Category: Hospital Mergers

Will Jewish Hospital Abandon Downtown Louisville Altogether?

jewish-eastI have not heard any good news about Jewish Hospital lately. KentuckyOne Health and its partner, the University of Louisville remain characteristically silent about their plans. What I have heard only confirms my perception of ongoing serious problems or even frank chaos. The least troublesome news available to me was that the senior administration of KentuckyOne Health will now be located in downtown Louisville. I was quoted as saying that keeping the headquarters of this state-wide organization in Louisville was not a surprise because running University Hospital and implementing the partnership with UofL was likely to be the major challenge for the company. While keeping headquarters and a few very high-paying jobs downtown must have been appealing to the city fathers who applauded the partnership, it seems to me that everything else points to a major withdrawal of clinical actives from downtown and the southern county in favor of the East End suburbs. Let me explain how this revelation occurred to me and outline the logic of why, in my opinion, such a move is a major priority for KentuckyOne Health and UofL’s joint strategy. For the sake of discussion, I predict that Jewish Hospital will shift a major portion of its clinical activity and even beds from Jewish and St. Mary’s Hospitals to new hospital facilities at its Dutchman’s Lane and Dupont Circle locations, and turn its downtown facility over to University control or even ownership. Continue reading “Will Jewish Hospital Abandon Downtown Louisville Altogether?”

KentuckyOne Health Notifies Its Physicians About Partnership.

KentuckyOne Health (KOH) sent the following email to its physicians and employees on Nov 21.  Most of the text is derived from promotional materials released at a press conference Nov 14. The text of the announcement itself is reprinted below.  Two additional tables comparing the new agreement with the previous failed merger attempt are included in the PDF version downloadable here. Following the KOH notice, I add a few thoughts of my own. Please also read my current analysis of the Joint Operating Agreement and the Academic Affiliation Agreement for background. Continue reading “KentuckyOne Health Notifies Its Physicians About Partnership.”

Judge Rules University of Louisville Hospital Subject to Open-Records Law.

University Hospital – Public or Private? UofL still wants to be the Judge!

Thanksgiving Day delivered a gift to the Citizens of Louisville in the form of a report by the Courier-Journal’s Andrew Wolfson that Judge Martin McDonald has rejected the hospital’s claim that it is a private corporation. The judge echoed my opinions and those of others that the University has “spent a lot of time trying to dream up legal fictions to maintain control” of the hospital. “Maintaining control” means that the University and its hospital have been able to hide the financial and other performance information that lie behind its claim to be in dire financial straits and justifying its recent handover to an outside private corporation. Despite at least three recent external and highly critical management audits of the hospital and its indigent care operations, the University has not had to provide a financial audit to justify the massive amounts of money it has funneled away from its Hospital’s bottom line.

Only last week, the Commonwealth signed off on a highly troublesome set of documents that transfers control of most of the clinical operations of the University and much of its academic and financial independence to KentuckyOne Health, part of a nationwide Catholic health and hospital system. In my opinion, the Commonwealth lost an important opportunity to settle this matter once and for all before its virtual endorsement of the University’s warrantee that UofL had the “free and clear ability and authority” to enter such a comprehensive reorganization of its governance structure. Indeed, the Academic Affiliation Agreement to which they Commonwealth was a signatory, appears to further immunize the University and its new partner from having to disclose “all information that relates to or is used in connection with the business and the affairs” of the new partnership.

No new information that was the subject of the lawsuit by the Courier-Journal, WHAS-TV, and the ACLU of Kentucky has yet been released. I rather suspect that the University will appeal Judge McDonald’s decision and that this case will linger on for a long time to come. In the meantime, the Commonwealth has given the University the operational right to define its own obligation to the Open-Records Law and public accountability at a time when the stability of the healthcare system of Louisville is in jeopardy. Continue reading “Judge Rules University of Louisville Hospital Subject to Open-Records Law.”

It’s KentuckyOne Health As UofL’s New Clinical Partner.

KentuckyOne Health alone is UofL’s new partner for clinical and academic affairs.  The documents have been signed, including by the Governor.  Implementation remains to be determined. The language in the limited press releases handed out is suspicially like that of the last iteration save that a Joint Operating Agreement is substituted for a full blown merger.  I provide copies of items from the press conference below.

Is it said that all clinical services will still be provided at University Hospital but women’s care is carved out to a separate entity in the same hospital building.  However, I am uncomfortable with the language used.  Seems to me I have heard all this before.  There was no mention of approval by the local Bishop at the press conference, and when I asked specifically later, no comment was available.  Similarly it was said that there would be no change in end-of-life care, but it is also clear that there will be different standards of care at Jewish Hospital and University Hospital for these important healthcare matters.

Obviously I will have more to say about this new business deal but I have no idea what amount of information will be released.  Press releases only tell us what the presenter wants us to know. The Governor and Attorney General did not use this occasion to setle the matter of whether UMA is a private corporation or not.  It took a court order last time to produce documents that that exposed troublesome   agreements.  I would like to be able to see the same range of documents that was made public before, but despite much talk by the presenters about the “transparency” of the RFP process (yes I almost laughed out loud) my expectations are very low.

The only other active player mentioned was Health Management Associates, but they dropped out of the negotiations earlier this month. There was no mention of Baptist Healthcare as a player.

Press-release documents provided at the conference are available to be downloaded below:

Announcement of Press Conference.
List of Speakers at press conference.
News Release- General Information.
Factsheet– UofL and KentuckyOne Health Partnership.
Factsheet– Center for Women and Infants at University Medical Center.
Frequently Asked Questions about the Partnership.
Questions from Board of Health Revisited.
Promotional Graphic.

Other Materials:
Letter sent to Medical Staff at Jewish and St.Mary’s Hospitals.
Letter from Jim Ramsey to Selected Friends.
Link to partnership documents provided by UofL as of Nov 20, 2012. (Download below.)

(The partnership documents just above were incomplete and are likely not current.)|

My interim analysis of documents: (These were prepared before the partial exhibits were made available. Please read the other caveats included!)

  • Joint Operating Agreement– as Word or PDF document.
  • Academic Affiliation Agreement– as Word or PDF document.
  • Lease Agreements– as Word or PDF document.

Peter Hasselbacher, MD
President, KHPI
14 Oct 2012