ROCK HILL — When Bill Masterton took over as the chief executive officer for Piedmont Medical Center in June 2012, he knew he faced a divisive issue who should build a new Fort Mill hospital.
The shouts of anyone but Piedmont left him confused and disappointed. Why was a portion of the community so adamantly against a hospital that had a proven track record of quality? he asked.
I knew the Fort Mill hospital situation was divisive, but I didnt realize the depth of the division, Masterton said Thursday.
Two days earlier, the Administrative Law Court awarded the certificate of need to Piedmont.
It was almost a year ago that Masterton stepped into a small, stuffy courtroom of the states Administrative Law Court in Columbia to explain why Piedmont should get permission to build the Fort Mill hospital.
The trial was an education for Masterton. He heard the history of the more than 10-year battle over who should build the hospital.
It started about 2000 when PMC talked with Piedmont Clear Springs Development Co. of Fort Mill, the developer of Baxter Village, about bringing health care to the rapidly expanding area of northern York County.
In 2006, the states Department of Health and Environmental Control gave PMC permission to build a 100-bed hospital in Fort Mill. Losing applicants, including Carolinas HealthCare System, successfully appealed and the case went back to DHEC.
In 2011, DHEC awarded permission to Carolinas HealthCare. PMC and Novant Health, operator of the Presbyterian hospitals in Charlotte, appealed.
With the decision, PMC has begun updating its plans, including making the patient rooms larger. New regulations in the Americans With Disabilities Act require larger rooms, Masterton said.
While PMC updated its plans, Carolinas HealthCare is considering its options which include asking Administrative Law Court Judge Phillip Lenski to reconsider his decision, appeal that decision to the states appeals court, or given the uncertainty over the states certificate of need process apply with DEHC to build a Fort Mill hospital. It also could end its efforts to build a York County hospital.
Last year, Gov. Nikki Haley vetoed funding for the certificate of need program, advising health care facilities to move forward with projects without a certificate. The state Supreme Court has heard arguments on her decision, but has not issued its opinion yet.
The uncertainty hasnt stopped Masterton from reading and re-reading Lenskis 40-page opinion. It provides Masterton with detailed statistics about how competition from Carolinas HealthCare cut into PMCs market share and profits.
According to Lenskis decision, PMCs occupancy fell from a high of 75.1 percent in 2003 to a low of 57.1 percent in 2009 during the middle of the certificate fight. The drop at PMC came when York Countys population grew by 22 percent.
Lenski wrote there was a direct correlation between Piedmonts York County patient loss and CHS gain 80 percent of Piedmonts decline went to CHS from 2005 to 2010. He noted by 2011 that more than 50 percent of the most serious health cases in York County were seeking treatment outside the county.
Lenski said that such competition would economically harm Piedmont with losses in the millions and also affect the hospitals, and other York County physicians, ability to offer quality health care.
Economic harm, Piedmonts desire to build a 100-bed hospital Carolinas HealthCare proposed 64 beds and PMCs commitment to York County were reasons on which Lenski based his decision.
While building a new hospital should do much to keep York County residents from traveling elsewhere for care, Masterton knows it will take more to gain peoples trust.
Getting permission to build a Fort Mill hospital was part of a three-pronged strategy to keep PMC competitive, he said Thursday. The first is the ongoing, $20 million expansion of the emergency room at the Rock Hill hospital. Currently, about 70 percent of the hospitals patients are admitted through the emergency room.
Masterton said the new emergency room should increase that percentage to 80. New construction on the emergency room is expected to be finished in June. Reworking the existing emergency room is expected to be finished by December.
Piedmont also has increased its number of primary care practices in York County from eight to 20, and may add more, Masterton said. Physicians and health insurance companies play a large role in determining which hospitals people go to for care. Lenski said Carolinas HealthCare referral patterns were responsible for the drop in PMC use.
Masterton said the two efforts should help people get to know the new Piedmont better.
If you havent been to Piedmont recently you havent been to Piedmont, Masterton said. There are a lot of new things from a new attitude to new relationship with the community.
What Masterton is most proud of though was Lenskis conclusion that either PMC or Carolinas HealthCare would be capable of providing high quality healthcare services at its proposed Fort Mill area hospital.
Masterton said thats what has been lost in the Fort Mill hospital debate, meeting the health care needs of northern York County residents regardless of where they go for treatment.
This is not Coke vs. Pepsi, Masterton said. It about the people of Fort Mill having a choice, having something closer to home. Compassionate care is the No.1 thing.
Don Worthington • 803-329-4066