JFL North
Hazel Philbert, interim chief executive officer at the Juan F. Luis Hospital on St. Croix, described the hospital's FY2025 budget request as “conservative” when she appeared before the Senate Committee on Budget, Appropriations and Finance on Friday. The facility’s management has asked the Legislature to approve an appropriation of $31,250,000, part of a total budget of $88,116,899 based on revenue and expenses.
A significant portion of the proposed budget will be earmarked for human resources and operations. Though JFL currently boasts 508 full-time employees, audits regularly report a “lack of staff.” Among the healthcare facility’s many vacancies is a need for a dietician, 3 ultrasound technicians, a certified surgical, a technician as well as over 30 nursing staff including a head nurse and a registered nurse. In a startling update, Ms. Philbert indicated that there are only 3 emergency room doctors on staff — insufficient for round-the-clock operations. A more appropriate complement of ER doctors is 7, lawmakers were informed.
Staffing shortages in the ER are having knock-on effects on patient wait times. While Ms. Philbert estimated the average waiting period at “about an hour and a half,” Senator Kenneth Gittens argued that the actual figure is far higher. “Every time my phone rings, all hours of the night, [it is] upwards of 12 hours [that] people are waiting,” he countered.
JFL said it is actively engaged in a host of recruiting efforts to attract new staff, while simultaneously working to retrain existing workers. Human resource tasks include “managing the increasing salary demands to ensure that salaries are at par with national standards,” and completing union negotiations to “decrease employee turnover rates and make JFL an even more attractive employer.” Preparation of promotional material is expected to “attract serious candidates to our healthcare facility,” Ms. Philbert said.
JFL Interim CEO Hazel Philbert (Credit: V.I. Legislature)
Like several other government entities, the hospital is also grappling with financial burdens, including $19.4 million in accounts payable as of May 2024. Still, Ms. Philbert was pleased with efforts that had whittled the outstanding accounts figure down from $54 million over six years. While the hospital’s management works to reduce debt, the interim CEO informed lawmakers that “a challenge persists in utilizing narrow operating margins to settle long-standing liabilities.” She referenced a $1.5 million annual payment to the Bureau of Internal Revenue that continues to divert funds from “critical necessities, essential for enhancing care quality.” The interim CEO confirmed that JFL owes “critical suppliers” as well.
JFL also made known that projected revenue for the current fiscal year might not be realized. Several factors have been blamed for the anticipated shortfall, including “operating at limited capacity in the surgical suite due to cash constraints and staffing shortages” at the JFL North site. A sharp decrease in Medicaid payments to the hospital is compounding the issue. Like the Schneider Regional Medical Center, the recent downsizing of the Medicaid program will result in a “significant increase in people seeking charity care from JFL. The lack of reimbursement and increasing healthcare costs places JFL in a cash flow deficit.”
While the GVI has committed to providing $30.25 million to the hospital, uncompensated care is expected to reach $54.9 million in FY2025. JFL currently cares for 3 boarders on site, down from 8 in May 2024, and is working with the Department of Human Services to “place these patients in appropriate care facilities.” According to Ms. Philbert, the monthly cost of a boarder is estimated at over $140,000. The hospital is also caring for 3 boarders in a Puerto Rican hospital at $5,100 monthly each.
Ongoing challenges like the decline in the Medicaid program are pushing JFL to “maximize revenue opportunities and implement ongoing improvements in our building processes,” remarked Ms. Philbert. It’s among several goals for the upcoming fiscal year, including augmenting revenue streams “to stabilize our systems, which are key to improving access to care and delivering quality patient care.” Management is also “committed to moving dialysis patients from the existing trailers to a hard and safe structure,” while expanding to 2 dialysis chairs - the number available before the 2017 storms. For Ms. Philbert, there is a “clear need for additional funding” for capital projects and other investments that will “provide better access to high-quality care and services that the Saint Croix community needs.”
The JFL North facility has battled its fair share of infrastructural issues including a leaky roof, a malfunctioning generator and dysfunctional air conditioning units. Though some repairs have been made, regular maintenance is needed, and a vacancy exists for a Director of Facilities Management.
In a general breakdown of their budget request, JFL intends to allocate $35,644,038 for personnel salaries, $25,487,113 for fringe benefits, 10,710,378 for supplies, $11,391,451 for other services, and $4,883,918 for utilities.
