Centra, DRMC spar at hearing in Richmond

RICHMOND — Centra, Danville Regional Medical Center and interested local residents wait for another recommendation to the state health commissioner on whether Centra’s request for a Virginia Certificate of Public Need should be approved or denied for an outpatient surgery center in Danville.

On Tuesday, leaders on both sides presented their cases and additional items for the state to consider at Virginia Department of Public Health hearings in Richmond.

Department Adjudication Officer Doug Harris will make his recommendation to the state health commissioner after weighing the relevant information and coming to a conclusion by July 9. The initial date for the commissioner’s decision is Oct. 29, but could be extended 25 days if department workload requires more time.

“These applications are never easy. There’s a lot of analysis that goes into these things,” Harris said.

Danville Regional argues for denial

Danville Regional’s argument hinged on how the proposed outpatient surgery center with two operating rooms would take higher-end revenue away from the hospital.

In its application, Centra indicated that the surgery center would be 40 percent local surgeon-owned, said attorney Tom Hancock, representing Danville Regional. He said that gives surgeons incentive to take patients away from the hospital.

“I think naturally, you’re going to take business where you have ownership,” said Danville Regional CEO Eric Deaton.

Deaton said he was concerned the surgery center would splinter the medical staff at a time when he focuses on building collaboration with the medical staff and the community. That also makes it hard to recruit physicians, he added.

“I think were building momentum and my concern is this momentum could be stifled with a surgery center,” Deaton said.

Deaton acknowledged that Danville lost 40 physicians since 2005, but also recruited 39 physicians, offsetting what was lost.

Danville Regional disputed the patient exodus from the local hospital. DRMC data showed that while outpatient orthopedic surgical procedures declined by 102 cases, general outpatient surgeries showed a slight increase from 686 in 2007 to 753 in 2009.

Deaton sees the data as an opportunity for the hospital to grow and add cases.

Additionally, Deaton said the Division of Certificate of Public Need staff report, which recommended denial of Centra’s request, didn’t factor in how DRMC is a teaching hospital affiliated with the Edward Via Virginia College of Osteopathic Medicine.

If Centra Ambulatory Surgery were to take away more surgical cases from the hospital, then Danville Regional may not be able to offer enough patient volume or experience for medical residents and other students, he said.

Losing revenue could hurt DRMC’s ability to continue its nursing and radiology tech education programs, as the hospital already subsidizes those by $90,000 every year, he added.

Centra argues for approval

Attorney Steve Rosenthal, representing Centra, attempted to justify the need to build more operating rooms when the state found a surplus in the planning district that includes Danville. He called the situation in Danville unprecedented and not one considered by the state medical facilities plan.

According to data submitted to Virginia Health Information, Danville Regional saw a drop of 3,000 surgeries from 2004 to 2008. DRMC hasn’t shown an ability to reverse the trend, Rosenthal added.

He relayed the concerns of several Danville surgeons who are losing patients. They are the ones calling it an exodus, Rosenthal said, adding its hard to figure that exodus into the state plan.

Centra doesn’t intend to pull patients from or harm DRMC, but believes it can stabilize the patient base and bring back the patients who are already leaving, Centra Executive Vice President Tom Jividen said.

My take on this is that revenue is already gone and is leaving the community as we speak, Jividen said.

Stopping the leakage of patients would help recruit physicians to the community, who when they visit surgeon’s offices, can see the decline in the records, he said.

Additionally, Rosenthal said the division staff report didn’t state that of 366 letters in opposition to the project, 343 letters are identical or virtually identical to the form letter Danville Regional put on its website www.hereforourcommunity.com.

Nearly all of the opposition is from Danville Regional employees, he added.

Rosenthal said surgeons, physicians and residents sent more than 1,800 letters of support on record. He added that one resident even crafted a petition and garnered 800 signatures in support.

The letters also show anecdotal proof how residents are refusing to go to the hospital and will travel significant distances to seek care elsewhere.

Jividen repeated that Centra proposed the project because both surgeons and physicians called asking for help as both patients and specialists were and continue to leave Danville.

What we intend to do is try to solve some of the problems, Rosenthal said. When you’ve got the areas surgeons coming to you and begging for help, I would say there’s a need.

Bozick is a staff writer for the Danville Register & Bee.