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Hospital Projects Get State Go-Ahead

Jun 13, 2019
Originally published on June 13, 2019 8:19 am

More than $324 million in new hospital construction was given tentative approval by health-care regulators this week in what could be the last batch of hospital projects subject to Florida’s “certificate of need” requirements. 

In all, seven projects got an initial green light, including two new specialty hospitals.

Most of the projects would no longer require such prior approval beginning July 1, under a bill passed by the Legislature during the 2019 session. The bill, which eliminates the so-called CON process for hospitals, has not formally been sent to Gov. Ron DeSantis, but he is expected to sign it into law.

“I think so,” Tallahassee health-care consultant Sharon Gordon-Girvin said, when asked if this will be the last round of certificate of need applications for hospital-related projects. “There’s no way they are going to bring back CON for hospitals.”

A priority of House Speaker Jose Oliva, the bill (HB 21) will phase out the CON program for hospitals over a two-year period, beginning with the elimination of the requirement for new general hospitals and tertiary services provided at those hospitals July 1.

The certificate of need program will remain intact for specialty hospitals for another two years. Regulators gave tentative approval to two new specialty hospitals this week: a $38.9 million facility that Encompass Health Rehabilitation Hospital wants to build in Hillsborough County and a $49.6 million psychiatric hospital that North Florida Regional Medical Center wants to erect in Alachua County.

While the CON process is being eliminated for hospitals, it will remain in effect for nursing homes, hospices and intermediate care facilities for the developmentally disabled.

The most expensive project approved by regulators this week was North Florida Regional Medical Center’s proposal to build a psychiatry hospital. The hospital wants to relocate 33 psychiatric beds from its existing building and add nine new psychiatric beds. The 42 beds would be placed in the new hospital.

Construction on the new hospital along with renovations to the old facility --- to help it reconfigure the space to add 30 more acute-care beds --- would total $179.5 million.

The CON program is a process that requires prior state approval of new health care services or expanded services. The state has four “batching cycles” annually, two for hospital beds and facilities and two for other services, such as nursing homes and hospices.

Applications for projects are submitted and reviewed on a competitive basis. The state announces tentative decisions, which can be appealed.

A trend in recent batching cycles has been for the Agency for Health Care Administration to approve most hospital projects, which it continued in this week’s tentative decisions, Gordon-Girvin said.

For instance, the state gave initial approval to three comprehensive medical rehabilitation projects in Hillsborough County.

In addition to the Encompass project, the state also gave tentative approval to a 24-bed $23 million comprehensive medical rehabilitation unit at Brandon Regional Hospital. Tampa General Hospital also would transfer 59 beds from its hospital to a new facility located on the Tampa General Hospital campus.

Gordon-Girvin said the decision to approve so many projects could be the agency “trying to give deference to the legislative branch, if you will,” noting that some lawmakers had tried for more than a decade to repeal what some consider an arcane law.

Meanwhile new comprehensive medical rehabilitation units at Aventura Hospital and Medical Center in Miami-Dade County and Oak Hill Hospital in Brooksville also got tentative approval. Aventura’s new unit is projected to cost $17.2 million. Oak Hill Hospital’s project is estimated to cost $16.2 million.

A project not involving comprehensive medical rehabilitation beds receiving tentative approval was a project pushed by Sacred Heart Health System in Northwest Florida. The system wants to establish a new neonatal level-two intensive care unit.