Central Kentucky hospitals are adding beds designed to care for the sickest of babies, patients with often long and expensive stays.
The state regulates the number and type of hospital beds through a certificate of need process to protect against an overabundance of any specific type of medical care.
The state health care plan was revised in May by the Department of Health and Family Services. It allows more beds for the sickest babies and adds a new designation for the most intensive level of care, said Diona Mullins, policy advisor for the state office of health policy.
There had been three levels of NICU beds and now there are four, explained Mullins. The state plan was adapted to improve the overall level of care for these babies, she said.
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In Lexington, Central Baptist Hospital and St. Joseph East have each applied to the state to upgrade some of their Level II beds to Level III. Central Baptist has applied to the state to change 16 of 24 NICU beds to Level III. St. Joe has applied to change 8 of 16 NICU beds to Level III.
The University of Kentucky also has applied to change 20 of its current Level III NICU beds to the new Level IV designation. UK has a total of 66 NICU beds.
The state will make a decision on those requests in August, and Mullins said all the changes requested seem to be in line with the state's revised health care plan.
The Level III beds will help keep expectant mothers from having to be transferred from St. Joe to UK if complications arise and will also allow families with at-risk births to plan ahead, said Denise Hundley, administrator of Women's Service Lines for KentuckyOne Health, which operates St. Joe's.
Who should care for these babies became a point of public debate in 2011 when St. Elizabeth Hospital in Edgewood in Northern Kentucky petitioned the state for permission to open a 12-bed NICU.
Dr. Michael Karpf, UK executive vice president for health affairs, told the Herald-Leader in 2012 that UK was "on the side of the angels" in opposing the move because UK had the appropriate specialists on staff to treat Kentucky's sickest babies.
The state originally denied St. Elizabeth's request but that decision was overturned and approval for the project was given earlier this month.
Kristi Lopez, a spokeswoman for UK Healthcare, said UK will not oppose the plans of St. Joe or Central Baptist to add Level III beds.
She said UK used research on pre-term birth to determine how many of UK's existing NICU beds should be designated Level IV to care for the most vulnerable babies.
In its application to the state, UK said that because premature birth rates appear to be stabilized, adding the Level IV beds will allow the hospital to add only about 15 additional patients in the first two years.
But Dr. Ruth Shepherd, director of the state's Division of Maternal and Child Health, said NICU beds also serve infants with significant health problems unrelated to premature birth.
According to UK's application to the state, average cost per day per patient is $5,348 and the average stay in a Level III bed is 44 days.
Hundley said the average stay for KentuckyOne Level II beds is 9 days and the average stay will grow as sicker babies are treated at St. Joe.
Mullins said Kosair Children's Hospital in Louisville has also applied to change 30 Level III beds to Level IV. (Norton has a total of 97 NICU beds.)
Level IV care requires a variety of specialized pediatric medical personnel to be readily available, Mullins said. Norton and UK are among the few hospitals in the state that can support that level of care.
Though St. Joe has a state of the art facility, there are no plans to compete with UK or Kosair for Level IV care, Hundley said.
"We acknowledge that UK and Kosair have that ability and respect their area and their territory," she said.