I. August 2013—Tennessee Certificate of Need Meeting

During the August meeting of the Tennessee Health Services Development Agency, the board approved the following applications for certificate of need.

A. Certificate of Need Review

1. Blount Memorial Hospital, Alcoa (Blount County), Tennessee (CN1305-015). The relocation and upgrade of an existing outpatient magnetic resonance imaging (MRI) unit from Blount Memorial Springbrook Health Center located at 220 Associates Boulevard, Alcoa, Tennessee, to Blount Memorial's East Tennessee Medical Group site at 266 Joule Street, Alcoa, Tennessee. If approved, the applicant will discontinue MRI services at the Blount Memorial Springbrook Health Center location. The estimated project cost is $2,214,216.

2. Cookeville Regional Medical Center, Cookeville (Putnam County), Tennessee (CN1305-016). The modification to existing hospital costing in excess of $5 million. The project includes the renovation and expansion of the central sterile supply department as well as the replacement of major equipment within the central sterile supply department and the relocation and expansion of the inpatient pharmacy department located at 1 Medical Center Boulevard, Cookeville, Tennessee 38501. The estimated project cost is $11,547,625.

3. ADC Recovery and Counseling Center, Memphis (Shelby County), Tennessee (CN1305-018). The relocation of an existing nonresidential substitution-based treatment center for opiate addiction from 3041 Getwell Road, Suite 101, Memphis, Tennessee 38118 to 4539 Winchester Road, Building B, Suite 1, Memphis, Tennessee 38118 at an estimated project cost of $961,168.

4. Raleigh Professional Associates, Memphis (Shelby County), Tennessee (CN1305-019). The relocation of an existing nonresidential substitution-based treatment center for opiate addiction from its current site at 2960-B Old Austin Peay Highway, Memphis, Tennessee, to 2165 Spicer Cove, Suite 9, Memphis, Tennessee, at an estimated project cost of $1,136,905.

B. General Counsel's Report

1. Rosewood Manor, Spring Hill (Maury County), Tennessee (CN0703-021A). Request for a 24-month extension of the expiration date from September 1, 2013, to September 1, 2015. The project was approved by unanimous vote on July 25, 2007, for the replacement and relocation of the existing nursing home and the addition of 30 Medicare-certified skilled nursing beds for an increase in licensed beds from 68 beds to 98 skilled nursing facility beds with an estimated project cost of $10,668,976. The original expiration date of September 1, 2009, was extended to September 1, 2011, on July 22, 2009, by a vote of 6-2-0 and extended to September 1, 2013, on July 27, 2011, by unanimous vote. Although the applicant requested only a 24-month extension, the agency granted a 36-month extension to September 1, 2016.

2. University of Tennessee Medical Center, Knoxville (Knox County), Tennessee (CN1005-022A). Request for an 18-month extension of the expiration date from October 1, 2013, to April 1, 2015. The project was approved by unanimous vote on August 25, 2010, for construction of an addition to the existing surgery department to house 13 new operating rooms and renovation of three small operating rooms for a net addition of 10 operating rooms and one endovascular suite with an estimated project cost of $18,432,272.

3. Baptist Memorial Hospital for Women, Memphis (Shelby County), Tennessee (CN1211-058A). Request for modification of the certificate of need to include two additional floors of shelled space to be used for physician offices with a projected cost increase of $3,409,200. The project was approved by unanimous vote on February 17, 2013, for the construction of an emergency department dedicated for pediatric patients and the initiation of MRI services with an estimated project cost of $14,105,241.

4. Johnson City Medical Center, Johnson City (Washington County), Tennessee (CN1106-021A). Update on status of and changes in the project and, if needed, modifications of the project. The program was approved by unanimous vote on September 28, 2011, for the renovation and expansion of the current radiation oncology department in the main campus building of Johnson City Medical Center with an estimated project cost of $14,999,924.

