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MHFR Committee unanimously approves psychiatric hospital in Cape Girardeau

JEFFERSON CITY, Mo. — The Missouri Health Facilities Review Committee unanimously approved a nearly $30 million project to establish a 102-bed psychiatric hospital in Cape Girardeau.

SoutheastHEALTH Behavioral Health Center would cover adult and adolescent inpatient behavioral health along with a coordinated outpatient program.

“Due to the central location of Cape Girardeau in southeast Missouri, patients are often transported long distance to the hospital’s emergency department for assessment and held for extended periods, awaiting transpiration to one of only a few remaining acute psychiatry beds in this part of the state,” Rep. Kathy Swan wrote in a letter of support. “In addition, neither of Cape Girardeau’s hospitals is set up to provide behavioral health for court-ordered involuntary commitments, further limiting access to much-needed services.”

But the discussion over whether or not to approve additional skilled nursing beds in a facility in Sikeston dominated Monday’s Certificate of Need hearing.

The MHFR Committee denied Delta South Nursing and Rehabilitation’s proposal by a 5-1 vote, after a lengthy discussion highlighted by nearly 10 parties opposed to the project. This was Delta South’s second attempt at adding more SNF beds this year.

In January, Delta South presented a proposal for 25 additional SNF beds to their existing facility in New Madrid County. The committee founds a few issues with the proposal including the lack of a documented waitlist and a failure to prove the need in the community.

The relatively new facility — which is still in its first year — was approved for three of the requested 25 beds. The need formula for the 15-mile radius shows a roughly 400-bed surplus.

Delta South came back to the May meeting with a new application, seeking 15 additional beds, which they said addressed the issues with the previous proposal. They submitted a waitlist and documentation of nearly 95 percent occupancy rate. Additionally, they weren’t seeking to add new SNF beds to the community but rather had come to an agreement where, if approved, Westfield Nursing Center would delicense 15 SNF beds.

Westfield ranges from 53 percent to 100 percent occupancy rate and has a much lower reimbursement rate — roughly $135 compared to Delta South’s $153.

One opponent equated transferring the beds from one facility to another as “rearranging the chairs on the Titanic” calling it a “stressed” market with the current bed surplus.

“I still have issues because we are hurting nursing homes that are taking Medicaid patients,” said Sen. Mike Cunningham. “Still gonna leave surplus beds, still gonna leave the same thing — nursing homes that are taking the Medicaid people are still stuck at the lower reimbursement rate.

“I think it hurts the other homes and I just can not support that.”

Opponents also pointed out that once Delta South has been operational for two years, and the meet occupancy requirements they could apply for an automatic 10 percent increase. There is also a provision that allows a nursing home to purchase beds from a competitor once they have been operational for two years.

Three additional robotic surgery systems were approved: one at Lee’s Summit Medical Center, one at St. Anthony’s Medical Center, and Barnes-Jewish Hospital.

CON’s were also approved for Landmark Hospital of Columbia to establish an 23-bed LTCH, for  Clarendale of Clayton to establish an 98-bed ALF, and for Moberly Retirement Center to establish an 18-bed RCF.

The next full CON meeting is scheduled for June 9, 2018 and the next expedited ballot is scheduled for May 22, 2018.