Ok, so there has been some rumblings about two 'reports' that have come out in the last few days.
The first, as is customary in all CON requests, the State of Tennessee Department of Health issued a review of the Spring Hill Hospital CON application. The full review can be downloaded here:
CN0604-028 Review by the Department of Health (pdf)
Also released this week is the HSDA's Application Summary for the Spring Hill Hospital CON application. The full application summary can be downloaded here:
CN0604-028 HSDA Application Summary (pdf)
Now, it is important to note a few things regarding the DOH review and the HSDA application summary:
1. The DOH review is a quantative analysis for the need for NEW beds in the region. This analysis follows an exact equation set by the Tennessee Health: Guidelines for Growth, 2000 Edition. The result of plugging in population projections into this magic box equation? The DOH determined there is not a need for NEW beds in the region. TriStar knew this from the very beginning, that's why they included in their application a commitment to delicense 56 beds in the region, to justify the licensure of 56 beds in Spring Hill.
For all of you Spring Hill Hospital opponents out there, what's the answer to this riddle?
56 TriStar beds - 56 TriStar beds + 56 TriStar beds
The answer: 56 TriStar beds, the same number you started with!
There are no new beds being requested in the Spring Hill Hospital CON Application.
In case you really are concerned about the DOH review, let me give you another example that should set your mind at ease...
In November 2002, while Williamson Medical Center was applying for a new 40 bed expansion (bringing the total bed count to 180 at WMC), the same magic box formula indicated that there was only a NEED for 100 beds in all of Williamson County. WMC argument?
"The 'need' of a total of 99 beds in Williamson County is grossly understated."
And my personal favorite (talking about the DOH's population projections):
"Any formula based on population figures obtained 12 years ago is, on its face, erroneous."
The result of that CON request to add 40 new beds to an already exceeeded bed need in Williamson County? You got it, the WMC CON request was approved, even with all of those excess beds the DOH said existed.
2. The HSDA Application Summary is a summary of the 300+ page CON Application Request. Notes in italics throughout the summary indicate staff comments. Much of the confusion regarding the projections that are included in the CON application stems from the way the HSDA defines "Primary Service Area". "Primary Service Area" usually includes the County that the proposed hospital will be located. For this application, the standard "Primary Service Area" can not be as easily determined because of the nature of the county line bisecting Spring Hill city limits. The CON Application clearly states that the hospital will attract primarily the part of their population that resides within 5 miles of Spring Hill.
HSDA Staff comments throughout the Application Summary are not an indication of the HSDA Agency Board's position, rather an attempt to clarify parts of the application that may be unclear, including the Primary Service Area.
Perhaps this illustration could help...
On forward to July 26th!
Friday, July 21, 2006
Dept of Health Review and HSDA Appication Summary
Posted by Gorilla in the Corner at 8:25 AM
Labels: Spring Hill Hospital
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IMPORTANT DISCLAIMER: The information on this website is a series of personal opinions and is not meant to reflect an official position by the City of Spring Hill.
35 comments:
Michael,
You conveniently left out most of the HSDA report, why is that? CA
Gorilla - thank you for explaining the above...so many think just because DOH said no need that means no hospital...and those are suppose to be the medical "experts" against the hospital!! I guess experts on their personal opinion, perhaps. DOH is not HSDA. They are two separate entities. You can call DOH (state, not your local) and ask how they fit into the CON process...and they will tell you...the ONLY thing they do is look at statistics. They have no bearing on the approval. And, as the Gorilla has so eloquently explained, how those statistics are used (removing beds where they are not needed to where they are, rather than just saying NO MORE BEDS!)
Please get the word out for those who can not come in person on Wed:
You can watch the HDSA meeting lie via videostream on July 26:
http://www.tn.gov/HSDA/
There are two reports: the DOH and then the HSDA. Do not try to dismiss this by stating that this is just the DOH report. The HSDA put their report out as well, and it was the most revealing of the two. You are correct the DOH is not the HSDA, but both of these entities put out reports stating that this hospital does not meet criteria. THE HSDA STATED VERY CLEARLY THAT SPRING HILL INFLATED THEIR NUMBERS AND THEY DO NOT USE THE RESOURCES THAT THEY HAVE. You can try to ignore it all you want, but the HSDA is the body represented by the Board that will hear this on Wednesday.
