United States: Mississippi CON Report - September 2015

I. September 2015 – Mississippi Certificate of Need Meeting

During the September 24, 2015, Certificate of Need meeting, Dr. Mary Currier, State Health Officer, concurred with the health and planning staff analysis and approved the following applications for Certificate of Need:

CON Review # ESRD-RLS-0615-009 - Bio Medical Application, Inc. d/b/a Fresenius Medical Care Dialysis of Rankin County-Brandon - Relocation of ESRD Facility within One Mile and Expansion of ESRD Stations - Location: Brandon, Rankin County, Mississippi - Capital Expenditure: $5,232,954.70 – Staff Recommendation: Approval

CON Review Number # C-NIS-0615-011 - Hattiesburg Clinic, Professional Association - Offering of Diagnostic Imaging Services of an Invasive Nature Including Digital Subtraction Angiography (DSA) - Replacement of MRI Equipment - Location: Hattiesburg, Forrest County, Mississippi - Capital Expenditure: $584,344 – Staff Recommendation: Approval

CON Review Number # HG-R-0615-013 - Singing River Health System d/b/a Singing River Hospital - Exterior Hardening Window Replacement - Location: Pascagoula, Jackson County, Mississippi - Capital Expenditure: $ 14,859,227 – Staff Recommendation: Approval

The next Certificate of Need meeting is scheduled for October 29, 2015, at 11:00 a.m.

II. Withdrawal of Proposed 2016 State Health Plan and Proposed Revisions to the CON Review Manual

In response to concerns raised by healthcare providers on October 6, 2015, the Mississippi State Department of Health withdrew proposed changes to both its Certificate of Need Manual and 2016 State Health Plan. Filed with the Secretary of State's office on September 4, 2015, the proposed changes to the Certificate of Need Manual would have increased the processing fees charged by the Department for Determinations of Reviewability (increasing from $250 to $1,000), Change of Ownership (increasing from $250 to $1,000) and Six-Month Extensions for Certificates of Need (increasing from $250 to $1,000). In addition, the Department proposed increasing its fees for Certificate of Need public hearings from $3,000 per day to $6,000 per day for each day of the public hearing and increasing the deposit for a public hearing from $6,000 to $12,000.

In addition to the proposed fee increases in the CON Review Manual, proposed State Health Plan changes would have relaxed the need requirements for establishing beds and services for post-traumatic stress disorder programs and would have revised the need criteria for End-Stage Renal Disease (ESRD) Facilities, satellite ESRD facilities and ESRD stations for the treatment of acute renal failure.

During the Department's September 30 hearing regarding the proposed changes, various healthcare provider representatives expressed concerns about the additional financial strain on healthcare providers caused by the proposed fee increases. The Mississippi Hospital Association (MHA) specifically focused on the hospital industry's financial strain in light of recent federal, state and commercial payer reimbursement reductions and increased compliance costs due to the Patient Protection and Affordable Care Act's requirements. The MHA also reminded the Department of the significant monies hospitals pay in provider taxes to fund the state Medicaid program.

MHA and other provider representatives questioned whether the Department had the legal authority to charge fees for the filings and a dialysis provider's representative expressed concerns regarding proposed changes to ESRD requirements in the State Health Plan. Following consideration of both written and oral comments, the Department withdrew the proposed revisions to both the CON Review Manual and the State Health Plan.

III. Certificate of Need Program Report – Filings/Reports in August/September 2015

A. Letters of Intent to Change Ownership

Heritage Manor of Rolling Fork – Change of Ownership – Received August 31, 2015

B. Determinations of Reviewability

1. Jackson HMA, LLC d/b/a Merit Health Central - Renovation of Cardiac Catheterization Labs – Received August 3, 2015

2. Merit Health Central - Cardiac Catheterization Equipment Replacement – Received August 3, 2015

3. Merit Health Central - Renovation of Cardiac Catheterization Labs – Received August 3, 2015

4. Alliance Healthcare Systems, Inc. d/b/a Williams Medical Clinic Use of a SRT-100 System/Unit (Skin Cancer Treatment/Removal) – Received August 7, 2015

5. Merit Health Wesley - Purchase of 100% ownership interest in Lee Enterprises, LTD, and continued provision of MRI Services – Received August 19, 2015

6. Starkville Surgery Center, LLC – Ophthalmology – Received August 21, 2015

7. Mississippi Methodist Hospital and Rehabilitation Center, Inc. d/b/a Methodist Rehabilitation Center Renovation of Sixth Floor Patient and Nursing Area – Received August 26, 2015

8. RCG of Clarksdale - Expansion of ESRD Stations and Home Program at Existing Facility – Received August 31, 2015

9. Anderson Regional Medical Center - Cafeteria and Lobby Renovation – Received September 2, 2015

10. Anderson Regional Medical Center - Cafeteria and Kitchen – Received September 2, 2015

11. University of Mississippi Center - Magnetom Avanto, A Tim and Dot System Eco - MRI Unit – Received September 8, 2015

12. GI Associates & Endoscopy Center - Update of Procedure Request – Received September 10, 2015

13. Tallahatchie General Hospital - Nurses Station Renovation – Received September 21, 2015

14. Oxford Health and Rehabilitation Center - Advanced Healthcare Management Oxford Health and Rehab Gym Addition – Received September 21, 2015

15. South Central Regional Medical Center - South Central Computer System Network Replacement and Enhancement Project – Received September 25, 2015

