Atrium says Novant shouldn't build new hospital beds

Plus: Cheap award tickets from Charlotte on American; South Charlotte library crunch; Lance CEO and 1950s mayor will see you on the greenway

Good morning! Today is Monday, November 18, 2019.

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State says 76 new hospital beds are needed in Mecklenburg — Atrium wants them all

- Atrium says Novant has ‘excess capacity’ that creates an ‘economic burden on the public’

- Both hospital systems say bed shortages are causing patient care to suffer

- Novant says it needs 20 beds in Matthews, stat: ‘Who wants to lie in a bed on a gurney?’

A battle is brewing between Charlotte health giants Atrium Health and Novant Health over which company gets to build new hospital beds — and where.

Mecklenburg County is growing so much that it needs 76 new beds in addition to the 2,200+ that Atrium and Novant already have, the state’s Department of Health and Human Services determined this year.

In new filings with the state, Atrium says patients are choosing to go to its hospitals so much more than to Novant’s that the state should award it all 76 beds, spread among its hospitals in University City, Pineville, Carolinas Medical Center (Dilworth) and a new facility in Cornelius. Novant, though, would like to add 20 beds in Matthews.

Bed hog? Atrium wants all 76 of the hospital beds the state says Mecklenburg County needs, including 18 at its Carolinas Medical Center campus. Novant wants to build 20 beds in Matthews.

Why it matters: Acute-care beds, and the operating rooms associated with them, are lucrative for hospitals. Once approved by state regulators, the beds can be important parts of medical centers for generations and can increase a hospital’s capacity to conduct surgeries.

In its filing with the state, Atrium makes the case that the demand for its hospital beds is outstripping its supply, resulting in bottlenecks of surgery patients waiting to be moved out of operating rooms. Between October 2018 and July 2019, more than 1,300 Atrium patients had to wait in operating rooms after surgery for more than 38 minutes, “long enough for a patient to begin recovering from anesthesia while still in the operating room, which is not ideal or standard practice,” Atrium said. While saying Atrium patients receive excellent care in the hospital, the backlog “results in delays in their recovery and return to normal life.”

But in the filings, Atrium also goes out of its way to talk smack about Novant and says that data show that Novant has “consistent surpluses” of acute-care beds:

Novant Health currently operates with excess capacity of acute care beds. As stated in the statute, excess capacity leads to unnecessary use of expensive resources, overutilization of healthcare services, and an economic burden on the public. By comparison, Atrium Health currently operates with the highest deficit of acute care bed capacity in the state.

Atrium’s advantage: Atrium today has 1,376 hospital beds, or 61% of the county’s total, compared with 862 for Novant (39%). Data submitted by Atrium shows that it was responsible for 58% of the discharges of Mecklenburg County residents from hospital beds in 2018, compared with 38% for Novant. It also treats most of the county’s Medicare and self-paying patients, compared with Novant, which has a higher percentage of insured patients. Gaining market share in healthcare is more complicated than in other industries, as it depends not just on consumer choices but on factors including doctor referrals, insurance networks and the healthcare services offered.

With 58% of all discharges from acute care in Mecklenburg County in 2018, Atrium says it is creating all the demand for new hospital beds while Novant has a surplus of beds. (Source: Atrium Health analysis of Truven Health Analytics data in Atrium Certificate of Need filing.)

Last year, the state awarded 50 new hospital beds to Mecklenburg: 38 to Atrium in Pineville and 12 to Novant in Huntersville. The state has to approve new beds to ensure that healthcare companies don’t add unnecessary facilities that drive up healthcare costs.

Asked to reply to Atrium’s claims, Novant released a statement from Roland Bibeau, president and COO of Novant Health Matthews Medical Center, who said: “Matthews is thriving and in order to better serve our community we have to grow along with it. The certificate of need we filed with the State is to ensure we have greater bed capacity for our patients, who travel from both Mecklenburg and Union counties, for care in their community hospital.” [11/18, 9:49pm: UPDATED FROM ORIGINAL VERSION TO INCLUDE NOVANT RESPONSE]

Delays in Matthews: In its filing with the state, Novant says it needs extra beds to accommodate growth in Matthews, where inpatient surgeries have increased 39% since 2014. Its filing made little mention of Atrium.

But it included letters from some Novant healthcare providers who said the need to expand in Matthews is critical:

  • “I am regularly frustrated with a delay of up to 2 months to get elective cases scheduled,” wrote Dr. Matthew Gullickson, an orthopedic surgeon.

  • “Patients are waiting in the ER for an inpatient bed for prolonged periods of time. … Many of my patients have experienced extended waiting times in the ER. Several patients have refused to go to the ER for needed further evaluations. Some have needed to travel longer distances to other hospitals. … This leads to delays in care and potential for adverse outcomes,” wrote Dr. Robert Malecki, a family physician.

  • “Frequently patients have to wait many hours in the ER just for a bed. … Who wants to lie in a bed on a gurney in the middle of busy hallways in the ER when you feel terrible?” wrote Dr. Sarah Morris, an OB/GYN.

The state is holding a public hearing on the dueling proposals on Dec. 16 at 10 a.m. in room 270 of the Government Center uptown. A decision could take months, or longer if there are appeals or lawsuits.

