Posted: May 14, 2010

By Danielle Walker

danielle.walker@insidebiz.com

After winning a majority vote from the Chesapeake Planning Commission in April, Sentara Healthcare took its proposal for a 20,000-square-foot emergency center to City Council on May 25. However, the proposal was unanimously denied by a 7-0 vote at the packed meeting.

Although Sentara identified a location for the ER in Chesapeake's Greenbrier area more than 10 years ago, a major drawback slowed the go-ahead for development: its proximity to Chesapeake Regional Medical Center, which is within two miles of the proposed space.

While Chesapeake Regional workers and affiliates protested the plans, along with some city residents, Sentara officials claimed that its free-standing emergency center would serve as a needed provider of health services to the Greenbrier and Great Bridge areas.

Kurt Hofelich, vice president for ambulatory operations and rehab services at Sentara Healthcare, said the emergency center would have provided a more "convenient" option for patients. "Since 1998, we identified that the Greenbrier corridor would be a growth corridor," he said.

Hofelich said that "every year more than 10,000 Chesapeake residents leave the city to access emergency service at another Sentara location."

As for the pending emergency center, he said that "a little less than half that capacity, [would be] visits we already had elsewhere."

The 20-bed full-service ER would have been staffed by doctors from the Emergency Physicians of Tidewater group, the same group that staffs other Sentara hospitals. Pharmaceutical services would also be available, and Hofelich said that future plans for the emergency center included a second floor, which they were "looking to lease to private physician groups." The plan also included "a long term ambulatory center."

One of the main points of dispute between Sentara supporters and Chesapeake Regional affiliates is how efficiently the free-standing emergency center would serve the community, in the proposed location.

Dr. Lewis Siegel, who practices Emergency Medicine at Chesapeake Regional, said that having two emergency care facilities within such close proximity could create confusion among patients.

"Patients are not sure where to go for different emergencies," said Siegel. He explained that many patients may not know the full scope of the symptoms they are experiencing, or the care necessary for those ailments.

Chesapeake Regional recently spent $6 million on expansions to its North Battlefield Boulevard facility, as part of an effort to service the growing number of patients in the area. The additions included a fully renovated and enlarged emergency center.

Wynn Dixon, the interim CEO of Chesapeake Regional, said that Chesapeake Regional sees "65,000 to 66,000 patients per year." Dixon also said the renovations would allow nearly 85,000 patients to be serviced in the future.

While Dixon said that Chesapeake Regional is "not anti-Sentara," he said Sentara's history of building ERs close to other hospital facilities is a "predatory practice." Dixon said that, "the tendency is not to put them in an underserved area, which is what our complaint is."

He went on to say, "The other dynamic is that Sentara is arguing for choice for our residents. On the surface I think this is a decent argument, but long-term the reverse is actually true."

Although Dixon said that some criticism arose concerning Chesapeake Regional opening an affiliate facility on May 1, the Urgent Care Center on Princess Anne Road, he explained that only primary and urgent care were made available there, and that these offerings are made clear to patients.

"We've been servicing those patients for 30 years, they are in our area," said Dixon about the Princess Anne center, which refers patients in need of additional care to other hospitals. "I don't think we are attempting to own the marketplace. It is not in the interest of this industry to be [monopolized]," he said.

While Sentara is the largest health care group in Hampton Roads, Hofelich said approval of the free-standing emergency center could have also meant partnership with Chesapeake Regional.

"We would admit a significant [number] of patients into the Chesapeake Regional center," said Hofelich prior to the city council ruling. "Ninety-five percent of patients who go into free-standing emergency centers are treated and released back home. Emergency services aren't necessarily in-hospital services."

Before the meeting, Hofelich also said that Sentara fully anticipated "having a collaboration at the proposed [location] with Chesapeake Regional" if plans for the $14 million two-phase project continued.  nib

*Story updated May 26, 2010