State: Heritage OB unit must stay open

A move by Heritage Medical Center to close its obstetrics unit due to financial necessity has been denied by the Tennessee Health Service Development Agency.

In October, the hospital announced it intended to close its obstetrics department due to an insufficient volume of patients.

However, the Certificate of Need application made by Heritage to discontinue the services was unanimously denied at the agency's meeting Jan. 28.

According to Melanie M. Hill, Executive Director of the agency, the vote was 9-0 to deny the certificate.

"The Health Services and Development Agency determined that the OB service was needed and that the discontinuance of services would not contribute to the orderly development of health care, especially for those in the community who are at risk," Hill said Thursday.

The request from Heritage asked for "the discontinuation of obstetrical and maternity services," according to the agency's January agenda.

"The four (4) hospital beds currently used for OB services will be switched to general medical-surgical hospital bed usage upon completion of this project," the request read. "No inpatient beds or major medical equipment will be added to this project."

The cost of the proposed discontinuance was listed at $38,000.

Heritage CEO Dan Buckner said Thursday that Heritage was "still in the decision making process," over the matter.

"We did not anticipate this decision," Buckner said of the certificate's denial.

Heritage will "be taking a step back to assess our needs," Buckner added, "and consider our future potential needs."

However, there are currently no OB doctors on staff to make the unit operable and, since last year, the hospital had utilized a transfer care agreement with Middle Tennessee Medical Center in Murfreesboro for obstetrical and maternity services.

"We don't have the doctors," Buckner said, "so we can't operate it regardless."

Last October, Buckner said there was an "insufficient obstetrics volume" necessary to keep the department open.

"Virtually every other department in the hospital has seen increased utilization in recent years, but our OB volumes continue to stagnate," Buckner said in an October press release. "It is regrettable that we have come to this, but our Board of Trustees and management feel that as stewards of the hospital, this decision has to be made to ensure the continued growth and vitality of Heritage."

Buckner had called the insufficient OB volume an "industry-wide issue," in October, adding that they were projecting even fewer births to take place at Heritage in 2008.

He also said that more than 70 percent of Bedford County women are currently choosing to have their babies in other counties.

Last June, Dr. Lana Beavers gave the hospital notice of her decision to stop delivering babies, due to her age and the location of the new hospital.

Then in August, Dr. Jan Crean and Dr. Dennis Wieck, the two OB/GYNs formerly employed by Heritage, told the Times-Gazette that their contracts with the hospital's OB department were being terminated.

The Tennessee Health Service Development Agency is responsible for regulating the health care industry in Tennessee through the Certificate of Need Program.

According to the agency's web site, a Certificate of Need "is a permit for the establishment or modification of a health care institution, facility or service at a designated location."

The agency says the Certificate of Need program "assures that health care projects are accomplished in an orderly, economical manner, consistent with the development of adequate and effective healthcare for the people of Tennessee."

-- Staff writer Sadie Fowler contributed to this report.