By Kathy Chaffin
Salisbury Post
When it comes to justifying the need for a community hospital in Kannapolis, state officials say the numbers submitted by Rowan Regional Medical Center and Novant Health in a certificate of need application just don’t add up.
A 119-page report released Tuesday by the Certificate of Need Section of the N.C. Division of Health Service Regulation outlines reasons for the March 28 denial of the application for Rowan Regional South.
Officials with Rowan Regional and Novant Health said they were reviewing the report and had no comment Tuesday. Marcia Meredith, media relations manager for Novant, did say that an appeal is likely.
The applicants have until April 28 to file an appeal.
Although the application states the intent of the 50-bed hospital would be to provide services to Rowan residents who cannot be adequately served due to their distance from the Salisbury medical center, the state report observes, “The new hospital’s proposed service area will be predominantly located in Cabarrus County.”
For example, it says, “approximately 58 percent of the projected population of the proposed (seven zip code) service area resides in two zip codes that are exclusively located in Cabarrus County (28025 and 28027), and another 33 percent of the population lives in zip codes that span both Cabarrus County and Rowan County.”
“If Cabarrus County residents were subtracted from the shared zip codes (28081, 28083 and 28138),” the state report says, “then the percentage of Rowan County residents to be served by the new hospital would fall far short of 42 percent.”
Furthermore, the report states the applicants’ service area includes two Concord zip codes (28025 and 28027) that are served by Carolinas Medical Center-NorthEast and Gateway Ambulatory Center/Copperfield Diagnostic Imaging Center, both of Concord.
CMC-NorthEast offers “significantly more services than will be offered at the new 50-bed hospital in Kannapolis,” it says.
“The applicants do not adequately demonstrate that it is reasonable for any residents of these two zip codes to drive to southern Rowan County for acute-care services when there is a larger hospital offering more services located in the same zip codes where they live.”
Other reasons for the denial outlined in the report include:
– The projected use of a Rowan Regional South was calculated based on existing use patterns at Presbyterian Hospital Huntersville, which would be the model for the proposed hospital, and Presbyterian Hospital Matthews.
State officials noted that neither of the Novant community hospitals are within seven miles of a regional medical center such as CMC-NorthEast.
“Therefore,” the report says, “the applicants do not adequately demonstrate that utilization at Rowan Regional Medical Center South is reasonably projected to be similar in utilization to these two Novant facilities.”
– In their application, Rowan Regional and Novant officials project that part of the market share of Rowan Regional South will be a direct shift from Rowan Regional. “Additional market share in each zip code will come from other hospitals currently serving patients in this area,” they say in the application.
State officials respond in their report, however, that the majority of patients projected to shift to Rowan Regional South would have to come from CMC-NorthEast, which they deem unlikely.
– In their market share projections, Rowan Regional and Novant officials contend that of the 2,836 discharges in 2013, 73 percent will be shifted from CMC-NorthEast with the other 17 percent from Rowan Regional. The other 280 patients projected to be served at Rowan Regional South would be shifted from hospitals in Mecklenburg or other counties.
The report says the applicants provided no statistical basis for how the projected market share increases were determined. “In summary, the applicants did not adequately demonstrate that the projections for discharges and acute-care patient days for Rowan Regional Medical Center South are based on reasonable assumptions.”
– Rowan Regional and Novant officials say the most important reason to approve the project is for consumers in the Kannapolis-Concord area. It will “create constructive competition in hospital services that will result in improved quality of care, increased patient satisfaction and reduced negotiated rates,” they contend.
Approving Rowan Regional South, they add, would not harm the ability of CMC-NorthEast to carry out its charitable mission or its financial stability.
State officials, however, say in their report that the applicants do not provide evidence to support either claim. The report further states that Rowan Regional South “would result in shifting medical/surgical patient days of care from CMC-NorthEast, which currently serves the proposed service area, and thus, would duplicate services provided by CMC-NorthEast to residents in the service area.”
– The state report also addresses use projections for the different proposed services included in plans for Rowan Regional South, such as the 12 treatment bays and two triage rooms in the emergency department.
“The applicants did not adequately demonstrate that the projected numbers of emergency department visits at the proposed new hospital are based on reasonable and supported assumptions,” it says.
Rowan Regional South would have been built on Moose Road just a few miles from the Lane Street freestanding emergency department proposed by CMC-NorthEast and approved by the Certificate of Need Section on Feb. 28.
Rowan Regional and Novant officials have appealed that decision.
Contact Kathy Chaffin at 704-797-4249 or kchaffin@salisburypost.com.