The next stop in the fight over whether Hackensack University Medical Center should be allowed to reopen Pascack Valley Hospital will be the Appellate Division of Superior Court, after a ruling Monday from state Superior Court Judge Peter E. Doyne.

Doyne declared that the proper jurisdiction for determining if the state’s Permit Extension Act of 2008 applies to the Westwood hospital license is the Appellate Division, not Superior Court.

That appeal could take as long as a year — and it would center solely on whether the deadline for reactivating the license could be extended beyond last Dec. 28, not on whether Hackensack’s application to do so should be approved.

The two hospitals opposed to reopening the Westwood hospital considered Monday’s ruling a victory. The longer the region goes without a hospital in Westwood, the harder it will be to prove that one is needed, they say.

“A new and unnecessary hospital only serves to weaken” the health care system in Bergen County, said Megan Fraser, a spokeswoman for The Valley Hospital in Ridgewood. “Since it opened its doors almost 60 years ago, Valley has welcomed patients from the Pascack Valley area.”

Englewood Hospital and Medical Center said through its spokeswoman that “Our dedicated physicians, nurses and other staff members have been providing uninterrupted, high-quality care to surrounding communities since [Pascack Valley Hospital] closed, and we continue to assist local towns, expand outreach efforts and provide more health care services to these communities.”

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Bergen County’s chief assignment judge ruled today that Hackensack University Medical Center must go to the state Appellate Division in Trenton with its effort to apply the Permit Extension Act to the hospital license at the former Pascack Valley Hospital in Westwood [download PDF of ruling from http://www.judiciary.state.nj.us/decisions/].

The state Health Commissioner issued a decision in December saying that the act, intended to help developers through the recession, did not apply. In her letter to Hackensack’s attorneys, she told them they could appeal her decision to the Appellate Division.

But Hackensack, which has applied for permission to transfer the hospital license and reopen the facility as a 128-bed community hospital, did not appeal. The case revolves around the Dec. 28 expiration date of the hospital license, two years after the hospital officially closed.

Without the extension, Hackensack’s application to reopen the hospital is moot.

Hackensack’s lawyers argued that the case properly belonged in Bergen County Superior Court.

Opponents of the hospital’s reopening, The Valley Hospital in Ridgewood and Englewood Hospital and Medical Center, disagreed. They asked the court to transfer the case to the Appellate Division.

Judge Peter E. Doyne ruled today that “jurisdiction properly reposes with the Appellate Division.”

He did not comment on the question of whether the permit extension act applies or not, but limited his decision to which court had jurisdiction.

“One is compelled to wonder whether the interests of Bergen County residents are best served by mandating the licensing process start anew,” he wrote. But that, he wrote, “is beyond the province of this court.”

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The Valley Hospital and Englewood Hospital and Medical Center: Statements about Permit Extension Act Opinion

VALLEY HOSPITAL: We are pleased that Judge Doyne reinforced the findings of the former Commissioner of the Department of Health and Senior Services, and that he agreed with our position that any future proceedings on this matter are more appropriately handled by the Appellate Division.

We continue to believe that the best interests of Bergen County residents will be served by having the strongest possible healthcare system, and a new and unnecessary hospital will only serve to weaken that system. For more than two years, we have been proud to care for thousands of patients from the Pascack Valley area, as well as offer a growing number of community health education programs and screenings.  We pledge to continue our efforts to enhance our programs and services to best meet the needs of all residents of the Pascack Valley community.

EHMC: We agree with Judge Peter E. Doyne’s ruling that HUMC must go to the state Appellate Division in Trenton to continue its proceedings and efforts regarding the Permit Extension Act.

Englewood Hospital and Medical Center continues its unwavering commitment to serve the residents of the Northern Valley, as it has for 130 years.  Our dedicated physicians, nurses and other staff members have been providing uninterrupted high quality care to surrounding communities since PVH closed, and we continue to assist local towns, expand outreach efforts and provide more healthcare services to these communities, as we have with our new ER and ambulance services.

A hearing to determine whether the legal battle to extend Pascack Valley Hospital’s license should be considered in the Law Division of the Superior Court of Bergen County or the Appellate Division in Trenton, originally scheduled for Jan. 22, has been postponed until Feb. 5 at the request of Hackensack University Medical Center (HUMC).

The lawsuit was filed by HUMC’s attorney, William Harla of DeCotiis, FitzPatrick, Cole & Wisler, against the health department and two hospitals opposing Hackensack’s plan, The Valley Hospital in Ridgewood and Englewood Hospital and Medical Center, It seeks to prove that the license was automatically extended by the Permit Extension Act. The 2008 law was sponsored by state Sen. Paul Sarlo and designed to help development projects stalled during the recession.

