Finally, on November 1, 2019, University of Louisville Health (UofL Health) purchased the system, ending two years of speculation and uncertainty about its future and the future of its health care assets.

UofL completed the purchase with the promise of a $50 million, 20-year loan from the Kentucky Economic Development Finance Authority. Half of that loan would be forgiven should the university meet certain criteria in regards to employment and service to underserved areas. The Jewish Heritage Fund for Excellence, the Jewish Hospital, and St. Mary’s Foundation also invested in the system by contributing $10 million and $40 million, respectively.

The ink was barely dry on the paperwork when UofL Health sprang into action and began the task of staffing a health care system that had been significantly stripped of its human resources. “One of the things we noticed was a pretty large gap in positions that needed to be posted verses those that were filled,” says Tiffany Nugent, vice president, human resources, UofL Health. Nugent and her HR team needed to fill 100 physician positions and about 300 nurse positions. Since the deal closed in November, they’ve managed to fill 150 nurse positions and some physician spots. But Nugent and her staff have a long way to go.

Pillars Of The Community

While KentuckyOne Health sat on the market some employees got cold feet and fled to other systems, leaving a severe staffing deficit. “A lot was unknown at the time,” says Nugent. Low staffing levels in the system, which comprises six hospitals and an assortment of physician groups, meant patients were shuffled between hospitals within the system. Some patents had to delay or even forego necessary medical procedures when doctors were unavailable to perform them. “Our number one goal as a hospital system is to provide the most outstanding patient care that we can. When your staffing levels are low, you can’t do that effectively. So, you have to divert (patients) to other hospitals that can,” says Nugent. UofL Health is primarily focused on staffing those hospitals that have lost the most doctors and nurses, which will in turn allow them to handle the patient load and put an end to patient shuffling. Nugent wants the system’s hospitals to be “pillars in the communities they’re in.”

Currently, UofL Health employs 8,000 workers in its hospitals and outpatient facilities and another 3,000 in its physician practices. Dr. Toni Ganzel, vice president for Medical Academic Affairs and dean of the School of Medicine at the University of Louisville, says the additional physicians and nurses will expand and strengthen access in both primary care and specialty and subspecialty care. They will be instrumental in training the system’s resident physicians and supporting the expansion of residency programs in primary care, as well as specialty care.

The acquisition allows UofL Health to preserve its transplant program, expand its patients’ access to clinical trials, expand educational training sites for its students and residents, and allow for closer mission alignment between the school’s academic mission and that of the health system. “It will allow us to continue to care for the most vulnerable populations, regardless of their ability to pay and through this expanded network help us to grow our mission of improving the health of our patients and the diverse communities we serve, striving to achieve health equity for all,” says Dr. Ganzel.

Combining Cultures

The transition of ownership from KentuckyOne to UofL Health means that some 5,500 former KentuckyOne employees joined the University of Louisville and UofL Health, bringing together three cultures: academic, Catholic and Jewish. UofL Health will endeavor to recognize and honor each of these cultures while creating a new one. “You’ve got university culture that’s closely tied to the university, which is a little different than the culture of a Catholic-run organization that KentuckyOne was. You have a lot of history…We’re taking all those cultures and honoring that history and creating something that works in a larger system,” says Nugent. “There’s a lot of work that’s going to be done around that in the next year or two.”

Research

As a result of the acquisition all former KentuckyOne Health physicians were folded into the University of Louisville’s gratis faculty and immediately began teaching students and residents alike in a clinical setting, says Dr. Ganzel. Many physicians will contribute to the research mission of the institution through translational research and clinical trials, which stands to strengthen the university’s research portfolio and provide cutting edge innovative care and access to life-saving clinical trials in cancer, cardiovascular, liver disease, and environmental health. Currently, though, they’re preparing for and responding to the realities of the COVID-19 pandemic, says Dr. Ganzel.

Prior to the acquisition, KentuckyOne Health was poised to close Jewish Hospital, which is home to key clinical, educational and research programs, including transplant, neuroscience and cardiovascular programs. But the November sale breathed new life into the facility. “Our relationship with Jewish and Frazier was a long standing one and played a critical role in the accreditation of several of our residency training programs, with 63 residents being trained there each year and 30 students. (It’s) also home to some of our strongest research programs, such as cardiovascular, liver, neuroscience, spinal cord injury and transplant. It would have been devastating for our university, as well as our community, to have lost this hospital,” says Dr. Ganzel. 

Looking to the future UofL Health has aligned its growth strategy with its volumes. As the volumes continue to rise and the system’s facilities continue to grow to meet the community’s needs, Nugent says, the system will add staff. “We’re having active recruiting meetings every week to continue to fill (staffing needs) as the system’s volumes allow,” says Nugent. •