Proposal for 3-bed ER defeated at state level

WAS SOUGHT WEST OF HWY. 169 ALONG HWY. 152

In a very rare decision, the Missouri Health Facilities Review Committee has denied a request to build a standalone three-bed emergency care hospital just west of the Twin Creeks area. The location is in Clay County, just west of Hwy. 169 along Hwy. 152.

The Missouri Health Facilities Review Committee denied the certificate of need on Tuesday, Sept. 12.

Of the 14 proposals reviewed by the committee, the Northland emergency care hospital was the only project that was rejected, and it was on a 3-2 vote.

On June 30, Richard Hill, attorney at law at Lashly & Baer, had submitted a 100-page certificate of need application on behalf of Northland Land Holding Company and Centerpoint Medical Center of Independence, which provided an overall picture of the community need for the proposed emergency health care services in the Northland.

In the application, the corporate entities contend that the average wait times at nearby hospital emergency rooms have surged to an average wait time of approximately 174 minutes.

In response to these wait times, Northland Land Holding and Centerpoint Medical Center of Independence were seeking approval from the Missouri Health Facilities Review Committee to construct a new surgical bed emergency care hospital to “meet the growing needs of the community.”

According to documents, the $37 million emergency care hospital with three medical beds would have occupied 5.5 acres west of the Twin Creeks area, which is bordered on the north by Interstate 435, on the south by Hwy. 152, on the west by Interstate 29, and on the east by Hwy. 169.

The main purpose of the 19,160-square-foot facility located at the intersection of North Holly Street and NW 88th Street would have been for strictly non-life-threatening emergency care, thereby reducing wait times at local hospital ERs.

The proposed emergency care hospital was projected to serve 7,664 patients in its first year of operation, 7,817 in its second year, and 7,974 in its third year.

Noted individuals and organizations that came out in favor of the proposed emergency care hospital included Congressman Emanuel Cleaver, State Sen. Lauren Arthur, State Rep. Maggie Nurrenbern, Kansas City Mayor Quinton Lucas, Kansas City Police Chief Stacey Graves, and chancellor of Metropolitan Community College Kimberly Beatty.

The proposed facility would have been distinctly different from the North Kansas City Hospital and Liberty Hospital because it lacks a Level 2 Trauma Center, which is fully equipped with seriously fast-track emergency services to handle life-threatening conditions.

In the certificate of need application, they make the argument that by 2025 about 1,325,348 people are estimated to live in the surrounding vicinity of the proposed emergency care hospital. Furthermore, they claim that the nearby hospitals have experienced overcrowding in their emergency departments, which can provoke adverse consequences for patients.

“The Centers for Medicare & Medicaid Services (CMS) indicate that delays in getting care in an emergency department can reduce the quality of care and increase risks and discomfort of patients with serious illnesses or injuries,” stated the certificate of need application.

In their data analysis, the average wait time for all reported facilities in Missouri is 159 minutes, and the average wait time for facilities in surrounding states is 132, compared to the 174-minute wait time at the three nearest emergency departments to the proposed location.

Some observers believe that longer wait times can be attributed to the significant population growth in Clay County and Platte County. Larry Rideaux, Ed D, president of the Metropolitan Community College-Maple Woods Campus, wrote in a letter of support for Centerpoint Medical Center, “Platte County and Clay County, the two counties comprising a significant portion of the region, have experienced remarkable population growth of over 10 percent in the last ten years.

This new facility would fulfill a vital healthcare need and contribute to the economic growth of our region by creating job opportunities and attracting healthcare professionals and businesses.”

But critics of the standalone emergency care hospital say that the wait times showcased in the certificate of need do not adequately reflect the current situation.

In a system where wait times significantly fluctuated during the COVID-19 pandemic, many are quick to point out it is disingenuous to showcase patient wait times at the height of the COVID-19 pandemic.

“The wait time referenced in the application was from July 2021 to July 2022 and that was during the Delta and Omicron COVID surge,” said Dr. Steven Starr, a cardiologist specialist with Meritas Health Cardiology and interim chief medical officer at North Kansas City Hospital.

“This year, the average wait time at the North Kansas City Hospital is 15 minutes,” added Starr.

Wait time is calculated from when a patient enters the hospital until they are seen by a qualified medical professional. The ER is not a place where it is first come, first serve. Patients are triaged upon their arrival and are then ushered into a room to be seen by a medical physician in a priority-driven manner based on the severity of their medical complaint. Patients have no control over how long they will spend in the emergency room.

Although there is no easy formula to guide the Missouri Health Facilities Review Committee in determining where hospital facilities should be placed, many local health professionals contended the proposed emergency care hospital would have been too close to existing hospital facilities.

“As might be expected, “some of the concerns were that this proposed location was eight minutes from Saint Luke’s North Hospital, 14 minutes from the North Kansas City Hospital, and 18 minutes from Liberty Hospital,” said Starr.

Critics also contended that a three-bed standalone emergency room may not be fully equipped to handle severe life-threatening conditions, such as a stroke, heart attack, or emergency surgery situations. Patients suffering from these conditions would need to be transferred immediately. In such situations, this could be detrimental to the patient, critics contended.

A very similar project in Independence received the committee’s approval. From the point of view of Dr. Starr, the remarkable community response ultimately impacted the outcome for the proposal at Twin Creeks.

“There was an outpouring of opposition from hospitals, doctors, community leaders, and local politicians,” said Dr. Starr.

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