FLORENCE — The pace of witnesses slowed dramatically in the contested case hearing for two proposed health care facilities in Florence.
Noel Falls, who prepared the two certificate of need applications submitted by RegionalCare Hospital Partners, testified again Tuesday for more than six hours, the second full day of his testimony.
Falls will continue answering questions this morning.
Falls is the final direct witness for RegionalCare supporting its proposal for a 300-bed replacement hospital and an adjacent comprehensive cancer center.
The methodology he used to determine the projections included in the applications has been questioned, as has his position as an expert witness.
Falls testified he used data about patient admissions and patient origins available through a database maintained by the state Health Planning and Development Agency and similar organizations in Tennessee and Mississippi to reach conclusions about patient migration and admissions from an expanded service area if the hospital and cancer center are built.
Richard Brockman, attorney for Alliance Oncology, has asked twice that Falls' testimony be excluded from the record and not used in determining the outcome. Brockman said Falls has yet to prove himself an expert.
Falls testified he has been preparing certificate of need applications in Alabama, Tennessee and Mississippi for more than 30 years.
He said he has prepared more than 500 certificate of need applications and testified in more than 250 hearings related to those applications.
The nexus for the credibility questions seems to be a standard of evidence regulation Alabama adopted in 2012, commonly called the Daubert rule, that requires witnesses presented as experts to "prove" their finding is based on reasonably accepted methodology using credible data.
Attorneys for both Alliance Oncology and Helen Keller Hospital have asked for calculations and formulas used to conclude the projections made in the applications for the hospital and cancer center. Falls has said those were made in a Excel spreadsheet document that was then removed to save memory space on his computer.
Under standards of evidence accepted prior to 2012, such calculations would not be required. Falls testified he prepared the certificate of need applications beginning in 2011. The application for the hospital was submitted on Dec. 30, 2011, and the application for the cancer center was submitted March 27, 2012.
The administrative law judge, Bill Chandler, of Montgomery, has not ruled on the applicability of the Daubert standard in this case, but has overruled the motions to remove Falls' testimony from the record.
During cross examination, Brockman questioned Falls on "discrepancies" in the financial data contained in the certificate of need application for the cancer center. Brockman said, based on depreciation standards of equipment from the American Hospital Association, the depreciation figure in the financial statements in the application under estimated by approximately $600,000.
Brockman had Falls do some simple calculations to illustrate that fact, to which Falls said he did not compile the financial pieces of the document but still thought the project was financially feasible.
Brockman disagreed. He said the financial information and the utilization numbers in the applications were deficient and incomplete.
Will Somerville, attorney for Helen Keller Hospital, has asked Falls to recreate step-by-step the process he used to determine patient origin as it relates to primary, secondary and tertiary service areas for the current and proposed hospitals.
Attorneys for RegionalCare called the intensive method a delay tactic, but Chandler allowed the style of questioning to continue.
Somerville will continue his cross examination of Falls when testimony resumes at 9 a.m. today.
Following the completion of Falls' testimony, which is expected to finish today, Helen Keller representatives will begin their case. Helen Keller has filed a motion to substitute witnesses from its witness list submitted prior to the start of the hearing. The motion hasn't been ruled on but, if accepted, would remove several doctors from the witness list and add additional community witnesses and different practitioners.
Jennifer Edwards can be reached at 256-740-5754 or jennifer.edwards@TimesDaily.com
Noel Falls, health care consultant for RegionalCare, testified about the content of the certificate of need applications filed by RegionalCare for a 300-bed replacement hospital and a comprehensive cancer center. His expert status was questioned by attorneys for Helen Keller Hospital and Alliance Oncology.
Noel Falls, health care consultant for RegionalCare, will continue his testimony. Falls compiled the certificate of need applications for the proposed 300-bed hospital and cancer center planned for Florence. Falls began his testimony Monday.
For Helen Keller Hospital
Larry Collum, president of the Helen Keller Hospital board
Sheffield Mayor Ian Sanford
Sheffield Councilman Steve Stanley
Dr. Laurence Carmichael, pulmonologist and sleep disorders specialist at Helen Keller Hospital
Sam Strickland, chief financial officer at Helen Keller Hospital
Colbert County Commissioner Rex Burleson
Tuscumbia Mayor Bill Shoemaker