Florida House Readies Renewed Push On Hospital Regulations

While the Republican-controlled House is taking aim again at Florida’s certificate-of-need laws, a top state official testified this week that many new hospitals are going through the existing regulatory process with little problem.

Florida is one of 35 states that have laws designed to require health-care providers to justify the need for certain types of new facilities and services. Some GOP lawmakers, including House Speaker Jose Oliva, R-Miami Lakes, have argued that such regulations unnecessarily drive up the cost of health care by artificially restricting the market and maintain that the state should take more of a “free market” approach to health care.

Molly McKinstry, a deputy secretary for the Florida Agency for Health Care Administration, told House members that in recent years most new hospitals have gone through the state’s current process without getting bogged down in regulatory fights. Those fights, which often include a hearing before an administrative law judge, can drag out for one to two years.

McKinstry said 25 acute-care hospitals received initial approvals over the past seven years. Of those 25 hospitals, 13 were approved without competitors challenging the certificates of need backed by regulators. Nine other hospitals were ultimately approved, and only three did not receive the final go-ahead.

Florida has scaled back its certificate-of-need laws several times over the last two decades. Rep. Cary Pigman, an Avon Park Republican who chairs the House Health Market Reform Subcommittee, told members of his panel that they can expect another CON rollback proposal during the 2019 session, which starts March 5.

While Oliva has sounded off on what he calls the “hospital industrial complex,” his counterpart, Senate President Bill Galvano, R-Bradenton, has been more cautious, urging against complete deregulation of the health care market.

House leaders in recent years have repeatedly called for eliminating or scaling back certificate-of-need laws, which also apply to such thing as building nursing homes. The effort also had support from former Gov. Rick Scott but ran into objections in the Senate.

The issue has divided the hospital industry in the past, with some hospitals favoring changes in the CON process and others opposed. Also, the Florida Health Care Association, a major lobbying group for the nursing-home industry, has made maintaining the CON process for nursing homes a priority for the 2019 session, according to information posted on its website.

McKinstry’s hospital figures didn’t include the last round of CON preliminary approvals that were announced in December. In an unusual move, the Agency for Health Care Administration approved eight CON applications for new hospitals, The state approved two new hospitals in Miami Dade County, a 100-bed acute care facility planned by the Public Health Trust of Miami Dade — which operates the Jackson Health System — and an 80-bed facility planned by a subsidiary of its competitor, the Hospital Corporation of America.

The agency also approved competing CON applications for new hospitals in Seminole and Orange counties.

Source: News4Jax

AdventHealth Plans Freestanding ER In Lake Nona

AdventHealth plans to build a freestanding emergency room with a helipad in southeast Orlando’s Lake Nona community
The 18,488-square-foot facility will be built on 6.54 vacant acres at 10093 Lake Nona Blvd., which is west of Narcoossee Road, south of Lake Nona Boulevard and north of State Road 417, according to a draft agenda for the Feb. 14 meeting of the Southeast Town Design Review Committee. The project, owned by Adventist Health System/Sunbelt Inc., is seeking approval as a standalone emergency room.
The new facility is part of a growing trend in the area to build more freestanding emergency centers. Freestanding emergency centers typically are owned and operated by licensed hospitals. The facilities are not connected to a main hospital campus but offer the same comprehensive 24/7 emergency services. The number of such facilities is on the rise in Florida, in part due to overcrowded ERs, and partly due to a desire to grow hospital system revenue. Hospital systems eventually may also expand them into full hospitals if they can prove the need for a facility. For example, HCA Healthcare Inc.’s Oviedo ER, built in 2013, became a $109 million, 64-bed hospital called Oviedo Medical Center in 2017.
The state had only 26 freestanding ERs in 2016 and that number has grown to 41, according to the Florida Agency For Health Care Administration. The total count will rise to 50-plus with the Central Florida projects in the works and may go even higher, since they fulfill a strategy for hospital systems to grow revenue by bringing emergency care closer to outlying, typically affluent suburbs, where people are more likely to be able to afford health care.
This is the sixth such facility AdventHealth has in the works or already has built.
AdventHealth broke ground on another freestanding ER in Oviedo last November. The Orlando-based nonprofit health care provider will open the 19,000-square-foot AdventHealth Oviedo ER by fall 2019. The facility at 8100 Red Bug Lake Road will include two kid-friendly patient rooms, imaging technology like X-ray, CT scan and ultrasound equipment, as well as a medical laboratory.
AdventHealth, which also has freestanding ERs in Lake Mary and Winter Garden, plans to build a $12 million, 14,000-square-foot freestanding ER in Deltona as well as a $15.6 million, 19,000-square-foot freestanding ER in Waterford Lakes that’s expected to open in second-quarter 2019 and have 300 temporary construction jobs and 100 permanent medical jobs at full buildout.
Its $65 million, 97,000-square-foot freestanding ER in Winter Garden opened in February 2016. That outpatient facility, which broke ground in 2013, brought 269 new jobs to the area, $14 million in additional annual payroll and a $23 million boost to Orange County’s gross domestic product, Winter Garden City Commissioner Colin Sharman previously told OBJ.
Meanwhile, AdventHealth system’s Altamonte Springs-based parent company Adventist Health System bought roughly 15 acres on the north and south sides of Lake Nona Boulevard in December 2017 for $9 million. The land is adjacent a vacant 67.24-acre site Adventist bought in 2016.

