State rejects LewisGale’s NICU request
JEANNA DUERSCHERL - The Roanoke Times file
The state has denied LewisGale Medical Center’s request to open a neonatal intensive care unit, saying that there is not a public need for more specialty care for babies in Southwest Virginia.
LewisGale plans to appeal the decision, said CEO Victor Giovanetti.
“Clearly, I respect the commissioner and her authority, but we are very disappointed and quite frankly I’m puzzled by it,” Giovanetti said. “We believed we proved beyond a doubt that this was in the best interest of the patients, babies, and it was in line with meeting the expectation of the parents and the physicians.”
In a letter dated Monday, state Health Commissioner Karen Remley said that adding NICU services at LewisGale would unnecessarily duplicate services already available. She said that not only was it not needed, but that approving a LewisGale NICU would also harm the quality of existing services.
“I am mindful of the community support for the project proposed in the application,” Remley wrote. “But I am also keenly aware of the effect proliferation of resources can have on neonatal services,which depend on sufficient volume in order to maintain clinical proficiency and overall quality of care. Special care nursery services, involving vulnerable and frail patients, should not be allowed to be duplicated when evidence strongly shows that sufficient volume would not exist to support proficiency and quality in neonatal care delivery.”
Read the entire story here.
What do you think? Should LewisGale be able to have a NICU or did the state get it right?
September 14, 2011 - 7:16 PM
Lewis Gale absolutely should be able to have a NICU. Personally, this past summer I had a very high risk pregnancy and although my Doctors and I took all the necessary precautions, we were faced with the reality that I may not deliver at my hospital of choice (Lewis Gale) if I was to have my baby before 34 weeks. Not only could I not go to Lewis Gale, I would not be able to have my doctor deliver my baby b/c he did not have rights to Carilion, nor did any of the doctors in his practice. They without a doubt have a monopoly on this situation. If a private hospital wants a NICU based on the growing needs of their patients, they should be able to be approved for one. It is not like they are wanting an entire wing to compete with Carilion- it’s a handful of beds. The NICU could be put in now while they are renovating the Labor and Delivery floor.
I read the article…. Of course Carilion would oppose. It’ll take business away from them, so I’m sure some of it is about the money. Carilion states their reason for opposition is because their NICU is not operating at capacity. So, do you wait until you are so full that there is no longer any room for emergencies? Right now Carilion has a monopoly in the area with their NICU. Lewis Gale should be allowed to have a NICU for their own patients as well.
I think it is absolutely ridiculous to not allow Lewis Gale to have a NICU. I agree with the previous two comments. Patients are being denied their right to choose which hospital they want to be treated at. Carilion is just worried they might have part of their profit taken away. It is also noted that Lewis Gale, unlike Carilion Roanoke Memorial, made it on the Joint Commission’s list of top hospitals.
With all due respect, I can’t help but wonder if the Commissioner’s opinion has been influenced politically, as it doesn’t make sense. Patients should have the opportunity to seek care from the institution that they feel will best meet their expectations regarding quality of care – especially as it relates to care provided by the doctor they choose for themselves and their baby. Lewis Gale has consistently demonstrated leadership in improving outcomes, and this improves the quality of care overall in the community. Look at Hospital Compare and the Joint Commission’s Quality Check reports to observe the facts. How does it meet the community’s needs if patients are forced into a certain hospital, or to a physician who has not historically provided their care? Being forced into a new system after nine months of continuous care would be like starting at square one – the consistency of care is lost. Also, why would other hospitals in northern regions of the state receive approval for a NICU under similar “necessity” circumstances, but not in SW Virginia? I don’t believe for a second that approving Lewis Gale’s petition will degrade Carilion’s ability to have a viable NICU – that just is not a sound argument. Surely Carilion can sustain its ability to care for sick babies despite Lewis Gale being able to provide a alternative choice. In fact, are these hospitals even going after the same patients? It’s my understanding that Lewis Gale would still transfer the most critical care to a level 1 NICU, but be able to care for high risk babies that do not require level 1 care needs. Do the right thing – approve Lewis Gale’s application. Allow all mothers to have a choice on where they deliver their babies. Allow consistency of care whenever possible, especially for those mothers who may be high risk, but want to stay with the doctor who knows them and their medical history best, allowing the best outcome. Lastly, allow Lewis Gale to drive up quality of care for mothers and babies in both facilities.
Carilion is very fond of its monopolistic business model and won’t be abandoning it anytime soon. If they could buy the roads leading to Lewis Gale just to barricade them they would!
You better believe this was a politically motivated. What do you expect from “non-profit” Carilion? They have to bring in as much money as possible in order for their Officers to bring in $1 million/year.
Way to go Carilion….. HCA/Lewis-Gale provides provides much better care IMO. It’s a shame this is all Carilion has anymore. No wonder they are losing doctors.
Come on, cut me a break. Lewis Gale and HCA will treat those Medicaid patients in their fancy NICU? The vast majority of patients that need care in any NICU anywhere are Medicaid patients. Those patients don’t get the pre-natal care and follow up and don’t follow the protocols as a demographic and that’s a simple fact. Most NICU’s don’t make money and I would bet that Carilion’s doesn’t make money now and I would further bet that their patient mix is heavily Medicaid so why would they argue the profit line on a money losing business? If HCA took Medicaid patients I would see their point on opening a NICU but they don’t. Sorry, but they can’t claim the high ground on this one to me.
All the arguments are interesting – but, the approval/accreditation process revolves around duplication of services – not patient choice. The same state approval process also affects the opening of additional medical schools. Also, I am certain that HCA/Lewis-Gale is like all other “for profit” institutions: Medicaid and zero $$ patients are admitted/stabilized and then transferred as quickly as possible to Carilion. I agree that NICUs($100K daily per patient) are never profitable. Sure, every hospital would love to be an organ transplant center, house a burn unit with hyperbaric chambers, have high-risk obstetric centers, and be the teaching mecca for a major medical school. Licensing standards, quality control, and state of the art modernity simply cannot be maintained when a glut of duplicate services are offered.
Why should it be up to anyone anywhere to tell a hospital what type of care they can or cannot give? As long as they have the expertise and the facilities available to do the job properly, I don’t think any agency, state or federal, should be able to tell them they can’t do so.
It makes no sense whatsoever to have two NICUs practically next door to each other. Carilion is a teaching hospital and the area’s main trauma center. That’s where the NICU should be.
If LewisGale wants to find a new income stream, they should go the opposite direction and support New Life Birth Center.
#7 Lewis Gale does take Medicaid patients when they walk through the ER. They have to by law. They have their fairshare of those wanting freebies , too.
If Carilion’s NICU isn’t operating at capacity then reduce the number of beds Carilion has and give some to Lewis Gale?
Free the health care system! Competition is generally a good thing. Give people a choice.
Another thought: What if there is a catastrophic event? In this day of terrorism, super bugs, earthquakes, etc, should we not have another place to take our sick babies? Maybe duplication is not such a bad thing.
I agree with Tass, but there again most hospitals and obstetricians don’t want competition and therefore will not embrace birth centers and midwifery care. Free the health care system of regulations and give people back the responsibility to choose their own health care provider.
I am saddened by some of the comments about NICU units on this board. I love Lewis Gale, but I fully support Carilion maintaining the NICU for the area. I want all the best specialists concentrated at one hospital so each child there will recieve the absolute best care.
I agree with Tess…Lewis Gale would be wise to have a natural birthing center instead of a NICU. We have limited options in the Roanoke Valley other than our two hospitals or a homebirth.
I sure hope we don’t have another flood like 1985, Roanoke Memorial was under water. Duplicity would be a good thing in that situation.