Floyd Medical Center has been denied a certificate of need by the Georgia Department of Community Health to open a $16.6 million open heart surgery program. Floyd was seeking to add two new operating rooms, 6,400 square feet of new construction and 5,450 square feet of renovation space for the program. It faced opposition from Redmond Regional Medical Center.
Floyd’s application was batched with Tanner Medical Center in Carrollton and Hamilton Medical Center in Dalton, both of which were also applying for OHS services. All three were denied approval. According to the CON decision, Floyd cited a 13.6% growth over the last three years in treating and discharging patients having “diseases and disorders of the circulatory system”, as well as population increase of 4.9% expected over the next five years. However, the DCH did not feel Floyd met the objective need criteria to start a new service.
Excerpt from the DCH decision:
Adult OHS services are currently available and being provided to FMC, TMC, and HMC service area patients. Existing adult OHS providers served 348 patients from the FMC defined service area, 390 patients from the TMC defined service area, and 166 patients from the HMC defined service area. The vast majority of Georgia’ s 159 counties do not have an adult OHS service located within their borders or even in a neighboring county, this is typical. The FMC, TMC, and HMC defined service areas do not present any characteristics or circumstances that are unique or exclusive to them. The issues present in the defined service areas exist across the planning region, which is the entire state.
FMC, TMC, and HMC each present numerous patient examples and physician letters of support attempting to identify a group of patients with no access to adult OHS services. The delays and difficulties identified by each applicant illustrate the challenges associated with OHS services. However, these challenges are not unique to the FMC, TMC, and HMC service areas.
FMC seeks an exception based on cost, quality, and financial access. It should be noted that FMC presents extensive information and data regarding race. FMC was informed at the 60 day meeting that there is no exception based on race. Additionally, FMC is located in the same county and in close proximity, less than 3 miles, to an existing adult OHS provider, RRMC.
In regard to cost, FMC asserts that RRMC’ s charges for adult OHS services are excessive. The Department does not control or regulate hospital charges. According to available to data, RRMC is not the exclusive adult OHS provider serving the FMC defined service area. FMC did not provide evidence of RRMC denying service to patients based on cost or patient ability to pay.
In regard to quality, FMC states that ” high overall mortality rates from major cardiovascular disease in the area; low use rates for open heart surgery and high mortality rate from major cardiovascular disease evidencing quality barriers for African American and other race/ ethnicity populations in the area; and relative high and increasing out-migration of area residents for open heart surgery” are evidence of a quality barrier to care. While these issues may be demonstrative of the healthcare challenges in the service area, they do not serve as evidence of a lack of quality adult OHS services available to patients. The applicant did not provide evidence that RRMC or any other existing adult OHS provider is operating below industry standards or outside licensure compliance standards.
In regard to financial access, FMC states that there is “low uninsured population use rate for open heart surgery services in the five-county area and lack of financial accessibility of the existing open heart surgery program in the area”. In general, the uninsured seek access to healthcare services at a lower rate than other segments of the community. This is primarily due to a lack of resources. FMC did not present evidence that RRMC, or any other existing provider, refuses to serve the poor.
Floyd has 30 days to file an appeal on the decision, but no determination has been made yet, according to Daniel Bevels, Floyd’s Public Relations.
However, Floyd has filed an appeal on the CON decision to allow Redmond to develop a new basic Level 1 perinatal service. The DCH approved Redmond’s application in late March. According to the CON Tracking Report, a hearing officer has been assigned, but no date for the hearing has been set. Previous report