Please lead us to the HSDA report? The board meets on a scheduled basis. Like other boards, they are people with other full time jobs who serve on the board in addition to their regular lives. They receive all materials a week before a hearing and then the hearing is where they discuss and vote...I am not familiar with this "report" from them and would like to see it. It would be public record if it existed, so could you lead us to it?
Yes click on the link in Gorilla's post above and you can read it for to yourself. It is quite amusing to see the HSDA tear apart each of the claims from HCA's application. Now I agree that the CON board will make the decision. However the CON board, as I understand, is part of the HSDA. So think about this, what would it look like if the CON board went against it's own agency's document? Not very good. It would most likely raise some eyebrows. The good thing is that the CON board members don't have time to read through the emotionally written letters stating "We need a hospital" that fail to provide any concrete evidence as to why they need a hospital, thus the aformentioned summary of the FACTS. So if nothing else, we have plenty of information for an appeal if needed. It ain't happening, accept it and move on.
The application summary is not a report, especially in government terms. I thought you were talking about an actual report rather than one perceived.
Dont be so defensive...I have never said I am for this hospital, in fact I sit on a fence. A hospital WILL be needed here in the future, simply based on population and the number of building permits issued, and the projected growth. I just don't know about THIS (HCA) hospital. We do not have major retailers coming here for any other reason but population growth- major retailers who have never gone into Columbia - which is at least twice the size. Major dollars being invested here. I remember this place when it was fields and trees.
But, at this point, I hope this hospital comes so all of the high and mighty opposition can be proven wrong (who I consider the rude ones with no Southern hospitality - you all must be the implants cause I ain't)
I am considered a medical expert with a business background for the record. So anywho a report is a report, and application summary is an application summary.
With your medical and business background, would you not agree that it would be quite detrimental to the HSDA for their report from Melanie Hill's, the Executive Director of the HSDA, staff to be discounted and not regarded as fact by the Board? Also anyone who is not just head over hills brainwashed by this whole thing can read the report and know that it is not very positive about the CON submitted by HCA. The HSDA report highlights errors in calculating population projections, underutilization of resources currently in place, drive times to MRH and WMC that are much shorter than to the proposed SHH for most of the HCA defined service area, and the fact that they threw in the information about the ambulances (which has absolutely nothing to do with this) seems quite odd, unless they were trying to demonstrate the behavior of the city leaders relative to allowing current providers to expand their services. The thing that clinches this the most for me is the ambulance thing being in the CON, as it is very negative towards Spring Hill as it states that even without being asked by Spring Hill when the RPS's went out, WMC and MRH made an offer that would have had an ambulance dead center in Spring Hill TWENTY DAYS AGO. I think that people will fly up there on Wednesday and make a ruckus in support of this hospital and it will only further reveal the true intent by the mayor of Spring Hill, garner for profit business to generate tax dollars, and gain public support by choosing a business (a hospital) that no one would oppose unless they had a deep understanding of health care. I know many people say the mayor of Spring Hill is an idiot, but he is not. This was a well contrived plan to gain tax dollars for his city. He put a lot of thought into this and I for one am impressed.
HSDA Staff comments throughout the Application Summary are not an indication of the HSDA Agency Board's position, rather an attempt to clarify parts of the application that may be unclear, including the Primary Service Area.
Right, and read the italicized notes entitled Notes to Agency Members. NOT ONE OF THEM ARE FAVORABLE TO THIS HOSPITAL. Also why do you think they included the ambulance issue? MRH and WMC didnt do it, the HSDA did. Explain that hot shot.
The HSDA Application Summary states 'a review of other recognized population sources' projections for Maury and Williamson Counties reveals significantly lower population projections than the applicant's consultant'
Here's the problem with the HSDA Population Projections review... The service area for the proposed Spring Hill Hospital is clearly defined to be an area within 5 miles of Spring Hill Hospital. Why wouldn't the HSDA staff review population projections specific to the proposed service area of Spring Hill?
The answer is because the DOH doesn't project census populations below the county level. Neither does the US Census Bureau.
