LARGO – Plans for a new regional medical center in Largo look like they may need a little nip-tuck. In a letter sent May 17, Robert Moffit, a commissioner and reviewer at the Maryland Health Care Commission (MHCC), an independent regulatory body charged with planning for and approving health system needs in the state, said […]
LARGO – Plans for a new regional medical center in Largo look like they may need a little nip-tuck.
In a letter sent May 17, Robert Moffit, a commissioner and reviewer at the Maryland Health Care Commission (MHCC), an independent regulatory body charged with planning for and approving health system needs in the state, said he would recommend against MHCC issuing a certificate of need (CON) for the hospital unless the proposal submitted by Dimensions Healthcare Systems and Mt. Washington Pediatric Hospital was scaled back. A CON is required for the project to be built.
Specifically, Moffitt calls for construction costs not to be more than $225 million, with the total cost not to exceed $543 million. Currently, the price tag is approximately $650 million. Additionally, the letter says the hospital’s capacity should be reduced to a total of 219 beds (204 general beds and 15 pediatric ones) with accompanying downsizing of space.
“(The hospital) must become the attractive alternative for physicians, patients, and payers that the current Prince George’s Hospital Center (PGHC) is not. I believe that the proposed project can be a vehicle for realizing these objectives. Certain changes need to be made in the proposed project, however, to achieve that end,” the letter said.
Dimensions responded to Moffitt’s letter on May 23, and said they intended to modify their application for the CON by August 31. The response, in the form of a letter through the law firm of Gallagher Evelius & Jones, also presented some counterpoints to Moffitt’s claims.
“The applicants respectfully do not agree with some of the concerns you expressed. In particular, Dimensions and its project partners are concerned that your conclusion that the proposed project is too large and too costly may conflict with their vision to adequately address the health care needs of Prince George’s County and throughout the Southern Maryland region,” the letter states.
This regional medical center has long been a priority for county and state leaders. County Executive Rushern Baker III pushed hard for full operating and capital funding earlier this year, butting heads with Maryland Gov. Larry Hogan on the issue. Democratic leaders in the General Assembly passed a bill to mandate funding for the regional medical center, provided the University of Maryland Medical System takes control of the project soon after a CON is issued.
Baker’s office did not provide a comment on the letter.
Del. Erek Barron (D-24), who said the hospital was one of his top priorities for the 2016 session, was disappointed to read Moffitt’s letter.
“The letter is very disappointing. I don’t think it should be scaled back, is the short answer,” he said. “But I recognize that they (MHCC) have a big say in whether or not this happens.”
Barron also said it was too early to think about revisiting the funding arrangement set forth in the bill until it is determined what, if any, changes will be made to the plan.
In his letter, Moffitt said his recommendations came from comparisons to the recently-approved Washington Adventist Hospital in Montgomery County, as well as his estimations of the actual use the new hospital will get. He said those estimations are less than those projected by Dimensions, which are “quite aggressive,” according to Moffitt, due in part to claims of capturing a larger market share from patients choosing the new center over other hospitals in Washington, D.C.
Moffitt does not think the growth in the number of patients at the new hospital compared to PGHC will be as strong, he said.
“Based on my different perspective on the market and how it is likely to change over time, as well as the larger forces mitigating against growth in the demand for hospital services, and the need to reduce the high levels of avoidable hospital use, I conclude that the project plan should trim service capacity as part of the plan to reduce the scale of construction and overall project cost,” Moffitt wrote.
Chief among concerns for Dimensions was that the comparison to Washington Adventist was flawed. That hospital does not have a trauma center, Dimensions says, while PGHC is the second busiest Level II trauma center in the entire state. The letter also notes the other hospital will not have its own central utility plant and will instead contract out for its utility needs. Dimensions does not believe this is an option for the new Prince George’s Regional Medical Center (PGRMC).
“At this point, Dimensions does not believe that a third-party outsourcing arrangement for utilities would be cost-effective at PGRMC in the long term,” the letter said. “But it will analyze the option further in response to your recommendations.”
Regarding construction costs, Dimensions says it is bound by prevailing wage laws and requirements for Minority Business Enterprise hiring not experienced in Montgomery County that add 15 percent to the construction costs.
A CON was expected to be issued for the PGRMC this summer, but after Moffitt’s letter, the timetable is now pushed back. Once a CON is issued, however, groundbreaking should occur within a year.