CHCC board warned: Resolution goes against CMS rules

The Commonwealth Healthcare Corp. board disclosed yesterday that a resolution it recently adopted has reportedly been flagged by the U.S. Centers for Medicare and Medicaid Services as something that could jeopardize the hospital’s recertification.

During yesterday’s meeting, five board members—chair Joaquin Torres, vice chair Pete Dela Cruz, and trustees Roy Rios, Philip Mendiola-Long, and Tony Raho—waited about six hours for a teleconference with CMS executive Rufus Arther but that did not happen as of 3pm yesterday.

Torres told Saipan Tribune that CEO Esther Muña had informed the board that CMS is not going to recertify the Commonwealth Health Center as a result of Board Resolution 2014-02, which requests the CEO to issue within 10 days a determination on the medical privilege application of Dr. Grant Walker, either by issuing a 90-day medical privilege for the physician or a show-cause justification why the privilege should not be accorded the doctor.

The board resolution was passed last April 23, but Muña has yet to act on it. The resolution passed with oppositions from Muña and trustee Tony Raho.

Alarmed by this new information, Torres said the board has agreed to ask for a conference call with CMS’ Arther to seek clarification.

The board, he said, extended the special meeting up to yesterday for the “scheduled” dialogue with CMS, but it didn’t happen as expected.

Torres, along with Pete Dela Cruz and Philip Mendiola-Long, pointed out yesterday that what the resolution provides is to ensure that “due process” is adhered to in the credentialing of staff.

“I understand that we cannot force Mr. Arther to talk to us. But at least we made good effort to seek clarification on the CMS statement and position on the board resolution. We don’t want to jeopardize recertification because we can’t afford to lose the Medicare funding [for the hospital],” Torres said after yesterday’s meeting.

According to Mendiola-Long, the board is “very curious as to why CMS would assume that there would be a citation effect by the resolution.”

Dela Cruz echoed this, reiterating that the resolution was adopted in the sense of providing due process where it is due.

Although the board serves as an advisory body, trustees believe that they have “fundamental fiduciary responsibility” and credentialing is clearly identified in Public Law 16-51, which created the corporation and its board, according to them.

“We need to question what the process is and ask why we’re not following the bylaws,” added Mendiola-Long.

Saipan Tribune learned that CEO Muña informed the board last May 5 about the CMS concern. The board was told that “Mr. Arther just wanted to express CMS’ concern with the resolution and how it is against their regulations.”

The board, it was learned, was also made aware by Muña that “if the hospital does not follow its own laws in Public Law 16-51 and does not follow CMS regulations, CMS wanted it to be clear that CHC will never get recertified.”

CMS is scheduled to decide on June 27 whether or not it will recertify its Medicare provider agreement with CHC.