SURGERY CENTER APPLICATION WITHDRAWN

Investors in a Cape Girardeau ambulatory surgery center are contemplating their next step after withdrawing an application for a certificate of need for the center at the last minute.

The application for the Mississippi Valley Surgery Center, a $5.6 million project, was withdrawn moments before the Missouri Health Facilities Review Committee was to meet Monday morning.

The committee reviews and grants or rejects all proposals for certificates of need.

An investor, Dr. August Ritter III, said the committee's decision in July to reject an application for an ambulatory surgery center in Jefferson County prompted the investors' decision to withdraw their application.

In the Jefferson County case, the committee counted all the operating rooms available in the area, "not just ambulatory surgery centers," said Ritter.

Investors had understood that only operating rooms in ambulatory surgery centers would be counted.

"We weighed that very heavily, and after talking to all our members this weekend we decided to withdraw the application," Ritter said.

James Wente, administrator of Southeast Missouri Hospital, and James Wente, president and chief executive officer of St. Francis Medical Center, had raised the issue of the number of operating rooms when the Mississippi Valley center was first proposed.

Mississippi Valley's application called for six operating rooms. The three existing surgery centers in Cape Girardeau have a combined total of nine operating rooms, and the hospitals have a combined total of 26 operating rooms.

Mississippi Valley investors said the population of the service area would accommodate 6.6 more outpatient operating rooms.

But Wente and Sexton said their calculations did not include the hospitals' operating rooms, which are not dedicated for either inpatient or outpatient surgeries.

Harvey Tettlebaum, an attorney representing the group of some 19 physicians investing in the ambulatory surgery center, presented to the committee a letter stating the application was being withdrawn "without prejudice."

A group of about a dozen people -- including the administrators of both Cape Girardeau hospitals -- were at the hearing Monday morning in Jefferson City to voice their opposition to the application. Neither Wente nor Sexton would comment on the withdrawal.

"I'm not sure what this means," Sexton said.

Ritter said he doesn't know what will happen next with the project.

"We're going to be talking to people, but we don't know what the next step will be right now," he said.

Rose Brower, chairman of the review committee, apologized to the group of opponents who had traveled to Jefferson City for the hearing.

"I have personally spent a lot of time going through the application," Brower said, adding the group had "the full apologies of the committee."

Ritter and Dr. William Kapp III, both orthopedic surgeons, had argued that the surgery center would be more cost competitive than the Cape Girardeau hospitals for outpatient surgical services. They said the hospitals would offer discounted rates or cut charges for services to prevent some patients from going to St. Louis or other areas for outpatient surgeries.

Wente and Sexton contended that the proposed center would take surgeries away from the two hospitals -- approximately half of St. Francis' outpatient surgeries -- and was unnecessary, given the number of operating rooms in the region.