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Judge Pogue says “DENIED”

October 25, 2007 ⋅  Email this post ⋅  Print this post ⋅ Post a comment

Although the Tennessee Health Services and Development Agency approved HCA’s request for a certificate of need (CON) to invest $110 million in Spring Hill to build a 56 bed hospital, Administrative Law Judge, Leonard Pogue, said no. The review process, requested by Maury Regional Hospital (MRH) and Williamson Medical Center (WMC), began in April 2007. Judge Pogue handed down the initial Order on October 12, 2007.

The Initial Order cited several items which indicated that MRH and WMC are fulfilling the medical care needs of the fast growing City and that the evidence presented by HCA was flawed in many respects. MRH indicated that “A review for the possible need of a hospital in Sprig Hill was done for MRH in 2005. This evaluation concluded that a full service hospital was not feasible in Spring Hill in the near or immediate term.” Mayor Leverette testified that “he had no reason to believe that MRH has ever failed to address the health care needs of the Spring Hill community.

The Order also indicates that “In 2005, WMC evaluated the need for additional medical services to Spring Hill, including a hospital. WMC concluded that its planning for Spring Hill should involve outpatient services rather than inpatient beds.” It was recognized that “The majority of Spring Hill residents live in Williamson County. However, Spring Hill officials have never approached WMC about providing different or additional medical services in Spring Hill.”

Surprisingly, the order reports that “In 2004….HCA commissioned an assessment of the area’s health care needs from Ed Stall, a health planning consultant, regularly engaged by HCA…” Mr. Stall’s report “concluded that the Spring Hill area did not yet need a hospital.”

“In the Fall of 2005, a Spring Hill real estate developer and then Chairman of the Spring Hill Chamber of Commerce, contacted HCA and invited its executives to a meeting in Spring Hill with local officials.” When the meeting was held, “The Spring Hill city officials present at the meeting had no background or expertise in health care and had not contacted any research or retained or consulted with any health care expert to advise the city on whether a new hospital was actually needed in Spring Hill. Neither WMC or MRH were ever invited to a similar meeting with city officials.”

In January 2006, HCA again utilized Mr. Stall’s services, requesting that he update his 2004 report. In his revised report, Mr. Stall “concluded that a 56 bed hospital was not needed in 2010 and that the bed need in 2010 was 42.”

Judge Pogue appeared to be very critical of population predictions for Spring Hill as presented by HCA. Dr. Ron Luke, testified as HCA’s expert in health care planning. The report states that, “Dr. Luke has limited experience in developing demographic models and is not a professional demographer.” Yet Dr. Luke is reported to have projected that Spring Hill’s population would be 60,373 by 2010 and 116,763 by 2014. WMC and MRH’s representative, Dr David Swanson testified that “the population growth projected by Dr. Luke is implausible and not likely to be achieved.”

In the “Conclusion” Judge Pogue writes that “Maury Regional Hospital and Williamson Medical Center having established by a preponderance of the evidence that the application for Certificate of Need for Spring Hill Hospital fails to meet the statutory and regulatory criteria, it is hereby ORDERED that the Certificate of Need filed for the Spring Hill Hospital be DENIED.”

The Initial Order will become final in 15 days unless either or both of the following actions are taken. (1) Written notice of intention to review the Initial Order is filed within 15 days. (2) A petition for reconsideration of the Initial Order, stating the specific reason, is filed within 15 days.

Information contained in this article is taken from the Initial Order document Docket No. 25.00-092967J

By Charlie Schoenbrodt