Did You Know?
Memorial has a successful history of providing state-of-the-art cardiac care to our community.
- Began offering emergency PCIs in 2001.
- Perform 180 emergency PCIs a year.
- Have two state-of-the-art catheterization labs to perform elective PCI procedures.
- Offer diagnostic, emergency, and rehabilitative cardiac services.
- Median "door-to-balloon" time of 65 minutes -far below the 90 minute national standard.
- Most cardiac doctors treat patient at both hospitals, so the expertise and experience is shared.
Our application is necessary because:
- Yakima County has a higher-than-state-average incidence of heart disease—likely due to high rates of high blood pressure, smoking and obesity.
- Yakima County has among the highest mortality rates due to cardiac disease in Washington State.
- As foreshadowed in the state report, with an aging baby boomer generation, the need for access to cardiac services will continue to increase.
- Over 700 individuals in our area receive PCI treatments each year. It is estimated that nearly 20% of those individuals are traveling to larger metro areas to receive care. We'd like to reduce that percentage and treat more patients locally.
- More people in our community (an average of 60% of patients in 2009 and 2010) choose Memorial for care when suffering a heart attack, arrhythmia, or for placement of pacemakers.
- Currently patients can choose Memorial for their diagnostic or emergency cardiac care. But, if their procedure is not found to be emergent, they must transfer to another hospital for treatment.
- Our community deserves a choice of where they receive this life saving procedure.
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Elective Angioplasty
Yakima Valley Memorial Hospital is thankful of your support of our Certificate of Need application to the Washington State Department of Health (DOH) to provide elective percutaneous coronary intervention (PCI) procedures, otherwise known as elective angioplasty.
The Certificate of Need process ensures that hospitals are planning adequately for growth, but not adding an unnecessary duplication in services. After assessing the procedures needed by residents from our service area (Yakima County, Kittitas County, and the eastern portion of Klickitat County) we believe we meet the State's rigid requirements to begin offering elective angioplasty procedures.
We submitted our application to the Washington State Department of Health (DOH) earlier this year. On December 21st we found out that that the DOH has denied us the Certificate of Need (CofN) to offer elective PCI.
As stated in our message to the public, Memorial is dismayed by the Department of Health's flawed Certificate of Need process and disturbed by the gross incompleteness of the statistics used by the DOH in their calculations. Two major discrepancies exist. We disagree with the base year used for calculating planning area need and the method of counting both inpatient and outpatient PCI procedures.
With trends in heart disease in Yakima County increasing at an alarming rate, Memorial will remain steadfast in pursuing choice for our community. In the coming weeks, we will be making recommendations to the Hospital's Board of Trustees to challenge and appeal this ruling.
To learn more about the need for expanded elective angioplasty in our community, please review the frequently asked questions and previous articles and letters.
Video
View the videos on the left to learn more about Memorial's Certificate of Need application, what it means to Yakima and healthcare in our community.
Frequently Asked Questions
What is PCI?
Percutaneous Coronary intervention (PCI), otherwise known as angioplasty, is a method of restoring blood flow to the heart muscle by reopening clogged arteries. This is often done by inflating a tiny balloon at the site of the blockage, and sometimes putting in a small metal device called a stent to hold the artery open. Experts agree that when a patient is having an acute heart attack, the quicker this happens, the better. The longer blood does not flow to the heart muscle during a heart attack, the more likely there could be permanent damage to the heart.
What is door-to-balloon time?
Door-to-Balloon time is the measurement of the time between when a patient having an acute heart attack comes through the emergency room door to when the balloon is first inflated in the clogged artery and blood flow is restored. The American Heart Association and the American College of Cardiology, along with many other national agencies, recommend that this time interval be no more than 90 minutes. Memorial's median door-to-balloon time is 65 minutes.
Do we need elective PCI at both Yakima hospitals?
In 2008, the Department of Health set very stringent requirements to control elective PCI access in our service area so that patient needs would be met without an unnecessary duplication in services. After assessing resident procedure levels in our service area, we believe Memorial Hospital now meets those requirements and community access should be expanded to multiple hospitals.
How much will expanding this service cost Memorial?
Memorial presently has two fully operational, state-of-the-art cardiac catheterization labs and a fully trained staff for providing emergency angioplasty. Providing this service on an elective basis will not require any additional capital expenditures or training.
How does this affect me?