Geek out: To see copies of Atrium’s applications to add hospital beds and operating rooms, check out the Ledger’s website here. They’re not light reading. The filings, known as “Certificate of Need” applications, are hundreds of pages long and contain hard-to-find market data. Novant’s applications are not available electronically, the state says.

American adds to ‘web specials’; 10,000 miles round-trip to a bunch of cities

American Airlines has added some super-cheap award tickets out of Charlotte in the next few weeks. If you have some frequent flier miles languishing in your account, you might want to check this out.

Last year, the airline added what is calls “economy web specials” on award tickets on a limited number of routes. Typically, a domestic nonstop round-trip costs at least 25,000 frequent flier miles.

But American seems to be adding to the number of routes it is discounting. In the next few weeks, out of Charlotte, the airline is making award seats available for as little as 10,000 miles round-trip to cities including Miami, Dallas, Chicago, San Francisco, San Diego, Phoenix and the New York area. Most are nonstops.

There seems to be a lot of availability the second week of December — after the Thanksgiving rush but before Christmas — but a search Sunday evening also returned some good deals for travel this week. There are even some fares at the 10,000-mile level that are months away. Tickets can’t be changed once purchased with miles, but they can be canceled with miles reinstated for a fee.

Unfortunately, you’ll have to search city by city on American’s not-always-awesome website. There’s apparently no map or list of where the deals are. Happy hunting.

San Francisco in February? American Airlines is expanding the availability of “web specials” that allow travelers to use as few as 10,000 frequent flier miles round trip to cities across the country. Here are the charts that list the one-way number of miles needed for nonstops in February for Charlotte to San Francisco (top) and San Francisco to Charlotte (bottom). If you paid for one of these tickets, it would cost nearly $400 in basic economy.

Loves me some internet

South Charlotte’s library desert

The South County Regional Library on Rea Road at Highway 51 closed this month for an $11M renovation — and it won’t reopen until 2021, the library says.

Libraries are renovated all the time, but if you look at the map of libraries, you’ll see that this one will sting. There’s now no library in south Charlotte south of SouthPark. The library says: “Children’s storytimes will continue at nearby community locations, including Gymboree Play & Music, the Morrison Family YMCA and Good Shepherd Presbyterian Church.”

Too bad, Ballantyne. If you want a book, it looks like you’ll have to truck it to Matthews or Steele Creek.

In addition to closing the South County library for renovations, Charlotte Mecklenburg Library is building a new Scaleybark location on South Boulevard and planning to renovate the main library uptown.

Snack magnate memorialized in bronze

Tony Zeiss, chairman of the Trail of History’s board of directors, dedicates a statue of Phil Van Every (1913-1980) on Saturday along the Little Sugar Creek Greenway behind the Metropolitan shopping center. Van Every was CEO of Lance Inc., served as Charlotte mayor from 1953-57 and started the Philip L. Van Every Foundation. (Photo courtesy of Maggie Akers.)

In brief:

  • A Dilworth hotel? A developer is eyeing Dilworth to build a hotel, according to city records. The half-acre site, on Ideal Way between Kenilworth Avenue and Charlotte Drive, is owned by Hope Haven Inc. City records say the land is “currently residential” but that it’s being considered “for a hotel use & add an office component to the surplus land.”

  • Epicentre converting to offices? Following two deadly shootings in recent weeks, the Epicentre uptown might be heading a different direction: “NBC Charlotte has learned leases for bars and restaurants are not being renewed and ads are already running offering office space.” The center is owned by Los Angeles-based CIM Group, which didn’t comment. (WCNC)

  • Expensive apartments: Inspire SouthPark, a luxury multifamily development, sold last week to private-equity firm Northland Investment Corp. for $145M. (Biz Journal/paywall)

  • Development called key factor in light-rail route: Former CATS chief Ron Tober says he has concerns about the route of the proposed light rail line running from Matthews to the airport area to Gaston County because it bypasses the middle of uptown, instead entering along I-277. “The major things the city seemed to be interested in was development. Ridership was a secondary consideration,” he told WFAE’s “Inside Politics” newsletter. Agenda also has a big piece today about the proposed line.

  • Toll time: The entire 26-mile stretch of the I-77 toll lanes between uptown and Mooresville opened on Saturday after four years of construction. An NCDOT spokeswoman said: “We encourage drivers who choose to use the lanes to allow extra time to get used to the new travel option. Although the lanes are open, there may still be some work going on in this area, so drivers need to use caution.” (WSOC)

Taking stock

Unless you are a day trader, checking your stocks daily is unhealthy. So how about weekly? How local stocks of note fared last week (through Friday’s close), and year to date:

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The Charlotte Ledger is an e-newsletter and web site publishing timely, informative, and interesting local business news and analysis Mondays, Wednesdays, and Fridays, except holidays and as noted. We strive for fairness and accuracy and will correct all known errors. The content reflects the independent editorial judgment of The Charlotte Ledger. Any advertising, paid marketing, or sponsored content will be clearly labeled.

The Charlotte Ledger is published by Tony Mecia, an award-winning former Charlotte Observer business reporter and editor. He lives in Charlotte with his wife and three children.