Applications

N. Noyes Community Hospital proposes to certify Therapeutic Radiology Services and Construct a two (2) Linear Accelerator Radiation Oncology Unit.

CTAAB concluded there is a need for 1 LINAC at the proposed facility:  

• Ensuring the type of service proposed is available locally is an important patient satisfier.  
• Shifting current capacity from Hornell to a new facility, with new equipment has the potential to improve quality of care for patients.
• Site development in anticipation of future utilization is appropriate, however:
• Historical data indicate that 2 LINACS in similar communities have been unsustainable locally
• Approving new capacity 3 years prior to implementation does not allow for adequate analysis.  

FF Thomspon Hospital proposes to purchase a new CT scanner and utilize the current scanner for interventional procedures only.

CTAAB concluded there is a need for the proposed capacity:

• There is not a community-wide need for incremental CT scanner capacity.
• However, there is evidence supporting an institutional need for capacity specific to perform interventional procedures.
• Current scanner is used at typical rates, however this does not account for the higher than typical proportion of IR procedures
• Additional growth in regional IR CT volume is reasonably anticipated.
• Growth in CT-guided invasive procedures support the sponsor’s plan to dedicate one unit to that service.
• Temporal access to CT services may be enhanced for FF Thompson emergent patients, potentially improving quality of care and associated outcomes.

Highland Hospital proposes to construct a two-story addition to house a perioperative suite and a 26 bed observation unit.

CTAAB concluded there is a need for the proposed capacity:

• There is no increase in operating suite capacity as a result of the project
• Although community capacity for observation is unavailable, demand for these services is increasing across the community and within Highland Hospital
• Gained efficiencies as a result of the project have the potential to positively affect outcomes for patients at Highland Hospital

Pittsford Pain Center LLC proposes to establish and construct a single specialty ambulatory surgery center to provide pain management services at 727 Linden Avenue, Pittsford.

• There is no demonstrated community need for additional Pain Management Capacity
• There are significant incremental costs associated with the project and no evidence of improved outcomes for patients
• Increases in efficiency and quality could be achieved without article 28 status.
• There is no demonstrated improvement in geographic or financial access

UR medicine proposes to renovate and expand by eight (8) beds the Neonatal Intensive Care Unit at Strong Memorial Hospital

CTAAB concluded there is a need for the proposed capacity.

• There is demonstrated community need for additional NICU capacity.
• SMH’s designation as a Regional Perinatal Center indicates institutional need.
• The proposed project has the potential to improve quality of care for patients and their families.

UMMC proposes to construct a new 8,498 square foot building addition at the hospital’s main site to include radiation therapy and medical services.

CTAAB concluded there is not a need for the proposed services: 

• Available historical evidence indicates there is not a community need for additional radiation oncology capacity in the Genesee/Orleans/Wyoming area, although patient migration to Buffalo providers is unavailable.
• Low patient volume would result in high per-patient costs and potentially lack of economic viability.
• The addition of radiation services at UMMC would provide residents with integrated primary care and medical and radiation oncology care. However, geographic access to radiation care would not be improved.  Access for Medicaid patients would be provided.
• While the application represents transferal of capacity within the CTAAB region, there is significant capital cost associated with the ‘relocation’ of radiation therapy services.

UR Medicine proposes to add two (2) infusion chairs and certify a radiation oncology extension clinic through conversion of a private practice, located at 262 Bank Street, Batavia.

CTAAB concluded that there is a need for the proposed Infusion Stations

• The addition of the two infusion stations provides an opportunity for integrated care for cancer patients being treated with radiation therapy that also need chemotherapy.
• UR Medicine is currently treating a large number of cancer patients from this region at the Wilmot Cancer Center who could receive their care closer to their home
• The applicant indicates that as patients of this region migrate to the new location, infusion stations that are no longer needed at the Wilmot Cancer Center will be removed from service.

The URMC Department of Imaging Sciences and F.F. Thompson hospital propose to add an additional CT scanner at F.F. Thompson Hospital

CTAAB concluded there is a not a need for the proposed CT scanner: 

• There is no community need for the additional scanner.
• There does not appear to be institutional need for the additional scanner.  
• The low volume of impacted patients (approximately 1 per month) and appropriate diversion protocols during CT scanner downtime should mitigate additional impact.  
• The nearest ED is approximately 18 minutes driving distance from FF Thompson.
• The additional scanner does not represent an increase in access for most patients.

Clifton Springs Hospital & Clinic proposes to renovate space on the second floor of the existing hospital facility to accomodate a Hematology Oncology Clinic, including 5 exam rooms and 13 chemotherapy bays.

CTAAB concluded there is a need for the proposed clinic:

• While the application represents an increase in ‘system capacity’ community capacity is not increased.
• The acquisition allows for ‘340B’ pharmaceutical pricing on an additional 10 chemotherapy stations in the region, which should reduce overall cost of treatment for this community.
• The acquisition increases integration with regional oncology services and formally provides infrastructure (EMR etc.) to that end.

Hepatitis C treatment protocols and drug therapy review for efficacy and cost effectiveness.  

CTAAB recommended that statewide guidelines developed by NY State’s Medicaid program regarding treatment protocols be adopted by the commercial insurers to ensure appropriate treatment of Hepatitis C patients in a manner which is economically sustainable.