The number of hospital beds reserved for Kentucky's sickest newborns will remain the same, for now.
Officials with the state Cabinet for Health and Human Services denied a request by St. Elizabeth Healthcare in Edgewood, in Northern Kentucky, to open a 12-bed intensive-care unit for premature infants. St. Elizabeth has fought for more than a year to open the unit, which would provide ventilation and other services to babies born between 28 and 32 weeks of gestation.
UK Healthcare in Lexington opposed the application.
The state denied St. Elizabeth's application Wednesday, arguing that there wasn't a need for more neonatal beds at St. Elizabeth because the services are available elsewhere in the state.
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St. Elizabeth isn't the only hospital that wants to care for these patients.
Lexington's Central Baptist Hospital had made preliminary plans to convert as many as 24 neonatal beds from Level II to Level III, the most complex level of care. Central Baptist filed the letter of intent with the state on Feb. 24, 2011. That's the first step in the process to file an application for a certificate of need, the state approval required to add or change the use of beds in a health care center.
Central Baptist spokeswoman Ruth Ann Childers said Friday that the hospital, which delivers the second-highest number of babies in the state, has not decided whether to proceed with the plans.
UKHealthCare, which has 58 of the Level III beds, opposes both moves. It argues that neither hospital has the resources to serve the sickest of sick infants.
"The judgment was appropriate," Dr. Michael Karpf, the University of Kentucky's executive vice president for health affairs, said Friday. He said these ill infants need care by pediatric specialists who are available at UK but not at other hospitals.
There are more of these babies to treat. Across the country, there has been an increasing number of premature births as more women schedule Caesarian deliveries and inadvertently cause an early delivery. Nationwide, 12 percent of births are premature. In Kentucky, health officials say, the number is 15 percent.
According to statistics from the Kentucky Chapter of the March of Dimes, $210 million is spent annually to care for premature babies. According to UK, 742 babies were discharged from its neonatal intensive-care unit last year, and the average stay in a Level III bed is 44 days. The average cost is $89,000.
Karpf said the St. Elizabeth decision isn't likely to bring more babies to UK. "We never anticipated mothers coming from Northern Kentucky," Karpf said. "This is not about mothers from Northern Kentucky coming to us. It's about what is right for babies."
"As far as I am concerned we are on the side of the angels here," he said.
John Dubis, St. Elizabeth's chief executive, agrees that the primary focus is helping sick babies but disagrees that his hospital shouldn't treat them.
"This is not a business decision. The women and families in Northern Kentucky have asked us repeatedly" for the service, he said. "The real loser here is not St. Elizabeth Healthcare; it's the babies."
He said he was "mystified" at the decision because the bulk of the state's review seems to support the position of St. Elizabeth.
The fight isn't over, he said. The hospital can appeal to the state or to the courts. "We haven't had a chance to digest all of the information," he said Friday. "We will be pursuing this. We will be vigorously pursing it."
The neonatal beds would have been added at the 486-bed St. Elizabeth Healthcare in Edgewood and could reduce the considerable risk that comes with transporting premature babies to other hospitals, he said.
Although Cincinnati Children's Hospital is not far, it can take two hours to assemble the team and arrange transportation of a sick baby there, not to mention the problem of traffic on Ohio River bridges dividing the two hospitals.
The St. Elizabeth system has six locations, 1,200 beds and 7,300 employees, he said, and St. Elizabeth Healthcare tends to 5,000 births a year.