In the end, Mississippi State Health Officer F.E. "Ed" Thompson, M.D., made a decision that he said was counter to the best interests of patients in Jackson, Miss.
Apologizing for his ruling but saying that he had little choice legally, Thompson denied a certificate-of-need application for Central Mississippi Medical Center's north campus last week, which threatens the future of the 3-year-old hospital.
If Thompson's ruling holds up on appeal, it will mark the first time competing hospitals have used a state CON process to close a functioning hospital.
Without CON approval, the 64-bed north Jackson satellite of Central Mississippi Medical Center must close Dec. 31 under an order issued by the Hinds County Chancery Court last June. The two-hospital system is owned by for-profit Health Management Associates of Naples, Fla.
HMA announced late last week that it plans to appeal the ruling to the chancery court. "Nobody has won, and the patients have lost," Thompson said after his announcement. "We're meeting the needs of the healthcare facilities, and we're meeting the needs of the health lawyers, but we're not meeting the needs of the people we should be focusing on."
Thompson said he denied the CON application for two reasons:
* The hospital's $43 million price tag was not justified despite the genuine need for the hospital's services in the community.
* The facility was in fact a new hospital, not merely a relocation of existing hospital beds, as its owners had argued.
Mississippi's state health planning laws bar the construction of new hospitals because of the area's oversupply of hospital beds.
The north campus employs about 200 people and treated more than 20,000 patients last year, officials said.
"It's a sad day for us," said Timothy Parry, HMA vice president, general counsel and corporate secretary. "We were very disappointed with the decision, because for three years the hospital has been operating and providing access to care to a lot of needy patients without any adverse impact on other hospital competitors," he said.
Parry said management is prepared to carry out the mandated closure if necessary, but it is exploring several options for the property. One alternative might be to keep operating the medical offices and outpatient services on the campus but close the inpatient hospital.
Parry argued that Thompson's ruling that the north campus was a new hospital and not a relocation was misguided because the main campus lost 64 serviced beds to compensate for the gain of 64 beds at the north campus.
Last week's announcement was just the latest twist in a CON battle that has been raging between CMMC and its two principal rivals in Jackson- 631-bed Mississippi Baptist Health Systems and 571-bed St. Dominic-Jackson Memorial Hospital-since before the north campus was built (Nov. 8, p. 2).
Officials at both of the challenging hospitals praised Thompson's ruling.
The two opposing hospitals have suggested alternative uses for the hospital-such as a rehabilitation facility or long-term-care center-that would not cut into their inpatient market share. Either use would require new CON approval.
"We will provide whatever support or assistance is appropriate to putting that facility to an appropriate use," said Andrew Taggart, a lawyer representing Mississippi Baptist Health Systems.