DOH had extended the PVH Certificate of Need (CN) in 2007, initially acknowledging a hospital was needed in the northeast corner of the State. Unfortunately the only applicant, HUMC, had withdrawn its request before a decision could be made. Purportedly they believed a negative decision would be driven by political concerns over need, and wanted to enhance their application’s foundation for approval.
Election day has passed and the pieces for reopening a hospital are aligning. The Governor elect stood at Pascack Valley Hospital (PVH) last August and declared it needed to be reopened. 61% of the Pascack Valley residents responded by voting for him. HUMC appointed the interim president to the position of CEO last week, thereby setting in place the necessary leadership to close a hospital deal. And 14 communities passed a referendum in an affirmative vote of support for a hospital’s need.
The question now—will HUMC submit a new application sooner or later? If later is the answer, new obstacles could emerge, some procedural and possibly legal. The CN extension will expire by year’s end but if the application is reinstated before then, it technically falls back into the DOH’s purview. With the art of legal maneuvering, timing could become a factor in this procedure.
What has become obvious over the past months is that the decision process for the DOH is complex with multi-dimensional considerations. It requires rational thinking so as to consider the competing objectives in health care access with regards to planning and regulation; but it also requires finding a balance of political accommodation among the vested interests. The interests include the patient as consumers, hospital and physician providers, and the (political) public policy objectives. Unfortunately the problem with this process is that it settles for a satisfactory, as opposed to optimal, solution.
Valley and Englewood’s opposition has enjoyed the support of political rhetoric with little substantive documentation. They’ve reduced a comprehensive health care report to selective sentences in a blatant effort to manipulate for self-interests. If the PVH’s extension expires it wouldn’t be surprising if they made a case that HUMC’s application be considered new, subject to a full CN process, which would be a tougher standard to meet in the “glut” of beds mentality. Naturally each day of delay will be portrayed as material to an argument that cites no need exists.
Each delay the opposition imposes raises the statistical risk of a trauma situation arising to the detriment of someone’s life. The map below illustrates the Dartmouth Atlas Project’s assessment of which communities were considered part of the Pascack Valley Hospital’s primary service area.
The highlighted area equals 105,000 residents. In about 10 days the hospital will have been closed for two years. One can only wonder whether or not transit time to a hospital has already played a factor in someone’s life.
Hopefully a focus will materialize soon that will lead to a rational decision for an optimal solution. A decision that understands a “glut” of beds and location are not equal. A decision that considers the concept of strategic management which appreciates the internal dynamics of bureaucratic exaggeration, the needs of logistical healthcare access and one that encompasses while balancing the entirety of the State Report’s objectives.
Some nice area hospital info. Why the fuss about a forprofit? In Texas we have both forprofit and nonprofit hospitals. Forprofit have private investors and the nonprofits have us, the public, as investors. We pay basically the same prices in both types of hospitals for services except forprofit pays their investors dividends and nonprofits cost us tax money. Good luck.
Comment by Restall — November 9, 2009 @ 4:25 PM
Expecting a rational + political decision would be like trying to mix vinegar and oil. Rational will be an astringent verdict to someone. Political will almost certainly be slick with a meager outcome. They don’t mix well.
Comment by Ronnie — November 9, 2009 @ 7:24 PM
I used to live in Texas. Texas is a much friendly place for private business to supplement public services – that cannot do it all. Not here in N.J. The entrenched opposition of not for profit hospitals, unions and their bought and sold politicians, would rather see you drop dead.
Comment by Michelle — November 10, 2009 @ 11:10 AM
I think I read my question in a previous post comment but didn’t see any response. What’s Hackensack’s incentive to move forward with this hospital? If it doesn’t get approved what’s their downside? They already have the development rights that Valley is fighting for in Ridgewood. You’re asking for a rational decision? Your own town’s Council couldn’t come to one with that ordinance. How do you expect the DOH to do that? Bureaucracy is the root of inefficiency and politics. Decisions aren’t made on what’s right. They’re based upon appeasing the most people.
Comment by Apollo — November 10, 2009 @ 12:17 PM
The last time I commented here was sometime in 2008. I didn’t think a resolution was going to take this long to know whether we’re going to have no hospital and just a lot of development over there.
The HUMC Hospital hasn’t been exactly open to us since the outspoken Ferguson left. Our elected masterminds haven’t offered any direction so I guess to have a rational decision you’d need someone who understood common sense.
Comment by hopalong7 — November 10, 2009 @ 6:23 PM
Move to Texas.
Comment by Michelle — November 12, 2009 @ 7:46 PM
The Governor of Illinois, and Senator Dick Durbin are willing to house Gitmo terrorists in a suburb of Chicago;just to create some jobs and bring revenues into their “broke” state.
All we are asking for is our hospital back.
Comment by S. Adams — November 16, 2009 @ 8:21 PM