NMI Healthcare Corporation Urged To Hire Medical Staff

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Federal funds at risk without adequate personnel

By Moneth Deposa

SAIPAN, CNMI (Saipan Tribune, Oct. 25, 2012) – Despite efforts of the Commonwealth Healthcare Corp. to address the immediate jeopardy status slapped on the Commonwealth Health Center (CHC) by the Center for Medicare and Medicaid Services (CMS), the hospital will remain noncompliant with federal standards if the corporation doesn't do more to hire and retain personnel, according to a CHC official.

In a letter to the corporation board, hospital services director Karen Buettner urged the board to take the necessary steps to hire and replace personnel.

Buettner said that CHC's current staffing problem is impacting the "Conditions of Participation for CMS certification" and is risking the federal dollars being received by the hospital from Medicare.

She specifically cited the need for adequate staffing in several departments to ensure patient safety and meet the CMS requirements. These include the need for three certified nurse midwives, three respiratory therapists, two laboratory technicians, one laboratory manager, one laboratory director, one quality management coordinator, one infection control coordinator, one inpatient pharmacist, one registered nurse to be assigned at the Department of Corrections, one social worker, one dietician, one staff developer, one physical therapist, two internal medicine physicians, and six mid-level providers.

Buettner told the board that the corporation has had an "exceptionally high" staff turnover rate this year in all areas of CHC and that recruitment efforts have not been able to keep up with the exodus. She added that the needed positions are also not generally filled by local hires.

"Without funding to hire the staff for hard-to-fill areas-staff required by CMS-plus replace or replenish some of the staff who have resigned, the hospital will remain out of compliance with CMS," Buettner told the board.

The director disclosed that during her July trip to meet federal health officials, Medicare repeatedly reminded them that CHC has been out of compliance with the Condition of Participation since 2010 and "this cannot continue."

30 nurses resign; only 10 hired

As of Aug. 4, corporation records show that CHC lost 30 nurses since the start of last fiscal year. In April this year, 24 foreign contract workers with eligibility status on Saipan were interviewed for nursing positions. However, only 10 have been hired since August.

"This still leaves gaps in our ability to reduce overtime and adequately staff the units," said Buettner, adding that there is a request to fill vacancies in the outpatient clinics with "graduate nurses" who have completed their nursing education but have not passed the NCLEX.

It was also disclosed to the board that CHC has several units where nursing posts are harder to fill due to the amount of experience required prior to employment. It was also learned that new graduates or non-experienced nurses are generally not placed in these units due to the need for solid advanced assessment skills. These units include the emergency unit, intensive care unit, operating room, hemodialysis unit, neonatal intensive care unit, and labor and delivery.

Exit strategy

One of the corporation's board members, Anthony Raho, believes that more nursing staff may leave their posts once they receive the full payment of their retirement contributions.

Raho, in a recent letter to board members, disclosed that he had talked with many hospital staff and most have either already decided to leave or are already planning their exit strategy.

The board did not discuss any specific decisions on the staffing problem at its recent meeting.

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