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Ii Table of Contents Page PART I Table of Contents Page PART I - PROJECT IDENTIFICATION AND GENERAL INFORMATION .................................... 1 PART II - PROJECT BUDGET ................................................................................................... 14 PART III - CONSISTENCY WITH GENERAL REVIEW CRITERIA AT COMAR 10.24.01.08G(3) .......................................................................................................................... 16 10.24.01.08G(3)(a). The State Health Plan .................................................................... 16 COMAR 10.20.10 - Acute Hospital Services ................................................................... 16 .04 Standards ................................................................................................ 16 A. General Standards ....................................................................... 16 (1) Information Regarding Charges ....................................... 17 (2) Charity Care Policy .......................................................... 17 (3) Quality of Care ................................................................. 19 B. Project Review Standards ............................................................ 21 (1) Geographic Accessibility .................................................. 21 (2) Identification of Bed Need and Addition of Beds ................................................................................. 23 (3) Minimum Average Daily Census for Establishment of a Pediatric Unit ..................................... 25 (4) Adverse Impact ................................................................ 25 (5) Cost-Effectiveness ........................................................... 31 (6) Burden of Proof Regarding Need ..................................... 38 (7) Construction Cost of Hospital Space ............................... 39 (8) Construction Cost of Non-Hospital Space ........................ 41 (9) Inpatient Nursing Unit Space ........................................... 41 (10) Rate Reduction Agreement .............................................. 44 (11) Efficiency .......................................................................... 44 (12) Patient Safety ................................................................... 47 (13) Financial Feasibility .......................................................... 49 (14) Emergency Department Treatment Capacity and Space ........................................................................ 51 (16) Shell Space ...................................................................... 63 COMAR 10.24.12—Acute Hospital Inpatient Obstetric Services Standards ................... 66 Section .04 Review Standards ............................................................................ 66 Section .04(1) Need ................................................................................. 66 ii Section .04(2) The Maryland Perinatal System Standards ...................... 66 Section .04(3) Charity Care Policy ........................................................... 76 Section .04(4) Medicaid Access .............................................................. 77 Section .04(5) Staffing ............................................................................. 79 Section .04(6) Physical Plant Design and New Technology .................... 81 Section .04(15) Outreach Program .......................................................... 82 COMAR 10.24.11 - General Surgical Services ............................................................... 82 .05 Standards ................................................................................................ 82 A. General Standards ....................................................................... 82 (1) Information Regarding Charges ....................................... 83 (2) Charity Care Policy .......................................................... 83 (3) Quality of Care ................................................................. 85 (4) Transfer Agreements ....................................................... 85 B. Project Review Standards ............................................................ 86 (1) Service Area ..................................................................... 86 (2) Need -Minimum Utilization for Establishment of a New or Replacement Facility .............................................................................. 88 (3) Need -Minimum Utilization for Expansion of An Existing Facility ........................................................... 91 (4) Design Requirements ....................................................... 91 (5) Support Services .............................................................. 92 (6) Patient Safety ................................................................... 92 (7) Construction Costs ........................................................... 93 (8) Financial Feasibility .......................................................... 94 10.24.01.08G(3)(b). Need ............................................................................................ 100 10.24.01.08G(3)(c). Availability of More Cost-Effective Alternatives ............................ 119 10.24.01.08G(3)(d). Viability of the Proposal ............................................................... 128 10.24.01.08G(3)(e). Compliance with Conditions of Previous Certificates of Need .............................................................................................................. 132 10.24.01.08G(3)(f). Impact on Existing Providers ........................................................ 132 10.24.01.08G(3)(b). Need ............................................................................................ 135 10.24.01.08G(3)(b). Need ............................................................................................ 139 Recruitment and Retention ................................................................................ 143 1. an assessment of the sources available for recruiting additional personnel ................................................... 143 iii 2. recruitment and retention plans for those personnel believed to be in short supply .................................................... 143 3. for existing facilities, a report on average vacancy rate and turnover rates for affected positions ............................ 145 TABLE 5. MANPOWER INFORMATION .................................................................................. 145 PART IV - APPLICANT HISTORY, STATEMENT OF RESPONSIBILITY, AUTHORIZATION AND RELEASE OF INFORMATION, AND SIGNATURE ........................... 145 iv MARYLAND ____________________ HEALTH MATTER/DOCKET NO. CARE _____________________ COMMISSION DATE DOCKETED HOSPITALS APPLICATION FOR CERTIFICATE OF NEED ALL PAGES THROUGHOUT THE APPLICATION, ATTACHMENTS AND EXHIBITS SHOULD BE NUMBERED CONSECUTIVELY. PART I - PROJECT IDENTIFICATION AND GENERAL INFORMATION 1. a. Adventist HealthCare, Inc. d/b/a Washington Adventist Hospital 3. a. Washington Adventist Hospital Legal Name of Project Applicant Name of Facility (ie. Licensee or Proposed Licensee) b. 820 West Diamond Avenue b. 12100 Plum Orchard Drive Street Street (Project Site) c. Gaithersburg 20878 Montgomery c. Silver Spring 20904 Montgomery City Zip County City Zip County d. 301-315-3030 4. Telephone Name of Owner (if different than applicant) e. Terry Forde Name of Owner/Chief Executive 2. a. 5. a. Legal Name of Project Co-Applicant Representative of Co-Applicant (ie. if more than one applicant) b. b. Street Street c. c. City Zip County City Zip County d. d. Telephone Telephone e. Name of Owner/Chief Executive 1 6. Person(s) to whom questions regarding this application should be directed: (Attach sheets if additional persons are to be contacted) a. Robert Jepson, Vice President a. Terry Forde, Interim President Business Development Washington Adventist Hospital Name and Title Name and Title b. 820 West Diamond Avenue b. 7600 Carroll Avenue Street Street c. Gaithersburg 20878 Montgomery c. Takoma Park 20912 Montgomery City Zip County City Zip County d. 301-315-3042 d. 301-891-5651 Telephone No. Telephone No. e. 301-315-3043 e. 301-891-5991 Fax No. Fax No. f. [email protected] f. [email protected] E-mail Address E-mail address a. Geoffrey A. Morgan, Vice President a. Howard Sollins, Attorney Washington Adventist Hospital Ober|Kaler Name and Title Name and Title b. 12041 Bournefield Way b. 100 Light Street Street Street c. Silver Spring 20904 Montgomery c. Baltimore 21202-1643 Baltimore City City Zip County City Zip County d. 301-592-4458 or 301-891-6214 d. 410-347-7369 Telephone No. Telephone No. e. 301-891-5991 e. 443-263-7569 Fax No. Fax No. f. [email protected] f. [email protected] E-mail Address E-mail address 7. Brief Project Description (for identification only; see also item #14): APPLICANT RESPONSE: Adventist HealthCare proposes the construction of a 170-bed replacement hospital facility on 48.86 acres in the White Oak area of Silver Spring (“White Oak campus”) with inpatient and outpatient services. Behavioral health services, including 40 psychiatric beds, will remain in renovated space inside the current Washington Adventist Hospital building on the Takoma Park campus, but not as part of Washington Adventist Hospital. Rather, behavioral health services in Takoma Park will be delivered under Adventist Behavioral Health. The Takoma Park campus 2 will house behavioral health, Adventist
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