Mission makes new case for Fletcher endoscopy center, but public opposition remains

Making another case: Mission Health’s Director of Planning and Public Policy Brian Moore gives a copy of his presentation to Lisa Pittman, the state’s project analyst for the certificate of need. Last year, the state denied Mission Health’s request for the relocation of an endoscopy suite to Fletcher. (photo by Caitlin Byrd)

Less than one year after the state rejected their first request to relocate an endoscopy center from Asheville to Fletcher, Mission Health and Pardee Hospital are trying again. But during an almost 3-hour long public hearing held in Mills River today, May 16, not everyone understood why these health systems are applying again, or what has changed.

When a health organization proposes a new facility like the endoscopy center, it must demonstrate there is a need for it in the community. Intending to make their case for the certificate of need to the state and give reasons for this second attempt to the more than 100 people who attended the hearing, Mission Health’s Director of Planning and Public Policy Brian Moore gave a less than 15-minute presentation that highlighted changes made within the last year — changes, he said, that make this proposal stronger than the one submitted in April 2011. 

The changes Moore cited included recent national recognitions and honors for both Mission and Pardee, projected population growth in South Buncombe and North Henderson County and an increase in endoscopy procedures at Mission. However, his two major points centered around convenience and location.

“Nearly 24 percent of Henderson County residents drove to Mission last year as opposed to receiving care in a community such as this,” he stated. “Our potential sites are severely limited by North Carolina general statutes that restrict hospital services to the home county of the provider. So hospitals such as Mission must keep services within Buncombe County. The only way you can have a joint project like this is to be on a county line.”

However, of the nearly 50 people who signed up to speak during the public comment portion of the hearing, only a handful supported this county line project that will cost an estimated $45 million. This may also be due to the format of the hearing, which did not allow Mission employees to make a statement regarding the application beyond the 15-minute presentation.

Like what happened at last year’s public hearing on the issue, officials from Fletcher’s Park Ridge Health openly expressed their opposition to the application for the certificate of need.

“Mission isn’t accustomed to being told no,” said Vice President of Park Ridge Jason Wells. “It’s not a certificate of want. They couldn’t show need a year ago and Brian wasn’t able to get up here for you today and show you that the need has changed.”

Also unconvinced by Mission’s presentation, CEO of Park Ridge Jimm Bunch called Mission’s request for the endoscopy suite, “a ballistic missile aimed at all providers in Henderson County.”

Echoing the frustrated sentiments of Park Ridge officials, many physicians called the request a duplication of services, saying endoscopic procedures are not emergent in nature and are already provided at Park Ridge and Pardee Hospital.

“There is no difference in the quality of care received from Mission and Pardee endoscopists than those offered at Park Ridge,” insisted Dr. Bruce Perlman.

Reminding the public that the endoscopy center is a joint venture, CEO of Pardee Hospital Jay Kirby explained that the endoscopy suite would benefit the community in western North Carolina. “We try not to make these decisions in a vacuum,” he stressed. He also noted that Henderson County residents choose Mission Health 75 percent of the time for care.

However, Dr. Keith Maxwell of Southeastern Sports Medicine, located in Hendersonville, N.C., did not agree with the theory behind those numbers. “The thing I’ve learned in all the years of practice is that patients follow doctors, they don’t follow hospitals,” he said.

This was not the case for Jill Gehrig. Both her husband and her father are handicapped veterans, and she utilized Mission’s endoscopy center for her husband. “It is a major hardship for me to get my husband or father to get the care that they need. And, speaking to access, it would be a god-send to my family to have this new facility,” she said.

The state will make a decision on this CON and Mission’s certificate of public advantage by the end of August.

However, Charles Cutler, who attended last year’s public hearing on the issue was not convinced that he won’t be attending another hearing if Mission’s request for a certificate of need is denied again.“Are we going to keep coming to these CON hearings? I will, but I’d like to stop having the discussion,”  he said.