The good news is the other sources used in the HSDA Summary do have published projections specific to Spring Hill.
Their 2010 population projections for Spring Hill:
UT Center for Business & Economic Research - 7,393
Tennessee Center for Policy Research - 9,428
Williamson County Planning Commission - 8,583
Take a look at their 2020 population projections for Spring Hill:
UT Center for Business & Economic Research - 8,647
Tennessee Center for Policy Research - 13,387
Williamson County Planning Commission - 12,000
By the way, the HSDA even acknowledges in the application summary that the current population of Spring Hill is approximately 23,000.
If these sources are missing 15,000 Spring Hill residents today in their county population reports, how many Spring Hill residents will they be missing in their county projections for 2010 and 2015?
Is it any wonder that the HSDA staff would think that the RPC population projections are unbelievable?
Don't expect a response from Chandler addressing this anomaly.
Here is the unexpected response from Chandler. It doesn't matter why they question these, it just matters that they do. Unlike anyone on this website and anyone in the community, the HSDA has the final say on this issue. We each have an alloted time on Wednesday. How much time do you think the HCA lawyers have to argue the population issue? How convincing with the argument be with MRH and WMC providing documentation that these numbers are inflated?
Here is something I didn't know until recently. In order for this hospital to be approved, HCA has to prove without a shadow of a doubt that they meet all three of the criteria, economic feasibility, orderly development of healthcare, and need. In order to defeat this for profit folly, we only have to prove that they do not meet ONE of the criteria.
So it is HCA versus WMC, MRH, St Thomas, Baptist, and Vandy. It will be interesting on Wednesday to see what the fall out is. As much as I would like to feel 100% confident that the HSDA, through their summary, has already agreed with us, I also know that we are up against a huge empire with deep political ties. However, I feel very reassured given the fact that the ambulance issue was mentioned in the CON summary. That is kind of a "and by the way" statement.
Hell, I have been wrong before, just ask my wife.
It doesn't matter that you disagree with the population numbers, the Board will agree with them.
"prove without a shadow of a doubt"
kind of "Grisham-esque" :)
Hey, haven't more people already signed the petitions than will be in Spring Hill in 2010 anyway?
Ciao!
Probably so, as there has been no prerequisite of Spring Hill citizenship to sign the petition. The petitions have more than likely been handled as the population projections, very loosely.
The interesting thing about the petitions is that any pertinent document relative to the CON was due in last week. The fact that the petitions have been witheld supports the hypothesis that people know they do not matter.
As I have said from the beginning, if the public's opinion mattered, this would be a referendum. This is just like in Reagen and FDR's Presidencies. Sometimes the government does the right thing, not the popular thing.
I recall a certain HSDA executive being quoted as saying "This is not a popularity contest" in the Advertiser last week.
"The interesting thing about the petitions is that any pertinent document relative to the CON was due in last week. The fact that the petitions have been witheld supports the hypothesis that people know they do not matter."
Oh contraire, look closely in the packet and you'll see 6,156 ACTUAL signatures (front and back sided) that have been summarized by zip code, as opposed to "available for viewing" (see Voices4Care). Even citizens from Columbia and Franklin were allowed to sign!
The point being that more will have signed by Wednesday than were included in previous CON population projections for Spring Hill in 2010.
You very well may have, as I am sure that HCA (who has been amazingly SILENT) the past few days has encouraged you to get even more. Again, it your petitions do not matter anymore than the ones do at C4C. Your County Commissioners represent you to the government, as do all the other elected officials that supported the opposition. Had HCA's "homeboy" not voted in the Franklin vote, their would not have been a victory there either (although a 4-3 vote could barely be called a victory). If you had a million signatures, what would it mean? Would it cancel the resolutions passed by the elected officials (which you elected to represent you)? Previously you all mentioned physicians, so I want to address that. At hospitals there is a Medical Executive COmmittee or other committee that represents all of the physicians. Notably all the physicians at MRH and WMC on the committees approved their resolution against this proposed hospital. Let me tell you how profound that is. Let's take WMC for example, there are MDs there from all the hospitals in Nashville, even Centennial. Guess what, the body that represents them voted against this hospital. Same with MRH.
