\n<\/strong>I tried to keep track of how things were progressing but it got difficult. Most of the significant court documents are available<\/a> in these pages and you can follow my earlier reports<\/a> here. Along the way, Kentucky\u2019s Attorney General joined the litigation\u2013 nominally to protect the Commonwealth\u2019s interest in the land under the hospital\u2013 but in so doing joining formally with UofL in opposition to Norton. \u00a0Additionally, in the midst of all the action, Kosair Children\u2019s Charities\u2013 for whom the Children\u2019s hospital is named\u2013 joined in a tag-team lawsuit<\/a> against Norton seeking to avoid having to pay the charitable funds it had promised to the hospital. (Kosair Charities is now a major donor to the University and supporter of its research.) \u00a0One or more informal and even court-ordered mediation efforts failed, somehow always at the last minute. \u00a0Special Master Commissioners were to be appointed by the court to sort out the complicated financial and legal claims made by both sides and to otherwise facilitate the progress of the litigation! It is my understanding the the Attorney General\u2019s office is backing away from a justification to evict Norton from its hospital.\u00a0 The lack of cash and a vanishing chance to seize physical control of the hospital for KentuckyOne may also be contributing to the shifting positions that UofL seems to be taking.<\/p>\n
As an aside, it is my guess is that Norton might not feel particularly comfortable with the fact that both the Governor and his Attorney-General-candidate son (both of whom I support) were and are lawyers for the firm that is representing UofL in both of the lawsuits above. \u00a0On the other hand, this is an election year and what politician hoping to gain elected office or to protect their party wants to take sides between UofL and UK!<\/p>\n
Even as we speak.<\/strong> Since my last update.<\/strong> Medical School Accreditation. Who is running the show and does it matter? Why am I writing about this now?<\/strong> Because this is planned to be a fast moving process that will likely require timely participation of the respective Boards of the two institutions, UofL management asked the Board of Trustees to allow its Executive Committee to act on behalf of the whole board.\u00a0 The Board of Trustees gave\u00a0such approval.\u00a0 The resolution was passed, apparently without discussion and not in public session. \u00a0To my knowledge,\u00a0the membership of the Executive Committee for this newly seated board has not yet even been named!<\/p>\n UofL has felt it has to win at all cost.<\/strong> When I first came to Louisville in 1984, I was called to make consultations on children in at least 3 different hospitals.\u00a0 Since then, a strong Norton Kosair Children\u2019s Hospital staffed by University and community physicians managed to rise above the internecine hospital wars of Louisville to serve well the families of Louisville and the region. I fearfully predicted in 2012 the possibility that the result of the UofL- Norton estrangement might be two separate free-standing children\u2019s hospitals in Louisville.\u00a0 We are well on the way to that result today. \u00a0Two hospitals competing for the scarce resources of money, specialty personnel, and the critical mass of patients needed to support a children\u2019s hospital in Louisville cannot be justified. \u00a0No party should have control of this community treasure for the purpose of excluding non-network providers, or to gouge competing health plans or hospitals with unfair charges.\u00a0 Who would argue differently? \u00a0Such concerns must be addressed in any mediation.<\/p>\n It is no secret that I have been disappointed if not ashamed of my University for the academic, ethical, clinical, and financial independence it has given away given away in exchange for support of its commercial research aspirations.\u00a0 UofL may argue that it was necessary to have taken sides and that the medical community was ripping itself apart anyway.\u00a0 I would like to think we could have taken a higher road. \u00a0Ironically, the scare tactic\/threat of a failed University of Louisville Hospital that was used as the justification for all the perturbations above has dissipated.\u00a0 However, the fact that University of Louisville Hospital is on its best financial footing ever is due to Governor Beshear\u2019s courageous support for healthcare reform in the shape of the Affordable Care Act. \u00a0If nothing else, a state University is supposed to bring its community together, not rend it asunder. \u00a0I invite both parties to surprise us with a little courage of their own.<\/p>\n Peter Hasselbacher, MD <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n
\nIn the meantime, much damage is being done.\u00a0 No one yet has said that my estimate of some $40 million in legal fees is too low, and the meter is still running. \u00a0The opportunity to have both Universities and their children\u2019s hospitals working together to advance the health of Kentucky\u2019s children (as in transplants and heart surgery) is evaporating as I write. The University of Kentucky is turning to Cincinnati Children\u2019s Hospital as a pediatric heart surgery partner<\/a> when it should have been able to partner within the Commonwealth. \u00a0Now both of Kentucky\u2019s programs are threatened<\/a>. \u00a0What UofL may claim as academic independence and prerogatives can be viewed by others as simple selfishness and greed. \u00a0The University\u2019s students are watching their teachers and mentors use heavy-handed methods to get their way.\u00a0 Surely no one is comfortable watching these two Louisville organizations on which we depend for so much, engaged in this gladiatorial combat.\u00a0 At this point, even a Solomon\u2019s judgment is going to give us a damaged child.<\/p>\n
