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Public Health and Health Planning Council STATE OF NEW YORK PUBLIC HEALTH AND HEALTH PLANNING COUNCIL COMMITTEE DAY AGENDA July 19, 2018 10:30 a.m. Empire State Plaza, Concourse Level, Meeting Room 6, Albany I. COMMITTEE ON ESTABLISHMENT AND PROJECT REVIEW Gary Kalkut, M.D., Vice Chair A. Applications for Construction of Health Care Facilities/Agencies Ambulatory Surgery Centers - Construction Exhibit # 1 Number Applicant/Facility 1. 181206 C OMNI Surgery Center (Oneida County) Hospice Services - Construction Exhibit # 2 Number Applicant/Facility 1. 181260 C Hudson Valley Hospice (Dutchess County) Residential Health Care Facilities – Construction Exhibit # 3 Number Applicant/Facility 1. 181155 C Oxford Nursing Home (Kings County) B. Applications for Establishment and Construction of Health Care Facilities/Agencies Acute Care Services - Establish/Construct Exhibit # 4 Number Applicant/Facility 1. 181251 E South Nassau Communities Hospital (Nassau County) Ambulatory Surgery Centers - Establish/Construct Exhibit # 5 Number Applicant/Facility 1. 172395 E Queens Endoscopy ASC, LLC (Queens County) 2. 181152 E Roosevelt Surgery Center, LLC d/b/a Manhattan Surgery Center (New York County) Residential Health Care Facilities - Establish/Construct Exhibit # 6 Number Applicant/Facility 1. 172198 E Leroy Operating LLC d/b/a Leroy Village Green Nursing and Rehabilitation Center (Genesee County) 2. 172313 E Kingston NH Operation LLC d/b/a Ten Broeck Center for Rehabilitation & Healing (Ulster County) 3. 181046 E Martine Center for Rehabilitation and Nursing (Westchester County) 4. 181112 E Clinton Square Operations, LLC d/b/a Bishop Rehabilitation and Nursing Center (Onondaga County) 5. 181144 E Park Terrace Care Center (Queens County) 6. 181165 E Queens Nassau Rehabilitation and Nursing Center (Queens County) 7. 181182 E MARNC Operating LLC d/b/a Massena Rehabilitation & Nursing Center (St. Lawrence County) Certified Home Health Agency - Establish/Construct Exhibit #7 Number Applicant/Facility 1. 181084 E Willcare (Erie County) C. Home Health Agency Licensures Exhibit # 8 Affiliated with Assisted Living Programs (ALPs) Number Applicant/Facility 161026 E Foundation for the Elderly Inc d/b/a Atlantis Home Care (Queens County) 172165 E Utica LHCSA, LLC d/b/a Oneida Home Care (Oneida County) Changes of Ownership with Consolidation Number Applicant/Facility 181393 E Community Care Companions, Inc. d/b/a Interim Healthcare of New York (Monroe County) 2 D. Certificates Exhibit # 9 Restated Certificate of Incorporation Applicant The Frederick Ferris Thompson Hospital Certificate of Dissolution Applicant Genesee Valley Group Health Association Ruby Weston Manor 3 Public Health and Health Planning Council Project # 181206-C OMNI Surgery Center Program: Diagnostic and Treatment Center County: Oneida Purpose: Construction Acknowledged: April 3, 2018 Executive Summary Description Central New York ASC, LLC d/b/a OMNI requests indefinite life in 2020, the center’s Surgery Center (the Center), a proprietary performance will be evaluated against the Article 28 freestanding ambulatory surgical original projections provided in CON 131026. center (FASC) located at 498 French Road, Utica (Oneida County), requests approval to be OPCHSM Recommendation certified as a multi-specialty FASC. The Center Approval, with no change to the operating is currently certified as a single-specialty FASC certificate expiration date specializing in pain management services. Multi-specialty FASC certification is requested to Need Summary accommodate the addition surgical specialties, The Center is in its third year of operations and including ophthalmology and endoscopy has begun efforts to attract charity care cases. services. No construction or renovation is The addition of multispecialty surgery services required, as indicated by the applicant. The only will assist in those efforts. At the time of review project costs are related to moveable equipment for indefinite life, the Center’s performance in and CON fees. relation to their projected Medicaid and charity care volumes (under CON 131026) will be The Center was approved by the Public Health evaluated. Council for a five-year limited life under CON 131026 and began operations effective Program Summary December 8, 2015. The applicant stated that Based on the results of this review, a favorable the Center has the capacity to handle additional recommendation can be made regarding the surgical cases in addition to the interventional facility’s current compliance pursuant to 2802- pain management cases currently being (3)(e) of the New York State Public Health Law. performed, and would like the flexibility to allow physicians in other specialties to use the Center. Additionally, adding other specialties will assist Financial Summary in