I. June 2013 – Mississippi Certificate of Need Meeting

During the  June  27, 2013 Certificate of Need meeting, Dr. Mary Currier, State Health Officer, concurred with the Health Policy & Planning staff analyses and approved the following applications for Certificate of Need.

  1. CON Review:  HG-A-0313-003 – Forrest County General Hospital d/b/a Forrest General Hospital – CON Amendment & Cost Overrun for: CON Review: HG-COB-1109-032; R- 0808 (Pine Grove Behavioral Health Bed Conversion) – Original Capital Expenditure: $1,865,047 – Additional Capital Expenditure: $321,870 – Revised Capital Expenditure: $2,186,917 – Location: Hattiesburg, Forrest County, Mississippi – Staff Recommendation:  Approval
  2. CON Review: HG-AA-0313-002 – St. Dominic-Jackson Memorial Hospital – Transfer of Ownership of Chapel – Capital Expenditure: $5,786,072 – Location: Jackson, Hinds County, Mississippi – Staff Recommendation:  Approval

The next Certificate of Need monthly meeting will be held on July 25, 2013, at 11:00 a.m.

II. July 3 Oral Proceeding on Proposed Freestanding Emergency Department P ilot Program

On July 3, the Department of Health (DOH) held a public hearing on the proposed freestanding emergency department (FED) pilot program.   Jim Craig, Director of Health Protection at DOH, explained that the main purpose of the program would be to decrease waiting time in hospital emergency rooms.

When DOH opened the floor for public comment, topics of discussion and DOH’s responses were as follows:

  • Relationship of proposed FED pilot program to existing state trauma program—The FEDs will not be part of the state trauma system.  Rather, an FED will transfer patients meeting trauma criteria in the same way as would a licensed hospital without an emergency department.  Specifically, emergency medical services would arrive, review the patient’s history and condition, and take the patient to the appropriate trauma center.  In the event of a conflict between the FED and the trauma center, emergency medical services would call medical control, which would make the final decision.  A related point was that the name “freestanding emergency department” itself could be misleading, as these departments will be more akin to after-hours clinics.
  • Distance between an FED and the nearest hospital—There was disagreement over whether the proposed FED pilot program should target rural or urban areas.  Some in attendance advocated a minimum distance of  ten miles between an FED and the nearest hospital in order to increase health care availability in rural areas.

The opposing view was that FEDs have been most successful in urban and suburban markets, and that the Jackson area, with five busy emergency departments within a five-mile radius, could benefit from an FED.  A rule requiring a minimum distance of  ten miles to the nearest hospital would restrict DOH’s flexibility in planning; if a minimum distance must be prescribed, five miles would be preferable toten.

  • Relationship of proposed FED pilot program to CON requirements—A proposed FED would have to be approved in accordance with the CON process.  That is to say, a hospital would have to obtain a CON if a proposed FED would represent an added service or a capital expenditure in excess of $2 million.
  • Duration of proposed FED pilot program—The pilot is likely to last for three years, at which time DOH will collect data and recommend to the State Board of Health whether to make the program permanent.

On July 16, DOH finalized without revision the proposed FED pilot program regulations, which will require a minimum distance of 10 miles between an FED and the nearest hospital.  The regulations will be a new Subchapter 83 of the Minimum Standards of Operation for Mississippi Hospitals, Title 15, Part 16, Chapter 41 of the Mississippi Administrative Code, and will become effective August 15.  DOH plans to provide each licensed hospital with information on how to propose an FED.

III. Certificate of Need Program Report – Filings/Reports Since May 2013 CON Meeting

A. Letters of Intent to Change Ownership

None.

B. Determinations of Reviewability

  1. Madison River Oaks Physicians Center 1, LLC – Construction of Medical Office Building  – Received June 3, 2013
  2. River Oaks Hospital – Improvements to Labor and Delivery Unit – Received June 14, 2013
  3. Highland Community Hospital – Geriatric Psychiatric Unit at Highland Community Hospital – 10-Bed Inpatient Geriatric Psych Unit, Distinct Part Unit – Received June 26, 2013

C. Letters of Intent to Apply for CON

Forrest County General Hospital, d/b/a Forrest General Hospital  –  Construction of Hospice Facility – Received June 26, 2013

D. Applications Received/Withdrawn

  1. Clarksdale HMA, LLC d/b/a Northwest Regional Medical Center  – Amendment to CON Review: HC-RC-0312-007; R-0853 – Related to Radiology Department – Received June 3, 2013
  2. Baptist Memorial Hospital – North Mississippi, Inc. – Hospital Infusion Services Addition – Received June 3, 2013
  3. River Oaks Hospital, LLC  – Establishment of Diagnostic Catheterization and PCI Services and Acquisition of Related Equipment – Received June 3, 2013
  4. Jackson HMA, LLC d/b/a Central Mississippi Medical Center – Relocation of Burn Center from Crossgates River Oaks Hospital to Central Mississippi Medical Center – Received June 7, 2013
  5. The Mississippi Methodist Hospital and Rehabilitation Center, Inc. d/b/a Methodist Outpatient Rehabilitation Construction of Consolidated Outpatient Therapy Facility  – Received June 7, 2013

E. Applications Received for Extension/Renewal of an Expired CON

None.

F. Additional Material Received in Response to Negative Staff Analysis

None.

G. CON Applications Deemed Complete

CON Review #: HG-CO-0513-004 – Greenwood Leflore Hospital – Cost Overrun to CON #R- 0833 (Replacement of Central Plant Equipment) – Approved Capital Expenditure: $10,767,909 – Additional Capital Expenditure: $1,200,937 – Location: Greenwood, LeFlore County, Mississippi – Date Complete June 6, 2013

H.  Six-Month Extension Requests Granted

None.

I.  Hearings Requested/Scheduled During the Course of Review

Hinds County Nursing & Rehabilitation Center, LLC  –  Construction/Relocation and Replacement of 119 Nursing Home Beds/Services – Capital Expenditure: $9,650,798 – Location:  Jackson, Hinds County, Mississippi – Date Scheduled July 29,2013-August 2, 2013

J.  Request for Hearing on Denial of Six-Month Extension CON Review # ESRD-NIS-0905-041; CON # R-0710 – Healthcare Engineers, LLC – Establishment of a Six-Station ESRD Facility in Tallahatchie County  –  Capital Expenditure: $254,085  –  Requestor: Alliance Health Partners, LLC d/b/a Tri-Lakes Medical Center.  To be scheduled.