Dialysis Clinic Closure on St. Thomas Leaves Patients in Crisis
On July 1st, patients relying on life-saving dialysis on St. Thomas were given less than two hours’ notice before the Caribbean Kidney Center shut its doors. The closure occurred without a transition plan, patient records, or any arrangements for continued care.
Dr. Walter Gardiner, the medical director of the clinic, emailed Schneider Regional Medical Center (SRMC) CEO Tina Commissiong just before 4 p.m. to announce the immediate closure. By 5 p.m., the clinic was closed. According to Commissiong, there was no discharge planning, no coordination for patient care, and no legal transition process in place.
The abrupt closure left 32 dialysis patients scrambling for care. By the next morning, they began arriving at SRMC, many without medical charts, lab results, or medication lists. SRMC’s chief nursing officer reported that some patients were admitted without even basic information about their medical conditions.
Dr. Gardiner explained to the Senate that the closure was due to sudden family medical emergencies among his staff, which made it unsafe to continue operations. However, Commissiong stated that the lack of a formal transition violated federal Centers for Medicare & Medicaid Services (CMS) rules and could legally constitute patient abandonment.
Federal regulations require a formal handoff process before any Medicare-certified dialysis center ceases operations. This process was not followed in this case. Fortunately, SRMC had expanded to 12 dialysis stations in October and was able to absorb the influx of patients, thanks in part to being fully stocked for hurricane season.
With hospitals in the Virgin Islands already facing significant challenges, the closure highlights the critical need for oversight and contingency planning for outpatient clinics. Lawmakers have yet to pass any local legislation addressing the issue, and no CMS penalties have been issued as of now. During a Senate hearing, lawmakers pressed for answers but deferred any decisions pending further investigation.