C. Letters of Intent to Apply for CON

1. Mississippi Methodist Hospital and Rehabilitation Center, Inc. d/b/a Methodist Rehabilitation Center Renovation of Sixth Floor Patient and Nursing Area – Received August 26, 2015

2. Oxford Pre-Op Imaging Center - Magnetic Resonance Imaging – Oxford – Received August 31, 2015

3. Senatobia Dialysis Clinic, LLC - Establishment of a 10 Station ESRD Facility – Received September 1, 2015

4. South Sunflower Hospital Renovation Project (Cost Overrun) – Received September 11, 2015

5. Hospital of Vicksburg – Relocation of an Existing Long-Term Acute Care (LTAC) Hospital – Received September 17, 2015

D. Applications Received/Withdrawn

1. Bedford Alzheimer's Care Center LLC - Relocation of 40 Skilled Nursing Beds within Forrest County, Mississippi – Received September 1, 2015

2. Bio-Medical Applications of Mississippi, Inc. d/b/a Fresenius Medical Care Mid-Mississippi - Establishment of Satellite ESRD Facility – Received September 1, 2015

3. CON Review Number: ESRD-NIS-0315-005 Bio-Medical Applications of MS, Inc. d/b/a Fresenius Medical Care - Establishment of a Satellite ESRD Facility – Withdrawn March 2, 2015

4. Jackson Heart Clinic, Professional Association - Acquisition of Cardiac Only PET Scanner and Offering of Cardiac-Only PET Services – Received September 1, 2015

5. Senatobia Dialysis Clinic, LLC - Establishment of a 10 Station ESRD Facility – Received September 1, 2015

6. Clarksdale, HMA LLC d/b/a Northwest Mississippi Regional Center - Cost Overrun to CON #: R-0852 - (CON Review Number: HG-FE-0312-006) - Acquisition or Otherwise Control of MRI Equipment and Conversion of Mobile MRI Services to Fixed Services – Received September 14, 2015

7. Senatobia Dialysis Clinic, LLC Establishment of a 10 Station ESRD Facility – Withdrawn September 25, 2015

E. Applications Received for Extension/Renewal of an Expired CON

None

F. Additional Material Received in Response to Negative Staff Analysis

None

G. CON Applications Deemed Complete

None

H. Six-Month Extension Requests

1. Memorial Hospital at Gulfport - SME on HG-RC-0611-012; R-0838 - Patient Tower Expansion and Renovation – Granted - Expires November 17, 2015

2. George Regional Hospital d/b/a George County Hospital - SME on NH-CB-0602-036; R-0668 - Establishment/Construction of a 60-Bed Nursing Home Facility – Granted - Expires November 19, 2015

3. Baptist Memorial Hospital - North Mississippi, Oxford - SME on HG-CRF-0612-015; R-0860 - Construction/Relocation and Replacement of 217-Bed Hospital/Services – Granted - Expires November 30, 2015

4. Fresenius Medical Care - North America, Inc. d/b/a RCG-West Point - SME on ESRD-CO-0612-014; R-CO-0842 - Establishment of Satellite ESRD Facility – Granted - Expires November 30, 2015

5. Memorial Hospital at Gulfport - SME on HG-RC-0902-064; R-0594 - West Building Renovation and Expansion – Granted - Expires December 21, 2015

6. Bedford Care Center – Warren Hall, LLC, Hattiesburg d/b/a Bedford Care Center – Picayune SME on NH-RLS-0304-003; R-0643 - Replacement/Relocation of a 120-Bed Nursing Home Facility – Granted - Expires December 24, 2015

7. St. Dominic-Jackson Memorial Hospital, Jackson SME on HG-RC-1214-002; R-0876 - Renovation of Operating Room East Area – Granted - Expires December 28, 2015

8. Renal Care Group, Tupelo, LLC d/b/a RCG of Central New Albany - SME on ESRD-NIS-0312-005; R-0854 - Establishment of Satellite ESRD Facility – Granted - Expires December 29, 2015

9. Clarksdale HMA, LLC d/b/a Northwest Mississippi Regional Medical Center, Clarksdale - SME on HG-RC-0312-007; R-0853 - Renovation/Expansion of Radiology Department – Granted - Expires December 29, 2015

10. Ocean Springs Hospital - SME on HG-A-0311-005; R-0751-A - Construction of Observation Units and Outpatient Services Improvements – Granted - Expires December 30, 2015

I. Hearings Requested/Scheduled During the Course of Review

CON Review Number: HG-RC-0515-008 - St. Dominic – Jackson Memorial Hospital - Renovation and Expansion of Emergency Department - Capital Expenditure: $40,071,029 - Location: Jackson, Hinds County, Mississippi - Requestor: Jackson HMA LLC, d/b/a Merit Health Central – Requested September 1, 2015 – To be scheduled

J. Request for Hearing on Denial of Six-Month Extension

CON Review: ESRD-NIS-0905-041; CON # R-0710 - Healthcare Engineers, LLC - Establishment of a Six-Station ESRD Facility in Tallahatchie County - Capital Expenditure: $254,085 - Requestor: Alliance Health Partners, LLC d/b/a Tri-Lakes Medical Center - To Be Scheduled

CON Review Number: HG-R-1207-031 - Singing River Hospital, Pascagoula - SME on CON # R-0761 - Renovation of Emergency Department and Patient Care Area - Capital Expenditure: $9,473,202 - Effective Date: March 27, 2008 - Extension Expiration Date: March 27, 2015 - Requestor: Singing River Health System, d/b/a Singing River Hospital, Pascagoula – To Be Scheduled

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