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FRIDAY, NOVEMBER 1, 2013, NO. 253

Deep concerns Territorial board discusses issues at STX hospital JUDI SHIMEL

Tom Eader

Trick or treat Supergirl and Superpuppy attract the attention of the bumblebee girls and other characters during the annual Halloween trick or treat event Thursday in Gallows Bay. Page 3.

ST. THOMAS — The absence of a functioning St. Croix District hospital board is making a difficult situation worse at the Gov. Juan F. Luis Hospital and Medical Center, hospital officials said during a territorial board meeting Thursday. Sen. Alicia Hansen pushed to have the board dissolved in July to bring back JLH CEO Kendall Griffith, who resigned after having problems dealing with the previous board. He returned to his post after two board members resigned and the board was effectively dissolved. The Virgin Islands territorial hospital board on Thursday said moves are underway to fix the operating room at JLH, which The Avis reported Tuesday has become overrun with internal disputes. They also addressed their efforts to meet Centers for Medicare and Medicaid Services compliance, reports of collusion by Virgin Islands senators and threats reported by physicians. They delayed action on the findings of a report by a federal inspector on the performance of JLH and did not release the report’s findings. The report by the Centers for Medicare and Medicaid Services was presented to the board Thursday. Board Chairwoman Lynn Millin-Maduro said the loss of a quroum curtailed a discussion about the hospital's ongoing CMS review. Maduro said the board's consideration of the CMS report will continue Nov. 8 at the next scheduled board meeting. Because of the sensitive nature of the subject matter contained in the report, the CMS findings were reviewed behind closed doors as part of an executive session. But earlier in the meeting deep concerns over the hospital's future with regard to Medicare and Medicaid funding, as a credentialed

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Police blotter ST. CROIX

Police investigating robbery, carjacking STEVE BULLOCK

Assault: 10:40 p.m. Wed., William’s Delight 9 p.m. Wed., King Street Robbery: 8:20 p.m. Wed., Mon Bijou Burglary: 4:21 p.m. Thu., Solitude 10:21 a.m. Thu., Strand Street, Frederiksted 8:28 a.m. Thu., Coakley Bay 8:02 a.m. Thu., Cotton Valley 9:40 p.m. Wed., Cotton Valley 8:41 p.m. Wed., Candido Guadeloupe housing community 8:14 p.m. Wed., Cane Bay 4:50 p.m. Wed., Work and Rest Larceny: 12:10 p.m. Thu., La Reine 9:09 a.m. Thu., Diamond Ruby Fire: 6:07 p.m. Wed., Hill Street, Christiansted Stalking: 10:46 a.m. Thu., Mars Hill ST. THOMAS-ST. JOHN Burglary: 5:36 p.m. Wed., Nazareth 5:21 p.m. Wed., Contant Larceny: 2:40 p.m. Thu., East End 1:40 p.m. Thu., St. John 12:27 p.m. Thu., Lockhart Garden 9:28 p.m. Wed., Bakkeroe 6:34 p.m. Wed., Tutu Park Mall Weapon/shots fired: 9:29 a.m. Thu., Charlotte Amalie 1:36 a.m. Thu., Red Hook 10:20 p.m. Wed., Savan 5:14 p.m. Wed., Brookman Road Stalking: 12:05 p.m. Thu., Charlotte Amalie 8:23 a.m. Thu., Sugar Estate Laundry 6:29 p.m. Wed., East End 6:02 p.m. Wed., Bovoni 4:42 p.m. Wed., Charlotte Amalie

ST. CROIX — Police on St. Croix are looking for three suspects who robbed a man at gunpoint and then stole his pick-up truck while he was disposing garbage Wednesday night at the Mon Bijou dump site. The incident occurred around 8:20 p.m., according to Melody Rames, police spokesperson. Rames said the suspects also took his wallet containing cash. The victim was not injured, she said. The officer responding to the incident spoke to the male victim, who told officers he was disposing trash when three men armed with handguns approached him and demanded his money and keys which he gave them, Rames added. “The suspects then got into the victim’s truck and drove away in a northern direction,” she said. According to the victim, two of the suspects had dark complexions with one suspect wearing black cargo pants. The third suspect had a light complexion and wore a white T-shirt. An hour after the incident, Rames said police recovered the vehicle that was abandoned in the same area.

