For a change, the Tennessee Health Services and Development Agency board has thrown HCA for a loss in Spring Hill, Tenn., a bedroom community south of the companys Nashville headquarters.
The certificate-of-need regulator has twice granted HCA permission to build a 56-bed hospital in Spring Hill. That CON is still being appealed by 108-bed Williamson (Tenn.) Medical Center and 155-bed Maury Regional Hospital, Columbia, Tenn., the nearest hospitals to Spring Hill. But the agency chose a joint venture of Maury Regional and 793-bed Vanderbilt University Medical Center, Nashville, to build a radiation oncology center in Spring Hill, for nearly $7.4 million, over a similar proposal that HCA made after the joint venture filed its plans. The board voted 10-0 in favor of the Vanderbilt-Maury Regional plan and 6-4 against HCAs proposal.
Vanderbilt brings its status as a comprehensive cancer centerone of 41 in the U.S. as designated by the National Cancer Instituteand a proven strategy of joint ventures with community hospitals in towns circling Nashville, said Ronald Hill, vice president of strategic development for Vanderbilt University Medical Center. Vanderbilt has been part of a joint venture with Williamson on a radiation oncology center since 1996 and has a similar venture with 198-bed Gateway Medical Center in Clarksville, Tenn. Gateway is owned by for-profit Community Health Systems, Franklin, Tenn.
Besides radiation oncology, Vanderbilt also partners with several Tennessee hospitals on cardiovascular care and providing physician staffing for neonatal intensive-care units, including Maury Regionals neonatal ICU, Hill said.
The linear accelerator planned for the Spring Hill center will free up capacity at Maury Regionals two linear accelerators, both of which are at capacity, Hill said. We had been looking at Spring Hill for a number of years because of the high population growth, Hill said. HCA argued that the demand for radiation oncology in the nine-county service area was enough for two linear accelerators in Spring Hill, but Hill said it would be better for patients to spread the accelerators geographically. Patients receiving radiation oncology have to make frequent trips for treatment, and cutting their travel time is a priority.
We argued that, basically, you could go forward with onethe Vanderbilt-Maury applicationand then if the need were so great over the coming years, HCA could reapply, Hill said.
Hill also noted that HCA has maintained that its planned Spring Hill Hospital would not be a threat to Williamson Medical Center and Maury Regional because the new hospital will be a local community hospital focused on primary care and emergency services. Putting a linear accelerator at the hospital would contradict that, Hill said.
But Tim Scarvey, vice president of strategic planning and development for HCAs TriStar Health System, said that HCA has continually evaluated the health needs of Spring Hill in the more than two years since it first made its proposal to CON regulators. TriStars 75-bed StoneCrest Medical Center in Smyrna, another bedroom community southeast of Nashville, opened in 2003 without radiation therapy and then sought CON approval for that service, Scarvey added. Just as Vanderbilt, Maury Regional and Williamson Medical Center respond to changes in the market and make proposals to the CON agency, TriStar continues to evaluate Spring Hills health needs, Scarvey said. Should HCA not appeal the rulings, the Vanderbilt-Maury Regional radiation oncology center could open in January 2010, Hill said.
Maury Regional and Williamson Medical Center appealed the CON boards second approval of Spring Hill Hospital to Davidson County Chancery Court in Nashville. A hearing on their appeal is expected in November or December, and a ruling shortly thereafter, Scarvey said. A further appeal could be made of that ruling to the Tennessee Court of Appeals, but once all appeals are exhausted, Scarvey said, construction would take 18 to 24 months.
HCA has not decided whether to appeal the radiation oncology rulings, Scarvey said. Well be before the (CON) agency again due to the significant growth in that area, so we have to keep that in mind, he added.