HEALTH FACILITIES REVIEW PANEL DOESN'T ACT ON ST. FRANCIS MRI PURCHASE

Missouri's Health Facilities Review Committee took no action regarding St. Francis Medical Center's decision to purchase an MRI system the hospital had been leasing for several years.

The committee met Monday in Jefferson City to discuss the purchase.

At issue was whether the hospital could purchase the system on its existing Certificate of Need, which was issued in 1989, or whether a new certificate would have to be issued.

Hospital officials argued that the original Certificate of Need was issued for a lease-purchase of the MRI system, and they simply exercised the purchase option.

Cost of the system was $850,000 through 1995 plus $895,000 for the purchase. The hospital's request for a new Certificate of Need to purchase a new MRI system was denied in October. The MRI now in place has been in use since 1990.

Tom Piper, administrator of the Certificate of Need program, said committee members determined the purchase did not qualify as a capital expenditure, one of the items for which a certificate is required. "That means it's not reimbursable by third-party payers such as Medicare or Medicaid," Piper said.

"We were being asked to look at it and see whether it was a capital expenditure or a cost overrun," said John Kimmons of Moberly, one of the members of the committee. "I don't think it came in under either one of those categories."

Certificates of Need are issued for equipment purchases of more than $400,000, capital improvements of more than $600,000, or the addition of long-term care beds. Expenditures must relate to direct patient care.

"It's our understanding that the review committee's consensus was that this was a St. Francis issue that does not require the committee's action," said Jay Wolz, a spokesman for the hospital.

"In essence, the committee agreed with our position that the purchase of the MRI was within the parameters of the original Certificate of Need."

Wolz said administrators have also decided to hold off deciding on whether to resubmit the application to purchase a second MRI until after new guidelines are introduced regarding equipment purchases.

Piper said a Certificate of Need technical advisory council was formed in September to draw up those new guidelines.

"It involves almost 50 experts from around the state who have given us feedback from six different teams on items that we deal with," he said.

Teams have been formed to study such topics as hospital bed additions, diagnostic equipment, invasive procedures and imaging equipment.

The advisory council will provide "real-world feedback in terms of what is reasonable, what is feasible, what can be predicted, the kinds of questions the committee needs answered so they can make their decisions," Piper said.

The six teams will meet March 6 to integrate their reports into a single final document, which will then be presented to the Health Facilities Review Committee on April 1, he said.

The committee will then review the report and decide whether to adopt the guidelines, Piper said.