I. January 2014—Tennessee Certificate of Need Meeting

At the January meeting of the Tennessee Health Services Development Agency, Jeff Ockerman gave an update on the development of the new nursing home and home health standards. The home health standards are currently being reviewed by TennCare, and the nursing home standards have been sent to TennCare for review. Both the home health and nursing home standards will be circulated for public comment soon.

The agency approved the following applications during the January meeting.

A. Certificate of Need Review

1. MUA of Middle Tennessee, LLC, Nashville (Davidson County), Tennessee (CN1308-031). The addition of interventional pain management services to a single specialty ambulatory surgical treatment center (ASTC) with one procedure room that is currently authorized to provide only manipulation under anesthesia (MUA) services, which are manual, not operative, surgical procedures. The estimated project cost is $113,000.

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

3. Woodridge of West Tennessee, LLC, Jackson (Madison County), Tennessee (CN1309-035): Establishment of a new 16-bed geriatric inpatient psychiatric facility located at 49 Old Hickory Boulevard, Jackson, Tennessee. The estimated project cost is $1,158,737.

4. The Village at Germantown Skilled Nursing Facility, Germantown (Shelby County), Tennessee (CN1310-039): The addition of 20* Medicare-certified skilled nursing facility beds to the existing 30-bed facility at an estimated project cost of $5,641,539. *These beds are subject to the 2013-14 Nursing Home Bed Pool.

B. General Counsel's Report

1. Parkridge Valley Hospital, Chattanooga (Hamilton County), Tennessee (CN1202-006A). Request for modification to the certificate of need by increasing the project cost by $566,006 from $140,000 to $706,006. This project was approved on May 23, 2012, with an expiration date of July 1, 2015, for the addition of 16 additional child and adolescent psychiatric beds and the relocation of all 48 of its licensed adult psychiatric beds to a new campus site.

2. Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville (Davidson County), Tennessee (CN0710-075A). Request for modifications and a four-year extension of expiration date from March 1, 2014, to March 1, 2018. Modifications include a change in the floor plan, which will result in a decrease in square footage from 372,140 square feet to 210,000 square feet of new construction and a $128,326,286 decrease of the total project cost from $248,326,286 to $120,000,000. On January 23, 2008, this project was approved for the expansion of the existing hospital through an adjacent building connected to the hospital and the addition of 105 beds.

The next agency meeting will be held on February 26, 2014, at 8:30 a.m.

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

A. Letters of Intent

1. Hospice Alpha, Inc., Nashville (Davidson County), Tennessee (Void). The establishment of a hospice agency to serve residents of Dickson, Montgomery, Robertson, Rutherford, Sumner, Williamson, and Wilson Counties at an estimated project cost of $100,000. The letter of intent is void as it did not meet the regulatory requirement that the parent office of a home health organization be in a county that is licensed by the organization as specified in Tenn. Code Ann. § 68-11-1607 and Agency Rule 0720-10-.03.

2. Uplands Wellness Center, Pleasant Hill (Cumberland County), Tennessee (Void): The relocation of 31 of the current 62 licensed intermediate care facility/skilled nursing facility beds from Wharton Nursing Home at 880 West Main Street to Uplands Wellness Center, a 4,808 square foot facility located at 55 West Lake Road in Pleasant Hill, Tennessee. The vacated beds at Wharton Nursing Home will become an Alzheimer's assisted living unit (ALU). The estimated project cost is $5,100,000. This letter of intent is void as a certificate of need application was not filed within the time frame set forth by Agency Rule 0720-10-.03.

3. Wharton Nursing Home, Pleasant Hill (Cumberland County), Tennessee (Withdrawn): The renovation of an adjacent building for relocation of 31 nursing home beds to Wharton Nursing Home located at 880 West Main Street, Pleasant Hill, Tennessee, and the conversion of 31 nursing home beds at Upland Village to a new 31-bed Alzheimer's ALU at 55 West Lake Road in Pleasant Hill, Tennessee. The estimated project cost is $5,100,000. This letter of intent was withdrawn.

B. Applications for CON

1. Select Specialty Hospital—North Knoxville, Powell (Knox County), Tennessee (CN1312-047): The relocation of 33 long-term acute care beds from 900 East Oak Hill Ave., 4th Floor, Knoxville, Tennessee, to leased space at North Knoxville Medical Center, Physicians Plaza B, 1st Floor, Knoxville, Tennessee. The estimated project cost is $13,910,744.

