The opposition behind 4 proposed ASCs

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From staffing challenges to excess capacity, here are four ASCs or ASC expansions that have recently faced opposition:

1. Employees of the University of Vermont Medical Center in Burlington are opposing a recently approved, $30 million ASC as the hospital faces staffing challenges. 

The Vermont Federation of Nurses & Health Professionals, which represents 2,400 of the hospital's staff members, wrote to the Green Mountain Care Board questioning the opening of a new surgical facility when the medical center is "unable and unwilling" to staff existing operations.

The union said the hospital has more than 300 union job vacancies and are instead filling staffing needs with traveling nurses. By opening the ASC, the union said, the hospital will be forced to operate with "less than adequate staffing."

Despite the opposition, regulators approved the ASC. 

2. The Heart & Vascular Institute of Alabama's planned cardiovascular ASC in Montgomery has been tabled after facing opposition from several hospitals and organizations. 

The planned ASC is opposed by Montgomery, Ala.-based Jackson Hospital & Clinic, Jackson Surgery Center, Montgomery (Ala.) Surgical Center and Baptist Medical Center South in Montgomery, an affiliate of UAB Health System. 

The Heart & Vascular Institute of Alabama's certificate-of-need request was denied July 28. It filed an exception to the recommendation Aug. 4 for the board to reconsider its application, which has been tabled. 

3. West Des Moines, Iowa-based UnityPoint Health filed a lawsuit in an attempt to block a large physician group from opening two cardiac catheterization labs in its ASC. 

The 250-physician Iowa Clinic received a certificate of need to add two cardiac catheterization labs to its surgery center in December, despite the opposition from UnityPoint-Des Moines. 

UnityPoint sued the Iowa health department in April to stop the ASC's expansion. The hospital cited a recent decline in case volume, excess cardiac catheterization services in the area and the revenue shift away from the hospital as reasons the new labs should not be approved.

The Iowa health department cited CMS' approval of low-risk cardiac catheterization procedures in ASCs as a reason for approval.

4. A long-running dispute between the city council in Beloit, Wis., Rockford, Ill.-based OrthoIllinois and Beloit Health System resulted in Beloit changing its zoning laws. 

OrthoIllinois applied to build an ASC in Beloit's Gateway Business Park, which drew strong opposition from Beloit Health System, the city's largest employer. 

The proposal received over 20 letters of opposition ranging from state representatives to healthcare providers. Reasons for opposition included criticism that the ASC will result in "excess capacity" at nearby facilities and that the for-profit ASC would "divert nearly two-thirds of their patients from local community hospitals while providing little to no Medicaid services." 

The city council has since voted unanimously to change the city's "hospital" zoning category with the broader term "medical facility." OrthoIllinois withdrew its application in Gateway Business Park but still has plans to open an ASC in the city. 

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