The Board also must know that the petitions that are signed do not address the other point of view. It is clear that if you ask anyone who is not fully informed of the risks versus benefits of this situation they will sign the petition, cause who wouldn't want something for free? If you all sat down and explained the tax hike that will occur if the two existing hospitals start losing money, the fact that HCA care costs more, or the fact that this hospital will create more delays in definitive care than it will prevent, I doubt you would have that many signatures.
Basically your petition is viewed by people informed of the issues both pro and con as being akin to the sampler at Publix who offers you a free taste of the daily discount. Who can say no to free sushi? How ironic that you all station yourselves in front of grocery stores!
So get all the petitions you want. Ask the folks in Brentwood how much it helped.
"The interesting thing about the petitions is that any pertinent document relative to the CON was due in last week."
Your ignorance prooves that you have never been to the HSDA office to view the file in person, or else you would have seen the 2 inch stack of petitions submitted two weeks ago.
It also prooves what many of us have known all along, that every bit of information that you regurgitate claiming to know the "facts" on this issue has come from somebody else who is using you as a mouth-piece for their fight.
Personally, I can give a damn if the hospital is approved or not. To me, it's just a matter of time. What I find despicable is your constant ranting and raving about the "truth", when every bit of evidence that you proclaim to have under your belt has been spoon fed to you.
Come on, admit it if you can.
"Your County Commissioners represent you to the government, as do all the other elected officials that supported the opposition."
As I recall, Commissioners Lynch and Hayes represent Spring Hill on the Williamson County Commission. And their vote ? . . . . . why it was in support of Spring Hill and against the opposition resolution!
First of all, there is no need to address your garbage remarks regarding the petitions or being spoonfed. You truly are in the same class as the people who will do anything that good ole Danny says. If you want to talk about spoonfed, we can talk about how HCA has convinced Spring Hill that they do not need a cath lab because they are a small town. Thats pretty interesting considering the whole crap reason that you feel like you need this hospital is growth.
On second thought, I will address the petition comment. If you can slow down your stupidity for half a second you will see that I said any signatures collected this weekend will be useless. But then again, so are those that have already been turned in. Two inches worth of paper huh? Seems to me you have just as much trouble with numbers as HCA does.
You are right,good ole Judy and Clyde did vote against the hospital. You know what else they did? They tried to rush through a resolution to purchase land by the Ag Center claiming that they knew more than the rest of the Commissioners about how the due diligence process should work.
Now I know Lynch is on the Board of Trustees at WMC, but that whole thing was pitiful to watch as he tried and tried to attach an amendment to resolution after resolution, only to be denied. As for Judy, trash regulator, Hayes, you guys were just ripping her apart a few months ago, so who cares what she thinks. The truth, and yes its true, is that this hospital is not going to happen.
All of your petitions are just going to be wasted paper, just like the time you have put into it was wasted. You could have used all that time to convince HCA that you needed a real hospital proposed.
This is the last I will post on here, as again, you all have refused to discuss the valid questions I posed regarding the HSDA summary. You would rather attack attack attack than admit that the HSDA tore through HCA's CON. You can dispute their findings all you want, in fact why don't you tell them on Wednesday that they are wrong. That should be fun to watch.
I will be there Wednesday to see all of your sad faces when you realize that the opposition was right. Go ahead and lash out in response to my post here. Just remember your curfew is 11 PM because son this is a school night.
I hate that you would rather be juvenile than discuss the issues. Then again there is no disputing the HSDA report. Keep in mind that this is the summary that the Board members read. I do not recall seeing a criteria that said, must have public approval. You will all look foolish on Wednesday as it is revealed that your petitions really were saying "We deserve healthcare more than Waynesboro, Lewis Co. and Marshall County, because we are Spring Hill and we are better than them." It must eat you alive knowing that you can't curse the Board after their decision huh?
