Fort Mill hospital case still focused on economic impact

dworthington@heraldonline.comApril 29, 2013 

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— Attorneys for Piedmont Medical Center on Monday pressed a consultant for their competitor, Carolinas HealthCare System, asking why she didn’t do a more thorough job reviewing applications to build a new Fort Mill hospital.

Piedmont’s attorney questioned consultant Kathy Platt during testimony before the S.C. Administrative Law Court. They wanted to know why she did not examine assumptions, financial projections and other key numbers in Carolinas HealthCare’s certificate of need application for a 64-bed hospital off Sutton Road.

Platt said she was not hired by Charlotte-based Carolinas HealthCare to validate its application, but to compare it to others submitted by Rock Hill’s Piedmont and Presbyterian Hospital of Charlotte. Her job was to offer advice to Carolinas HealthCare, including questions to raise about the other applicants.

This is the second time the Fort Mill hospital certificate has been before the Administrative Law Court. In September 2009, the court overturned a decision by the state Department of Health and Environmental Control to award the certificate to Piedmont.

In September 2011, DHEC awarded the certificate to Carolinas HealthCare. Piedmont and Presbyterian appealed, but Presbyterian dropped out just before the case was to be heard.

Monday marked the beginning of the third week of the trial, in which Carolinas HealthCare is presenting its case. Piedmont attorneys already have called their primary witnesses, but might call rebuttal witnesses later this week or early next week.

DHEC is also represented at the trial, and agency officials explained their decision during a day of testimony last week.

Judge Phillip Lenski has until May 18 to announce his decision. He can request an extension, which attorneys for both sides said is likely, given the complexity of the case and the time the trial has taken.

Platt, an Atlanta-based health care consultant, was the first of two expert witnesses to testify for Carolinas HealthCare. She explained and then defended her analysis, comparing the hospitals’ applications to the criteria DHEC used in making its selections.

Carolinas HealthCare was best qualified on 14 of the 33 criteria DHEC can use to evaluate certificate-of-need applications, she said, and the two hospitals were equally qualified on 11 factors. Piedmont did not meet the standard on 14 of the criteria, she said, many of those financial in nature.

Some areas where Piedmont fell short, she said, were related to projected patients or to Piedmont’s desire to build a 100-bed hospital. The state identified the need for 64 beds in York County.

“It’s clear in my mind that Carolinas best met the criteria,” Platt said.

Attorneys for Piedmont challenged her analysis, particularly when it came to economic harm. In awarding the certificate of need to Carolinas HealthCare, DHEC said, the Charlotte hospital “best met” the criteria for adverse affects on other facilities.

Carolinas HealthCare’s Fort Mill hospital would have no effect on Piedmont Medical Center, Platt said, because it would only shift patients in northern York County it already serves at it’s downtown Charlotte and Pineville hospitals.

For basic hospital care, those patients would be able to go to a Fort Mill hospital that is closer to home, Platt and others from CHS have testified.

Piedmont officials and doctors have testified that loss of the York County patients to Carolinas HealthCare already has affected the Rock Hill hospital and doctors’ practices, and that a continued loss of patients would reduce the stream of patients and revenue for both.

In some cases the lost of patients could affect doctors’ medical skills, because a certain number of cases are needed to maintain proficiency, doctors testified.

Carolinas HealthCare did not include an adverse economic impact analysis, Platt said, because a Fort Mill hospital run by that company would not change its market share in York County.

The biggest change in market share would have come had Presbyterian been awarded the certificate, she said, as it would have to draw patients from Carolinas HealthCare, Piedmont Medical Center and Springs Memorial Hospital in Lancaster.

Platt’s own economic impact analysis – what she called a worst-case scenario – showed a loss of about 60 general hospital cases for Piedmont Medical Center.

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