TriStar Greenview Regional Hospital’s effort to establish an ambulance service in Warren County appears to be on life support.
An emergency administrative regulation issued Jan. 2 by the Kentucky Cabinet for Health and Family Services essentially reverses the 2018 emergency regulation that formed the basis for Greenview’s certificate of need application for an ambulance service.
That earlier regulation from then-Gov. Matt Bevin’s administration cleared the way for Greenview to apply for a certificate of need under a “nonsubstantive” review process that put the burden of proof on the existing ambulance provider, Med Center Health affiliate Med Center EMS.
The two Bowling Green hospitals have been wrangling about the certificate of need application since it was submitted by Greenview on Sept. 26, 2018. They were headed for a hearing on the CON application the week of Jan. 27, but this latest emergency regulation puts that in doubt.
Language in the regulation released by Gov. Andy Beshear and Acting CHFS Secretary Eric Friedlander takes direct aim at the regulation put forth by the Bevin administration.
A prelude to the emergency regulation states: “The previous administration declared that a public health crisis existed in counties without adequate ambulance services to treat medical emergencies with urgency and with respect to patient choice. However, there is not a lack of access or issue with patient choice.
“The formal review process is more appropriate than the nonsubstantive review process for applications to establish a Class I ground ambulance service.”
The regulation indicates that a failure to reverse the 2018 emergency regulation will result in “a loss of state funds due to litigation regarding that prior action.”
Med Center Health has a lawsuit pending that contests the basis for the nonsubstantive review, but now that may not be needed.
Wade Stone, executive vice president of Med Center Health, released a statement Monday praising the latest action by the CHFS.
“Med Center Health commends the Cabinet for Health and Family Services on its decision to reverse the effects of a certificate of need regulation which was issued in September 2018,” the statement says. “That regulation, had it not been reversed, promised to negatively impact ambulance service in Warren County. The Cabinet restored integrity to the certificate of need process by taking action this past Thursday and making clear that a public health crisis does not exist in our community involving access to ambulance service and patient choice.
“The Cabinet’s newly stated position has received local and statewide bipartisan support and will ensure that the Bowling Green-Warren County community will continue receiving outstanding care from an award-winning ambulance service.”
In the months since Greenview submitted its original CON application, Stone has insisted that Med Center EMS has proven to be a competent ambulance provider after taking over Warren County’s ambulance service in 1980.
He has pointed out that Med Center EMS, unlike most other ambulance providers around the state, operates with no financial support from the city of Bowling Green or Warren Fiscal Court.
The fiscal court magistrates, responding to Greenview’s original CON application, passed a resolution in support of maintaining the current arrangement with Med Center EMS.
Warren County Judge-Executive Mike Buchanon said he saw no reason to disrupt “what we consider to be an ideal situation for county taxpayers.”
Greenview, owned by Nashville-based HCA Healthcare, has portrayed Warren County’s ambulance environment as less than ideal. Its CON application and a statement by Greenview CEO Mike Sherrod have indicated that Warren County is experiencing gaps in its ambulance service.
“We remain committed to providing residents with a choice in emergency services,” Sherrod said in a statement released in September. “Bowling Green is one of the fastest-growing cities in Kentucky, yet it has only one existing ambulance provider. If approved, our new ambulance service will fill a critical gap in access to care.”
On Monday, Sherrod said he wasn’t sure what the next step will be for Greenview in its attempt to start an ambulance service.
“We were surprised to learn about the unexpected announcement by the Cabinet for Health and Family Services regarding ground ambulance service proposals,” Sherrod said in an email. “TriStar Greenview Regional Hospital has an application for a Class I ground ambulance service before the cabinet, and we are working to learn more about what this announcement means for our application process. TriStar Greenview remains committed to our patients and to providing Warren County residents with a choice in emergency services.”