While UKHealthCare officials say they can prove their hospital needs 120 more beds, they admit there is the possibility that other regional hospitals won't agree.
"The potential terrible PR problem is that the financial viability of a community hospital may be at stake," said David Hawpe, a member of the health committee of the University of Kentucky Board of Trustees. The health committee met Thursday. The full board of trustees meets Monday.
Hawpe said he supports adding the 120 beds, but it could be tough to convince neighboring community hospitals that UK isn't trying to put them out of business, he said.
Permission to add the beds must be acquired from the state through a months-long certificate of need application process. Other hospitals and anyone receiving health care in Fayette County or contiguous counties can ask for a hearing on UK's application.
UK consistently fills more than 75 percent of its beds, said James Zembrodt, director of strategic planning. That is the level required by the state before expansion can be considered. But, he said, UK is the only hospital in the 17-county Bluegrass Area Development District that regularly meets that level of capacity.
While UK aims to take care of the sickest, most complicated patients, a large number of patients at the hospital don't require that level of care, said Barbara Young, chairwoman of the health committee. She said she was "playing devil's advocate" in asking whether that fact opens the door for other hospitals to make the argument that the UK expansion isn't needed.
"They could say, 'Hey, that's too much,'" said Colleen Swartz, chief nurse administrator.
But Dr. Michael Karpf, UK vice president of health affairs, said he didn't think it was valid argument. UK isn't taking routine patients away from smaller hospitals, he said — rather, UK is creating access to top-level care for patients those hospitals can't adequately treat.
"We are not going after their gallbladders" Karpf said, referring to a fairly routine surgery.
University of Kentucky President Eli Capiluto, who attended the Thursday meeting, said relationships between smaller hospitals and UK create a comprehensive health care system in line with the goals of the federal Affordable Care Act. He said this is positive for the community hospitals.
Karpf made the announcement that UK was seeking the 120 beds in an Aug. 31 Op-Ed in the Lexington Herald-Leader, in which he said the new beds were the only way to alleviate UK's average wait time in the emergency room. The average wait time of 10 hours, 44 minutes, is the longest in the state.
The additional beds were not discussed at day-long June board retreat, and Karpf kept conversation Thursday to a minimum, twice telling Swartz and Zembrodt that they had only minutes to make their presentations on the issue. The wait times at the hospital were not specifically addressed at Thursday's meeting.
UK has until Oct. 1 to file its formal application for the additional beds. "Affected parties," defined by state law as anyone who gets health care in the geographic area served by the hospital; other facilities that provide similar care; or third-party payers such as health insurance companies may request a public hearing about the need for the beds. The deadline to do so would be Dec. 5.
Zembrodt said other criteria for getting the certificate of need include quality of care, but UK has never had a application denied on that issue.