their charity care efforts. Approximately 500 Project costs of $19,998 will be met via equity additional cases are projected to be performed out of the Company’s cash reserves. The during the first incremental year. proposed budget is as follows: The Center has only been operating for two Current Year Year One years and will continue to operate under their Revenues $3,980,388 $4,174,184 “limited life” approval. The Department will Expenses 3,557,744 3,628,644 continue to monitor the Center’s Medicaid and Net Income $422,644 $545,540 Charity Care efforts, and when the center Project #181206-C Exhibit Page 1 Recommendations Health Systems Agency There will be no HSA recommendation for this project. Office of Primary Care and Health Systems Management Approval, with no change to the operating certificate expiration date, conditional upon: 1. The project must be completed within one year from the date of the Public Health and Health Planning Council recommendation letter. Failure to complete the project within the prescribed time shall constitute an abandonment of the application by the applicant and an expiration of the approval. [PMU] 2. The continued submission of annual reports to the Department as required under approval of CON 131026. [RNR] Council Action Date August 2, 2018 Project #181206-C Exhibit Page 2 Need Analysis Analysis The service area, Oneida County, has two freestanding multi-specialty ASCs and two freestanding single- specialty ASCs. The table below shows the number of patient visits at ambulatory surgery centers in Oneida County for 2015 and 2016. ASC Total Patient Visits Facility Name Type 2015 2016 Multi Apex Surgical Center (opened 7/10/15) 362 3,449 Multi Griffiss Surgery Center 3,329 3,781 Single Mohawk Valley Endoscopy Center 8,568 8,538 Single OMNI Surgery Center (opened 12/8/15) N/A 2,486 Total Visits 12,259 18,254 Source: SPARCS-2017 The patient visits above constitute a 48.9% year-to-year increase. The center began operation in Dec 2015, but didn’t receive its Medicaid Provider number (approval) until June 2017. Hence, there was no Medicaid utilization for 2016. Per this application, the center is reporting 12.4% Medicaid utilization for 2017. The Charity Care utilization has been low thus far: 0% in 2016, and 0.2% for 2017. The applicant indicated that becoming a multi-specialty FASC will enable the Center to offer a broader range of surgical services to the community and be able to provide care to the underserved residents of Oneida, Herkimer, and Madison counties. They believe this will help them to achieve the Medicaid and Charity Care commitments made in their establishment application. The Center indicated that they are committed to providing health care services to patients in Oneida, Herkimer and Madison Counties and surrounding service areas, regardless of their ability to pay. The Center maintains a Charity Care Policy to provide financial assistance to those patients who are unable to meet their financial obligation to the Center. A Financial Assistance Application must be filled out by the patient/guarantor prior to the date of service. The Center's Charity Care Policy provides a sliding fee schedule to patients meeting the financial criteria using the Federal Poverty Income Guidelines. The center has contacted Utica Community Health Center (a FQHC) and Upstate Family Health Center, Inc. (an Article 28 FQHC look-alike) in Utica. Center staff make periodic visits to educate these, and other area physicians, of the services provided, their acceptance of referrals, and the availability of financial assistance for qualifying patients. Opposition The Department received a jointly signed letter of opposition from Mohawk Valley Health System, Oneida Health System, and Apex Surgical Center (jointly owned by Oneida Health System and area physicians) requesting the CON be disapproved due to need and proximity to St. Elizabeth Campus and St. Luke’s Campus. Additionally, the signatories request the project be withdrawn by the Department since the FASC is still under their limited life and is not yet meeting its charity care projections. The FASC has the space and capacity to add specialties and believes that the expansion of surgical offerings will assist them in meeting their projected charity care commitment. The projected volumes, which appear reasonable and are based on physician commitment letters, project a financially feasible operation. The proposal to add surgical procedures enhances access through choice. Additionally, as the center is only in its third year of operation, and only received Medicaid certification in 2017, it is difficult to fully assess their service to the underserved. When the center requests permanent life in 2020, the center’s performance will be evaluated against the original
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