OHS: Manchester Hospital Application for Cardiac Care Service Expansion Does Not Meet Statutory Criteria Required for Approval
Proposal Does Not Improve Care Quality or Accessibility
(HARTFORD, CT) – The Connecticut Office of Health Strategy (OHS) announced today that the Certificate of Need application submitted by Manchester Hospital and St. Francis Hospital for the expansion of cardiac care services does not meet all of the criteria under Connecticut General Statutes § 19a-639 that are required for approval. The application, submitted in April 2018, sought to establish and operate a diagnostic cardiac catheterization lab and angioplasty service without on-site cardiac surgical backup at the 238-bed Manchester Hospital.
Hearing Officer and OHS Attorney Micheala Mitchell said, “OHS commends Manchester and St. Francis Hospitals on their excellent cardiac care work. The intention of this application speaks to their commitment to cardiac patients; however, the program they seek to establish does not improve access to cardiac care for residents in the service area, nor does it advance the current quality of patient care. It is important to note that the need for emergency angioplasty is down six percent—good news by any measure—and there are already two hospitals within 10 miles of Manchester Hospital with emergency cardiac programs. Establishing a third program in this service area only shifts volume, it doesn’t improve access. While a laudable intent, I was unable to find that the applicants demonstrated a clear public need for the proposal, or that its implementation would improve the quality of, or access to, cardiac care.”
CON applications must meet statutory criteria including demonstrating a clear public need for the service and how the proposal will improve quality, accessibility, and cost-effectiveness of health care delivery in the region. OHS analyzed the Manchester/St. Francis Hospital application, public hearing record, and comments and determined:
- There is no clear public need for the program. Between 2015-2018, emergency angioplasty procedures for patients within the proposed service area has declined by six percent;
- The addition of a percutaneous cardiac intervention (PCI) program at Manchester Hospital would result in financial gain for the hospital, but, by the applicant’s own projections, it would take two years to reach compliance with American College of Cardiology Foundation guidelines for volume and would shift patients from the St. Francis Hospital and Hartford Hospital programs situated approximately 10 miles away and able to treat residents in the service area;
- Establishing a PCI program at Manchester Hospital does not improve the quality of care for cardiac patients; the hospital is currently operating well within national standard guidelines for ‘door-to-balloon’ times and in transporting patients in need of emergency cardiac care; and
- Creating a new program at Manchester Hospital does not meet professional guidelines set forth by the 2011 American College of Cardiology Foundation/American Heart Association/Society for Cardiovascular Angiography and Interventions for elective angioplasty: ‘it is only appropriate to consider the initiation of the PCI program without on-site cardiac surgical backup if the program will clearly fill a void in the healthcare needs of the community. Institutional financial gain, prestige, market share, or other similar motives are inappropriate considerations for the initiation of a PCI program without on-site surgical backup.’
The applicants may request oral argument on this application within 21 days of the date of the proposed decision.
Pursuant to multiple sections of the General Statutes, OHS leads the Health Systems Planning Unit that administers the Certificate of Need program—a regulatory responsibility to promote statewide health facility and service development and monitor the impact of provider acquisitions and consolidations on the communities they serve.
All documents related to this CON application can be found in the OHS CON portal under Docket # 18-32224. Click on the blue filter icon next to ‘docket number’, type 32224 in the first box, then click ‘filter’.
Contact: Juliet Manalan
Communications Director, Connecticut Office of Health Strategy
450 Capitol Avenue
Hartford, CT 06106