An Open Letter to the Jewish Community on Hospital Merger

Dear friends,

We realize you might have questions about the proposed merger between Jewish Hospital and St. Mary’s HealthCare, Saint Joseph Health System and the University of Louisville Hospital. We appreciate that the Jewish Community of Louisville has allowed us to clarify some details relating to the merger that might seem confusing and to address some of the issues that have been raised.

We’d like to share with you an overview of the merged organization and why we’re merging, as well as some facts to help clarify some misperceptions about the full range of services that will be offered.

One of the most important items is to fully understand which organizations are actually merging. The merging organizations are: Jewish Hospital & St. Mary’s HealthCare, University of Louisville Hospital/James Graham Brown Cancer Cen-ter and Saint Joseph Health System. The sponsors of these organizations will remain after the merger. Those include: Jewish Hospital HealthCare Services, Catholic Health Initiatives and the University of Louisville.

We want to emphasize that the Jewish Hospital brand will not go away with this merger. In fact, as part of the merger documents, there are specifics that outline that there will always be a Jewish Hospital in the downtown medical center.
Likewise, the historic commitment that JHHS has had to the community will only increase. The JHHS board will increase our investment in medical research and education as well as our commitment to the local Jewish community in the coming years. The JHHS board will retain financial assets that will ensure our century long commitment to both the Jewish community and medical research and education continues for decades to come.


Why merge?

First and foremost: The three potential partners believe Kentucky’s health challenges are too big for any single organization to solve. Kentucky ranks among the top 10 states with the worst health indicators for cancer, obesity and death due to heart disease and stroke, and more than half the state is designated as medically underserved with a growing scarcity of physicians across the state.

We are committed to the merger in order to expand most health services now being provided throughout the health system including care for the poor, the at-risk and the uninsured.

Over the years, the depth of this commitment has been evident in the increasing amounts each has given in community benefit – which includes charity care. In 2009 alone, the three partners together provided more than $270 million in community benefit including indigent care. When all Catholic Health Initiatives’ entities are included, that number swells to more than $850 million.

In order to continue their mission to provide such high levels of charity care, University Hospital and Jewish Hospital & St. Mary’s HealthCare have sacrificed much needed capital investment in their facilities, which has taken a toll on both organizations. Without sufficient capital, their ability to maintain and grow their facilities and equipment and increase services demanded by the community will be limited, and current levels of service may suffer.

During the first three years of the merger, over $200 million has been set aside to upgrade University Hospital and Jewish Hospital as part of a total $320 capital infusion. In addition, a new $100 million electronic medical record system will be implemented. Not merging will eliminate the capital investment both organizations need to continue their mission of providing indigent care and training for future generations of health care providers.

The new merged health system will include hospitals, clinics, specialty institutions, home health agencies, satellite primary care centers and a physician group with 91 combined locations. Such an integrated system will improve health care outcomes statewide and provide increased opportunities to efficiently move research from bench to bedside.

Through an academic affiliation agreement with the UofL School of medicine, physician training programs can be expanded throughout the Commonwealth and address both the rural physician shortage and UofL’s statewide service commitment to provide the most recent knowledge and technology to rural areas.

Given all the inherent benefits of the merger, we plan to come together to serve our communities, our employees and our state. There is so much we can accomplish together to address the health challenges facing the people of Kentucky today and to secure a healthier future for the Commonwealth.

Why are there so many unanswered questions?

The signing of the definitive agreement in June provided a broad outline of how we will come together in terms of information systems solutions, human resources policies and procedures, clinical interaction, etc. We recognize there are challenges to simultaneously upholding both the academic requirements of the School of Medicine and abiding by the Ethical and Religious Directives (ERDs) of the Catholic Church, but we will do both – as have similar partnerships across the country.

The medical school faculty is not included in the merger and will continue to provide unparalleled clinical care and training with some teaching programs being provided outside of the merged health system.

We are continuing to work on the details of merger and will update the community on our progress as milestones are achieved. Be assured that throughout this process and beyond, our legendary commitment to patients will continue, unabated, as it has over the past century. We pledge to continue providing health care and expanded access to all regardless of their ability to pay.

Will health care delivery be changed?

The sanctity of the doctor-patient relationship will remain unchanged with physicians providing patients with a full array of clinical options and assisting with their decision-making regardless of where services are provided.

The protection of academic freedom will continue without limiting the content of curriculum or location of university classes. This is critical for the University to maintain its certification. University employed and private physicians currently practice medicine at many hospitals and clinics and will continue to do so after the merger.

UofL clinics will not be part of merger and will continue to provide health services for their patients.

Physicians will continue to inform patients and families of all available options for end of life care including hospice, terminal sedation and palliative care. Advance Directives can be honored, consistent with ERDs. In fact, Saint Joseph Hospital in Lexington has an inpatient hospice unit.

Organ donations will continue to be performed and are consistent with ERDs.

The vast majority of reproductive services, including miscarriage management and treatment for ectopic pregnancy, can be provided consistent with ERDs as can medically indicated abortion treatment and emergency contraception. Elective abortions are not performed at University Hospital or any Jewish Hospital organization today.

Procedures such as vasectomy and in vitro fertilization can be provided consistent with ERDs. These are currently done primarily in physician offices.

Emergency contraception and family planning will continue in an office setting.

What remains to be decided?

The only procedures to be performed in a hospital setting outside of the merged entity are tubal ligations following either vaginal or C-section deliveries. It’s important to understand that this is not a decision someone who is pregnant makes quickly. State law requires 24-hour written informed consent (KRS 212.347) from the mother. This specific instance is the one area that the partners are still working to resolve. It is important to understand that Jewish Hospital HealthCare Services will be an active partner with the University of Louisville in addressing this significant issue. We are very close to providing an answer to this vital question.

Looking forward

The new entity will be governed by a community board of trustees led by Bob Hewett, a long-time Board member of St. Joseph Health System. Approximately 17 of the 18 community board members live in Kentucky. Ten board members live in Louisville. One CHI senior executive resides in Denver. Of the 18 board members, Jewish Hospital HealthCare Services appointed four board members: Gerald D. Temes, M.D., LouAnn Atlas, Richard Schultz and Russell Williams, MD.

We fully understand that there have been many legitimate questions asked about this merger. It is our firm belief that the history of the Jewish Hospital organization highlights the value of strategic partnerships and the need to continually evaluate how we can provide better care to our community. Our mission will continue after this merger just as it has for over 100 years.

By combining our efforts as one organization, we believe we can achieve our ultimate goal of providing a healthier Kentucky. We ask for your support in this worthy endeavor.

Gerald D. Temes, MD
Jewish Hospital HealthCare Services
Board Chair

Louis Waterman
Board Chair

David Laird
President & CEO

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