afternoon at the Territorial Hospital Board's decision to abandon the service and execute a contract with the Caribbean Kidney Center, owned by Dr. Walter H. Gardiner.
The patients were accompanied by their caretakers who also expressed displeasure with the decision. The main reason for the sharp rejection of the board's action was a universal rebuke of Dr. Gardiner's dialysis service by both patients and caretakers alike. They said they were wary of the Caribbean Kidney Center (CKC), alleging that Dr. Gardiner had not treated patients with respect in the past, among other allegations. Forty-seven of the 49 patients at JFL have signed a petition registering their opposition to being transferred to Dr. Gardiner's facility. The other two members were away receiving medical care but have expressed verbally their opposition to being transferred to CKC.
One patient who has been receiving care at JFL for 8 years spoke of a friend who was receiving care at Mr. Gardiner's facility. He said the friend begged to be removed from the Caribbean Kidney Center and claimed "Gardiner is a very disrespectful guy, I don't want to be there no more." This patient's story was one of many.
A caretaker representing her grandfather who started dialysis in 2019 at JFL, said that when given the option to choose dialysis treatment for her grandfather, "we chose [JFL] because it's close to home and also Dr. Gardiner's reputation did not perceive him well, and we just wanted the better care for him." The caretaker also lauded the service at the hospital to the resounding applause from other caretakers and patients in the JFL conference room.
"The level of care that my dad has been able to get here at the hospital has been exceptional," the caretaker said as she was interrupted by responses of "yes" and loud applause from others in the room. "Not only from the doctors, the nurses... just everyone in general and he has thrived in being here," she added, speaking to the level of detailed care showed to patients. "Even if it's something as simple as his blood pressure was just a little elevated one day, somebody would call me or meet at the door when I'm picking him up" and not only notify of the elevation, but ask for possible reasons why.
Dr. Gardiner refuted the claims in a response to the Consortium Monday morning. "Quite frankly, no one person could be guilty of all the things I was accused of yesterday," he said. Dr. Gardiner requested that the Consortium meet with him in person so that he could address "every single item that was brought up." The Consortium will also be given a tour of the Caribbean Kidney Center, which we intend to record to show the community.
Territorial Board Chairman Christoper Finch told the Consortium that the board was aware of some of the complaints, however, Dr. Gardiner had assured the board patients would receive warm treatment.
"We knew there were some concerns and we discussed this with Dr. Gardiner, and Dr. Gardiner assured us that he was welcoming to all the patients," Mr. Finch said. "One of the big concerns that I understood that people wanted to keep their own nephrologist and not use Dr. Gardiner as their nephrologist. So a lot of the discussions were about granting privileges to other doctors so that people could come in with their own doctors, which he has been very willing to do."
JFL Abandons Dialysis Services
The angst surrounding the Caribbean Kidney Center was a result of JFL's decision to stop providing dialysis treatment at the hospital. Mr. Finch said the decision was made based on a Centers for Medicare and Medicaid Services (CMS) ultimatum that the hospital come up with a plan to provide care in a suitable facility. Currently, JFL dialysis patients are receiving treatment in temporary trailers at the hospital built after Hurricane Maria battered the medical facility. Though those trailers have served the patients and the hospital well, the concern is that a natural disaster such as a hurricane could destroy the trailers, leading to a potential disaster for patients.
Mr. Finch said CMS was pressuring the hospital to find a suitable facility. "We were under some pressure from CMS that people were supposed to be out by this hurricane season, " he said. "The patient advocacy groups have been very, very concern at that point that they would go through another hurricane season and something could happen to the trailers and they could end up going back to the states. That's not off the table; that's still a concern and that's why I mentioned earlier if Hurricane Sam had gone a little bit to the west, that's what we would be thinking of today instead of this conversation."
The options included building out a new facility, renting a space and making it suitable for dialysis services, or contracting out the service. JFL chose the latter.
The dialysis advocacy group told the Consortium following Sunday's meeting that the federal government had provided enough funding for a more secure space along with all the necessities needed for a certified dialysis operation. The funding would be available until a new facility could be built, the group members said. However, a space was never chosen, said group members, even after the advocacy group had located multiple options.
Angel Rivera, a member of the Dialysis Support Group at JFL, stated, "There was a plan from all the way 2019 that the federal government had given funds [to the hospital] to find a hardened structure whether it be to rent or lease a facility. They would have provided financing to build it out, staff it and equip it. [JFL] never moved on it."
"We went all around St. Croix looking for hardened structures," stated another member. The group members said the information was emailed to Dyma Williams, current JFL acting CEO. "We never got responses back. Many of these structures that we found, all they needed was proper plumbing and electrical for the dialysis machines and the air conditioning units," said a support group member.
Mr. Finch told the Consortium that finding a suitable space for dialysis service was difficult, describing certain levels of quality that must be met. And he said building a new structure, though considered by the hospital, was ruled out because of the pressure from CMS to be out of the trailers by this hurricane season — a timeline that was not enough for the requirements of a new dialysis unit.
Relative to Dr. Gardiner's Caribbean Kidney Center being the chosen firm, Mr. Finch said the hospital received only two bids, and the other company was asking for too much money.
