CLARKSBURG -- United Hospital Center may be among those West Virginia institutions vying for a chance to offer open heart surgery.

"We have to have our planners crunch numbers," said Bruce Carter, UHC president and chief executive officer. He said it may be January before hospital officials know if they can present a viable bid for a certificate of need.

Carter, who said UHC's attempt to offer such surgery was rejected under old state standards eight years ago, believes the hospital may qualify under new standards proposed by the state Health Care Authority Tuesday. UHC already performs diagnostic heart catheterizations and non-surgical cardiac care.

As part of a Legislature-ordered rewrite of the state health plan, the authority released the proposal to the governor this week. He has 30 days to approve, reject or amend it, according to Louie Paterno, a board member of the regulatory agency.

While Carter suspects UHC could easily meet the minimum caseload of 200 surgeries per year within three years of opening that a partnered hospital must have, proximity to other open heart programs could still be a problem. The new plan requires qualifying hospitals to not have a detrimental effect on the open heart caseload of other programs within a two-hour area.

Both Ruby Memorial and Monongalia General hospitals in Morgantown offer open heart surgery. Three other programs in the state are at Charleston Area Medical Center, St. Mary's Hospital in Huntington and Wheeling Hospital.

UHC's proximity to the Morgantown programs may particularly complicate its pursuit, given the fact it is partnered with Ruby through the West Virginia United Health System.

"They (system) would be pursuing the CON (certificate of need)," said Carter. "It could be a negative impact on yourself."

While he expects a spirited discussion to continue for some time, Carter believes large community hospitals such as Clarksburg should be allowed to do open heart procedures as a matter of keeping up with modern medical standards.

"It's (open heart surgery) no longer the big, black box that it was 25 years ago when it was only done in huge centers," Carter said.

John Law, spokesperson for the state Hospital Association, agreed.

"You have to look at where people need health care services," said Law of the association's official stand. It represents hospital interests statewide.

Money is another issue, Carter said. Open heart surgery would be a definite financial boost to almost any large community hospital.

"It's a case of the outs looking in and the ins wanting the outs to stay out," Carter said, adding the authority has done a good job of holding a middle ground. "It'd be a great subject for a high school debate class. I could do two hours on either side."

Charleston Area Medical Center currently has the second highest open heart caseload in the nation, Carter said, primarily because so few West Virginia hospitals are in the game.

Profitable programs have become highly desirable since 1997's federal Balanced Budget Act. The act limited the amount of reimbursements for Medicaid and Medicare patients to levels hospital officials say are below costs.

West Virginia hospitals overall lost $80 million in 1999 and 12 state hospitals have lost money for two years in a row, according to the Hospital Association. UHC was not among those with negative balances.

Paterno said the first step in pursuing one of the open heart slots is to send a letter of intent to the authority. UHC has yet to do so.

The road to actual operations may be a slow one, he added, involving lengthy hearings. He anticipates it will be at least a year before a new program could be up and running.

Regional editor Nora Edinger can be reached at 626-1403 or by e-mail at nedinger@exponent-telegram.com.