A state agency has denied a local group’s application to develop an independent, inpatient hospice facility in Macon County.
The Hospice House Foundation had applied to the Department of Health and Human Services (DHHS) for a Certificate of Need (CON) that would have allowed them to build a new hospice facility in the county with six inpatient hospice beds. In a letter sent out last Friday, Feb. 25, that application was denied.
“We are very disappointed in the state’s decision not to approve our Certificate of Need application,” said Michele Alderson, president of the Hospice House Foundation of WNC. “We had hoped for approval but were aware that a Certificate of Need is not always awarded to the applicant during the first submission.”
The Hospice House Foundation continues to maintain, however, that there is a need for the facility. Alderson pointed out that the state has approved petitions to the State Medical Facilities Plan on three occasions, stating that a six-bed inpatient facility was warranted to serve the six county western North Carolina region.
“We are undeterred,” said Alderson. “It is still a fact that there is an identified, unmet need for hospice inpatient beds in our community as reflected in the state plan. Our original position has not changed and we are determined to see that the need is fulfilled.”
In a press release on Tuesday, Chris Comeaux commented, “We are carefully studying the state’s response to our application.” Comeaux is the president of Four Seasons Compassion for Life, a non-profit hospice provider based in Henderson County and a partner in the drive to establish a hospice house facility in Macon County. “We have other options and are considering them all,” he said.
“We believe that we can make this project a reality for our community,” Alderson said. “While the state did not feel our project would be the best or only way to meet that need, we still believe our project is the right project. No one else has been willing to step up and meet that need.”
Alderson noted that in November, more than a hundred people attended a public hearing on the CON application, the vast majority of whom supported the project.
“I know a lot of people will be disappointed,” said Tim Hubbs, CEO of Angel Medical Center in Franklin. “However, we believe that the state made the right decision,” he added. “According to their standards in the 2011 State Facilities Plan, there was not a sufficient need to support this inpatient facility.”
Hubbs said that while the state’s findings regarding the CON application offered no surprises, it did show that projections made by the organization concerning need, growth and financial support were “way off.” He added that another key factor was that, with the exception of Highlands-Cashiers Hospital, the facility did not have the support of other medical care providers in the area, including Angel.
Hubbs also said that Angel intends to make new efforts to reach out to the community that supports the hospice house project. “While we may not be able to satisfy the requests of all of those that were wanting a hospice house here, we’ve already been discussing making efforts within the hospital to see if we can make at least a couple of rooms to provide that type of care and try to improve in that area,” he said. He acknowledged, however, that the hospital won't be able to provide the freestanding, home-like facility that proponents of a hospice house want to see in Macon County.
Lisa Pittman, project analyst at the DHHS Division of Health Service Regulation, said she could not comment on the findings because of the potential of appeal and/or litigation. She explained that anyone who feels the decision was in error can file a petition for a contested case hearing within 30 days of the decision date (deadline: March 27).
For an appeal to be successful, the petitioners would most likely have to satisfy a judge with the Office of Administrative Hearings that each of the nonconforming items listed in state findings on the application had been addressed or prove the findings were in error.
According to statute, the administrative law judge must make his recommended decision to the director of the Division of Health Service Regulation within 270 days after the petition is filed. The director then makes the final agency decision, which may be appealed to the N.C. Court of Appeals.
The first section in the 41-page report of findings regarding the CON application, states that the applicants “failed to adequately demonstrate the need for the proposal.” This is one of many findings that supporters of the project are likely to contest if they choose to submit an appeal. An additional reason stated in the denial was a failure to demonstrate the ability to raise funds for the project.
“One of the things the state wanted to see was a strong commitment and support for a hospice house from the community in the form of dollar donations,” explained Alderson. “We have done very well in raising funds to date, especially considering that we have yet to begin our capital campaign.”
Alderson added that the Hospice House Foundation will continue their efforts to raise the funds needed for the facility through fundraisers such as the third annual Cut-a- Thon which will be held on June 11. The organization is reaching out to the community and accepts cash donations, pledges and endowments.
“We knew that this would be a long hard road,” said Alderson. “For the residents of our community we will remain diligent to find a way for our dream of a hospice house to become a reality.”