HCA wins ASC approval after 3rd CON application, despite Bon Secours pushback

Last month, Nashville, Tenn.-based HCA Healthcare received certificate-of-need approval to develop an ASC in Hanover, Va., after two consecutive rejections by state health authorities, reported the Richmond Times-Dispatch on Aug. 13. 

The $21 million Middle Virginia Surgicenter will be the first phase of a plan to develop a larger hospital in Hanover County, according to the report. However, an executive with Bon Secours, a rival health system based in Cincinnati, called the development a "predatory and undeniable market share play." The Times-Dispatch noted that competition is fierce for the Hanover market, as residents are "relatively wealthy" and aging.

HCA's first two proposals for CON approval were larger in scope and cost. The first was for a $234 million, 60–room hospital, while the second was for a freestanding emergency room. Both proposals, planned at the same site, were denied by Karen Shelton, the state health commissioner. 

Bon Secours has taken center stage in opposition to HCA's attempted development in the area. Its COO, Christopher Accashian, said HCA's plan is designed to sway patients away from Bon Secours, which currently operates the only hospital in the county, Memorial Regional Medical Center. He alleged that HCA provided no data regarding the origin of its patients or support for its claim that a substantial number of residents in the area prefer HCA for outpatient care. 

The approved proposal is for an ASC with three operating rooms. Construction is expected to begin next year and be completed in 2027. As a part of the approval agreement, HCA's new facility must care for all patients regardless of their ability to pay. It must also provide charity care at almost 1% of the center's total patient services revenue. 

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