COLUMBIA — Beds and the bottom line dominated the debate Monday as the S.C. Administrative Law Court continues to consider an appeal over who should get to build a new Fort Mill hospital.
Piedmont Medical Center representatives argued their plans for a $120 million, 100-bed facility at the intersection of S.C. 160 and U.S. 21 are the right size – and capable of being expanded as the population increases in northern York County. PMC-Fort Mill could be as large as 250 beds, they said in a hearing Monday at the Edgar A. Brown Building.
Carolinas HealthCare System wants to build a $78 million, 64-bed facility on Sutton Road. The state health plan calls for 64 beds. Carolinas HealthCare representatives say that moving 36 beds from Piedmont’s Rock Hill hospital to a new Fort Mill hospital will create an imbalance in the distribution of hospital beds countywide.
The debate over the appropriate number of beds came as the trial entered its fourth week. Both health care systems have presented their witnesses. Monday’s session turned to rebuttal witnesses with Piedmont attorneys recalling Bill Masterton, the hospital’s CEO, and two expert witnesses, health care consultants David Levitt and Dan Sullivan.
Judge Phillip Lenski of the Administrative Law Court is determining whether the state Department of Health and Environmental Control was correct in awarding a certificate of need for the Fort Mill hospital to Carolinas HealthCare in September 2011.
Piedmont and Presbyterian Hospital, then an applicant for the hospital, appealed the decision. In May of 2006 Piedmont was awarded the certificate and Carolinas HealthCare and Presbyterian successfully appealed that decision.
Levitt said that a 64-bed facility is too small, even using Carolinas HealthCare’s own projections. He said that Carolinas HealthCare would need 90 beds to meet demand by 2020. According to Levitt, Carolinas HealthCare plans call for adding up to 20 beds.
Levitt also disputed that moving beds from Rock Hill to Fort Mill creates an imbalance of beds countywide. With a 100-bed Fort Mill hospital and the Rock Hill hospital the number of beds per 1,000 people would be 1.19 throughout the county, he said.
With a 64-bed hospital, the beds-per-1,000 people ratio would be .76 in northern York County by 2020 and 1.36 in Rock Hill and western York County. “There would be not enough beds in northern York County and too many in Rock Hill/western York County,” he said.
The consultants and Masterton also focused on “adverse economic impact,” one of the criteria DHEC considered in making its decision and a primary emphasis in Piedmont’s case.
PMC officials argue that patients leaving northern York County for care at CMC-Pineville and other CHS hospitals are affecting local health resources and revenues.
Piedmont witnesses have testified the hospital and some specialists in York County are seeing more patients who have less ability to pay and that Carolinas HealthCare referral practices are reducing their number of patients, their revenue and in some cases affecting their medical skills of doctors because they need to see certain number of cases to maintain their proficiency.
Carolinas HealthCare has refuted that claim, noting it does not plan to taken market share from Piedmont at CMC-Fort Mill. Most of those coming to CMC-Fort Mill will be existing Carolinas HealthCare patients who live in northern York County and wanting health care closer to home, officials have said.
Masterton defended the management of PMC. He noted that consumer price index for health care costs is growing by about 3.7 percent annually. Piedmont kept its growth in expenses to 1.2 percent. “That demonstrates our ability to control costs,” he said.
He also said Piedmont’s after-tax income continues to decreased. It was $2.8 million in 2009, according to hospital records. It is predicted to be an $18,000 loss by 2020 “and that’s only going to get worse,” he said.