TARPON SPRINGS — Helen Ellis Memorial Hospital lost its latest attempt to win permission to perform open heart surgeries.
But the hospital may have another avenue to explore if the state agency that regulates open heart surgery centers adopts a proposed rules change. Now, the state requires hospitals to obtain a certificate of need from the Agency for Health Care Administration to perform open heart surgeries. The certification process was designed to provide regulatory oversight of new programs to discourage duplication and promote cost-efficiency.
The agency reviews how people are utilizing existing services and various demographic trends to determine if a certificate is warranted. Helen Ellis has applied for a certificate of need four times over the past several years, most recently in April 2006. The AHCA has denied the requests, citing an insufficient demand for such services in District 5, which covers Pinellas and Pasco counties. But now the AHCA has proposed a licensing system that would allow hospitals to perform open heart surgeries once they have fulfilled a variety of requirements.
Under the new system, a hospital could qualify for two different licenses.
• A Level I license would allow hospitals to perform elective angioplasty procedures.
• To qualify for a Level II license, which would allow for open heart surgeries, a hospital would be required to perform at least 1,000 cardiology procedures within the last year. At least 400 of those must be angioplasty procedures.
Helen Ellis is now authorized to perform emergency angioplasties only. Last year, the hospital performed about 800 cardiac catheterization procedures and 65 emergency angioplasties, hospital CEO Don Evans said.
With the addition of elective angioplasty procedures, Evans said he expects the hospital would qualify for a Level II license within the first year.
The change was prompted by 2004 legislative reforms that eliminated the need for certificates of need for some types of facilities, including open heart surgery centers.
The case is being reviewed by the state Division of Administrative Hearings, which is expected to rule on the matter by mid August.
At stake for Helen Ellis is millions of dollars in revenue. While the scope of open heart operations can vary greatly, Evans estimated the cost of those surgeries between $30,000 and $35,000. The ability to perform such surgeries could generate between $3.6-million and $4.2-million in revenue the first year, and increase in the following years based on the number of procedures, said Jerry Touchton, marketing manager for the hospital.
The hospital already has operating rooms that are suitable for the open heart surgeries and a team of cardiac surgeons to perform them, Evans said.
Six hospitals within District 5 are certified to perform open heart surgeries. Two of those — All Children's Hospital/Bayfront Medical Center and Largo Medical Center — did not perform the minimum number of surgeries required within the first year, suggesting that another facility within the district wasn't needed, the AHCA said.
The two open heart centers closest to Helen Ellis — Morton Plant Hospital in Clearwater and Regional Medical Center Bayonet Point in Hudson — contested the hospital's application, saying an additional center in the district would have an adverse financial impact on their programs and could diminish the quality of care due to limitations on personnel resources.
Together, Morton Plant and Bayonet Point performed 89 percent of all open heart surgeries in the district in 2005, according to the AHCA.
Helen Ellis Memorial Hospital appealed the agency's decision to the 1st District Court of Appeals. In April, the court upheld the ruling.
Evans said he was disappointed by the decision. "We believe very strongly that there is a real need for this service in this area," he said.
An open heart center in Tarpon Springs would cut down on travel time and allow local patients to receive care at a hospital where their doctors already practice. "It's a continuity of care issue," Evans said.
The hospital would also benefit from the resources and experience of its parent organization, University Community Health, which operates the Pepin Heart Hospital in Tampa, Evans said.
Helen Ellis Memorial has applied for a Level I license and is waiting to hear if the proposed rules change is approved, Touchton said.
But the change has been challenged by Martin Memorial Medical Center in Stuart, which argues that the proposed changes contradict statutory requirements.
Rita Farlow can be reached at [email protected] or (727) 445-4162.