Next Round in Norton Healthcare v. UofL.

Only Superficially About Cooperation with UK?

The lawsuit stemming from UofL’s claim that Norton had violated its land-lease agreement with the Commonwealth, and the initiation of a process by the University to wrest physical ownership of Kosair Children’s Hospital from Norton is on the docket for Franklin County Circuit Court on March 18. Norton is asking for a judicial determination that its non-binding Letter of Intent (LOI) to cooperate more closely with the University of Kentucky over children’s health does not violate is ground lease with the Commonwealth or any other agreement with UofL. Because the Commonwealth actually holds the lease, the Finance and Administration Cabinet intervened as a defendant on the side of UofL.

Brief background.
This lawsuit was initiated in August 2013 immediately following the signing of a letter of intent between Norton and the University of Kentucky to collaborate more closely over children’s care.  Neither Kosair Children’s nor UK on their own have a large enough patient-base to recruit enough specialty physicians to optimally support some pediatric programs such as cardiac or transplantation surgery at both Hospitals. UK’s cardiac surgery program is already under stress from low patient volumes and discontinued some services.  Some patients needing services and probably others, can go to other excellent children’s hospitals in Cincinnati, Indianapolis, Nashville, or even further afield. Norton’s Kosair Hospital is the only stand-alone full service pediatric hospital in Kentucky. Kentucky Children’s Hospital is a part of UK Hospital.  Although the letter of intent was the trigger, other factors were operating in the background, including that UofL had already promised to turn over its pediatric services to its newest clinical partner KentuckyOne Health at the earliest opportunity. Longstanding colleagues in the School of Medicine have told me they believe the threat to physically evict Norton from the children’s hospital that Norton built and managed is not just a negotiating tactic, but is the University administration’s ultimate goal. In this setting, no amount of negotiating– mediated, serious, or otherwise– has a chance of success. I would be delighted to be proven wrong.

Is there any other reason?
Although the LOI was the excuse, UofL has been withdrawing from its longstanding academic and clinical partnerships with Norton for some time in favor of Jewish Hospital and now KentuckyOne Health. I do believe a significant factor is a seemingly pathological inability to enter on the same field with UK except for basketball or football. Of course there are selected academic and research interactions– some of which are mandated– but the notebook full of examples of cooperation with UK that President Ramsey mentioned yet again at last month’s Board of Trustees meeting has never been released to the public let alone to me when I requested it. Being perceived as UK’s little brother has always stuck in our craw. In this case however, I believe it is all about ownership and control of Norton Kosair Children’s Hospital for the benefit of UofL’s newest partners, and over control of the state’s neonatal ICU beds. One may fairly ask why Dr. Gerard Rabalais, Chairman of UofL’s Department of Pediatrics, Chief of Staff of Kosair Children’s Hospital, and long-time fruitful partner with Norton is sitting this one out on the sidelines during this coordinated attack. For all the reasons above and more, this conflict has immense consequences for the medical, academic, and financial health of the Commonwealth. This is more than an academic hissy-fit. The community needs to pay attention.

I have been following this matter since its inception with an emphasis on putting the court filings and disputed documents on-line for public inspection. I wanted to allow the parties’ arguments to speak for themselves. Some may say that I have a bias towards one side, but given my extensive history with both organizations over 30 years— including sitting on the Dean’s council when things began to go bad— it has proven impossible for me not to. I have asked all three parties to the lawsuit for copies of their filed briefs for the upcoming hearing– which as of today the Court Clerk tells me is still on the docket. When-and-if these public documents arrive, I will summarize and make them available in these pages. If not, I see a road trip to Frankfort in my future.

Peter Hasselbacher, MD
President, KHPI
Emeritus Professor of Medicine, UofL
March 2, 2015

[Addendum, March 3:  Although a hearing is still listed in the on-line docket, I understand that it has been cancelled or postponed.  No one is talking.  Off to Frankfort.]