Police sources, however, indicated that the vehicle, a white Toyota Tacoma with license plate CER615, was recovered near a residence just west of the bridge in Estate Glynn. Wednesday’s robbery and carjacking is similar to two other recent armed robberies in which the victims’ vehicles were stolen. Two masked gunmen robbed a man and carjacked his vehicle in La Grande Princesse Sunday morning. Witnesses said there may have been a third suspect, operating another vehicle. The victim’s vehicle later was found torched in the Little Fountain area, not far from where the suspects abandoned the truck in Wednesday's robbery. The first-degree robbery occurred in the parking lot of the Lyme Nightclub in La Grande Princesse, according to Rames. She said the victim told police he was walking out to his car around 4 a.m. and was approached by two masked and armed suspects. Both suspects were dressed in all black and demanded money from him as well as the keys to his vehicle, Rames said. As was the

case in Wednesday’s robbery, police said the suspects took the victim’s wallet, containing about $100 in cash. They also drove away with his vehicle. The vehicle, a brown four-door 2006 Nissan Pathfinder with license plate CEM-322, was set on fire in the Little Fountain area. Firefighters responded to a report of a vehicle fire around 4:59 p.m. and upon arrival found the vehicle totally engulfed in flames. The vehicle was completely destroyed. On Oct. 17, three suspects robbed a couple near Altona Lagoon and carjacked their vehicle, which was later found torched on Ha'penny Beach Road. The victims told police they were sitting in their car at about 4:25 a.m. when a light colored vehicle drove up to them and two armed and masked suspects demanded that they get out of their vehicle, according to Rames. The male victim said he and his girlfriend were sitting in his red Mercury Mountaineer when they observed a white or light-colored Ford Explorer drive up and then leave. “It circled the area and returned,

and two men with cloths over their faces got out and came out to both sides of the vehicle,” the man said. He said the suspects pointed handguns at them and demanded that they get out from the car. They took a gold chain and two rings from the man along with his wallet, which contained about $100 in cash and personal documents. He said the suspect who robbed him appeared to have dreadlocks, but he could not see his face. His girlfriend also was unable to identify the suspect who ordered her out of the car. A third suspect, identified by the victim as the driver of the Ford Explorer, remained in the vehicle while the two others robbed them. After robbing them, the man said the suspects drove off with his red four-door 2006 Mercury Mountaineer with license plate CDW-342. Police later found the vehicle near the entrance to Ha'penny Beach, however, it had been stripped of several parts and burned, Rames said. Anyone with information can call the Criminal Investigation Bureau at 712-6037, 712-6077, 911 or Crime Stoppers USVI at 1-800-222TIPS.

HOSPITAL: FROM PAGE 1 institution, were expressed by the chairman of the St. Croix District hospital board. Acting Board Chairman Dr. Anthony Ricketts said the hospital is struggling under profound financial hardship to make improvements recommended by CMS. The loss of a functioning local board in July is slowing down the process in implementing recommendations and is making a tough financial situation even worse, Ricketts said. There were further hints about the nature of CMS-related talks behind closed doors as hospital board member Maria Tankenson-Hodge made a motion to enter executive session. Hodge, an attorney, cited the Virgin Islands Code relating to the conduct of public meetings, but getting more specific she said some of the discussion would involve personal disclosures, the possibility of untimely disclosures of a personal nature and the chance that certain individuals could be named for censure.

