Another blow for Centra

Centra was dealt another blow in its quest to expand its operation in Danville.

The Virginia Division of Certificate of Public Need staff report recommended the state health commissioner deny Centra’s request to provide diagnostic imaging in the area.

The report recommended partial approval of Danville Regional Medical Center’s request by recommending approval for the hospital to add a CT scanner upon meeting certain conditions to provide free CT services to indigent patients.

The state health commissioner still needs to make a decision on Centra’s separate Certificate of Public Need request to build two operating rooms in Danville. That decision is expected by late October.

The diagnostic imaging report, completed Monday, is only a recommendation and the state health commissioner makes the final decision. The process to evaluate the COPN requests will continue to an informal fact-finding conference scheduled on July 29, said Erik Bodin, director of the Division of COPN.

DRMC and Centra filed competing requests for a COPN to offer more diagnostic imaging in Danville. DRMC applied to offer an additional CT scanner and large-bore MRI. Centra applied to offer CT, MRI and nuclear medicine imaging.

“Obviously we’re very disappointed. We’ve known it was going to be an uphill battle all the way for this one and the surgery center,” said Centra Executive Vice President Tom Jividen. “We were hoping the people in the state would see the logic of our argument. We’re continuing to do everything in our power … We are pleased since filing our application there have been a number of improvements to health care in Danville.”

DRMC CEO Eric Deaton agreed with the report’s finding that Centra would duplicate services already available in Danville and would cause a capacity surplus that would increase the overall cost of care.

“If the commissioner follows staff’s recommendation, it will preserve jobs in this area and ensure continued access to high quality care for folks in the Dan River Region,” Deaton said in a news release.

The staff recommended denial of Centra’s request because less costly alternatives are available to residents, Centra’s proposed project would “unnecessarily duplicate” existing services in the planning district and the project doesn’t comply with the standards of the “State Medical Facilities Plan.”

The report stated Centra has the potential to “disrupt the local health care system” by competing with a sole community provider hospital.

“The most apparent alternative to Centra’s proposed freestanding diagnostic imaging center and a more efficient and more effective manner of meeting the needs of the population would be to capitalize on the existing diagnostic imaging resources at DRMC,” the report stated.

The staff recommended approval for Danville Regional’s CT scanner because the hospital demonstrated an institutional need to expand CT capacity.

The commissioner can authorize placement of a new CT scanner at an existing medical facility where a CT scanner performs an average of 7,400 procedures. DRMC’s two CT scanners performed well above that threshold in 2008.

Danville Regional could not prove needing more capacity for MRI, which is underutilized. The hospital reported performing only 1,839 MRI procedures in 2008, according to Virginia Health Information data.

Centra argued it could provide competition and an alternative for local patients. The staff report said adequate demand is necessary for competition to improve overall delivery of service.

“In the delivery of health care not all competition is entirely beneficial. Competition may encourage Danville Regional Medical Center to be more responsive to the needs of the local physicians and population, but the presence of a competitor may also irreparably harm DRMC’s ability to address those needs by creating a competitor for the very services that DRMC already provides, and for services that DRMC already has excess capacity,” the report continued.

The Virginia Department of Health will hear requests from Centra and Danville Regional at an informal fact-finding conference at 10 a.m. July 29 in the conference center at 9960 Mayland Drive in Henrico.