With Rome's sign-off, the sale of a St. Louis Jesuit hospital to an investor-owned chain was scheduled to take place Feb. 28 over the staunch objections of the local archdiocese and the Catholic Health Association.
St. Louis Archbishop Justin Rigali argued from the beginning that the hospital should have been sold to two local Catholic systems, SSM Health Care and Unity Health, which had made a joint bid. But their proposal came nowhere near the $300 million offered by Tenet, thus raising the issue of how much religious sponsorship is worth to a Catholic facility.
The answer from the Vatican was, not as much as some American Catholics think it is.
In a five-page statement issued Feb. 24, Rigali expressed his "regret" that it is necessary to sell the hospital "to a for-profit entity, which, however honorable it may be, still exists to pursue a for-profit goal."
The CHA, in a statement, said it objected to the sale on the grounds that "a publicly traded, investor-owned corporation such as Tenet Healthcare Corp. is inherently incapable of sustaining the Catholic character of Saint Louis University Hospital."
But Rigali said he accepted the sale on the condition that specific requirements set by the Vatican be met:
* Tenet must operate the hospital according to the Ethical and Religious Directives for Catholic Health Care Services, as established by the National Conference of Catholic Bishops.
* Pastoral care must be continued around the clock under university direction.
* Tenet and the university must commit to instruct students, interns, residents and fellows in accordance with Catholic principles.
* Tenet must maintain the hospital's previous level of charity care.
* Existing graduate medical education programs in pediatrics, obstetrics and gynecology have to continue at other Catholic hospitals.
John Kerr, spokesman for Saint Louis University, stressed that those conditions were not demanded by the Vatican after the fact; "they were established by the university and Tenet very early on and set by the board of trustees."
Missouri Attorney General Jay Nixon, who held a hearing on the transaction in December, approved it Feb. 23. He agreed that the university board of trustees acted in good faith, that using the proceeds of the sale for medical education is consistent with the university's not-for-profit status and that a fair price was paid.
The university board of trustees unanimously selected Tenet's bid last Oct. 4. Under terms of the final agreement signed last week, Tenet will pay $300 million for the 303-bed hospital, an occupational health subsidiary and several physical structures. Tenet and the university will establish a partnership for healthcare education in St. Louis. Tenet has committed $100 million to new programs and joint ventures.
Tenet, which already owns four community hospitals in St. Louis and several others in rural Missouri, will designate Saint Louis University Hospital as its hub healthcare facility for the region. It will invest $50 million over five years to maintain and update equipment and programs.
Tenet also will donate $1.5 million to endow a professorial chair in healthcare ethics at Saint Louis University and $100,000 for an international ethics conference.
Tenet expects the hospital to contribute more than $5 million a year in local and state taxes in Missouri.