Physician certifications:

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FRIDAY, NOVEMBER 1, 2013

During the public portions of the three-hour meeting, the territorial board acted on physician certifications. Of the eight eligible candidates presented on a list to the board, seven won approval. The eighth, Dr. Albert Titus, was withheld for further discussion. Titus, a general surgeon who was suspended from duty last weekend, was one of two physicians named in a

recent report appearing in The Avis about rising tensions among physicians working at JLH. Ricketts specifically pointed to a CMS demand for action on physician credentials and said the St. Croix board's inability to act is problematic. "The only reason this is before the territorial board is because the district board has not met?" asked board member Angel Dawson, who also is Department of Finance commissioner. Ricketts answered yes. When asked by a reporter why Titus' name was not promoted for board action Thursday, JLH Interim Chief Executive Officer Kendall Griffith declined to comment. "That is something I am not able to discuss at this time," Dr. Griffith said. At the end of Thursday’s meeting, Maduro confirmed that Titus' name came up for discussion in executive session with more discussion to follow on Nov. 8. "We also discussed one of the candidates who was put up for credentialing," Maduro said. The board chairman said the outcome of the upcoming executive session would be reported out upon completion as part of the public record.

Operating procedures: Titus was one of several physicians who spoke out about problems occurring in the hospital’s operating room. The problems recently led to the loss of the hospital’s only surgeon specializing in repairing the cir-

Special Report A Special Report on the troubled Gov. Juan F. Luis Hospital and Medical Center published in The Avis on Oct. 29 revealed the following: • No vascular surgeon at the hospital since Oct. 18. This means patients with ailments impacting the circulatory system, like gunshot injuries, dialysis emergencies or aneurisms, may be treated by a trauma surgeon without specialized training in vascular surgeries, have to wait for a vascular surgeon to fly over from St. Thomas or have to be airlifted off island for care. • Vascular surgeon Dr. Christopher Seaver resigned after finding spray painted on his car “You’re a piece of s---,” finding dead chickens on his car with a note that read “We’re watching you,” and had his salary cut. • General surgeon Dr. Albert Titus was suspended over the weekend although hospital officials are not confirming the cause. • The operating room is overculatory system. Dr. Christopher Seaver, a general and vascular surgeon, resigned after he reported receiving threats, vandalism to his car and dead chickens placed on his and his wife’s car, and after having his salary cut. Titus’ suspension over the weekend added to the deficit of

run with tension and disputes among physicians and staff. • A Centers for Medicare and Medicaid consultant found spray painted on her car "You Are Next" after a dispute in the operating room. • The hospital is dangerously close to losing CMS compliance, which could force the closure of the hospital. • Physicians are alleging that local senators are influencing decisions at the hospital to benefit their friends. • Physicians are alleging that the Association of Hospital Employed Physicians union is trying to block reform that is necessary to make the hospital financially viable. The trend nationally is for hospitals, particularly in small areas, to convert to a hospital system that directly employs physicians with productivity clauses, rather than the system at JLH where all hospital physicians are on contract and have private practices. available surgeons. The head of the St. Croix hospital board and its interim CEO said meeting emergency surgical needs has become a priority. But Ricketts added that the problem involved the entire surgical staff.

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PUERTO RICO:

Police chief to resign amid reform SAN JUAN, Puerto Rico (AP) — Puerto Rico's police chief has submitted his resignation as the U.S. territory prepares to reform an agency that federal prosecutors have accused of corruption, illegal killings and civil rights violations. Hector Pesquera said he would step down Nov. 15, more than a year after he was appointed to lead the secondlargest force in the U.S. with roughly 17,000 officers. Gov. Alejandro Garcia Padilla accepted the resignation late Wednesday and said he would announce a new police chief in the upcoming days. Pesquera was the former director of the FBI office based in Puerto Rico, and he was appointed police chief just months after the department reported a record 1,136 killings on an island of 3.7 million people. It is unclear what prompted

the resignation, which comes one day after a U.S. marshal was named to oversee a federally mandated reform of the island's police department that Pesquera has said he supported. Pesquera did not return messages for comment. He told radio station WKAQ that he's leaving for personal reasons, but did not elaborate. "It was time to go," he said during the interview. "For the past 19 months, I have given it my all and I go with my head held high." During his tenure, the number of killings subsided somewhat, with 749 killings reported so far this year compared to 794 in the same period last year. Rep. Jose Aponte, former speaker of the island's House of Representatives and a member of the main opposition party, said in a phone interview that

