Gov. Eloy S. Inos and Commonwealth Healthcare Corp. (CHCC) CEO Juan N. Babauta recently received a comprehensive report from the departing members of the Commissioned Corps Hospital Assistance Team, which included over 200 operational recommendations for quality practice and sustainability for the public hospital.

The team's officer in charge, Rear Adm. Chris A. Bina, told the two officials that the sustainability plan has multiple recommendations that altogether, if adopted, will ensure that CHCC is placed and stays on a path of quality and sustainable operations.

He said the team established “aggressive yet achievable timelines” that hospital leadership should enforce for the best interest of those being served by the hospital. The recommendations' timeframe starts March 2013 through December 2014 and include both short- and long-term objectives.

Among the areas that need immediate action is the hiring of a laboratory manager and a Center for Medicare and Medicaid Services compliance officer to ensure continued compliance with Medicare standards. The team recommends using Commissioned Corps officers for both posts, being the most cost-effective option available.

According to Bina, many of the plan's recommendations focus on CHC governance, finance and resource allocation. He said the ability of the hospital management team to make daily decisions serves as a lynchpin for the corporation's success.

“The current reality of multiple layers of decision-makers prevents hospital management from efficiently responding to the short-term and strategic issues that are necessary for quality and sustainable operations. Confusion in this area is exacerbated by a lack of clarity regarding the role of the advisory board,” states the report.

Bina said the board should focus on high-level leadership issues such as long-term capital improvement plans, developing a vision for the health care system including Tinian and Rota clinics, and planning for the long-term financial sustainability of the corporation. The daily operations of the hospital should be left to hospital leadership, he added.

According to the report, CHCC's financial situation worsened due to the CNMI government's lack of Medicaid payments to the hospital and to off-island providers caring for Medicaid eligible patients.

“When the CNMI does not pay for care received by its Medicaid patients at other healthcare facilities in the U.S., they can no longer refer CNMI Medicaid patients to those systems. This results in either CNMI being forced to pay inflated, open market cost of healthcare at foreign facilities, or CHCC is forced to treat these patients,” states the report.

It was also pointed out that the Tinian and Rota clinics can be self-sustaining assets if the corporation will develop a strategy to provide fully integrated continuum of care across the entire CHCC health system.

There's a need also to fill the key leadership posts such as CFO, senior legal counsel, revenue cycle administrator, COO executive assistant/public information officer, and the need to create a procurement office.

Bina described the plan they offered to CHCC as a “starting point,” intended to be adapted to the evolving goals of the healthcare system overseen by CHCC and the needs of its patients.