The hospital’s license expired on Dec. 28 after a two-year extension granted by the previous state health commissioner when the hospital went bankrupt and closed in 2007.

The suit was pending before the Law Division in Hackensack before Valley filed a motion to transfer the case. The health department has filed a brief siding with Valley and Englewood, arguing that it belongs in the Appellate Division. Englewood’s lawyers have also filed a motion supporting the case’s transfer.

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The state Department of Health has joined opponents of the reopening of Pascack Valley Hospital in arguing that the legal effort to extend the hospital’s license belongs not in state Superior Court in Bergen County but in the Appellate Division in Trenton.

A hearing on the issue, originally scheduled for next Friday before Judge Robert C. Wilson in Bergen, has been postponed until Feb. 5 at the request of Hackensack University Medical Center, which wants to reopen Pascack.

HUMC contends that the Permit Extension Act of 2008, intended to help developers whose projects were stalled by the recession, applies in the case of the Westwood hospital.

The hospital’s license expired on Dec. 28, after a two-year grace period allowed by the previous state health commissioner when the hospital went bankrupt and closed.

Hackensack says the permit act automatically extends the license until Jan. 1, 2011.

Hackensack, which bought the facility at auction, has applied to the state Health Department for approval to reopen it as a 128-bed community hospital. The license must be extended for its application to be considered.

The Valley Hospital in Ridgewood and Englewood Hospital and Medical Center oppose the plan, arguing that Bergen County already has enough hospital beds and that the reopening would cause harm to the others.

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Nearly half the state’s hospitals have laid off workers, many have reduced services and most are treating growing ranks of patients who can’t or won’t pay, according to a survey by the New Jersey Hospital Association.

“Just like other businesses, hospitals continue to feel the economic pressures of the recession,” said association president Betsy Ryan. “But unlike other businesses, hospitals can’t simply adjust by reducing their output or cutting back on hours.”

Englewood Hospital and Medical Center and Hackensack University Medical Center reported layoffs last year. Englewood laid off 24 workers in November. Hackensack announced a cut of up to 125 positions in September.

Nearly a fourth of hospitals surveyed curtailed services, including eliminating pediatric programs and behavioral health services. These were in addition to the cuts in care made by 17 percent of the responding hospitals in 2008.

More than half the state’s 73 acute-care hospitals responded in December to the association’s second annual economic impact survey.

“The economic outlook will continue to stress New Jersey hospitals for some time,” said Englewood Hospital and Medical Center spokeswoman Maria Margiotta. “This only strengthens arguments opposing the reopening of an acute-care hospital in Westwood.”

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With the former Pascack Valley Hospital license expired, Hackensack University Medical Center (HUMC) should expand the services offered at its satellite emergency department in Westwood. Using a model popularized in northern Virginia of having freestanding emergency centers with the ability to treat some life-threatening conditions along with additional outpatient services is more beneficial to residents than a for-profit hospital.

The state issued a report last year called The New Jersey Commission on Rationalizing Health Care Resources that studied the efficiency and strength of area hospitals. It concluded that the state, especially Northeastern Bergen County, has a surplus of hospital beds that will continue to rise. The report said “based on the current financial picture, the residents of New Jersey should expect a wave of additional hospitals that will face financial distress in the next few years.”

Critics from Englewood Hospital and Medical Center and Valley Hospital in Ridgewood cite that in their opposition to reopening the hospital as a for-profit. Meanwhile residents from parts of the Northern and Pascack valley areas are campaigning for the hospital because they want to be able to access health services closer to home.

Traffic is a major issue when trying to drive from that area to Englewood and Ridgewood, so Westwood is certainly more convenient to get to. But since the HUMC-run emergency department at the former Pascack Valley Hospital does not treat life-threatening conditions, people still need to go to the other hospitals.

Residents have been dealing with the traffic for the two years since Pascack Valley Hospital closed and are seeking relief. There is a remedy that’s proven successful in another region with even worse traffic conditions.

Northern Virginia has several freestanding emergency departments that are equipped with CT Scans, EKG testing capabilities, blood testing labs and other resources. These centers provide much more than just X-raying a broken bone or determining if someone has swine flu. Patients are still transferred to an acute care hospital for certain situations, but a good number of emergency room visits don’t require an overnight stay. A lot of essential care is available at these freestanding departments, which are much more convenient to access than the closest acute-care hospital.

This is what residents need. Opening another hospital, especially a for-profit facility, doesn’t need to happen for quality emergency care to be delivered. The rest of the former Pascack Valley Hospital property can be used by medical offices for dialysis, MRI/radiology, surgeries, and other outpatient services.

