HCA Healthcare trying for third time to build facility in Hanover (2024)

For the third time, HCA Healthcare is trying to build a medical facility at a site on Sliding Hill Road in Hanover County. And for the third time, rival health system Bon Secours is pushing back.

After failing to build a hospital and a freestanding emergency room last year, HCA has now applied for a Certificate of Public Need to erect a $21 million outpatient surgery center.

The health system said the new facility would better distribute resources throughout the Richmond area and lower patients’ costs. But Bon Secours called the project “an undeniable play to expand HCA’s footprint north of the James River” that would snap patients away from Bon Secours’ nearby hospital, Memorial Regional Medical Center.

Both health systems have aimed to build facilities in the wealthy, aging suburb of Hanover. The Virginia Department of Health is expected to issue an opinion next week.

If the plan is approved, an HCA subsidiary called Middle Virginia Surgicenter LLC will build a three-room outpatient surgery center at 10054 Sliding Hill Road, near the onramp to Interstate 95.

Instead of building new operating rooms, HCA would move them from Retreat Doctors’ Hospital in the Fan neighborhood and Henrico Doctors’ Hospital. The health system said its hospitals performed 4,000 surgeries in 2022 on patients who live closer to Sliding Hill Road than any existing HCA facility.

A new surgery center would improve health care access to these patients at a lower cost. Outpatient centers generally cost less because the patient goes home the day of the procedure. Common operations at these centers include colonoscopies, biopsies and cataract surgery.

But Bon Secours has cast doubt on HCA’s claims. In a letter written last month by Christopher Accashian, Bon Secours’ chief operating officer for the local market, Accashian claims HCA has provided no data to reinforce its claim that it performed 4,000 surgeries for residents in the Hanover area. A website that tracks hospital metrics in the state, Virginia Health Information, does not count outpatient surgeries.

The website does count inpatient surgeries, and Accashian claims HCA conducted far fewer inpatient surgeries for Hanover-area residents.

“HCA’s inpatient surgical patient origin data do not support its claim,” he wrote.

HCA’s real motive, he wrote, is to take market share away from the only hospital in Hanover, Bon Secours’ Memorial Regional Medical Center; it was the same reason HCA attempted to build a hospital and an ER on Sliding Hill Road.

This is a key point in the argument between the two systems. Before the health department approves a new facility, it considers if the addition would hurt existing providers.

Days after Bon Secours wrote its letter, HCA shot back. Thomas Stallings, a lawyer for McGuireWoods LLP, which represents HCA, said Bon Secours does not like the fact that so many Hanover patients prefer HCA.

“Bon Secours’ distaste for that fact, however, does not make it untrue,” he wrote. “Bon Secours’ criticisms of Middle Virginia Surgicenter’s projections are meritless.”

Stallings wrote that HCA submitted all the necessary statistics for its application and that its plan to relocate the operating rooms is consistent with the state’s standards. The relocation would improve distribution of resources, bring lower-cost procedures to Hanover and optimize surgeries by converting hospital operating rooms into ambulatory surgery rooms, he wrote.

That the previous projects were rejected is irrelevant, Stallings wrote.

Last year, HCA proposed building a 60-bed hospital for $234 million on Sliding Hill Road. Similar to the current project, HCA wanted to move beds from Retreat Doctors’ Hospital to the Hanover site.

Having determined the plan lacked sufficient public need, Dr. Karen Shelton, the state health commissioner, shot it down.

HCA responded by proposing a $39 million freestanding ER, but that plan was rejected, too. Instead, Shelton approved Bon Secours’ competing proposal to build a $17 million ER at 11400 North Lakeridge Parkway in Hanover, which Bon Secours said will ease overcrowding at Memorial Regional.

Three health care groups have written in support of HCA’s newest plan.

CrossOver Healthcare Ministry, which treats low-income patients, said some patients lack transportation and that having a surgery center closer to home would promote better outcomes. Virginia Physicians Inc., a multispecialty practice, wrote that HCA’s facility would give a large number of patients prompt, efficient and cost-conscious care.

Virginia Gynecologic Oncology, which is part of the HCA Virginia Physicians network, said some Hanover patients leave the county for care because they prefer an outpatient facility and that HCA’s plan would bring them an option closer to home.