5. Southern Sports Surgery Center, Hendersonville (Sumner County), Tennessee (CN1204-019A). Request for a change of ownership/control to enable Drs. Gautsch and Grutter (currently 50% owners each) to sell 38% to SurgCenter Development. Per the approved application, they may eventually sell other ownership interests to other physicians (no more than 13.04%). CN1204-019A authorizes the applicant to relocate an approved but unimplemented certificate of need for the establishment of an ambulatory surgical treatment center (ASTC) from 1163 Nashville Pike, Gallatin, to 127 Saundersville Road, Suite A, Hendersonville. It also expands the designated use of the ASTC to multi-specialty services. The approved project cost is $3,355,533. The expiration date was extended to May 30, 2015, by operation of law because of the length of the contested case appeal filed by Hendersonville Medical Center, which was voluntarily dismissed.

The following applications were deferred from the May meeting and withdrawn.

A. Certificate of Need Review

1. Spinal Health Care Associates, P.C., Cordova (Shelby County), Tennessee (CN1212-060). The establishment of a specialty ASTC providing only manipulation under anesthesia (MUA) services in one procedure room in Cordova at an estimated project cost of $472,667.

B. General Counsel's Report

1. Agency Determination: MUA Medical Clinic of Knoxville, LLC (CN0811-112A), and MUA of Middle Tennessee, LLC (CN1009-045A). Agency staff request for agency determination regarding whether manipulation under joint anesthesia (MUJA) is permissible under a certificate of need limited to the provision of MUA services, which are manual surgical procedures with no operative surgical procedures to be performed.

The next agency meeting will be held on September 25, 2013, at 8:30 a.m.

II. Certificate of Need Program Report—Filings Since July 2013 Meeting

A. Letters of Intent to Apply for CON

1. Woodridge of West Tennessee, LLC, Jackson (Madison County), Tennessee (CN1308-void). Establishment of a new 16-bed geriatric psychiatric facility. Notice of intent was not published between August 1 and August 10. Accordingly, the letter of intent is void.

2. Love Ones, Memphis (Shelby County), Tennessee (CN1308-void). Establishment of a home healthcare organization serving Shelby, Fayette, and Tipton Counties. The applicant's address was not stated in the description section of the letter of intent and, accordingly, the letter of intent is void.

B. Applications for CON

1. Pioneer Community Hospital of Scott County, Oneida (Scott County), Tennessee (CN1308-030). Discontinuation of obstetric services affecting five beds at an estimated project cost of $5,000.

2. MUA of Middle Tennessee, LLC, Nashville (Davidson County), Tennessee (CN1308-031). Addition of interventional pain management services at its ASTC, which currently provides MUA services to be provided in the same one-procedure room that is currently licensed at an estimated cost of $113,000.

3. Smoky Mountain Ambulatory Surgery Center, LLC, Knoxville (Knox County), Tennessee (CN1308-032). Addition of interventional pain management services at its ASTC, which currently provides MUA services to be provided in the same one-procedure room that is currently licensed at an estimated cost of $53,000.

III. Projects Deemed Complete for Review at September 2013 Meeting

A. CON Applications Deemed Complete for CON Review

1. Community Hospices of America-Tennessee, LLC, d/b/a Hospice Compassus-The Highland Rim, Tullahoma (Coffee County), Tennessee (CN1306-020). The initiation of hospice services in Decatur, Hardin, Humpreys, Perry, and Wayne Counties. Hospice Compassus is currently licensed in Bedford, Cannon, Coffee, Franklin, Giles, Grundy, Hickman, Lawrence, Lewis, Marshall, Maury, and Moore Counties. The estimated project cost is $63,000.

2. CSPM Surgery Center, Chattanooga (Hamilton County), Tennessee (CN1306-021). The establishment of a single specialty ASTC limited to pain management, with one operating room limited to patients of Center for Spine and Pain Medicine, P.C. at 7446 Shallowford Road, Suite 102, Chattanooga, Tennessee 37421 at an estimated project cost of $683,350.

3. The Health Center of Hermitage, Nashville (Davidson County), Tennessee (CN1306-022). The relocation of 60 of the 150 nursing home beds approved but unimplemented from CN1107-024A and the addition of 30 new Medicare-certified skilled nursing home beds for a total 90 Medicare-certified skilled bed nursing home. The estimated project cost is $20,142,000.

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