Lebanon officials won't oppose Summit plan

Though they stopped short of endorsing Summit Medical Center's plans for an outpatient surgery center off Hartmann Drive, Lebanon lawmakers said Monday they have no plans to oppose the $11 million project.
University Medical Center has submitted opposition to Summit's request for a state-issued certificate of need (CON) to operate the facility, maintaining local physicians' financial interest in the planned development would allow them to "cherry pick" patients by referring only paying patients to the Summit center.
Lebanon Mayor Don Fox, however, said he believes competition between the parent companies of UMC and Summit – Health Management Associates (HMA) and Hospital Corporation of America (HCA), respectively – would improve health care locally.
"If we have a retail store come in, we don't oppose that because we have another one similar to it," Fox said. "We're not known in Lebanon for driving businesses away. The Summit project is something I would not oppose."
Much to the chagrin of Mt. Juliet city squires, UMC has also opposed a certificate of need application to state officials made by Dr. Bob Kaelin and his associates with Tennessee Sports Medicine for an operating room inside a surgery center off Mt. Juliet Road.
According to records on file with the Tennessee Health Services and Development Agency (THSDA), which oversees the certificate of need process, UMC supported Kaelin's request for a certificate of need to operate the MRI portion of the project, which Tennessee Sports Medicine was awarded last summer.
Summit Medical Center has also issued formal opposition to Kaelin's plans, and a Summit spokesperson said last week they have no plans to withdraw the opposition.
Fox described UMC's decision to oppose the CON request for an operating room at the same Mt. Juliet facility as a "legal maneuver."
"UMC didn't see anything wrong with it until Summit made their move to come up to Hartmann Drive," Fox said. "It's just to look like they've been on the same page. I had a real question whenever I saw that they had previously supported Kaelin's group at Mt. Juliet Road.
"Now, suddenly, their (UMC's) attorney has convinced them to oppose it. That's because it's a legal maneuver. It has nothing to do with need. It's just a legal maneuver, in my opinion."
In his capacity as a city squire, Ward 3 Lebanon City Councilor William Farmer said the Lebanon City Council "doesn't have anything to say about this" as it is a matter to be decided by the THSDA.
Still, as a private citizen, Farmer said he had always questioned why the CON exists at all.
"I don't think I've got the right to require a law firm coming out of Nashville to get a certificate of need," Farmer, a Lebanon attorney, said. " … As a citizen, I question the whole process of requiring a certificate of need. I've always thought it was kind of a closed shop requirement. I can certainly understand why the health care providers want to have that closed shop. It helps keep competition out, but that sometimes isn't the best thing for consumers."
Like Farmer, Fox noted competition between UMC and Summit – should it receive a certificate of need – would ultimately benefit residents in Lebanon and Wilson County.
"My uncle built the Sunset Restaurant, and we didn't oppose Cracker Barrel coming in or any of these others," Fox said. "Competition will improve services, and competition will improve prices. It always has and always will."
UMC officials issued a written statement Monday that did not speak to Lebanon officials' statements or previous statements made by Mt. Juliet lawmakers.
Instead, UMC Chief Executive Officer Mark Crawford reiterated the hospital's argument regarding limited service providers' history of cherry picking "paying business from the community hospitals that are challenged to provide care and services for all that walk through our doors.
"This is absolutely the wrong time for these ventures to take paying patients away from our community hospital during these times of reimbursement uncertainty," a written statement issued by Crawford read. "We have all read about the recent changes to TennCare and other payers."
In the 15 months since HMA acquired UMC, Crawford added, upgrades to the hospital and its technology have topped the $7.2 million mark. He noted the hospital announced details surrounding a five-year plan which includes $20 million in capital improvements and an "aggressive" physician recruitment plan to add 50 new physicians in five to six years.
Staff Writer Brian Harville can be reached at 444-3952 ext. 16 or by e-mail at brian.harville@lebanondemocrat.com.