ATTORNEY GENERAL IS KEY TO HOSPITAL PLAN

A good deal is resting on a decision from the Missouri attorney general's office regarding the proposed merger of Southeast Missouri Hospital and St. Francis Medical Center in Cape Girardeau. With last week's announcement that the St. Francis president and chief operating officer is leaving soon for Iowa, the Jefferson City decision is even more weighty.

Representatives of both hospitals have known all along that any time a merger is proposed between medical facilities in the same community, there are enormous and numerous hurdles to cross. Among them is being able to show that the merger would be beneficial to those seeking hospital treatment in the future. Based on an analysis of hospital services that currently are duplicated, plus a commitment in the merger plan to freeze costs, there are good indications that the merger would produce both more efficient services and competitive costs.

It is a given that the U.S. Department of Justice takes great interest in hospital merger plans. In many cases, such plans -- even those with strong community support -- are routinely challenged in court. Just recently, a planned merger between two Poplar Bluff hospitals was rejected by a federal judge after a Justice Department challenge.

However, whenever a state's attorney general works out an agreement in these situations that is likely to produce benefits to a community, the Justice Department rarely intervenes. That is why a hearing by staff members from Attorney General Jay Nixon's office, held last year, was so crucial.

Hospital representatives have continued to work with the folks in the attorney general's office since that hearing. No doubt, there have been requests to modify the merger plan that was made public at the time of the hearing. Now hospital representatives believe the attorney general is on the verge -- perhaps as soon as a week from now -- of announcing his decision.

There is a high degree of anticipation that the attorney general will look favorably upon whatever agreement has been worked out. It would be natural to assume that any such agreement would be good news for future hospital services as well as costs in Cape Girardeau.

And, of course, this decision will have a significant bearing on how St. Francis handles the resignation of CEO James Sexton, who is leaving to become president and CEO of North Iowa Mercy Health Center and Network in Mason City, Iowa.

The hospital's capable vice president of human resources, Don "Dusty" Rhodes, has been named as interim CEO. If the merger plans can be concluded quickly -- within a matter of weeks -- there would be no need to go through a full-blown search and hiring process for someone to lead St. Francis.

Many individuals, businesses and organizations have indicated their support for the merger plan. There also has been some stiff opposition. Because of this dynamic, the final plan is likely to be more favorable to health-care consumers. And, with the attorney general's blessing, the merged hospital system would place Cape Girardeau on an even higher level of medical delivery for a wide area between St. Louis and Memphis.