Columbia County Appeals Hospital Denial

November 4, 2009 -- The Columbia Health District Board of Directors voted unanimously Oct. 28 to ask the state for an informal hearing on the proposed denial of the application to build a small 12-bed hospital in St. Helens.

The deadline for submitting the letter of request was Nov. 2. The hearing will be set within 15 days, unless there is a request for an extension.

The State Public Health Division on Oct. 22 issued a proposed denial of the health district’s certificate of need for the Columbia River Community Hospital. The informal hearing is an opportunity for the health district to present updated information or additional testimony in order to  overturn the denial.

At the CHD meeting, hospital project manager Tary Carlson reported the hospital team had reviewed the state’s key points in their proposed denial: Billing rates, ambulance transports, the lack of primary care physicians and financial viability. He said the team would address each of these points.

On billing rates, he said that it is common for hospitals in Oregon to segregate urgent care-level patients from emergency-level patients and to charge appropriately. In the CRCH, he said, “the charges were calculated with this methodology using Legacy's rates, so urgent care cases would not be charged emergency room rates.” He said the team is gathering examples to address the state’s concerns.

Carlson said that the team is working to clarify and provide more specific data on the ambulance report, which was prepared by Columbia River Fire & Rescue and the Scappoose Fire District. The study showed that between 30 percent and 50 percent of the ambulance transports out of the county could stay at a local hospital.

On the shortage of primary care physicians, Carlson said that the team believes that a new hospital will be a magnet for more physicians to locate in the area. “Other small rural hospitals have been able to increase primary care physicians." 

Carlson said the state reviewed the overall feasibility without the property tax income, since it is not income directly related to the operation of the hospital. “We feel updating the proforma to include changes that have occurred with interest rates, additional revenue projections and costs will help the overall financial picture of the hospital.

Although Carlson said a reversal is difficult, the informal hearing would be a opportunity to address the state's concerns. 

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