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Planning Commission stops forward motion on rehab hospital category

Thursday, March 25, 2010 by Kimberly Reeves

A discussion of a zoning category – or even a conditional overlay – for what might be termed a “rehabilitation hospital” seemed to end up firmly DOA at Tuesday night’s Planning Commission meeting.


Jerry Rusthoven, on behalf of the Planning and Development Review Department, approached the Codes & Ordinances subcommittee of the Planning Commission last week, asking that a discussion with stakeholders be initiated on the topic. A vote to put the topic on this week’s agenda barely passed, 3-2.


Rusthoven provided a timeline for events: Last year, the city learned the Central Texas Rehabilitation Hospital, once located within Seton Hospital on 38th Street, was seeking a site for its own facility. A conditional use permit plan, for a site in the Ridgelea subdivision on Jefferson Street, started going through the city channels last November. At the same time, a developer working with Central Texas Rehabilitation Hospital also began the pursuit of a site in the Heritage neighborhood, which Rusthoven agreed to consider as a “convalescent service” rather than a more intense hospital use.


Eventually, city staff realized it was giving different consideration to the same facility on different sites, simply because it went to different people in the same department. Guernsey called for a review of the ordinance.

Most recently, Zoning and Platting Commission denied a conditional use permit on the Jefferson Street site. That decision has been appealed to Council.


The reason the Planning Commission was having a discussion on the topic at all was enough to make some commissioners feel uncomfortable: Different members of city staff presented different rulings on an appropriate zoning category for separate sites intended for the same facility once housed within the Seton Hospital campus.


“I’m disheartened and confused by this whole conversation,” Chris Allen of the Rosedale neighborhood told commissioners during his one-minute comment. “This whole process is an answer to a question no one is asking.”


Commissioner Danette Chimenti agreed. While Chair Dave Sullivan clarified for colleague Kathy Tovo early in the discussion, that the discussion was intended to focus on the zoning category and not the Central Texas Rehabilitation Hospital situation, the discussion frequently drifted back to the specifics of the case.


“We have GH, and this can be used today,” said Chimenti of the general hospital  zoning category. In less intense zoning categories, GH could be a used as a conditional overlay. “I would believe the timing of this is such that it’s a response to the needs for a particular project and developer. It sets a bad precedent, and I don’t think that’s appropriate. ZAP had a ruling against this. It makes this look like some kind of end run to that.”


Rusthoven’s argument, after department review headed by Director Greg Guernsey, was that the confusion over the rehabilitation hospital – was it really as intense as a hospital or could it reside somewhere between GH and convalescent care? – might require a new gentler hospital zoning category. Levels of care, dictated by Medicare reimbursements, produced facilities with a range of purposes from long-term nursing care to short-term rehabilitation to intense acute care to general hospital care.

Should less intensive medical facilities be forced to meet hospital guidelines?


The city’s assessment was that Central Texas Rehabilitation Hospital would be the first true rehabilitation hospital – a category with more intense staffing than the traditional nursing homes but less intrusive uses than an acute care facility – but members of the neighborhoods impacted by the decision were unconvinced.


Already, Rosedale had experienced one facility that appeared to go from nursing care to rehabilitation hospital some mix of rehabilitation hospital and acute care, and the impact on the neighborhood appeared unchanged. Mary Engle, another neighbor, argued she had heard no argument that would appear to justify a new zoning category for the stand-alone hospital site.


“Tonight, I’ve heard nothing that would seem to require a different zoning category and nothing about what makes this use different from general hospital high-intensity use,” Engle said. “I hope we can proceed with caution and prudence here. I just have a concern that we are rewriting code because of our current needs.”


Commissioners sided with her, led by Chimenti. Saundra Kirk, who had worked in the rehabilitation area, was willing to open the topic for discussion, but she didn’t get a lot of support, with the exception of Dave Sullivan and Jay Reddy. Even then, it appeared more for purposes of exploring information than signing onto a deal. Sullivan even suggested that the discussion might end up with a recommendation of how to sequester the various hospital types but using current categories.


Instead, commissioners lined up in opposition: Mandy Dealey and Dave Anderson considered it a waste of staff time. Chimenti was opposed. Tovo, who lived blocks from the potential hospital site, eventually abstained from a vote. And Ben DeLeon, whose wife had a baby last week, was absent from the discussion.


“It didn’t get five votes,” Sullivan said. “It’s dead.”

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