First, it affects your right to choose the hospital where you receive your heart care. Currently patients can choose to come to Memorial for their heart care, only to be told they need to move to a different hospital, if they need angioplasty, a service we perform regularly on an emergency basis but are prohibited from offering electively.
Second, it reduces stress, inconvenience and cost. Assume you choose to have a diagnostic cardiac procedure done at Memorial and your doctor finds a blockage but determines it is not an immediate threat to your life. Instead of addressing the concern at that time, you will be required to have a similar procedure performed at a different hospital for the blockage to be addressed. Currently while the doctor might be the same, you would need to endure two procedures; two charges; two 24-hour recovery periods; and the procedure will be done at a different hospital than you chose for your initial treatment.
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Memorial and Emergency Angioplasty: News articles and related publications
September 2011
Certificate of Need Laws - The Beginning of the End?
Garvey Schubert Barer Legal Update
Date: September 14, 2011
Description: The Ninth Circuit Court of Appeals decision in Yakima Valley Memorial Hospital v. Washington State Department of HealthMemorial's Effort
Yakima Herald Republic-Letter to the Editor
Date: September 5, 2011
Description: DR. RICHARD D. TWISS clarifies points regarding Memorial offering elective angioplastyCourt sees limit to Wash. state's CON power
Modern Healthcare
Date: August 26, 2011
Description: The Ninth Circuit Court of Appeals decision in Yakima Valley Memorial Hospital v. Washington State Department of HealthAppellate Court Allows Challenge to CON Laws
Medpage Today
Date: August 26, 2011
Description: The Ninth Circuit Court of Appeals decision in Yakima Valley Memorial Hospital v. Washington State Department of HealthCourt Holds Certificate of Need Laws May Be Unconstitutional
JD Supra Legal News
Date: August 22, 2011
Description: The Ninth Circuit Court of Appeals decision in Yakima Valley Memorial Hospital v. Washington State Department of HealthNinth Circuit Holds Washington State's Certificate of Need Law May Place an Undue Burden on Interstate Commerce-Parallel Antitrust Challenge to Law Fails
American Health Lawyers Association E-mail Alert
Date: August 22, 2011
Description: The Ninth Circuit Court of Appeals decision in Yakima Valley Memorial Hospital v. Washington State Department of HealthCertificate of Need Case Raises Questions for Hospitals
Washington State Health Association Bulletin
View Article: (pdf attached)
Date: August 22, 2011
Description: The Ninth Circuit Court of Appeals decision in Yakima Valley Memorial Hospital v. Washington State Department of HealthAppeals court ruling allows Memorial fight to continue
Yakima Herald Republic
Date: August 19, 2011
Description: The Ninth Circuit Court of Appeals decision in Yakima Valley Memorial Hospital v. Washington State Department of HealthLocal hospitals get to the heart of the matter
Yakima Herald Republic
Date: August 2, 2011
Description: Memorial pursues Certificate of Need for elective AngioplastyMemorial Hospital continues in its battle for approval to perform elective heart angioplasties
Yakima Herald Republic
Date: March 26, 2011
Description: Memorial pursues Certificate of Need for elective Angioplasty2010
Memorial still blocked from offering angioplasties
Yakima Herald Republic
Date: May 29, 2010
Description: Federal court rules against Memorial's bid--Memorial is still blocked from performing elective angioplasties.2009
No surprise, Memorial not on the angioplasty list
Yakima Herald Republic
Description: State Department of Health announces that nine new hospitals are approved to add elective angioplasty to their cardiac services-Memorial Hospital is not included on the list.
Date: October 26, 2009Memorial sues state over angioplasty rules
Yakima Herald Republic
Description: Memorial Hospital sues Washington State over angioplasty limitations.
Date: March 24, 20092008
Yakima Regional to keep Monopoly on Elective Angioplasty
Yakima Herald Republic
Description: The state Department of health extends Yakima Regional's monopoly on doctor-advised angioplasties. Memorial is set to challenge this decision.
Date: December 22, 2008Competition by hospitals could be a good thing
Yakima Herald Republic-Editorial
Description: Competition between hospitals could be a good thing. Memorial is still planning to apply for elective angioplasty permissions
. Date: April 20, 2008The heart of the matter
Yakima Herald Republic
Date: April 15, 2008
Description: New state rules may soon allow Memorial to perform elective angioplasties.Letters to the Editor
Description: DR. RICHARD D. TWISS clarifies points regarding Memorial offering elective angioplasty
Date: May 17, 2008
Read Letter
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