\nAt my update in March<\/a>, UofL\u2019s demands seemed to have shifted somewhat . The University downplayed but did not apparently abandon its claimed right to evict Norton. \u00a0Short of cash at home, UofL apparently seemed willing to settle for money. \u00a0Frankfort Circuit Court Judge Wingate<\/a> noted, \u201cwhat remains in this case is the issue of the amount of the reimbursement that needs to be paid from Norton. This should be able to be taken care of through mediation.\u201d<\/em>\u00a0 Further proceedings were pretty much put on hold, but things did not apparently go anywhere fast.\u00a0 Obviously the Judge\u2019s rosy prediction failed to emerge. \u00a0In the meantime, UofL continues to torpedo efforts to work cooperatively with UK.\u00a0 The Department of Pediatrics, and indeed University Physicians, Inc., the multi-specialty faculty practice that should have been a good thing for the University, are in bad shape financially. (How they got that way is an interesting story in itself.)<\/p>\n
\n<\/strong>I have been waiting for announcements that the UofL and the Kosair Charities lawsuits have been settled, and also for the anticipated announcement that the UofL School of Medicine has been released from its probationary status<\/a> by the Liaison Committee for Graduate Medical Education (LCGME).\u00a0 Neither has happened.\u00a0 Given that the LCME once considered Kosair Children\u2019s hospital and corresponding financial support from Norton as considerable strengths of the Medical School\u2019s programs, I wonder if the LCME is also waiting for some resolution from the courts. Without a children\u2019s hospital, one of the the Medical Schools\u2019 strongest teaching programs gets flushed away. \u00a0Seems to me that UofL is more vulnerable to being damaged by the rupture of the current partnership than is Norton.\u00a0 All of us will be damaged in any event. Whoever\u2019s idea it was to promise to turn the school\u2019s pediatric service over to CHI\/KentuckyOne and to put that promise in writing made a disastrous miscalculation, one whose damage will be with us for some time to come no matter what happens now.<\/p>\n
\n<\/strong>As of today, there are only two American medical schools still on probation<\/a>\u2013 UofL and Baylor College of Medicine in Houston.\u00a0 I hope it is a coincidence and not an omen that Baylor is also part of the Catholic Health Initiatives system.\u00a0 Of note, the University of Arizona College of Medicine- Phoenix was just put on accreditation warning<\/a> by the LCME, apparently as a result of its \u201cpartnership\u201d with Banner Health. \u00a0The reported concern of the LCGME was that the Dean of the medical school did not have sufficient control of the school or access to the university president.\u00a0 In my opinion, our Dean in Louisville stands in the same shoes.\u00a0 The conduct of non-educational affairs of our medical school lies in the hands of its Executive Vice President for Health Affairs David Dunn, and President James Ramsey. They are calling the shots and that would be obvious to the LCGME.\u00a0 This is a critically important issue.\u00a0 Following last week\u2019s Board meeting, I am concerned that the stated priority for a promised new educational building on the Health Sciences Campus \u00a0is not as robust as is required. The priority for the HSC Instructional building will be submitted in November, “but a lot can happen before then.”<\/p>\n
\nThe final act on the agenda of the UofL Board \u00a0of Trustees meeting<\/a> was a litigation update by its lead Stites & Harbison attorney. The resulting board-resolution was made available to me by the University and is attached.<\/a> The two parties appear to be having their heads knocked against each other once again. \u00a0A \u201cmediation order mandates that by September 18, 2015, each party must submit a confidential statement outlining\u00a0the parameters of two to three proposals acceptable to that party.<\/em>\u201d\u00a0 [No more shifting sands of demands.\u00a0 No more torpedoing of settlement by piling-on last-minute poison pills.]\u00a0 \u201cIn October, each party is scheduled to meet individually with the appointed mediators,\u201d<\/em> and in November will \u201center into five consecutive days of mediation.\u201d<\/em>\u00a0 Of course, both parties remain free to \u201cpursue settlement discussions separate and apart to effectuate a final and binding agreement,\u201d<\/em> and presumably not by means of an oral agreement!<\/p>\n
\nNow you know as much as I do.\u00a0 I am hoping for the best.\u00a0 One might think that forcing the parties to outline some acceptable positions before the actual head-to-head mediation might be effective, but I have no experience in that approach.\u00a0 Surely it will make it more difficult to claim the high ground should mediation fail yet again.\u00a0 And yet it might.\u00a0 From the first moment that\u00a0UofL announced its plans to merge with Catholic Health Initiatives, and then to form a joint venture with KentuckyOne Health, I predicted that a struggle over who controls Children\u2019s Hospital was going to be both prominent and destructive.<\/p>\n
\nPresident, KHPI.
\nEmeritus Professor of Medicine
\nSeptember 8, 2015<\/p>\n![\"ky-flag\"](\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/09\/ky-flag-150x79.png\")
![\"both-logos-150\"](\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/03\/both-logos-150-150x79.jpg\")
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