Lexington Medical Center can reopen third heart catheterization lab

The battle over heart care in the Midlands continues to showcase the contentiousness of South Carolina’s health care Certificate of Need Program as the future of the program is debated in the Legislature.

State health officials two weeks ago approved Lexington Medical Center’s request for a certificate of need to open a third heart catheterization lab. The decision comes less than a year after courts ruled that lab shouldn’t have been opened when the review program that assessed duplication in services was shut down for lack of funding. Lexington still faces a challenge on the lab because Providence Hospitals is appealing the approval.

The Lexington-Providence battle likely will be among the topics brought up in an expected Certificate of Need floor battle in the S.C. House this week. The S.C. Department of Health and Environmental Control already has approved regulations that weaken the program’s restrictions. Rep. Murrell Smith, R-Sumter, led a long effort to fix the program and now wants to kill it altogether. One bill being considered would allow the program to continue for now with a sunset clause to kill it in five years.

The future of the program is murky at best, sort of like it was in 2013. Then Gov. Nikki Haley had vetoed funding for the program and DHEC director Catherine Templeton had told to healthcare executives to proceed as if there were no program.

Several health care entities filed suits, claiming Haley couldn’t shut down a legislatively required program simply by not funding it. Meanwhile, other entities, such as Lexington Medical Center, decided to go ahead with expansion plans without going through the process. The S.C. Supreme Court ruled in April 2014 that only the Legislature could end the program. By that time, Lexington had opened a second open heart surgery unit and a third cath lab.

An administrative law court judge in September ordered Lexington to shut down both of its new additions until it received full approval. Lexington finally gained that approval on April 14 for the cath lab. The hospital hasn’t yet asked for a certificate of need for the second open-heart surgery unit, according to hospital spokeswoman Jennifer Wilson.

“While Lexington Medical Center is clearly pleased that the hospital’s request for a third cardiac catheterization lab has been approved, the process of getting there demonstrates that South Carolina’s current CON laws are flawed and need to be changed,” Wilson said. “The laws create unnecessary steps in hospitals’ efforts to add facilities that will clearly benefit patients.”

The program originally was designed to prevent duplication of medical services and equipment that drives up costs and dilutes quality. Providence, long a leader in heart surgery in the state, and Lexington fought for years over Lexington’s request to open a first open heart surgery unit. In 2009, Providence agreed to drop its challenge if Lexington dropped its objection to Providence’s expansion of its hospital in Northeast Richland. Lexington also paid Providence $15 million, and Providence de-licensed one of its cardiac operating rooms to grant that capacity to Lexington.

This story was originally published April 28, 2015 at 8:16 PM with the headline "Lexington Medical Center can reopen third heart catheterization lab."