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State rules create fight for hospital beds

Posted August 11, 2008
Updated August 14, 2008

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— A three-way battle for new hospital beds in Wake County is shaping up between WakeMed, Rex Healthcare and Novant Health.

State regulators have determined that, based on growth projections, the county needs another 41 hospital beds. Novant Health wants to build a new hospital in Holly Springs, while WakeMed wants to open a women's hospital in north Raleigh and Rex wants to add to its obstetrics and surgical-patient beds.

All three hospitals plan to file their applications with the state Division of Health Service Regulation by Friday.

Novant Healthcare wants to build a $110 million, 46-bed facility in southeastern Wake County. Holly Springs officials spent Monday assembling the letters of support from local residents for Novant's effort – hundreds of letters, each a plea for a local hospital.

"One gentleman said, 'Because I don't want to die on the way to WakeMed or Cary.'" Mayor Dick Sears said. "I think that's the real answer."

The letters show community support for the hospital, but it's not that simple. Building or expanding a hospital anywhere in the state is complicated and time-consuming.

A hospital isn't like a regular business. Don Dalton of the North Carolina Hospital Association explained that most bills are paid for by tax dollars, not by patients.

"Sixty percent of all hospital patients are paid for by Medicare or Medicaid or another government program. It automatically sets it outside the free market," Dalton said.

State regulators have to approve each project through a Certificate of Need process. The process allocates health care services to control costs, determining how many beds are needed in a given geographic area.

Earlier this year, those regulators decided the Wake County needs 41 hospital beds based on growth projections. 

"It is an extremely competitive market, and I think that's why you're seeing so much press and so much interest in these 41 acute-care beds, " Rex vice president Erick Hawkins said.

After the applications are in, the public can comment on each plan. A decision on which hospital gets the beds could come next year.

22 Comments

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  • Timtooltime Aug 13, 2008

    No Hospital for Franklin county and no Hospital for Hollysprings ! The state hoods would lose influence ! Vote Independent and rid the tarrants !

  • Wake1 Aug 12, 2008

    You have to really study the whole healthcare arena to truly understand how it all works - it's not as simple as it would seem. Wake County is very fortunate to have the hospitals it does - they do a lot for the community - Novant has not - they just want to tap into this market.

  • Wake1 Aug 12, 2008

    For all you hospital experts out there - hospitals don't operate as a normal "free market" business. Someone mentioned just let the hosptial go out of busniess if they can't compete - that's a pretty stupid statement! Hospitals face mounting pressures everyday to do more with less. That doesn't mean that hospital suppliers (of services, supplies, etc) cut hospitals any slack when charging them for their services - even though hospitals oftentimes have to wait weeks if not months to get paid for the healthcare services they provide.

  • ezLikeSundayMorning Aug 12, 2008

    My understanding is that the hospitals bill Medicaid at their approved room rate, based on their overhead. That means the state has an interest in when new hospitals get built.

    The problem is, the underlying method of calculating the bill is garbage. Medicaid should figure a fair rate based on averages of all the area hospitals and pay that. If a hospital can't make it on that, tough.

    Let them have as many beds as they want, if they are smart they will build in such a way that they can shut down whole sections or floors when they are not needed.

    I agree, southern Wake needs a hospital. And live in Eastern Wake, its just about fairness.

  • retired and luv it Aug 12, 2008

    Can someone explain to me why the state has to regulate hospital beds? It is an invitation for politics to insure that their politically correct choice is assured to be chosen and has little to do with health needs. Good Hope in Harnett Co. is a prime example. Let free enterprise and the local people choose their health care. The State should put some of that expert management ability they think they have toward DOT, Probation, or most any other boondocle they have going on at any given time.

  • GrnEydSher Aug 12, 2008

    Why now that Novant has made this proposal is WakeMed and Rex stepping up. If it were that important to them they should have done this long ago. Let Novant build I sure could use a closer hospital. I've got a Holly Springs address but pay Fuquay taxes. So I surely would like to see something closer.

  • Adelinthe Aug 12, 2008

    This should be in Fuquay or Angier.

    God bless.

    Rev. RB

  • Adelinthe Aug 12, 2008

    Ridiculous!!!

    Build them all; there's plenty of business to go around and people need nearby care.

    Plus not regulating beds may cause prices to come down.

    God bless.

    Rev. RB

  • sweetsea Aug 11, 2008

    The process is politicized and a small independent hospital like Good Hope in Erwin gets crushed by the bigger and more politically connected ones in their quest for new beds. There needs to be a lot more beds available in most hospitals. Anytime you need one there is always a wait for a bed and the ER's are even worse.

  • Kristen_-_RN Aug 11, 2008

    Novant - a world class corporation that runs incredibly facilities - is bidding to spend a huge amount of money to provide healthcare to a whole lot of people who don't live particularly close to a hospital.

    What is the problem?

    And competition between the hospitals absolutely benefits patients in a myriad of ways. So to say it won't effect costs to have another company here is very overly simplistic.

    Hospitals compete in certifications, wait times, staffing - when one succeeds, the others rush to follow suit. And when a hospital improves - the patient's outcome is improved.

    I hope and pray that Novant gets approval... it would be a benefit directly to my part of the county. But I sincerely believe that it would be a benefit to all of Wake County as well.

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