U of L Hospital stuck in middle of merger debate

LOUISVILLE, Ky. (AP) - The ownership of University Hospital in
Louisville is being questioned as the community debates a
controversial merger proposal.
The facility is the main teaching hospital for the University of
Louisville and it gets millions of dollars from the government to
treat the poor.
But U of L officials say it is private because it is managed by
the nonprofit University Medical Center Inc., not by a government
"University Hospital is NOT a public hospital," U of L said on
a website defending the proposed merger between University and
Jewish Hospital & St. Mary's HealthCare and St. Joseph Health
System of Lexington.
The distinction could be important in getting approval for the
merger, according to The Courier Journal (http://bit.ly/r7d7FB).
Some Kentucky lawmakers and advocates for the poor say Louisville's
"public hospital" shouldn't have to follow Catholic directives
against sterilization and birth control.
The issue has prompted some calls to rethink the deal, partly
because it would require low-income women who rely on University
Hospital to be subject to one religion's rules on reproductive
The hospitals have agreed to follow Catholic policies because
Denver-based Catholic Health Initiatives, which owns St. Joseph,
will own 70 percent of the new venture. The new system would be a
considered a ministry of the Catholic Church, meaning it must have
approval from Louisville Archbishop Joseph E. Kurtz. He has said he
will approve the deal only if the hospitals keep their pledge to
honor the church's health care directives.
Amid the debate, Gov. Steve Beshear and Kentucky Attorney
General Jack Conway have said they think of University Hospital as
a public institution. They note its real-estate ownership, state
contracts, and its long history as the area's safety-net hospital.
The hospital was built with $73 million in tax dollars 30 years
ago to replace Louisville's dilapidated General Hospital. The state
gave it $61 million last year to provide care to the poor.
It serves as the region's trauma center, and it turns over most
of its annual profits to U of L under a long-standing affiliation
"I think most people in Louisville believe University Hospital
belongs to us," said state Rep. Tom Burch, D-Louisville, chairman
of the House Health and Welfare Committee. "I want to be sure that
anybody who wants a service (at University Hospital) can get that
service without getting permission from a religious organization."
Jon Fleischaker, an attorney for The Courier-Journal and an
expert on Kentucky's open-records and meetings laws, said the
hospital is "a public agency that is directly connected to the
He said that's because the hospital "operates as a part of the
University of Louisville medical school - part and parcel."
University Hospital chief executive officer James Taylor said in
a letter to The Courier-Journal last month that the hospital is not
public. He stated that "neither I nor any of my fellow 3,000
employees are employed by the government or the university."
Taylor's letter said UMC owns the license to operate the
However, definitions can vary.
U of L School of Medicine Dean Dr. Edward Halperin said there
isn't a generally accepted definition of "public hospital."
Halperin said in an email that complex relationships between
medical schools, local governments, building ownership and
contracted hospital operators make it difficult to distinguish
public from private.
Jill Horwitz, professor of law and of health policy management
at the University of Michigan, said operating a hospital, as UMC
does, "is not the same as owning it."
Whether the public-private question will have an effect on the
merger is difficult to say. The transaction needs approve from
various authorities, which is expected to take months.

Information from: The Courier-Journal,

(Copyright 2011 by The Associated Press. All Rights Reserved.)

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