St. Peter appeals state's elective angioplasty ruling

OLYMPIA - Providence St. Peter Hospital officials have appealed a decision that allows Capital Medical Center to offer a heart-related procedure in non-emergency situations. The appeal sets the stage for a possible hearing before an administrative health law judge.

Capital in October won the right to offer elective angioplasties to its patients after the state Department of Health approved its certificate of need request. The privately held west-side hospital has performed angioplasties on an emergency basis for years, but the hospital applied for the certificate of need this year to offer them in non-emergency situations. Previously, Capital was required to send its patients to St. Peter or to another hospital for the elective procedure.

The appeal was filed by St. Peter, a nonprofit, on Nov. 20, the last day of the appeal period, DOH spokesman Steve Saxe said Thursday. A date and location for the hearing before a DOH health law judge has not been set, although it likely will be held at DOH’s offices in Tumwater, he said. St. Peter spokeswoman Deborah Shawver added that the two sides also will meet before the hearing to try to work out some kind of settlement, she said.

“Hopefully, the appeal process will uphold our certificate of need approval,” Capital chief executive Joe Sharp said Thursday. “They (St. Peter) are certainly within their rights (to appeal) and we will let the appeal process take its course.”

Shawver said Thursday that the hospital appeal won’t prevent Capital from offering elective angioplasties, but the hospital is seeking additional language about how the terms and conditions of the certificate of need approval will be enforced.

“We are particularly concerned about the provisions for charity care,” she said.

Capital has met the criteria to offer the elective angioplasty procedure, but one of the conditions is to raise its level of charity care, according to the DOH decision in October.

The 40-page decision states that “Capital Medical Center will use reasonable efforts to provide charity care in an amount comparable to or exceeding the regional average amount of charity care provided by hospitals in the southwest Washington region. Currently, this amount is 2.74 percent of gross revenue and 6.16 percent of adjusted revenue.”

DOH noted in the decision that Capital has “historically provided significantly less than the average charity care provided in the region, ” spending 0.26 percent and 0.81 percent of gross and adjusted revenue toward charity care in 2007, according to data included in the decision.

St. Peter contributed 3.34 percent of its gross revenue to charity care in 2008, Shawver said.

St. Peter officials also have acknowledged that performing elective angioplasties is a lucrative business. Sharing that business with Capital could lower St. Peter’s revenues by $1.5 million to $2 million annually, while Capital likely would gain that much. Capital also wants to offer its patients the convenience of having elective angioplasties on site rather than having to send them across town to St. Peter.

Whether St. Peter successfully appeals the certificate of need approval still is to be determined, but Saxe said DOH already tracks charity care spending at hospitals across the state. If a hospital fails to meet or exceed charity care standards, the agency can ask for corrective measures or even revoke an approved certificate of need, he said.

Rolf Boone: 360-754-5403