United States: Tennessee CON Report - February 2015

I. February 2015—Tennessee Certificate of Need Meeting

At the February meeting of the Tennessee Health Services and Development Agency, Julia Bayles with the Office of Health Planning announced that the final draft of the 2014 State Health Plan has been sent to the Governor's office for review and approval. In addition, the Office of Health Planning is currently reviewing the standards for inpatient psychiatric beds and is soliciting recommendations for review of standards for other provider types. The Office of Health Planning is also currently reviewing the Joint Annual Reports for hospitals and home health agencies to assist in its review of the home health standards. The final meeting for review of the hospital Joint Annual Report is scheduled for April. Finally, Ms. Bayles announced that the Office of Health Planning will issue a review letter to the agency regarding intrathecal pumps in connection with the upcoming applications to be heard at the March meeting of the agency.

The agency approved the following applications during the February meeting.

A. Certificate of Need Review

1. Waynesboro Health & Rehabilitation Center, Waynesboro (Wayne County), Tennessee (CN1411-045): The relocation and replacement of Wayne Care Nursing Home's 46-bed facility from 505 South Main Street (License No. 277) to Waynesboro Health & Rehabilitation Center's 109-bed (License No. 178) facility at 104 J.V. Mangubat Drive, with construction of an addition for a combined 155-bed dually certified nursing home with an 18-bed Memory Care Unit. The estimated project cost is $5,658,318.

B. General Counsel's Report

1. Memorial Hospital Ooltewah Satellite Cancer Center with Linear Accelerator, Ooltewah (Hamilton County), Tennessee (CN1202-004A): The request for a two-year extension of the expiration date from July 1, 2015, to July 1, 2017. The project was originally approved on May 23, 2012, for a hospital modification in excess of $5 million and the initiation of linear accelerator services at the satellite campus. The estimated project cost is $10,216,658.

2. Overton County Nursing Home, Livingston (Overton County), Tennessee (CN1204-017AE): The request for a six-month extension of the expiration date from March 1, 2015, to September 1, 2015. The project was originally approved on July 25, 2012, by unanimous vote for modification by new construction and renovation of the existing 160-bed nursing home with an expiration date of September 1, 2014. On July 23, 2014, a six-month extension requested was granted. The estimated project cost is $6,344,844.

3. Metro Knoxville HMA, LLC d/b/a Tennova Healthcare-North Knoxville Medical Center, Powell (Knox County), Tennessee (CN1206-027A): The request for modification to expand positron emission tomography (PET) services from one day a week to three days a week. This project was approved on September 26, 2012, by unanimous vote for mobile PET services one day per week with an expiration date of November 1, 2015. It was implemented on April 8, 2013. The estimated project cost is $1,298,562.

4. Maxwell Aesthetics, PLLC, Nashville (Davidson County), Tennessee (CN1303-009A): The request for a two-year extension of the expiration date from August 1, 2015, to August 1, 2017. This project was approved on June 23, 2013, by unanimous vote for the construction, development, and establishment of an ambulatory surgical treatment center (ASTC) limited to plastic surgery with one operating room. The estimated project cost is $1,322,564.

The following application was deferred to the March 2015 meeting.

A. Certificate of Need Review

1. Southern Hills Surgery Center, Brentwood (Williamson County), Tennessee (CN1411-047): The relocation of an existing ASTC from 260 Wallace Road in Nashville to an unaddressed site at the northeast corner of the intersection at Old Hickory Boulevard and American General in Brentwood. The estimated project cost is $17,500,000.

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

II. Certificate of Need Program Report—Filings in February 2015

A. Applications for Certificate of Need

1. Scott Hamilton Proton Center, Franklin (Williamson County), Tennessee (CN1502-004): The establishment of a proton therapy center for cancer patients, the acquisition of proton therapy equipment and related components, and the initiation of outpatient proton therapy services at an estimated project cost of $105,682,789.

2. Chattanooga-Hamilton County Hospital d/b/a Erlanger East Hospital, Chattanooga (Hamilton County), Tennessee (CN1502-005): The modernization of the 2004 certificate of need (CN0504-047AE), which is currently in process, by upgrading the cardiac catheterization laboratory to perform interventional cardiac procedures from Erlanger East Hospital. The estimated project cost is $300,000.

3. Trustpoint Hospital, LLC, Murfreesboro (Rutherford County), Tennessee (CN1502-006): The addition of 33 beds such that the bed complements will change as follows: adult psychiatric will increase from 31 to 59 beds, geriatric psychiatric will change from 28 to 36 beds, medical detoxification beds will increase from 10 to 18 beds, and physical rehabilitation will decrease from 27 to 16 beds. There will be a total bed increase from 96 to 129 beds. All bed increases will occur within existing space and will be licensed as hospital beds. The estimated project cost is $932,000.

