Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-261 - Open heart surgery standards and need forecasting method

Current through Register Vol. 24-14, July 15, 2024
(1) Open heart surgery means a specialized
				surgical procedure (excluding organ transplantation) which utilizes a
				heart-lung bypass machine and is intended to correct congenital and acquired
				cardiac and coronary artery disease.
(2) Open heart surgery is a tertiary service
				as listed in WAC
				246-310-020. To be granted a
				certificate of need, an open heart surgery program shall meet the standards in
				this section in addition to applicable review criteria in WAC
				246-310-210,
				246-310-220,
				246-310-230, and
				246-310-240.
(3) Standards.
(a) A minimum of two hundred fifty open heart
				surgery procedures per year shall be performed at institutions with an open
				heart surgery program.
(b)
				Hospitals applying for a certificate of need shall demonstrate that they can
				meet one hundred ten percent of the minimum volume standard. To do so, the
				applicant hospital must provide written documentation, which is verifiable, of
				open heart surgeries performed on patients referred by active medical staff of
				the hospital. The volume of surgeries counted must be appropriate for the
				proposed program (i.e., pediatric and recognized complicated cases would be
				excluded).
(c) No new program shall
				be established which will reduce an existing program below the minimum volume
				standard.
(d) Open heart surgery
				programs shall have at least two board certified cardiac surgeons, one of whom
				shall be available for emergency surgery twenty-four hours a day. The practice
				of these surgeons shall be concentrated in a single institution and arranged so
				that each surgeon performs a minimum of one hundred twenty-five open heart
				surgery procedures per year at that institution.
(e) Institutions with open heart surgery
				programs shall have plans for facilitating emergency access to open heart
				surgery services at all times for the population they serve. These plans
				should, at minimum, include arrangements for addressing peak volume periods
				(such as joint agreements with other programs, the capacity to temporarily
				increase staffing, etc.), and the maintenance of or affiliation with emergency
				transportation services (including contingency plans for poor weather and known
				traffic congestion problems).
(f)
				In the event two or more hospitals are competing to meet the same forecasted
				net need, the department shall consider the following factors when determining
				which proposal best meets forecasted need:
(i) The most appropriate improvement in
				geographic access;
(ii) The most
				cost efficient service;
(iii)
				Minimizing impact on existing programs;
(iv) Providing the greatest breadth and depth
				of cardiovascular and support services; and
(v) Facilitating emergency access to
				care.
(g) Hospitals
				granted a certificate of need have three years from the date the program is
				initiated to establish the program and meet these standards.
(h) These standards should be reevaluated in
				at least three years.