Office Of Health Strategy Issues Final Decision In Manchester Hospital/St Francis Hospital Certificate Of Need Application To Expand Cardiac Care
(HARTFORD, CT) – Connecticut Office of Health Strategy (OHS) Executive Director Vicki Veltri today announced that a final decision has been rendered in the Manchester Hospital/St. Francis Hospital Certificate of Need application for the establishment of a diagnostic and emergency percutaneous coronary intervention (angioplasty) program at Manchester Hospital. Regulators approved the creation of primary—or emergency—angioplasty and upheld the June 2019 denial of elective angioplasty services. In rendering its final decision, OHS examined the original application and public hearing record in addition to considering new information brought forth by the applicants during oral argument.
Executive Director Veltri said, “Experts and policymakers all agree that faster door-to-balloon times are better for cardiac patients. In considering the new evidence Manchester Hospital submitted during oral argument, OHS was able approve the emergency angioplasty program under state guidelines—and that improves the accessibility of healthcare in Connecticut, benefits patients, and helps keep costs down. Manchester Hospital is a strong advocate for their patients; we believe this program will benefit area residents facing cardiac emergencies.”
An April 2018 Certificate of Need (CON) application submitted by Manchester Hospital and their partner St. Francis Hospital sought to establish a diagnostic cardiac catheterization lab and primary and elective angioplasty service without on-site cardiac surgical backup at the 238-bed Manchester Hospital. In a June 2019* proposed decision, OHS regulators determined that the application did not meet the criteria for approval under Connecticut General Statutes § 19a-639, nor did it meet professional guidelines for institutional volume or quality of care. During oral argument before OHS on July 25, 2019, Manchester Memorial Hospital provided additional information related to travel times for patients who needed transport from the Manchester Hospital emergency room to either Hartford Hospital or St. Francis Hospital, the two closest PCI-capable treatment centers.
The final decision finds that the applicant has met the statutorily-required burden of proof for establishing a diagnostic and primary angioplasty service at Manchester Hospital in collaboration with St. Francis Hospital. Additional highway crash data submitted to OHS highlights the impact on travel times between the Manchester Hospital service area and the two closest PCI-capable hospitals which are about 10 miles away from Manchester Hospital. In fiscal year 2018, I-84 experienced 672 vehicle crashes between the hours of 9:00 a.m. - 9:00 p.m., the same time frame corresponding to the highest volume of cardiac patients at Manchester and Rockville Hospital emergency departments.
The final decision also finds that the applicants provided no new facts or evidence that would reverse the June 2019 denial of an elective PCI program. That determination found that creating a new elective PCI 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.
The applicants have 15 days from the issuance of final decision to request reconsideration.
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. 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’.
*The proposed decision came out in June 2019, NOT June 2018 as previously indicated.
Contact: Juliet Manalan
Communications Director, Connecticut Office of Health Strategy
450 Capitol Avenue
Hartford, CT 06106