St. John's Mercy Loses Bid to Stop New Patients First Hospital

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St. John's Mercy Health System lost in today's ruling, which will allow a competitor to build a new facility in St. Louis County.
The area's largest Catholic hospital system, St. John's Mercy Health System, has lost its bid to change the way new health care facilities are permitted in Missouri -- and, not so coincidentally, stop a competitor from constructing a new facility in St. Louis County.

St. John's Mercy had sought to block the state from approving the new facility, to be called Patients First Community Hospital, or Patients First. (It's part of a growing group headquartered in Washington, Missouri.) But the appeals court rejected the hospital's arguments in an opinion released this morning.

The state has long required new health care facilities to obtain a "certificate of need" showing their services are needed -- but, since 1996, it's exempted facilities costing less than $1 million from that process. Pointing specifically to Patients First's plans to build a new three-bed facility in St. Louis County, St. John's Mercy had challenged that exemption as unfair.

The Patients First facility was to cost $953,750 -- slipping right under the line in which a certificate of need would be required.

The opinion, penned by the Court of Appeals Eastern District's Chief Justice Kurt S. Odenwald, finds that St. John's Mercy had standing to challenge the exemption. But, as Odenwald writes, the hospital system ultimately failed to show why the exemption should not stand.

St. John's Mercy had argued that the exemption wasn't valid because it conflicted with a different regulation requiring all new hospitals to get a certificate of need. But Odenwald suggests that argument is silly on its face:

"[L]ogically, we can only conclude that had the legislature intended for all new hospitals to require a certificate of need, there would have been no reason for the 1997 amendment," he writes. "We do not presume the legislature to enact meaningless provisions."

We're not quite sure why Odenwald is so optimistic when it comes to the Missouri Legislature. (Really, has he seen the silliness coming out of there lately?) But surely, today's ruling is good news for health-care consumers. Since when is competition such a terrible thing?

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Snoozie
Snoozie

I believe if they bring costs under $1,000,000 they don't need a certificate of need, and then later they can add on whatever they want to add. It's a way to get around the certificate requirement, and everyone knows that's what they're doing.

KittyLitterKing
KittyLitterKing

That's pretty much the case in a nutshell.  St. John's (and other facilities around the state) are trying to keep the competition out.  And Patients First is trying to use a loophole to avoid the Certificate of Need requirement.

More shocking:  Did an RFT writer just encourage free markets?  For health care, even??

jinx
jinx

Certificates of need should be waived in any instance that involves a hospital that refuses medical services or procedures to patients based on so-called moral principles.

Mike N.
Mike N.

"Pointing specifically to Patients First's plans to build a new three-bed facility in Washington"  Is it really just three beds or is that a typo?  (I'm thinking maybe an urgent-care type place could be considered three beds?)

Sarah_Fenske
Sarah_Fenske

Nope, the three-bed part isn't a typo -- based on my (very limited!) research, it appears these Patients First facilities are more like clinics and urgent cares than what we think of as hospitals.

That said, I did confuse one thing: the facility in question was proposed for St. Louis County -- it's the company as a whole that's headquartered in Washington, Missouri. Hopefully that now makes more sense...

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