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Hearing weighs Encompass Health’s 50‑bed Brantford rehab hospital as supporters cite access and jobs and challengers press payer and methodology risks
Summary
At an Office of Health Strategy CON hearing, elected officials and clinicians urged approval of Encompass Health’s proposed 50‑bed inpatient rehabilitation facility in Brantford, citing local gaps and economic investment; intervenors questioned the company’s need methodology, Medicare Advantage conversion risk and supporting letters of local facility support.
A Connecticut Office of Health Strategy hearing on Encompass Health Rehabilitation Hospital at Brantford’s certificate‑of‑need application featured public officials and clinicians urging approval while intervenors pressed company witnesses on payment mix, supporting evidence and the applicant’s need methodology.
Representative Robin Comey, who identified herself as the representative for the Hundred and 2nd District, told the hearing she supported the 50‑bed proposal on the grounds that ‘‘high quality rehabilitation care doesn’t exist in close proximity to my community’’ and that ‘‘they are promising approximately $70,000,000 in local economic investment, a 140 to a 150 good paying jobs’’ if the project proceeds.
Rachel Rusconi, president of the Shoreline Chamber of Commerce, said the facility would fill a regional gap — the nearest comparable inpatient rehabilitation option is about 25–30 minutes away — and would strengthen the local continuum of care by easing transitions between home health, skilled nursing and an IRF.
Clinicians who testified said the facility would meet clinical needs. An orthopedic spine surgeon described cases in which patients require ‘‘several hours of rehab per day’’ that short‑term rehab providers do not consistently provide. Dr. Brian Michaelosco, medical director at Encompass’s Johnston, R.I., hospital, said the Johnston facility (opened August 2024) has been ‘‘well above 90 percent’’ discharge‑to‑community rates and reported that ‘‘this month ... 94 percent of those patients have gone back to the community successfully, with about a 3 percent rate to skilled nursing facilities and ... about a 1.5 percent rate to be readmitted’’ to hospitals.
Intervenors and agency questioners focused on financial and methodological risks. They pressed Encompass witnesses about accreditation and compliance, company discharge statistics and how Encompass calculates need for additional IRF beds in Connecticut. Company witnesses gave multiple metrics: the Encompass national average discharge‑to‑community figure cited to CMS fee‑for‑service data was reported as about 70.3 percent, while an ‘‘all‑payer’’ source produced a higher figure (about 84 percent last year); regionally the Northeast Medicare Advantage mix was described as 19.4 percent for quarter 1 year‑to‑date.
Questioners also raised concerns about Medicare Advantage (MA) authorization and conversion practices. Encompass witnesses acknowledged MA plans generally require prior authorization and said the company’s clinical liaisons screen referrals so they do not seek authorization for patients they deem inappropriate; they reported improvement in regional MA conversion statistics but acknowledged variability across markets. Counsel for intervenors sought to introduce an Encompass earnings call transcript in which the company’s CEO referenced ‘‘margin anxiety’’ related to regulatory changes and the new Team (bundled payment) model; the hearing officer allowed the document to be shared for discussion but noted late‑submission considerations.
Intervenors further argued the need analysis relied on national fee‑for‑service benchmarks that may not reflect Connecticut’s falling fee‑for‑service share or newly approved local capacity. Encompass representatives said recent additions to the Northeast region portfolio (including Danbury and Johnston) are accounted for and that the company’s regional analysis still shows a bed need in the proposed service area; they noted a service‑area definition that excludes some recently approved facilities outside the proposal’s primary catchment.
Financial projections for the proposed Brantford facility were reviewed on the record. Questioners pointed to year‑one net Medicare patient‑service revenue of $17,417,820 and year‑one Medicaid net revenue of $880,944 in the applicant’s worksheet and noted a projected rise in Medicare revenue to $29,699,912 by year three, underscoring the proposal’s heavy reliance on Medicare reimbursement.
The hearing officer allowed participants to submit written comments to the Office of Health Strategy, acknowledged requests for time to analyze newly filed slides, and called a short break. No formal agency decision was recorded in this session.
