The challenge of change

May 15, 2011

CHA president and chief executive officer

The history of Catholic health care in the U.S. has been one of almost continuous change and risk. The constant has been our mission, and we have made adaptation after adaptation to remain available for the mission.

In the past two years, we have sadly watched several Catholic hospitals become secular hospitals. Almost invariably, it has been due to financial challenges. Many Catholic systems that hoped to intervene and keep these hospitals Catholic, found themselves having to pass because the financial outlay threatened to undermine their own systems.

This year, several Catholic hospitals negotiated their sale to for-profit operators with the condition that they remain Catholic. They worked closely with their local bishops. In some cases, specific criteria were included in the sale contract in addition to requirements that the hospital continue to be operated in compliance with the Ethical and Religious Directives for Catholic Health Care Services.

The CHA bylaws have a mixed history on for-profits. For two years, they could be members. Then, the bylaws were changed in 1995 to no longer allow for-profit hospitals to be members.

CHA is faced today with a group of members who are trying to operate as Catholic hospitals, but are now for-profit. In talking to them, it is clear they know this will be a challenge, but they are willing to accept that challenge to have a chance to keep Catholic health care in their communities.

We also have one of our large systems joining with an equity partner to achieve the capital to help other Catholic hospitals in the future.

The CHA board of trustees and its governance committee have studied this question several times. It challenges us to answer the question "What makes any of us a Catholic hospital?" We have a strong statement of shared identity that is excellent, but it is silent on the taxable status.

The board realizes the importance of this issue. It will take careful study, reflection and consultation to answer this question. The board also thinks that while the study is taking place, it is important not to break our ties with those for-profit hospitals that are making great efforts to stay Catholic.

Therefore, the board will be asking the Membership Assembly, at its annual business meeting convened at the Catholic Health Assembly in June, to vote on a temporary exception to the bylaws for one year to permit current members that have or may become for-profit to remain members for fiscal year 2012 only. This will allow us the time needed to study this issue. The governance committee will be responsible for assembling the appropriate expertise to study this issue and present a recommendation to the board for its review and decision.

If the board's decision includes permanent changes requiring an amendment to the bylaws, the proposed amendment will be presented to the Membership Assembly for vote in June 2012. There are significant challenges and issues associated with this decision, and we will be looking for the expertise and input of many members of our ministry. In the meantime, this seems to be the most advantageous way to go forward.


Copyright © 2011 by the Catholic Health Association of the United States
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