Pesquera helped instill trust again in Puerto Rico's police officers. "His departure at this time goes against the best interests of Puerto Rico," he said. "The job he did was good, it was effective." Pesquera is leaving as Puerto Rico prepares to fight an increase in drug trafficking, with federal authorities noting an uptick in the number of cocaine seizures and other drugs. Police have said at least 75 percent of killings in the U.S. territory are tied to drug trafficking. The police department also faces a multimillion dollar, 10-year federal reform that will see numerous changes, including the creation of new disciplinary procedures, a use-of-force policy and additional training for officers before they're assigned to the streets.

ing what took place. That is within the jurisdiction of the police department.” Police spokesperson Melody Rames was asked if she had heard about any complaints of dead chickens being left on vandalized cars. Rames said she would look into it. Then there was the matter of the salary cut. Griffith said Seaver was one of five physicians who received similar salary reductions. The interim CEO said the hospital had no choice. “There were five physicians who were in that category and each physician went back to their NOPA position,” he said. “That was also a union issue we couldn’t break.” Tensions in the JLH operating room reportedly involved a CMS inspector who intervened during an angry confrontation. Following that incident, the inspector’s vehicle was reportedly found vandalized in the hospital parking lot. The alleged vandalism contained a threat — “You’re Next” — scrawled across the vehicle. Rames said those sorts of incidents were most likely to appear as calls for police assistance, and the details may not have made it back to her.

on at the hospital from a regulatory and operational standpoint,” Griffith said. Territorial board members are particularly interested in getting Legislative support over the issue of facility fees paid by insurers. As reported by Schneider Regional Medical Center Chief Executive Officer Bernard Wheatley, CIGNA recently said his facility owes $1 million after performing a random audit. At JLH the figure approaches $6 million, he added. The dispute arises over facilities fees, charged each time doctors perform a surgical procedure. When hospital administrators explained the doctors who work on their staffs also collect facilities fees when they perform surgeries at their private offices, board member Dawson questioned the practice. “Why would the insurance companies pay when there is such a disparity between the hospital and the private physician?” he asked. Wheatley said insured patients are being treated more often in their doctor’s offices while indigent and self-paying patients are treated at the hospital. “It’s getting complicated,” he said. Some physicians are alleging that situation is causing the hospital to lose out on millions of dollars in care being provided at physician’s private offices. Maduro suggested the board pursue the matter as a policy issue. She asked attorney Lorn Kleeger if the board should pro-

BILLS: FROM PAGE 5 ment to retirees who he claims are waiting as long as eight to nine months to be paid their retirement benefits. “It seems to be a good idea but funding is my concern,” Gittens said. “Before we do anything and identify funding any where else, we need to make sure our retirees are paid.” Voting yes to forward Bill No. 30-0049 to full session were Sens. Capehart, Cole, Jackson and Sanes. Gittens voted no. Bill No. 30-0193, the third bill introduced at Thursday’s session, was an amendment to Title 5 of the Virgin Islands Code and proposed to increase the homestead exemption from $30,000 to $60,000. However, the bill’s sponsor, Sen. Terrance Nelson, later amended that sum from $60,000 to $300,000. Voting in favor of moving the bill to full session were Sens. Capehart, Cole, Gittens, Jackson and Sanes. Bill No. 30-0096 was the fourth and final bill brought for consideration at Thursday’s session. Sponsored by Sanes, the bill

