Our view

Another milestone in hospital battle

April 3, 2014 

  • In summary

    Judge makes a compelling case for awarding certificate of need to Piedmont Medical Center.

Tuesday’s decision that Piedmont Medical Center should be allowed to build a new Fort Mill hospital is no guarantee that the matter is settled. We hope, though, that this is one significant step toward resolving a conflict that has lasted nearly a decade.

Initially, PMC, Carolinas HealthCare, the parent company of Carolinas Medical Center, and Novant, owner of Presbyterian Hospital, filed with the state Department of Health and Environmental Control for a certificate of need to build the hospital. DHEC first awarded the certificate to Piedmont in May 2006 before the decision was appealed by CHS and Novant.

DHEC then awarded the certificate to Carolinas HealthCare in September 2011. Piedmont and Novant appealed that decision to the S.C. Administrative Law Court. Novant dropped its bid, but PMC prevailed Tuesday with a decision by Judge Phillip Lenski to award it the certificate.

The decision ended a long wait for Piedmont and CHS. But, depending on what CHS decides to do next, it could just be the end of another chapter in this drama.

In a sense, Lenski’s lengthy rationale for his decision brought the discussion full circle, back to the substance of the case PMC was making nearly a decade ago. Lenski gave a great deal of weight to claims that PMC would suffer grievious financial hardship if CMC were to siphon patients from the Fort Mill area.

Lenski said that losing that patient base would adversely affect PMC’s ability to provide quality health care in the rest of York County. Lenski specifically cited testimony that Piedmont would lose between 1,600 to 3,000 patients per year and between $12 million to $22 million in income annually if CHS were to win the bid to build the new hospital.

CHS still could appeal the decision to the state Court of Appeals. And the issue is further muddied by the state’s decision to suspend the certificate of need program after Gov. Nikki Haley vetoed funding for it and lawmakers failed to override the veto. With the certification program in limbo, CHS ostensibly could file to build a new hospital in Fort Mill without having to get a certificate of need.

Of course, another option for CHS would be to throw in the towel and let PMC build its hospital.

A resolution to this long-running battle would be good news for the medical community and the residents of York County. For example, a number of local physicians have stood back to see how this case would end before deciding whether to change their affiliation to CHS.

But once the new hospital is opened (which is likely to be 2018 at the earliest) residents would reap the most benefits. Fort Mill patients, of course, would not have to drive to Rock Hill, Charlotte or the CMC facility in Pineville, N.C., for medical care.

PMC also could take advantage of a new customer base and economy of scale to customize and improve care at both its existing hospital in Rock Hill and in the new one slated to be built at the intersection of S.C. 160 and U.S. 21.

Lenski offers a compelling argument in making the case for choosing PMC. In addition to potential economic hardship if CHC were to build the hospital, Lenski said PMC’s ability to provide comprehensive service throughout York County also might suffer.

He noted that Piedmont provides a countywide ambulance service and pays the county’s indigent care tax. The hospital also is involved in a variety of charitable efforts and other events in the county.

Finally, Lenski notes that PMC could build a 100-bed hospital in Fort Mill, moving 36 beds from its Rock Hill hospital, while CHC plans only a 64-bed facility in Fort Mill. And PMC’s future plans call for an expansion in Fort Mill to 250 beds while CHS’s proposal calls for just 20 more beds.

Again, though, this battle might not be over, depending on what tack CHS decides to take. We hope, though, that the end is near.

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