Helen Ellis cleared to perform open-heart surgeries
By NICK COLLINS
Published October 14, 2004
TARPON SPRINGS - After nearly two years of trying, Helen Ellis Memorial Hospital has won state approval to perform lucrative open-heart surgical procedures.
The state Agency for Health Care Administration indicated two weeks ago that it would approve the hospital's application, reversing an initial denial of the request.
Helen Ellis administrators said Wednesday they are working to begin doing coronary bypass operations, valve surgeries and angioplasty procedures within nine to 15 months.
But as Helen Ellis sets up its program, competing hospitals in Pinellas and Pasco counties are urging the state, even contemplating legal action in some cases, to stop the Helen Ellis program before it starts.
Helen Ellis administrators hope to perform about 150 open-heart operations and 400 angioplasties in their program's first year, said Steve MacLauchlan, the hospital's CEO and president.
These procedures, unlike many others offered by hospitals, can generate revenue. Helen Ellis could take in $15,000 to $18,000 for each open-heart operation and $5,000 to $8,000 for each angioplasty performed, MacLauchlan said.
The $4.25-million to $5.9-million in annual revenue will help the hospital and eventually could move its finances out of the red, MacLauchlan said.
Hospital additions, facility renovations and new equipment for the program will cost $5-million to $6-million. The hospital already has a team of surgeons trained for open-heart procedures from its parent organization, University Community Health, on staff, MacLauchlan said. The surgical team has been at Helen Ellis for about a year providing other types of care.
Training technicians, nurses and other support staff will be made easier by the hospital's involvement with University Community Health, MacLauchlan said.
The Helen Ellis program also would benefit from the resources and experience of University Community Health's Pepin Heart and Vascular Institute. The institute works with General Electric to develop new open-heart techniques, and Helen Ellis can draw on its research, said Phoebe Ochman, public relations manager for University Community Health.
MacLauchlan said the Agency for Health Care Administration likely reversed its decision on his hospital's application after reviewing the market in Pinellas and Pasco counties. The area's aging population means more procedures will need to be performed. Cluttered roads mean transferring patients to other facilities is becoming harder, MacLauchlan said. Helen Ellis is 15 miles from other hospitals that already perform open-heart operations, and it can take up to two hours to get patients into surgery if they are first taken to Helen Ellis, MacLauchlan said.
"Time is muscle," he said. "The quicker you can get a patient in, the better the outcome."
An AHCA spokeswoman would not say Wednesday why the agency reversed its denial, citing an "active legal case."
That's where the potential competitors of Helen Ellis come in.
Three hospitals in the area that already provide open-heart procedures objected when Helen Ellis, Mease Countryside and St. Anthony's Hospital applied to AHCA two years ago for certificates of need, which are required to set up a medical program.
The objecting hospitals were Largo Medical Center, Morton Plant Hospital in Clearwater and Regional Medical Center Bayonet Point in west Pasco County. They held that additional competition in the field would diminish the quality of health care in the area.
"It would represent an unnecessary duplication of complicated services that are best offered by a limited number of facilities," said Robert Weiss, attorney for Morton Plant Hospital.
Added competition would spread thin the limited number of qualified doctors, Weiss said. Instead of the existing good programs, patients would be left with many mediocre ones.
Helen Ellis, Mease Countryside and St. Anthony's were denied their applications for open-heart programs in February 2003 and given 21 days to appeal. Helen Ellis was the only hospital to file for reconsideration.
A hearing was set for January 2005. But on Sept. 28, AHCA filed its notice to approve the hospital's program.
Stephen Ecenia, attorney for Bayonet Point and Largo Medical Center, said he was "absolutely stunned" when he learned of AHCA's reversal.
"We were flabbergasted to see this document they filed that we don't believe they were authorized to file," Ecenia said. "It's a decision that seemed to come out of the blue, and I can't fathom why it was made."
Ecenia said he believes that once AHCA filed its denial, it no longer had jurisdiction over the Helen Ellis application. The Division of Administrative Hearings has control over the case, Ecenia said.
Ecenia said he has made contact with AHCA attorneys to point this out. He hopes to hear back from the agency in the next few days. He added that if AHCA does not revisit its decision to approve the Helen Ellis program, he is prepared to take legal action against the agency.
Weiss said he also had been in contact with AHCA attorneys but declined to comment on possible legal actions.
"It's important to recall that AHCA determined some time ago to deny the application," Weiss said. "We don't believe any circumstances have changed since then."
The current application process, which results in hospitals attacking other hospitals, was the target of a bill supported and signed by Gov. Jeb Bush this summer, said governor's spokesman Jacob DePietre.
"Facing round after round of litigation from competitors slows the process down and makes it inefficient," DePietre said.
The law will speed up the process in the future and help make health care affordable for more people, DePietre said.
A new process for approving open-heart and other programs still is being sorted out under the guidelines of the legislation, DePietre said.
Administrators from Mease Countryside said they have asked AHCA to reconsider their facility's application after seeing the agency's reversal on the Helen Ellis application.
"We basically said to AHCA, "If you're going to reopen the process, then you should look at all the applicants again,' " said Jeff Friedman, director of operations at Mease hospitals. "We're not sure how this is going to affect us. . . . Right now we don't know what criteria they used to change their mind."
In the meantime, the staff at Helen Ellis already has begun the process of opening its program. Architects are reviewing the designs for additions and renovations and will submit them to AHCA to get a building permit within a month, MacLauchlan said.
"It's going to have a tremendous impact on area health care," he said. "The medical community is abuzz, and I've had physicians calling me right and left to say congratulations. This is probably the best thing that's happened in terms of health care in this community in many, many years."
