OHS hearing on Norwalk Hospital’s bid to add elective PCI highlights access, transfers and cost data requests

Norwalk — The Office of Health Strategy (OHS) heard several hours of testimony and public comment on Norwalk Hospital’s certificate-of-need application to add elective percutaneous coronary intervention (PCI) services without on-site cardiac surgery, with witnesses stressing competing concerns about patient access, safety protocols, transfer burdens and market impacts.

Supporters, including state and local elected officials and clinicians, told OHS that Norwalk residents face unnecessary travel and delays for some urgent cardiac care. State Representative Pete Roberts, who said he was born and raised in Norwalk, urged approval to reduce those burdens. Clinicians described frequent interfacility transfers and the clinical risks and duplicated testing that can result. "Having a fully functional cardiac cath lab at Norwalk Hospital will elevate the care, save lives, and will be a superb addition to Connecticut's focus on patient centered care," said Dr. Jeffrey Kuvin, chair of cardiology for Northwell Health, which is affiliated with the applicant hospital.

The applicant presented transfer counts and statewide procedure data to show local need. Counsel for the applicant said the record includes roughly 198 transfers in 2024 with diagnoses linked to the circulatory system and pointed to CHIME statewide data showing roughly two-thirds of PCI procedures occur in inpatient settings. The applicant argued that changes in national certification and the statewide plan support elective PCI at community hospitals without on-site surgery, and that Norwalk Hospital has staffing, protocols and transfer agreements in place to follow current professional guidelines.

Opponents, led by counsel for intervening Stamford/Stanford Health interests, urged OHS to apply statutory CON criteria strictly and said the record does not show an unmet need that would justify adding a fifth elective-PCI provider in the service area. "The application is for a certificate of need, not a certificate of convenience," the intervenor's counsel said in closing, arguing the statutory standard is the trigger for approval, not convenience or preference.

Public-comment speakers framed the issue as one of equity and patient experience. Karen Gottlieb, executive director of Americares free clinics, said bringing elective PCI closer to home is "not a convenience. It's a matter of equity, safety, and survival," and told the panel that previous denials have left low-income and uninsured residents with harder, riskier paths to care.

OHS staff pursued technical questions about definitions (emergent/STEMI, urgent/acute, and elective/stable categories), transfer volumes, follow-up care and coding, and asked for more detailed cost data. The hearing officer requested that both the applicant and the limited intervener complete OHS tables (average cost per self-pay and commercially insured patient) for three procedure types — inpatient primary PCI, inpatient secondary PCI and outpatient secondary PCI — and indicated those materials should be filed as a late submission by the end of the week (date listed on the record). The applicant agreed to provide the requested data as a late filing.

No final decision was made at the hearing. The hearing officer adjourned the session and left the administrative record open for the requested late-filed materials and for OHS to issue a subsequent prefiled order. The record remained open at adjournment for OHS’s review and action.

What happens next: OHS will consider the written record (including any late-filed cost tables), testimony and exhibits before issuing a ruling on the CON application. The hearing record will remain open until OHS closes it and notifies parties of next steps.