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Rendering of one of the new cardiac cath labs Northwell Health is planning to build in Riverhead. Artist's rendering: Peconic Bay Medical Center

Uncertainty over East End cardiac cath lab location continues, with two sites again recommended to commissioner

The location of a future cardiac catheterization facility on the East End remains up in the air.

The New York State Public Health and Health Planning Council today sent that decision to the desk of Commissioner of Health Dr. Howard Zucker with a recommendation that both Southampton Hospital and Peconic Bay Medical Center be granted permission to build and operate a cardiac cath lab.

Council members seemed unable to decide which location would better serve the East End region and focused on the potential fiscal impacts a cardiac catheterization facility at Peconic Bay Medical Center would have on Southampton Hospital.

Peconic Bay Medical Center in Riverhead, part of the Northwell Health System and Southampton Hospital in Southampton, soon to become part of a health system centered around Stony Brook University Hospital, have competing applications for the cardiac catheterization facilities.

Recommending both for approval — mimicking the action last month of the council’s review committee — is an unusual step, but council members voiced concerns about approving one site over the other. Among them: the impact on the long-term fiscal viability of one hospital — specifically Southampton.

Health Department staff recommended only Peconic Bay Medical Center be approved for the facility. The committee on Nov. 17 disregarded that recommendation and instead recommended that both PBMC’s and Southampton’s applications be approved.

Health Department staff members reiterated their reasons for recommending PBMC for the facility.

“The department stands by its recommendation for approval of Peconic Bay’s application and disapproval of Southampton’s primarily because of location,” staff member Charles Abel told council members.

Council member Dr. John Rugge, CEO of Hudson Headwaters Health Network, voiced concern over fiscal impacts on Southampton Hospital if its application is denied in favor of Peconic Bay’s.

“If the Peconic application is denied, there will be no financial impingement on the viability of Northwell,” Rugge said. “If the Southampton application is denied, will that have a damaging impact on the viability of that system in an area that Northwell doesn’t serve?”

A consultant to Southampton Hospital told the committee last month choosing PBMC as the site for the East End “will do great harm to Stony Brook University Hospital, Southampton Hospital, Eastern Long Island Hospital and Brookhaven Hospital.” Consultant Frank Cicero said it would result in the loss of $25 million in annual revenue to the other hospitals collectively — $18 million in annual revenue losses to Stony Brook alone, he said.

Health Department staff member Daniel Sheppard said the health department must evaluate the applications “in the context of the current regulations” and “it was a very difficult decision.”

The regulations require the department to examine the impacts in terms of quality of care — a minimum of 300 acute cases per year is required, Abel said. The department determined that the East End generates about 312 acute cases per year. That’s not enough to sustain facilities at two sites, he said.

Rugge said the council’s “review needs to be broader” and should consider the impact of the decision on other providers. “We have the prerogative to come to a different conclusion,” Rugge said.

Sheppard stressed the geographic consideration, not just in terms of mileage — though he noted that Riverhead is located where the twin forks join together — but also in terms of where the demand for the services exists.

“When you look at the utilization for these services… Riverhead is more centrally located for the majority of the people in need. Not to take anything away from the folks on the South Fork, but the South Fork makes up about a third of the need,” Sheppard said.

“It’s an analysis of location of need.”

Peconic Bay Medical Center is proposing to build a catheterization/electrophysiology suite with two catheterization labs and a nine-bay prep and recovery area within a three-story addition near the existing emergency department, complete with a rooftop helipad, at an estimated cost of more than $42.6 million.

Southampton Hospital is proposing one catheterization operating room with a price tag of between $750,000 and $850,000.

Eastern Long Island Hospital in Greenport, which like Southampton is becoming part of a new Stony Brook health system, supports locating the facility in Southampton rather than in Riverhead.

The time frame for the commissioner’s decision could not be immediately ascertained.

The council met today in New York City. Its proceedings were webcast live.

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