III. Projects Deemed Complete for Review at March 2015 Meeting

A. Consent Agenda

1. The Home Option by Harden Healthcare, Oak Ridge (Anderson County), Tennessee (CN1501-001): The initiation of home health services in Blount, Campbell, Claiborne, Grainger, Monroe, Morgan, Roane, and Scott Counties. If approved, the applicant's sister agency, Gentiva Certified Healthcare Corporation, proposes to delicense the same 8 counties. The agency is located at 800 Oak Ridge Turnpike, Suite A208, Oak Ridge (Anderson County), Tennessee, and is currently licensed for Anderson, Jefferson, Knox, Loudon, Sevier, and Union Counties. The estimated project cost is $38,000.

2. Advanced Diagnostic Imaging, P.C. d/b/a Southern Sports Medicine Institute, Gallatin (Sumner County), Tennessee (CN1501-002): The continuance of in-office magnetic resonance imaging (MRI) serviced limited to extremities approved in Thomas L. Gautsch, MD, PC (CN0110-088A), under the ownership of Advanced Diagnostic Imaging, PC d/b/a Southern Sports Medicine Institute (SSMI), an existing multi-specialty physician practice group that Dr. Gautsch is joining. Other than the change in ownership, no change in site, equipment, or imaging services will occur. The estimated project cost is $624,935.

3. Baby + Company Nashville, Nashville (Davidson County), Tennessee (CN1501-003): The relocation of an approved but unimplemented CON (CN1406-022) for a birthing center from leased space at 2106 21st Avenue, Nashville (Davidson County), to leased space at 3212 West End Avenue, Nashville (Davidson County). The facility will include 4 birthing suites, 3 examination rooms, and various support areas in approximately 7,800 square feet. The estimated project cost is $2,080,111.

B. Certificate of Need Review

1. Chattanooga-Hamilton County Hospital Authority d/b/a Erlanger East Hospital, Chattanooga (Hamilton County), Tennessee (CN1412-048): The initiation of radiation therapy service with the acquisition of a linear accelerator located at Erlanger East to complement oncology services and to replace an existing linear accelerator at Erlanger Medical Center. The project will decrease the number of linear accelerators from two to one. The estimated project cost is $10,532,562.

2. Saint Thomas Midtown Hospital, Nashville (Davidson County), Tennessee (CN1412-049)*: The establishment of a satellite emergency department (ED) that will have eight treatment rooms and will be physically connected to Premier Radiology. The ED will provide full emergency diagnostic and treatment services at the hospital and will utilize Premier Radiology for diagnostic services. The estimated project cost is $65,757,172. *Please note that this application will be heard as a simultaneous review with the application filed by TriStar Southern Hills Emergency Department at I-65.

3. TriStar Southern Hills Emergency Department at I-65, Brentwood (Davidson County), Tennessee (CN1412-050): The establishment of a satellite ED in a leased building to be constructed at the intersection of Old Hickory Boulevard and American General Way in Brentwood, Tennessee. The facility will contain eight treatment rooms for emergency diagnostic and treatment services, including laboratory services. The estimated project cost is $11,316,699.

4. Life Care Centers of America, Inc. d/b/a Life Care Center of East Ridge, East Ridge (Hamilton County), Tennessee (CN1410-044): The replacement of the existing 130-bed facility with a new 108-bed facility on the same campus located at 1500 Fincher Avenue, East Ridge (Hamilton County). Twenty-two beds will be delicensed. The estimated project cost is $24,874,400.

5. Pentec Health, Inc., Nashville (Davidson County), Tennessee (CN1411-046): The establishment of a home care organization and initiation of home health services for specialized skilled nursing home services under physician-ordered plans for patients: (1) implanted intrathecal pumps and (2) receiving immunoglobulin-G replacement therapy. The parent office will be located in leased space at 424 Church Street, Suite 2000, Nashville, Tennessee, and no branch offices are proposed. The applicant plans to utilize Pentec Health's existing pharmacy whose compounding branch site is located at the parent office at 4 Creek Parkway in Boothwyn, Pennsylvania. The pharmacy has an active Tennessee license. The proposed service area is all 95 counties in Tennessee except Hancock, Perry, and VanBuren Counties and the estimated project cost is $142,028.

6. Southern Hills Surgery Center, Brentwood (Williamson County), Tennessee (CN1411-047): The relocation of an existing ASTC from 260 Wallace Road in Nashville to an unaddressed site at the northeast corner of the intersection at Old Hickory Boulevard and American General in Brentwood. The estimated project cost is $17,500,000.

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