Nashville, Tenn.-based HCA Healthcare, one of the largest ASC operators, is again facing pushback as it plans for expansion. This time in Central Virginia, where HCA rival Bon Secours Mercy Health of Cincinnati has a prominent presence.
Here are 10 things ASCs need to know:
1. The state's department of health rejected HCA applications to build a hospital and freestanding emergency facility in Hanover, Va.
2. The department accepted a third application for an outpatient facility, greenlighting HCA to build a $21 million ambulatory surgery center with three operating rooms that it said will be the first piece of a larger hospital. Construction is expected to begin next year and be completed in 2027.
3. An executive with Bon Secours called the development a "predatory and undeniable market share play." The Richmond Times-Dispatch on Aug. 13 noted that competition is fierce for the Hanover market, as residents are "relatively wealthy" and aging.
4. Bon Secours alleged HCA is trying to grab market share from its hospital in the area, while HCA said it is expanding access to care close to where patients live and work.
5. "We are in the early stages of the planning process for the facility," a spokesperson for HCA told Becker's. "The surgical center would significantly benefit our patients by improving access to high-quality surgical services from their preferred health system at a location much closer to home."
6. Pending state approval, HCA plans include a 60-bed hospital, a freestanding emergency room, a second medical office building and a possible 90-bed hospital expansion.
7. On Aug. 14, Bon Secours broke ground on a 10-bed, freestanding emergency facility in Hanover, Va. Ambulances can immediately transport patients to Bon Secours Memorial Regional Medical Center in Mechanicsville, Va., for direct admission, bypassing the hospital ED.
8. "These expanded emergency and imaging services will help to decompress high volumes on the main campus of our award-winning Bon Secours Memorial Regional Medical Center while also improving medic reliability and emergency transport times for the Hanover community and beyond," John Emery, president of Bon Secours' Memorial Regional and Kilmarnock, Va.-based Rappahannock General hospitals, said in a news release shared with Becker's.
9. HCA is also facing pushback in North Carolina, where the state attorney general's office is asking the state health department to deny HCA Healthcare's CON application to add 26 acute care beds to its Asheville-based Mission Hospital. The health system is also facing a lawsuit from the North Carolina attorney general's office alleging it cut emergency and cancer care at Mission Health, lapsing on its 2019 purchase agreement.
10. Reclaim Healthcare WNC, a group of physicians, nurses, elected officials and community advocates, has criticized HCA's alleged "harmful culture and practices" and launched a campaign to replace HCA with a nonprofit organization. Leaders at Reclaim have criticized several changes at HCA, including the closure of two family-medicine practices with only 45 days notice, the failure of HCA to maintain relationships with physician groups and the departure of more than 200 physicians and 600 nurses, among other allegations.
"The current utilization of Mission Hospital's services is very high, including services related to the ICU and adult medical and surgical beds. Currently, Mission Hospital accepts thousands of patient transfers from other hospitals across the region," a spokesperson for Mission told Becker's. "These transfers reflect a need for the addition of higher acuity beds and services offered by Mission, which will meet the needs of patients in western North Carolina. Additionally, if approved, Mission believes that it can make these beds available on a more expedited timeline than other applicants."