Additional photographs and maps supporting this article can be seen here.
Another place to collect medical dollars. Is the sky the limit?
In a previous posting, I categorized my effort at investigative journalism as a Hardy Boys adventure. I had in mind the young detectives of my boyhood reading, but a friend advised me that modern-day Hardy Boys are members of US military special forces who conduct “dark” operations. Given the nature of the secrecy surrounding healthcare planning in Louisville, perhaps I am on target in either scenario. In any case, to maintain an appropriate image of impartiality, I conducted my next excursion to the east as Nancy Drew.
As the growth of medical facilities in Louisville has evolved, all three major hospital systems have leapfrogged beyond the confines of the Watterson Expressway to the Gene Snyder Freeway (I-265) and beyond. Of course, this is neither unexpected nor unjustifiable. This is where Louisville’s population is settling — especially those with good medical insurance. I might offer my services there too. Indeed, as a patient, unless there was some special reason I needed to go downtown, I too would rather stay closer to home. Inspection of maps, real estate transactions, and observations on the ground make it clear to me that our hospitals are ready, willing, and able to expand their east-county facilities even further. New construction has already begun. What will stay downtown remains to be seen. This article will focus on the developing medical center springing up around the intersection of the Gene Snyder and Old Henry Road. I invite you to share my field trip with me and to add what you can.
More than I bargained for.
My intention was to visit Jewish Hospital Medical Center Northeast which opened in 2009, and which I had not seen before. Driving east on the Expressway, I was surprised to see the Old Henry exit marked with a hospital sign. (There is there is no hospital in the area, only emergency and urgent-care facilities! Hospital attorneys take note.) What I saw first was a striking large modern building that turned out to be the Baptist Eastpoint medical center. I frankly had no idea that it was also located there. Ironically, amusingly, or disappointingly; what we are seeing is a replay of the situation in St. Matthew’s where hospitals have set up on either side of a major ringing-expressway. Given the seeming historical “me too” strategy of medical development, we should probably not be surprised at this.
Short history of the land.
A Google aerial view of Jewish Northeast allows a good orientation to the medical center area. It is obvious that the whole area was formerly agricultural in nature– full of nursery farms. I understand the land was previously owned by Mr. Carl Ray who continues to develop the area as President of of Terra Development Company. As of today, the only existing buildings on the core site are the Jewish Northeast structure itself, and just across Old Henry Trail on the site of an older farm, the adjacent, just-built Premier Surgery Center of Louisville.
When Jewish Hospital and St. Mary’s Healthcare bought the land for its existing medical center, I understand there were discussions about purchasing additional land further east along Old Henry Road that did not come to fruition. Instead, in February of 2011, Jewish Hospital and St. Mary’s Healthcare purchased 40 acres just to the north along Old Henry Trail for $16 million from the Old Henry Healthcare Real Estate LLC. The hospital then sold 2.3 acres of that land to the new surgical center.
A. Jewish Hospital Medical Center Northeast.
B. Premier Surgery Center of Louisville
C. Forty acres owned by Jewish Hospital- St. Mary’s Healthcare.
D. New residential construction.
E. St. Joseph Catholic Orphanage land. (Former possible VA location)
F&G. Baptist Eastpoint medical center.
H&I. Other land available for medical businesses.
J. Entrance to Lake Forest Development.
I have prepared a page of additional maps, photographs, and descriptions.
Room to grow.
The long and short of it is that KentuckyOne Health now has control of a huge area of land in the newest center of medical development in Louisville. The immediately adjacent non-owned land is under the control of real estate holding companies with names such as Jefferson Healthcare Old Henry, LLC; or Old Henry Healthcare II, LLC, with posted signs all over promoting administrative and clinical medical usage. An even larger parcel of adjacent land is owned by St. Joseph Catholic Orphanage some of which might be potentially available for transfer between the sister religious organizations. [Note the two major new roads giving access to the Orphanage land from the south. Someone must have some plans!] I have no idea what KentuckyOne has in mind with all this land and possibility. At least two preexisting farms and houses on the Jewish Hospital-St. Mary’s property have been demolished. Old Henry Trace was closed. A large water tower was recently completed. Perhaps something big is coming along. I will likely continue to be the first to speculate and the last to know!
What’s happening in the medical facilities now?
The current medical center itself and adjacent partner outpatient surgical facility have ample parking, but there were not many cars present. Literature displayed in the lobby of the medical center emphasizes emergency care, a surprisingly (to me) extensive variety of diagnostic medical imaging, diagnostic cardiac care, rehabilitation, and specialty physician offices. These are profit centers for hospitals. Special emphasis was given to cancer and cardiac screening services and to cancer care.
I was told that Jewish Northeast itself does not perform any surgery. I have always wondered why independent or “partner” outpatient surgical centers are so often located adjacent to hospitals, or in the case of Jewish Hospital East, full-scale outpatient medical centers. It seems to me that these facilities would be competing. I hope one our readers will explain this. The only thing I am sure about is that it must have something to do with charges and reimbursement!
Again, I should have known but did not, that the Catholic Orphanage land to the north was one of the proposed sites for the replacement Louisville Veterans Hospital. One can reasonably speculate that the potential of having a VA adjacent to it would have held much interest for both Jewish Hospital and the University of Louisville in the event that hospital was not built downtown– or for that matter even if it was! The land was purchased right in the midst of the joint Jewish-UofL planning over their merger/acquisition. (One is led to wonder how much of the ongoing opposition to building the the new VA Hospital at the Brownsboro Rd. Location comes from this quarter?) UofL wants very much to increase its patient volume and income from cancer care. It trails community leader Norton Healthcare in this regard and very much wants more east-end business.
Not just one medical center, but two!
After an outsider’s tour of the Jewish Hospital Medical Center facility, I drove over to Baptist Eastpoint just a hop, skip, and jump away. Its huge parking lot was also not very full on this mid-Thursday afternoon, but the facility is impressive. It has attached designated cancer and outpatient surgical centers. A wide variety of services are available similar to those at Jewish Northeast. I always assumed that competing hospitals and medical facilities clustered together to make themselves easily available to practicing physicians who had many options of where to work and admit their patients. This possibly-incorrect assumption on my part may no longer be relevant in an era where hospitals become medical silos and employ their own physicians. I would be interested in better informed input from some of you readers.
In my previous article, I alluded almost in passing that the expanding healthcare horizon to the east already contained outpost colonies. I am embarrassed that I did not realize how far along things were. All my previous musings remain unchanged in specifics, only amplified in degree. I do not know if current residential development this far east could support another full-scale hospital now, but certainly some day it will. If KentuckyOne Health can afford to wait it out long enough (they will need more cars in the parking lot), it may make more sense to build a hospital here than at the already-crowded Dutchman’s Lane location. There is little doubt that the corporation is looking for another hospital in Louisville.
It is said of physicians that we are intrinsically more oriented to short-term planning rather than long-term. That is one of the traits that is supposed to differentiate us from “business people.” Obviously there has been a lot of business planning going on. While such planning has no doubt been internally well-coordinated within individual corporations, I assert loudest, if not first, that community planning for our health care needs has not been coordinated at all. “Anti-coordination” seems to be the rule. More attention is paid to profitability for individuals and businesses than to what is best for the physical health of the Louisville community. All the while our individual and financial health continues to deteriorate. Surely we can do better than this!
Naturally, and as always, if I am incorrect in any of my facts or interpretations, I invite anyone to clarify matters in the Comments below, or privately using the link in the right sidebar of the Policy Blog home page. I will respect your privacy if that is your wish.
Peter Hasselbacher, MD
Emeritus Professor of Medicine, UofL
March 30, 2013