HOSPITAL: FROM PAGE 2 “Our other problem is nursing. We have a definite shortage of nurses. We give priority to emergency surgeries. Elective surgeries are another issue,” Ricketts told the territorial board. Griffith said JLH has secured the services of a St. Thomas vascular surgeon after Seaver’s departure. He also said the hospital acquired a nurse, specializing in operating room management, considered a key to streamlining general procedures. JLH also is in the process of hiring five operating room nurses, two surgical technicians and three certified registered nurse anesthesiologists. As part of his director’s report to the board, Griffith also announced that Six Sigma procedures are being implemented in the operating room. Six Sigma is a procedure developed by Motorola more than 50 years ago. Former JLH CEO Jeff Nelson, who died of a gunshot injury at his Minnesota home on Oct. 22, first introduced Six Sigma to the St. Croix hospital. Ricketts on Thursday reported that 68 JLH staff members recently completed Six Sigma training.

Threats surrounding the operating room: Griffith also briefly addressed the circumstances leading to Seaver’s resignation, particularly the allegation that dead chickens were laid on the hood of his car and on his wife’s car, along with written threats. “Those matters took place outside the hospital,” Griffith said. “We have no way of know-

Outside influence: In a Special Report published in The Avis Tuesday, physicians allege that local senators are influencing decisions at the hospital and exerting their influence to benefit their friends. Griffith saw things differently. “I think the senators have the right to ask us what is going

mote legislation establishing a facilities fee structure for insurers to follow. Board member Wilbur Callender, a private practice physician, said some of his peers make up to $5,000 a day for treating a single patient through multiple procedures. “The docs are here to make money,” he said. Doctors at JLH acknowledged that sentiment when they formed the Association of Hospital Employed Physicians. As the chief of JLH, Griffith said he has no problem with the union’s efforts to agitate for more money. “The unions have been working well with us. We try to work with the unions. We know they have to represent their constituents,” he said. But, Griffith added, there are limits and whatever salaries apply to staff physicians were negotiated with the union long ago. “If there were to be an exception with that, we would go back and negotiate,” the interim chief said. Under the NOPA system, JLH doctors currently make $90,000 a year and are allowed to refer patients to their private practices, as well as place their own fee on services rendered in the hospital. Nationally more and more hospitals are converting to a hospital-employed physician structure in order to keep funds circulating within the hospital, a reform Nelson attempted to make at JLH to prevent so much money from leaving the hospital.

FRIDAY, NOVEMBER 1, 2013

adds Federally Qualified Health Centers to a law in the Virgin Islands Code that requires hospitals in the territory to provide treatment for pregnancy, communicable disease, emergency medical, dental and behavioral services to minors. Sanes’ bill however, did not receive the same welcome as the resolution to honor Brady. “I would not be in support of this legislation, being a mother, if my child can go into one of these clinics for emergency care without me knowing, what if they have some sort of complication,” Capehart asked. Sanes reiterated that the law, as it is enforced under the Virgin Islands Code, already allows hospitals to provide emergency care to minors and that his bill only adds clinics that qualify as FQHC’s to the language. “All we are doing is just adding the names of the clinics that are FQHC’s to the Virgin Islands Code, Sanes said. Sens. Capehart, Cole, Gittens, Jackson, Malone and Sanes all voted in favor of forwarding Bill No. 30-0096 to full session.

Magnitude 6.6 quake strikes north central Chile SANTIAGO, Chile (AP) — A 6.6-magnitude earthquake rocked north-central Chile on Thursday, causing buildings to sway in the capital and nervous people to run out into the streets. But Chile's emergency services office said no damages to infrastructure were reported and Chile's Navy discarded the possibility of a tsunami. The U.S. Geological Survey said the quake's epicenter was located about 33 miles southwest of the city of Coquimbo or about 250 miles from Santiago. Its depth was 6 miles. Chile is one of the world's most earthquake-prone countries. A magnitude-8.8 quake and the tsunami it unleashed in 2010 killed more than 500 people, destroyed 220,000 homes, and washed away docks, riverfronts and seaside resorts. That quake was so strong it shortened the Earth's day slightly by changing the planet's rotation. The strongest earthquake ever recorded also happened in Chile, a magnitude-9.5 in 1960 that killed more than 5,000 people.


Deep concerns