Hospital Association, Mon Health oppose new micro-hospital Certificate of Need bill
Mar. 26—dbeard @dominionpost.com MORGANTOWN — While the governor's bill to repeal the Certificate of Need process died in February, some delegates are making a stab at doing away with CON for what they term micro-hospitals.
And as with the prior bill, the West Virginia Hospital Association and Mon Health oppose this one.
The House Health Committee held its informational hearing on HB 3487 on Tuesday.
It would eliminate from CON requirements construction or acquisition of a small format or micro-hospital owned by a system with one or more existing licensed hospitals in the state.
The new facility would have to be located to increase care capacity without jeopardizing any nearby critical access hospitals.
It could include up to 25 in-patient beds, up to 25 emergency room beds (there was confusion if the bill meant 25 total or 50 beds total, and the bill sponsor wasn't sure but guessed 50), a CT scanner, an MRI scanner and other services. The cost could not exceed $100 million.
Lead sponsor Wayne Clark, R-Jefferson, said this is the third year they've tried to move this bill. The Eastern Panhandle has a bed shortage, with just WVU Medicine's critical access Jefferson Medical Center and WVUM's 160-bed Berkeley Medical Center serving 250, 000 people.
"Many of us that live in border states have to go out of state for our services, " he said. In his area, the go to Maryland and Virginia.
The bill, he said, would expand local care, bring more providers into the state, and keep money in the state that's going elsewhere.
Jim Kaufman, president and CEO of the WVHA, explained their opposition.
The effect of the bill, he said, would be to eliminate CON altogether. Under legislation passed two years ago, a company could build a micro-hospital then immediately expand to 1, 000 beds without a CON.
The average critical access hospital (located in a rural area either more than 35 miles from the nearest hospital or more than 15 miles in areas with mountainous terrain or only secondary roads ; maintain no more than 25 inpatient beds that can be used for either inpatient or swing-bed services ; and furnish 24-hour emergency care services seven days a week) provides 90 % of its services on an outpatient basis and can expand those services without a CON, he said.
The sometimes testy questioning by Eastern Panhandle delegates focused on beds versus services. The delegate maintained that the bill will expand care in the panhandle.
Kaufman maintained that systems must make business decisions based on various factors. They could expand services without beds — as WVUM is planning at Jefferson, without affecting federally established critical access status.
They could add beds to a critical access hospital and lose the increased Medicare and Medicaid reimbursements in exchange for volume. Or they could — as Mon Health did in Marion and Harrison counties — obtain CONs to build new small-format hospitals. Or they could build another critical access hospital.
Part of the decision, he said. Would hinge on the payer makeup — how much money comes from the government and how much from commercial insurance.
The panhandle delegates argued that more facilities is better. Kaufman countered that existing facilities have a responsibility to remain economically viable in order to go on offering care.
Mon Health comments Asked for thoughts on this bill, David Goldberg, president and CEO of Mon Health System and Davis Health System — Vandalia Health Northern Region, and executive vice president of Vandalia Health, told The Dominion Post, "A small-format hospital — some say micro-hospital — is a hospital. It meets all Centers for Medicare & Medicaid Services (CMS) licensure requirements, state rules and regulations, and life safety standards expected of a hospital.
"We have a successful demonstration model with Mon Marion Neighborhood Hospital and the soon-to-be-opened Mon Harrison Neighborhood Hospital, " he said. "Both went through the CON process and faced no opposition or issues in receiving state approval. No one should be exempt from following the state process. Apply and prove the feasibility and need.
"We did, demonstrating to both the community we serve and the state the need and the justified rationale for its approval, " Goldberg said. "Mon Marion Neighborhood Hospital is recognized by Becker's Healthcare as the fastest ER in the state and among the top 10 in the country. We have had no infections or hospital-acquired conditions since opening and served 15, 000 ER patients in 2024. We support maintaining the laws as written, and this form of hospital should be held to the same standards as those applied by the federal government for a licensed hospital."
WVU Medicine did not wish to comment at this time.
HB 3487 on the committee's Thursday agenda for markup and passage for recommendation to the full House. It would need to pass out of the House to the Senate by April 2, Crossover Day, the 50th day of the session. when bills need to leave their house of origin.
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