Some Roman Catholic leaders are taking steps to ensure this month's deal between Columbia/HCA Healthcare Corp. and a Cleveland-based Catholic healthcare system is the last of its kind.
The Archdiocese of Chicago made a public release last week of a pastoral letter from Cardinal Joseph Bernardin that, in part, promoted not-for-profit healthcare as the preferred form of delivery system. The letter, titled "A Sign of Hope," repeated the cardinal's desire for Catholic hospitals to remain not-for-profit and was widely distributed at a meeting of Catholic hospital and health system heads and religious sponsors held Oct. 30 and 31 in Chicago. That meeting was closed to the public and press.
"We are experiencing a troubling trend in our nation: viewing healthcare primarily as a business commodity," Bernardin said in the letter. "The most evident manifestation of this is the movement to transform healthcare delivery from a not-for-profit to an investor-owned status. In quite strong terms, I urged that all involved in the Catholic health ministry join with others to ensure viability of not-for-profit healthcare in our nation."
A 50-50 deal closed earlier this month between investor-owned giant Columbia of Nashville, Tenn., and Cleveland-based Sisters of Charity of St. Augustine Health System, or CSA (Nov. 6, p. 3). The four CSA hospitals, which have assets of $438 million, are no longer tax-exempt.
The Catholic Health Association last week was preparing to send to its more than 560 hospital members action plans designed to promote not-for-profit healthcare delivery. The plans are expected to be available in the coming weeks and were drawn together as a result of the October meeting, called the "New Covenant Initiative."
"There is a commitment to pursue avenues of increased collaboration among Catholic providers," said the Rev. Michael Place, who attended the meeting as an adviser to Bernardin. "It was a very positive meeting, and it will result in enhanced Catholic ministries."
Meanwhile, the CSA-Columbia venture has sent mixed signals to Catholic hospitals and healthcare systems considering partnerships and joint ventures. It was approved by the Vatican despite opposition from one of three bishops.
Bishop James Malone of the Diocese of Youngstown, Ohio, opposed the deal, which allowed a CSA hospital located in Canton, Ohio, to form a joint venture with Columbia.
"Canonically, if there's any weight that was given to the approval (of the CSA-Columbia deal), it's given to the bishop whose diocese has the mother house," said the Most Rev. A.J. Quinn, an auxiliary bishop in the Diocese of Cleveland.
CSA's four hospitals are in three diocese in northeast Ohio and South Carolina. They are 266-bed St. Vincent Charity Hospital in Cleveland; 183-bed St. John West Shore Hospital in Westlake, Ohio; 426-bed Timken Mercy Medical Center in Canton; and 235-bed Providence Hospital in Columbia, S.C.
"I think Rome gave more weight to Cleveland, because that's where the mother house is," Bishop Quinn said. "The Sisters of Charity of St. Augustine have been in healthcare for nearly 150 years. "
As a policy issue, some observers of Catholic healthcare said Rome's approval doesn't mean it agrees with the investor-owned model as a way of delivering healthcare.
"All Rome ruled on was (the control) of (CSA's) assets and whether they would be put in jeopardy," Place said. "Mission-wise, they weren't asked to rule on the deal."
This week, Chicago Catholic healthcare executives will disclose the name and top executives of a managed-care network of Catholic hospitals in Chicago. Of the 20 Catholic hospitals in the Archdiocese of Chicago, fewer than half have signed on to the network (Oct. 9, p. 20).
"We expect more will join," Place said. "Some hospitals weren't comfortable because the network was an unknown commodity, but that is changing."
Place said Bernardin plans to meet personally with all chief executive officers of the Catholic hospitals that haven't joined the network. Mercy Hospital and Medical Center on Chicago's South Side already withdrew from a letter of intent that would have affiliated the hospital with a network led by the University of Chicago Hospitals.