I just sat through the most hilarious piece of footage ever. I just watched the Fox 17 report about the hospital argument. Huebner was on there talking about how every second counted in an emergency. However just last week, during the HCA lovefest at the UAW Hall, he cheered a slide show that explained why Spring Hill did not need a cath lab for emergent heart attack care. This just reinforces why the HSDA makes the decision regarding the need for this hospital. The people supporting it are so convinced that there is a need for emergency care because every second counts, yet they do not understand why not having a cath lab is a bad thing. As well, the reason they have so many signatures is because they are impeding the flow of people into the Kroger store. As usual they placed people in uncomfortable situations in order to garner their signature. Wednesday people such as Barber and Huebner will understand why they looked so foolish on TV crying out for emergency care. This proves one point HCA has manipulated people into being their puppets. We want Emergency Care, We don’t need a cath lab!! We are full of nonsense and don’t have a clue how foolish we look on TV!!!
Here's a question. If the people living in Spring Hill are so concerned about the need to get to a hospital quickly in an emergency, why don't they use the ambulance service?
This city has come together in a profound way, through city officials and lay people. It has brought together diverse groups in a common interest in unprecedented numbers.
Wednesday will be a small step for a hospital, but a very large step for Spring Hill!
CELEBRATE!!!!!
This had made the city look really bad to other towns, especially when our citizens are claiming to need emergency care, but then it comes out in the newspapers that we don't use our ambulances at all. It begs the question that another poster asked, If we need such rapid care, why are we driving to the hospital rather than calling the ambulance.
If every second counts in an emergency (which it does) and we need emergency care (which every community does) then answer some questions. Emergency does not start when your feet cross through the ER doors.
Why has no one pushed to get the fire dept up to BLS level of care? To my knowledge they still are operating as first responders. Franklin went through our testing after Spring HIll did and we put our BLS equipment in service today. Better treatment options means better care.
Why has no one stopped the nuclear diplomacy? Why will no one stop HCA getting our ems as a door prize for showing up to propose a hospital. We need to stop the brinksmanship and negotiate for real ems coverage, not Rural Metro. If the city wants Spring hill ems then pay the money and make ems part of the fire dept.
Prehospital care plays a major part in the "we need emergency care". THat is what is being compromised.
be safe all
ole fire fighter
This is the latest post from a site that actually asks the hard questions that the readers and owner of this site refuse to answer, www.theothersideoftheissue.com
I just want to share a couple of things with you this AM. First, I just watched the Fox 17 news story regarding the harassment of individuals at Kroger' s this weekend by Mr. Barber and the Preacher Man. It was noted that the Preacher Man had a table set up in the lobby of the Spring Hill Kroger with a big sign that read "Stop and Sign the Petition Supporting Our Spring Hill Hospital." He was also noted to shout "Hey have you signed the petition yet." I am sure that if someone stated they had not, he probably used his classic tagline of "You must hate Spring Hill if you are opposed to this hospital."
Even more revealing than the shorts worn by Huebner, which revealed exactly why his voice is several octaves higher than most men, as the fact that he and his cronies kept shouting that they need more emergency care. "Seconds matter in Emergencies" was the common theme. This is very interesting, as just 6 days ago during the HCA love fest at the UAW Hall, Huebner cheered as HCA went through their slide show explaining why this hospital did not need a cath lab. So on regional TV, here was the Preacher Man and his cronies (did anyone notice that Waylon Jennings was still alive and that he commented during the report?) telling everyone that they needed faster emergency care, despite having stated that they did not need emergency cardiac care less than one week ago.
The other question raised by this report on Fox 17 was this: If you are so worried about fast care, why are you driving yourself to the hospital anyway? It is hard to believe that these guys are so scared for their safety when they only generated around 240 ambulance runs last year. Finally, to the guy who claimed that his friend had to deliver on the interstate, I claim BS, as you are full of it.
The other noteworthy thing that I want to share with you all is that I am very concerned about Kroger's involvement in this harassment. I contacted Kroger's assistant manager last pm, Mr. Allen, who stated that Kroger's has a very strict "no unauthorized solicitation" policy. He stated that Huebner and his cronies must have gotten approval from the zone manager to harass the citizens of Spring Hill in their lobby. This was quite bothersome to me, as I shop at Kroger's, as do many other members of the opposition. Thus I emailed the Kroger's board of directors with my concerns. I expect a reply from David Dillon, the CEO of Kroger's, sometime today. If you would also like to share your concerns with him regarding this endorsed harassment, his email address is David.Dillon@kroger.com.
