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Nurses Urge AG to Investigate Merger of Providence and St. Joseph Health

Thursday, January 14, 2016


Members of nursing unions told GoLocal that they are calling on Oregon Attorney General Ellen Rosenblum to closely scrutinize the merger between two of the state’s largest Catholic health care systems. 

Providence Health and Services and St. Joseph Health System have asked Rosenblum to waive scrutiny of the proposed merger. The merger would affect governance and control of over 50 hospitals and numerous affiliated entities, in seven states—including eight Oregon hospitals, creating one of the largest Catholic hospital systems in the U.S. 

Malinda Markowitz, National Nurses Union vice president, told GoLocal that the request to Oregon’s AG for a waiver of a thorough review of the merger was “concerning.” She said that, given the size of the chains, a potential reduction of services for Oregon patients and St. Joseph’s history of patient care worries nurses the most.

“NNU has substantial concerns about the impact of the proposed merger of these two hospital systems on patients, taxpayers, RNs and other employees, and the affected communities,” Markowitz said. “The effort by the two hospital systems to block public review symbolizes exactly why careful scrutiny is needed."

Attorney General Ellen Rosenblum

Rosenblum Considers Waiver

On November 30, Providence Health & Services and St. Joseph Health System submitted an official request for a waiver to Rosenblum’s office.

In the waiver, the two merging groups said that Oregon Statute 65.803 1 (a) and (b), which stipulates that the Attorney General must review such mergers, does not apply in their case, in part because both groups are non-profit organizations.

Rosenblum said in a letter dated December 16 to the companies and other interested parties that she would “consider granting a waiver of the approval requirements.” 

This week, the NNU wrote a rebuttal to Rosenblum, saying that “the waiver should be denied because Providence Health and Services and St. Joseph’s Health System have not demonstrated that approval of the transaction is warranted,” the letter read. “Despite the massive wealth of the proposed combined entities, the proposed merger is likely to harm the communities the purport to serve.”

Issues With the Merger

The NNU specified three main areas for Rosenblum to review: charity care and other community benefits in Oregon; reduction of reproductive and end of life care; and the negative impacts on cost and accessibility of healthcare services.

“In their application for waiver, the hospital systems have only described in the vaguest terms how the consolidation would enhance healthcare for underserved populations, including the poor and vulnerable,” Markowitz said. “However, data submitted by PHS to the Oregon Health Authority shows PHS’s charity care spending as a percent of its operating expenses in 2014.”

She also said that the ethical and religious directives for Catholic healthcare prohibit Catholic healthcare providers from offering a range of “beginning of life” and “end of life” services, meaning that 

“This merger must ensure that all the hospitals remain open, that all jobs and services are maintained—and that the new organization is held accountable for providing charity care and community benefits to the communities it serves,” Markowitz said.

Markowitz said the nurses were also worried about the availability of health services. She pointed out that while will reap financial benefits from the merger,  the hospital systems have not specified what will happen with increased profits, and whether they will benefit the communities they serve.

“We are opposed to any and all mergers that don’t guarantee patients and their communities a higher standard of care,” Markowitz said. “Until the issues of concern to RNs and patients are adequately addressed, NNU strongly urges Attorney General Rosenblum not to waive an investigation—and instead to conduct a full review of the transaction, including holding public hearings, to ensure this is the right move. The communities served by these hospitals deserve no less.”


Related Slideshow: By The Numbers: How Oregonians Rate Their Healthcare Providers

A report from the Oregon Center for Public Policy shows how Oregonians rated their individual CCOs (Coordinated Care Organizations) in 2014 based on percentages of total customers who were satisfied with their service.  The report shows both adult and child approval percentages for eight different categories including how well their doctor communicated to the quality of their health plan. GoLocalPDX averaged these approval percentages to determine the CCOs where customers were the most and least satisfied overall in 2014. 

Prev Next

#16: Umpqua Health

Umpqua Health Alliance

2014 Adult rating: 65.5

2014 Child rating: 68.8

2014 Overall rating: 67.2

Incorporates: Douglas County

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#15: Western Oregon

Western Oregon Advanced Health

2014 Adult rating: 63

2014 Child rating: 73.3

2014 Overall rating: 68.2

Incorporates: Coos and Curry Counties

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#14: PacificSource

PacificSource Community Solutions - Central Oregon

2014 Adult rating: 65.8

2014 Child rating: 73

2014 Overall rating: 69.4

Incorporates: Deschutes, Cook, and Jefferson Counties

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#13: Columbia Pacific

Columbia Pacific CCO

2014 Adult rating: 66.6

Child rating: 72.1

2014 Overall rating: 69.4

Incorporates: Clastop, Tillamook, and Columbia Counties

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#12: Cascade Health

Cascadia Health Alliance

2014 Adult rating: 67.1

2014 Child rating: 72

2014 Overall rating: 70

Incorporates: Klamath County

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#11: Trilliam Community

Trillium Community Health Plan

2014 Adult rating: 64.9

2014 Child rating: 76

2014 Overall rating: 70.5

Incorporates: Lane County

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#10: EOCCO

Eastern Oregon Coordinated Care Organization

2014 Adult rating: 68

2014 Child rating: 73 

2014 Overall rating: 70.5

Incorporates: Baker, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wheeler Counties

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#9: Yamhill Community

Yamhill Community Care Organization

2014 Adult rating: 64.6

2014 Child rating: 77.1

2014 Overall rating: 71

Incorporates: Yamhill, parts of Marion, Clackamas and Polk Counties

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#8: All Care CCO

All Care CCO

2014 Adult rating: 68.5

2014 Child rating: 73.9

2014 Overall rating: 71.2

Incorporates: Josephine and Jackson Counties

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#7: Health Share

Health Share of Oregon

2014 Adult rating: 71.3

2014 Child rating: 72.5

2014 Overall rating: 71.9

Incorporates: Clackamas, Multnomah, and Washington Counties

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#6: FamilyCare


2014 Adult rating: 67.1

2014 Child rating: 77

2014 Overall rating: 72.1

Incorporates: Clackamas, