Lewis-Gale NICU plans generate opposition

An effort by Lewis-Gale Medical Center to add a neonatal intensive care unit faces two hurdles, including opposition from Carilion Clinic and a state government report recommending against allowing the new service.

The Salem hospital, which is owned by the national for-profit company HCA Inc., is seeking approval from the Virginia health commissioner to add an NICU with eight specialty bassinets to treat babies born with complications, such as those who are premature or have low birth weight.

The government report, which was completed by staff working for the Virginia Department of Health, says the $3.4 million Lewis-Gale project does not appear to be economically viable and would be a duplication of services already available at Carilion. Lewis-Gale had projected that the NICU would lose $91,290 in the first year and $60,678 in the second year.

But the staff report suggests that the loss is "significantly understated."

Lewis-Gale spokeswoman Nancy May said the project is not intended to be a profitmaker for the hospital system.

"Over the long term, it may break even, or there might be a modest profit," she said.

Instead Lewis-Gale officials have been consistent in saying they are interested in establishing an NICU to help keep mothers and babies together in the same hospital.

"We want to provide the very best service for our moms and babies," May said. "The bottom line when you have a baby who needs NICU services, it is in the best interest of the mom, the baby, and the family to be able to keep that mom and baby together."

Carilion did not oppose the project during a public hearing in September, but the health system's head of pediatrics, Dr. Alice Ackerman, wrote a letter Oct. 1 detailing her concerns with Lewis-Gale's proposed NICU.

"The addition of NICU beds proposed in Lewis-Gale's application will increase the number of beds in an already oversupplied market during a time when both the region and nation are experiencing a decrease in birth and prematurity rates, diminishing the overall need for NICU care," Ackerman wrote.

Specifically, the 60-bed NICU at Carilion Roanoke Memorial Hospital operates at 71 percent capacity and has not exceeded 80 percent this year. The state recommends that NICUs operate at a capacity threshold of 85 percent.

Ackerman said that any new services at Lewis-Gale would diminish the NICU numbers at Carilion.

The health department staff report also suggests that Lewis-Gale's projections for the number of patients it would serve is "overly ambitious" and furthermore says any new admissions would "only come at the expense of existing providers."

May said she couldn't comment on the capacity level at Carilion or the state's recommended threshold.

While the government report recommends denying Lewis-Gale's application for an NICU, it offers an alternative suggestion that Lewis-Gale seek to establish an intermediate level nursery for babies who need extra care but do not need the specialized care of an NICU.

Lewis-Gale's application for an NICU comes as the hospital made several changes as it vies for a larger slice of the maternity market in the region. In April, Lewis-Gale announced a $2.5 million renovation to its maternity wing shortly after adding three doctors who specialize in obstetrics and gynecology to the hospital staff.

The next step for Lewis-Gale's application will come when the Virginia Department of Health holds a fact-finding conference in early November in Richmond to discuss the application. State Health Commissioner Dr. Karen Remley then will make the final determination.

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