Proposed new rules in Illinois would make the sale of most healthcare facilities in the state subject to exhaustive certificate-of-need review.
The proposal, which is expected to be considered by a state committee later this month, would apply to hospitals, nursing homes, ambulatory surgery centers and renal dialysis centers.
Now facilities can seek an exemption to CON regulation in order to complete a sale without an indepth state review. The proposal would all but do away with those exemptions. "If the operational control is going to change hands and if the control of the physical plant and assets will change hands, that's when a CON will be required," said Don Jones, health planning specialist with the Illinois Health Facilities Planning Board, which oversees the CON process.
Jones said the state board proposed the new rules in reaction to significant acquisitions by large corporations. More change in the hospital market is due. In the Chicago area, for example, Nashville-based hospital chain Columbia/HCA Healthcare Corp. is selling at least two of its eight hospitals.
If sales and acquisitions are going to occur, Jones said, the state board "would like to see who that entity is and what its intentions are."
Illinois has 152 not-for-profit, 31 public and 12 for-profit acute-care hospitals.
The proposed rules must be approved by the state's Joint Committee on Administrative Rules, which governs rule changes adopted by state agencies. The committee is expected to review the proposal later this month.
One clause under attack in the proposed rules would expand regulatory oversight for healthcare facilities establishing outpatient services. The Illinois Hospital and HealthSystems Association has complained that expanding oversight puts hospitals at a competitive disadvantage.
In testimony before the health facilities board, Ann Guild, assistant vice president at IHHA, said the provision discourages cooperation between providers. "Why should a large corporation work with the healthcare facilities in the community to provide a niche service when it would be subject to fewer regulatory barriers and have a reduced cost of doing business by acting alone?" she said.