Iowa Court OKs Open-Heart Surgery at Competing Hospitals

(CN) – The Iowa Court of Appeals ruled Wednesday that Mercy Medical Center in Cedar Rapids can begin performing open-heart surgery despite St. Luke’s Hospital’s insistence that it should be the only local hospital allowed to offer it.

In a 19-page opinion penned by Judge Amanda Potterfield, the state appellate court rejected St. Luke’s appeal and found that Mercy Medical should be allowed to establish its own open-heart surgical program to combat “increased patient wait times, resulting in increased hospital costs, loss of wages, and stress.”

Mercy, a Catholic nonprofit hospital represented by attorneys from Des Moines-based Dorsey & Whitney LLP, first sent a letter to the Iowa Department of Public Health in 2015 about its plans to become the second hospital in the Cedar Rapids area to offer open-heart surgery.

It also filed a certificate of need application, claiming it no longer wants to lose an estimated 150 potential cardiac surgery patients each year.

St. Luke’s is also a faith-based nonprofit and is the only other hospital in the community that offers open-heart surgery. It immediately spoke out against Mercy’s proposal at a public hearing.

St. Luke’s also petitioned for a declaratory ruling on proper interpretation of a state “minimum utilization” rule which requires a hospital to perform at least 200 procedures annually.

The request was denied and the State Health Facilities Council granted Mercy’s application despite a projection of less than 200 open-heart surgeries per year, using the minimum utilization rule as a guideline rather than a mandate.

St. Luke’s – represented by attorneys from Des Moines-based Brown, Winick, Graves, Gross, Baskerville and Schoenebaum PLC – appealed after it was denied relief by both the council and a state district court.

On Wednesday, the Iowa Court of Appeals affirmed the lower court’s denial, agreeing with its finding that if the rule were supposed to be interpreted as a mandate, it should have “stated that programs ‘must’ project over 200 surgeries per year, and that caseloads over 200 are required, instead of ‘encouraged.’”

Judge Potterfield’s opinion also found that substantial evidence showed local cardiac surgery patients were waiting an average of four to nine days as a result of limited access, and their stress “is exacerbated by having to leave the Mercy system to receive care in a new health system.”

“The question is not whether patients are receiving substandard or worse care when they transfer to St. Luke’s. The question is whether the patients are experiencing problems in obtaining the care,” Potterfield wrote. “Based on the evidence the council found more credible, patients—whether they originate their care at St. Luke’s or Mercy—are experiencing longer wait times, which results in a number of stressors and challenges for those patients and could ultimately result in patient death.”

Attorneys for both hospitals did not immediately respond to requests for comment sent Wednesday.

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