Lynch, Milmed and Antell. The opinion of the court was delivered by Lynch, P.J.A.D.
St. Joseph's Hospital and Medical Center (St. Joseph's) appeals from a decision of the Health Care Administration Board (HCAB) of the Department of Health (Department) rendered on September 2, 1976 which denied St. Joseph's application (pursuant to N.J.S.A. 26:2H-7 et seq.) for a certificate of need for the establishment of a cardiac surgery program at its facility in Paterson, New Jersey.
On appeal St. Joseph's contends that (1) the action of HCAB in denying its application was, as stated in its brief, "an Arbitrary, Capricious and Unreasonable Action, Both Procedurally and Substantively," and (2) "HCAB Improperly Used Licensing Standards in Denying the Applicant a Certificate of Need."
Appellant's first contention is that the action of HCAB was "procedurally" improper because its "Findings" were based on an incomplete tape recording of the deliberations leading to the decision. We find no merit in the contention.
Appellant next contends that the findings and conclusions of HCAB were not supported by substantial credible evidence in the record and therefore must be rejected. In this respect it contends that HCAB improperly rejected the findings and recommendations of Hearing Examiner James A. Yocum,
who had recommended granting of appellant's application for the certificate of need.
We have carefully reviewed the record and recognize that appellant has offered some persuasive arguments that its particular facility appears to be suited to establishment of a cardiac surgical unit, including the fact that it has established a substantial operation of diagnostic catheterization procedures, having performed in excess of 875 in the year 1975 and an average of 86 a month in 1976, or approximately 1,000 for that year. All experts agreed that one in every four catheterizations ultimately results in cardiac surgery and also that it is desirable that the catheterization laboratory and open heart surgery unit should be in the same hospital. In this respect, therefore, St. Joseph's demonstrated that it would probably meet the quantitative guideline that a cardiac surgery facility should satisfy, i.e. from four to six cases a week, as well as providing catheterization and open heart surgery in its own institution.
However, in fulfilling the legislative objective in this context St. Joseph's facility, and its virtues, cannot be considered in isolation, divorced from the responsibility which has been imposed upon the Department of Health in carrying out the legislative policy. N.J.S.A. 26:2H-1 provides that the Department has "the central, comprehensive responsibility for the development and administration of the State's policy with respect to health planning, hospital and related health care services" in furtherance of the policy that "hospital and related health care services of the highest quality, of demonstrated need, efficiently provided and properly utilized at a reasonable cost are of vital concern to the public health."
In considering whether to grant a certificate of need for the establishment of a health care service the applicant must establish that the proposed project is necessary to provide required health care "in the area" to be served and will contribute to the "orderly" development of adequate and effective health care services. N.J.S.A. 26:2H-8.
And in making such a determination the issuing authority must take into consideration, among other things, "(a) the availability of facilities and services which may serve as alternatives and substitutes, (b) the need for special ...