“Florida Hospital [AdventHealth] plans to build medical office space on the newly acquired Lake Nona property,” AdventHealth previously said in an email to OBJ. “We are expanding our presence in the Lake Nona area to meet the health care needs of this fast-growing community in the years to come. Florida Hospital’s goal is to make health care easier to access by having facilities located within 10 miles of 90 percent of the Central Florida population.”

AdventHealth parent Adventist Health System is the second-largest employer in the area with more than 83,000 employees for 2018. The health care system operates nearly 50 hospital campuses and hundreds of care sites across the U.S. in almost a dozen states and serves more than 5 million patients each year.
Founded in 1908, the $3.36 billion nonprofit AdventHealth system headed up by CEO Daryl Tol provided $45.3 million in uncompensated health care in 2016.

Source: OBJ

Planned Marion Hospital Spurs Legal Challenge

Three hospitals in Marion and Citrus counties are challenging a state decision to sign off on a new 66-bed hospital in Marion County, according to documents posted Thursday on the state Division of Administrative Hearings website.

The dispute stems from the Florida Agency for Health Care Administration’s preliminary approval June 1 of a certificate of need for the 66-bed hospital proposed by Munroe Regional Medical Center.

Obtaining certificates of need are a critical regulatory step in building hospitals and other types of health-care facilities.

Ocala Regional Medical Center, West Marion Community Hospital and Citrus Memorial Hospital filed a challenge to the certificate-of-need decision, contending in part that the approval would lead to an unnecessary duplication of patient beds and services in the area and would result in a loss of patients for the competing hospitals.

The Agency for Health Care Administration on Thursday sent the challenge to the Division of Administrative Hearings, where it will be heard by an administrative law judge.

Source: Health News Florida

2 Rival Healthcare Providers To Build Hospitals In Same Florida City

After a nine-month process, an administrative law judge approved construction proposals from two rival healthcare organizations — clearing the way for both providers to build a hospital in Venice, Fla., according to the Sarasota Herald-Tribune.
Here are nine things to know.
1. The law judge approved Sarasota (Fla.) Memorial’s proposal for a 90-bed hospital and Venice Regional Bayfront Health’s proposal for a 210-bed replacement facility.
2. The Florida Agency for Health Care Administration previously approved the construction projects for both organizations in December 2016. Less than a month after state approval, both healthcare organizations submitted a challenge against the other’s proposal.
3. The hearing about the projects took place in summer 2017, with weeks of testimony and more than 180 lengthy legal filings from each side. The judge’s ruling ended the nine-month legal battle.
4. In an 89-page order, Judge W. David Watkins upheld the state agency’s decision to approve both applications.
5. In his ruling, Mr. Watkins wrote that Sarasota Memorial’s evidence pointed to a need for the 90-bed hospital “based on the proposed service area’s growing population, SMH’s existing patient base in the proposed service area, and the need to improve geographic and financial access for service area residents who are currently traveling great distances to access inpatient services at the SMH main campus.”
6. Additionally, Mr. Watkins said Venice Regional’s project will allow for additional services in Venice, including a heart valve replacement program and enhanced neurosurgical and stroke care.
7. Both systems released statements about being pleased to move forward with construction.
8. The judge’s decision sends the case back to the Florida Agency for Health Care Administration for final approval. The state agency is expected to affirm its earlier approval.
9. The battle between the two systems over care delivery in south Sarasota County has been publicized for more than five years, according to the report. The saga began when Sarasota Memorial moved to open an urgent care facility a mile from Venice Regional.
Source: Becker’s Hospital Review

Public Company Proposes New Hospital In Miami-Dade

under construction

An affiliate of Acadia Healthcare filed a letter of intent with state officials to establish a new hospital in Miami-Dade County.
The Florida Agency for Health Care Administration received the letter of intent from South Florida Behavioral Health LLC, an affiliate of Franklin, Tennessee-based Acadia Healthcare (Nasdaq: ACHC), for a 104-bed adult inpatient psychiatric hospital. The applicant doesn’t have to specify the location of the hospital within the county until later in the certificate of need application process.
Acadia Healthcare Chief Development Officer Steven T. Davidson, who signed the letter of intent, couldn’t immediately be reached for comment. The company owns 568 facilities that treat addiction and behavioral health problems in 39 states, Puerto Rico and the United Kingdom. Its only South Florida location is the Wellness Resource Center in Boca Raton.
Under the certificate of need process, AHCA determines whether there is sufficient demand for a new hospital and whether the applicant has a suitable plan. Acadia Healthcare’s application is due March 8. The agency would issue its decision on June 2.
Source: SFBJ

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