JFL North, the 50,000-square-foot temporary hospital on St. Croix. By V.I. CONSORTIUM
Nurses have given the leadership of the Juan F. Luis Hospital and Medical Center 30 days to expedite the move to the new modular facility called JFL North, citing “dire, stressful environmental conditions” owing to failing infrastructure.
“VISNA requests the evacuation of JFL and activation of JFL North within 30 days,” wrote Yvette Rivera, president of the V.I State Nurse Association, speaking during a Committee on Heath, Hospitals & Human Services hearing Friday.
JFL North has been hit by yet another delay that has set its opening date back by at least a month. The facility is now anticipated to have a start date sometime in November.
Darryl Smalls, executive director of Facilities & Capital Development for the Territorial Hospital Redevelopment Team (THRT), said the postponement was a result of manufacturing delays with the world’s steel shortage, a major component which is needed to erect a 260,000-gallon water storage tank that is to provide water to the building.
“In June 2022, we were informed by the tank manufacturer that due to “Force Majeure,” which in legal terms translates to, 'unforeseeable circumstances that prevent someone from fulfilling a contract,' the delivery of the tank would be delayed and was rescheduled to be shipped to the territory by July 31, 2022. On August 4, 2022, we were once again notified by the tank manufacturer that, “production of the Juan F. Luis Hospital, MIP 01605-0 has been further delayed due to ongoing supply chain disruptions and steel raw material challenges," Mr. Smalls explained.
After encountering “numerous roadblocks,” Mr. Smalls said the tank finally arrived on St. Croix on September 26 and that the construction of the Mechanical Building, which commenced in December 2021 is more than 75 percent complete.
That information was however not shared with the nurses who under VISNA, collectively submitted a written testimony outlining their dissatisfaction with current working conditions at the hospital.
“While the association recognizes that this transition to JFL North is a monumental undertaking, the fact is that the current working environment is untenable … the staff deserves to work in a safe and healthy workplace,” stated Ms. Rivera.
“The association VISNA can no longer allow this situation to drag on and would like to see this matter addressed with a sense of urgency,” she insisted.
But even while he said he understood the sense of urgency, Douglas Koch, JFL chief executive officer, called the timeline “irresponsible,” arguing that the authorities were not going to expedite the construction at the risk of creating an unsafe workspace for patients and staff.
“We will not do it until we can assure that,” he remarked, as he sought to rally the support of the Legislature and the hospital board.
Once the mechanical building has been completed it will be used to house the critical systems required for the temporary hospital to operate such equipment as components of the life safety system, the domestic water supply system, the medical air and vacuum delivery systems, the oxygen supply system, the emergency backup generators, the fire suppression system, and the liquid propane distribution system.
JFL North is anticipated to be a state-of-the-art structure with brand new surgical suites and technology, along with dedicated labor and delivery rooms that allow for a mother to recover and stay in the same room throughout her stay. The building will also have a fully outfitted trauma and emergency services department, a new 128 slice CT scanner with a full cardiac imaging package and many other services. FEMA obligated $111.4 million for a 101-bed temporary structure.
The original building was severely damaged by the passage of Hurricanes Irma and Hurricane Maria five years ago, and FEMA agreed to build a temporary hardened structure to meet the regulatory compliance requirements set forth by the Centers for Medicare and Medicaid Services (CMS), and the Joint Commission on Accreditation of Hospitals (TJC). However, several setbacks have caused the temporary facility to remain under construction.
Based on Mr. Smalls’ testimony, the next steps to facilitate the opening of the interim hospital include the certification of the various internal systems, the installation of internal and external signage, the implementation of the transition plan which includes upcoming tabletop and live exercises, orientation of key staff such as the physicians, nurses and other ancillary staff, as well as training on newly installed equipment to name a few.
The training and certification processes, he noted, could not be accomplished without the systems that are currently nearing completion.
He added that while there are several other key components that are required to support the operability of JFL North that have yet to be implemented, they will not prevent the opening of the interim hospital.
Mr. Koch provided a detailed outlook on an opening timeline. “Based on our current construction schedule, all systems are to be installed and operational by October 31, 2022. The coordination of the testing and certification processes will commence during the third week of October and run into November 2022. Once we receive notification that all the systems have received favorable certifications and no further modifications are required, the Leadership of JFLH will immediately initiate the official transition process to relocate the existing patients within JFLH to JFL North. Once this transition is completed, all impatient services will cease operations within JFLH."
The other components include the construction of the Critical Administration building that will house critical, non-clinical functions such physician and nursing administration and serve as the main entrance to JFL North, physically connecting the interim hospital to the V.I. Cardiac Center. A tentative date of July 2023 has been announced for its completion.
Another key component is the development of the recently leased five-acre parcel located directly east of JFL North which, once developed will include parking for staff and visitors, a critically needed building to provide storage for food and medical supplies, medical records storage, and support services for Facilities Maintenance.