Crucian company opening private dialysis clinic on St. Thomas
Published: August 21, 2013
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ST. THOMAS - The Caribbean Kidney Center plans to open a new dialysis clinic on St. Thomas in about eight weeks to cover a dire shortage as the dialysis unit at Schneider Regional Medical Center has been at capacity for several months.
The hospital has been turning patients away and absorbing some of the overflow through the Emergency Room.
The new facility will be able to accommodate 60 patients when it opens. A second phase, which may or may not follow, depending on the demand the clinic experiences after it initially opens, will add capacity for an additional 180 patients, according to Dr. Walter Gardiner, the owner and medical director of the Caribbean Kidney Center on St. Croix.
"There is a desperate need," Gardiner said of the availability of the life-saving procedure on St. Thomas. "There are patients being dialyzed in the Emergency Room because they have no space in the hospital's unit. There are people who are off-island who want to come home and can't come home because they can't receive treatment. We want to meet those people's needs immediately."
Currently, according to Eunice Gumbs, the vice president of patient care services at Schneider, the dialysis unit is serving 101 patients regularly, another 14 are being treated in the Emergency Room and a waiting list stands at 35 patients, with a total of 77 patients turned away in the last year.
In recent testimony before the Senate, hospital officials said the dialysis unit is losing about $2 million a year, partly because of the cost of maintaining traveling nurses at higher rates of pay than permanent nurses - a hospital wide problem - and partly because of low reimbursement rates. Specifically, some patients had not paid their Medicaid premiums, cutting off reimbursements to the hospital.
Caribbean Kidney Center, open since 2003, is the only private dialysis provider in the Virgin Islands. The center has been certified by the Centers for Medicare and Medicaid Services, according to Gardiner.
The new facility will be located within walking distance of the hospital at the Island Periodicals Building, Gardiner said.
"We project, based on the population of St. Thomas, that we will generate about 150 to 180 patients," Gardiner said. "We want to meet the needs of the entire island. We are going to build a facility big enough to take care of all the patients."
Gardiner said the facility will be on St. Thomas long term regardless of any fluctuations in demand.
Hospitals all over the country are shutting down outpatient dialysis units, mostly because of the difficulties of managing cost, he said.
The cost of treatment at the new clinic would be no more than the rates currently charged at Schneider, according to Gardiner.
The Caribbean Kidney Center maintains a social worker to ensure that patients are adequately insured and meeting their responsibilities, according to Gardiner.
In recent years, Gardiner's St. Croix clinic, and Gardiner himself, have sparked controversy.
After the Centers for Medicare and Medicaid Services found deficiencies at Luis Hospital's dialysis clinic, the federal agency ordered the hospital to cut the clinic's patient load to address the deficiencies. Luis Hospital planned to transfer some patients to the Caribbean Kidney Clinic on St. Croix, but at a meeting with hospital officials in April 2011, 20 patients picked to be transferred said they would not go.
Gardiner also filed a lawsuit against Luis Hospital alleging wrongful termination after he was fired in February 2012.
Nurses had alleged that Gardiner was volatile and erratic in his behavior, and Gardiner filed legal complaints that the hospital had unlawfully attempted to monopolize dialysis services.
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