We know it would be great if every region could have its own full service hospital, but the state study shows that New Jersey, especially northern Bergen County, doesn’t have the inpatient volume to support that saturation. But Bergen County’s population density and road congestion are the exact conditions for when quality freestanding emergency departments are valuable.

They provide for quicker medical treatment and allow municipalities’ ambulances to get back in circulation sooner. When it comes to getting treatment for an emergency, there’s nothing more important than time and efficiency.

Instead of appealing the state’s decision to let the hospital license expire, HUMC should work on providing more valuable services at its satellite emergency department.

That’s a plan that would really serve the residents’ needs.

To read editorial and reader comments go to northjersey.com

Hackensack University Medical Center’s efforts to keep the former Pascack Valley Hospital in Westwood temporarily open will have to be done before an appeals panel, a judge ruled.

Superior Court Judge Robert Wilson denied a request by the hospital to challenge state Health Commissioner Heather Howard’s decision this week to let Pascack’s license expire on Monday.

HUMC attorneys wanted to argue their case before Wilson in Hackensack, but the judge ruled Wednesday that any challenge should be heard by the state appellate division. Wilson’s ruling was released today.

No state appellate court had received an appeal from HUMC as of Thursday afternoon, a courts spokeswoman said.

Mary McCarthy, an HUMC spokeswoman, would not say what the hospital’s next step is. “We are pursuing every avenue and evaluating all of our options to re-open” Pascack, she wrote in an e-mail today.

HUMC had wanted Howard to extend Pascack’s license by a year. An extension would have allowed the issue to be decided by the next health commissioner, one who will be appointed by Governor-elect Chris Christie. Christie made a campaign promise to support reopening the 128-bed community hospital, which closed after declaring bankruptcy two years ago.

“This week’s decision by the New Jersey Department of Heath and Senior Services was the right one,” said Megan Fraser, a spokeswoman for the Valley Hospital in Ridgewood. “It reinforced the need for regional healthcare planning and a strong healthcare system for the residents of Bergen County.”

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State Health Commissioner Heather Howard has denied a request from Hackensack University Medical Center to extend the license for a hospital at the former Pascack Valley Hospital in Westwood. That license is due to expire on Monday.

The Permit Extension Act of 2008, intended to help developers whose projects were stalled by the recession, does not apply in the case of the Pascack Valley Hospital license, Howard wrote in a letter to the medical center’s attorney.

Hackensack had asked for another year, under the act, to have its application to open a 128-bed community hospital in Westwood heard by the State Health Planning Board. An extension would have allowed the issue to be decided by the next health commissioner, one who will be appointed by Governor-elect Chris Christie. Christie made a campaign promise to support the reopening.

The battle between Hackensack and the two hospitals that oppose the reopening now moves to the courts.

Even before Howard’s ruling, Hackensack filed suit on Monday in Bergen County Superior Court to win an extension of the hospital license.

But Howard’s ruling specified that appeals should be filed in a different venue, the Appellate Division of Superior Court in Trenton.

Nevertheless, Anne Marie Campbell, a Hackensack spokeswoman, said the hospital would pursue the Bergen County action.

No hearings have been scheduled.

Howard’s ruling set off a firestorm of comment from state lawmakers and other local politicians, who accused her of ignoring the will of the people and an opportunity to encourage jobs and development. But it was welcomed by the opponents of Hackensack’s plan as a move toward rational health planning.

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This week, we received word that New Jersey Commissioner of Health and Senior Services Heather Howard has notified Hackensack University Medical Center that its recent request to extend Pascack Valley Hospital’s license beyond its expiration date of December 28, 2009, has been denied.

As had been reported, Hackensack had argued that the Permit Extension Act of 2008, applied to the Pascack Valley Hospital license and that they should be granted an extension.  In her letter to Hackensack, Commissioner Howard stated that the Permit Extension Act is not applicable because Hackensack has failed to gain Certificate of Need approval to open a hospital before the expiration of the hospital license.  In addition, Commissioner Howard stated that it was clear that the Permit Extension Act was intended for the physical development of property and not designed to extend licenses.  Lastly, she stated that Hackensack is outside of the timeframe for which they could have requested modifications to the letter detailing the closure of Pascack Valley Hospital.

The notification to Hackensack included the provision of the right to appeal a decision within 45 days and we currently expect that Hackensack will file an appeal.  It is our understanding, however, that the court grants considerable weight to an administrative decision, making it unlikely for the court to overturn the Department’s decision.

We are encouraged by this news as it reinforces our fundamental message of the importance of rational healthcare planning and maintaining a strong and healthy healthcare system for all Bergen County residents.  We will continue to keep you advised on this important issue and we thank you for your continued support.