2. Ave Maria Home, Bartlett (Shelby County), Tennessee (CN1312-048): The replacement of 35 of the current 75 skilled nursing beds at 2805 Charles Bryan Road, Bartlett, Tennessee, and the addition of 30 Medicare-certified skilled nursing beds at 2840 Charles Bryan Road, Bartlett, Tennessee. If approved, the facility will have a total of 105 beds. The estimated project cost is $7,999,960.

3. SBH-Kingsport, LLC, Kingsport (Sullivan County), Tennessee (CN1312-050): The establishment of a new inpatient psychiatric hospital and initiation of inpatient psychiatric hospital services with 72 new licensed psychiatric beds (18 adult beds, 16 geriatric beds, 28 child and adolescent beds, and 10 chemical dependency beds). The estimated project cost is $11,717,915.

4. Saint Thomas Midtown Hospital, Nashville (Davidson County), Tennessee (CN1401-001): The renovation of surgical suites, patient care areas, and support space for the realignment and consolidation of total joint replacement services in 94,337 square feet of space and without new construction. The number of licensed beds will not change, and the estimated project cost is $25,832,609.

5. East Tennessee Children's Hospital, Knoxville (Knox County), Tennessee (CN1401-002): The renovation and expansion of the neonatal intensive care unit, the neonatal abstinence syndrome unit, perioperative services, and specialty clinic located on the hospital's campus. There will be no change in the number or complement of licensed beds, no services initiated, and no major medical equipment purchased. The estimated project cost is $75,300,000.

III. Projects Deemed Complete for Review at February 2014 Meeting

A. Consent Calendar

1. Professional Home Health Care, LLC d/b/a CareAll Home Care Services, Brownsville (Haywood County), Tennessee (CN1312-049): The relocation of the home health agency's parent office from 901 Highway 51 South, Covington (Tipton County), Tennessee, to 1151 Tammbell Street, Brownsville (Haywood County), Tennessee. The home health agency's service area is comprised of Benton, Carroll, Chester, Crockett, Decatur, Dyer, Fayette, Gibson, Hardeman, Hardin, Haywood, Henderson, Henry, Lauderdale, McNairy, Madison, Obion, Tipton, and Weakley Counties. The estimated project cost is $59,300.

B. Certificate of Need Review

1. Love Ones, Memphis (Shelby County), Tennessee (CN1309-033): The establishment of a home care organization and the initiation of home health services in Fayette, Shelby, and Tipton Counties. The parent office will be located at 2502 Mount Moriah, Suite A-148, Memphis, Tennessee. The estimated project cost is $177,800.

2. Crestwyn Behavioral Health, Germantown (Shelby County), Tennessee (CN1310-040): The establishment of a 60-bed mental health psychiatric hospital to be constructed on an unaddressed tract of land on the east side of Crestwyn Hills Drive, Germantown, and offer 15 beds for psychiatric care of adolescents, 30 beds for adults of all ages, and 15 beds for adult chemical dependency care. The estimated project cost is $26,875,862.

3. Methodist Healthcare—Memphis Hospitals d/b/a Le Bonheur Children's Hospital, Memphis (Shelby County), Tennessee (CN1311-042): The establishment of a pediatric outpatient center to include the acquisition of magnetic resonance imaging (MRI) and computed tomography (CT) equipment and initiation of those services to be operated as an outpatient department of the children's hospital. The facility will be located at 100 North Humphreys Boulevard, Memphis, Tennessee. The estimated project cost is $26,798,857.

4. Methodist Healthcare—Memphis Hospital d/b/a West Cancer Center, Germantown, (Shelby County), Tennessee (CN1311-043): The establishment of a comprehensive cancer center, the relocation of linear accelerator (LA), positron emission tomography (PET), CT, MRI services and equipment, the replacement of an MRI and acquisition of an additional LA, and the establishment of ambulatory operating rooms. The center will be operated as an off-campus outpatient department of the hospital. The estimated project cost is $60,554,193.

5. The Farms at Bailey Station, Collierville (Shelby County), Tennessee (CN1311-045): The addition of 30* skilled nursing facility beds, certified for Medicare participation, to be part of the 30-bed skilled nursing facility approved by CN1303-008A, for a total of 60 skilled nursing facility beds as part of a continuing care retirement community. The estimated project cost is $6,306,575. *These beds are subject to the 2013-14 Nursing Home Bed Pool.

6. Karing Hearts Cardiology, PLLC, Johnson City (Washington County), Tennessee (CN1311-046): The acquisition of a cardiac PET scanner and initiation of PET services at 701 State of Franklin Road, Suite 2, Johnson City, Tennessee, at an estimated project cost of $391,585.

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