I woud just ask that everyone stay the course over the next two days, as HCA is in retreat mode. They have refused to answer any questions since the Department of Health report and the HSDA summary came out last week. Although Huebner and his cronies are doing all they can to make the citizens of Spring Hill look like idiots on the TV, those of us with some sense will come out on top. I think we all know what the board will decide on Wednesday, as, despite what Mr. Barber thinks, there is more to proving need than collecting a bunch of signatures by harassing people at the Kroger's.
I hope someone else saw the news this morning. I was half asleep after running calls for a good bit of night so i vaguely remember the news as i got off work. Did i see that HCA's board is voting today on a buy out offer from another company?
be safe all
ole fire fighter
More lies...
Dept of Health Review and HSDA Application Summary
23 July, 2006 21:31
"This is the last I will post on here"
Ambulance Service
23 May, 2006 21:23
"I will only be posting on my site www.theothersideoftheissue.com..."
"I will be responding to your posts here on my site,so that I am not censored."
Hey Silverback you dumbass,
Read the invitation sent to Chandler to rejoin the site by Glass.
If Chandler or any of the paramedics would like to respond to this question, I would love to have your input (but please, no cutting and pasting of 40 or 50 articles this time).
You conveniently forgot to mention that didn't you?
What part of 'This is the last I will post on here' did I misunderstand, exactly?
to anon 7/24 @ 15:05
First i do not always agree with silverback but the the term "dumbass", even in jest would not seem to apply.
Second i will answer your question. Would "you conveiently forgot to mention that didnt you" be your question? If so forgot to mention what?
be safe all
ole fire fighter
“We set the date for the closing prior to knowing when the CON (certificate of need) hearing would be,’’ said Cheryl Chubbs, vice president of marketing for HCA. “We closed on the property in accordance to the terms of the purchase agreement, but we are still dependant on the HSDA (Health Services Development Agency) approving the hospital.’’
That sure seems like confidence huh? but we are still dependant on the HSDA approving the hospital. Hmm, seems to me someone has lost their confidence.
Maury Regional’s commitment to Spring Hill goes back to 1989, when General Motors’ Saturn plant opened. “We provided onsite medical care to the plant and still do that today. We’re the only hospital in America that provides onsite healthcare to a General Motors plant,” Otwell says.
He recalls that the hospital supported the location of Spring Hill’s first physician in 1998, and that office now has three full-time doctors and one nurse practitioner, all on the staff of Maury Regional. The hospital launched a specialty clinic in Spring Hill in 2005 with specialists rotating to that site. In March, Maury Regional opened a new urgent care clinic in Spring Hill and expanded to seven-day-a-week coverage a month later. This summer, Maury Regional’s new comprehensive diagnostic center in Spring Hill is scheduled to open. “So we think we have a long history in Spring Hill providing care as that community has grown, and we have every intention to continue to expand services to respond to that growth,” he says.
ouser suggests that the members of the Health Services and Development Agency “just be very careful in these sorts of decisions, that for whatever pressures they may be feeling or whatever process they may be going through, that they don’t begin to erode the long-standing traditions and support of the facilities that are there. There’s a real values question here, and I don’t mean values in the sense of economic value. I mean, is the system going to support existing facilities in their growth as opposed to profligate growth that can diminish services across the board?”
I just want to say that I found this site through the Topix link which I look at every week or two. I had no idea that there was such a diverse group of individuals in our little town that have finally got together and spoke up!!
It wasn't too long ago that the good ole boys ran this place, and that's a fact!! Keep shaking things up and let them have it!!
Does anyone in their right mind believe the preposterous population predictions in the HCA application? I mean, really, sure Spring Hill is growing, but do you honestly think it's going to be bigger than Knoxville in 10 years? No community in the United States has sustained the kind of growth rate contained in this application for 10 years. There will not be 200,000 plus people in Spring Hill in the lifetime of anyone reading this. The population projections are the most ridiculous aspect of this application.
yes, but don't tell these people that. They will curse you, call you drunk, and try to dismiss you. Ask Chandler about that. They do not want but one opinion on this issue, the misinformed opinion that Spring Hill is the new Los Angeles. I guess they have a point, since it seems that like the masked gangbangers of LA, this site lets anonymous posters rule the site.
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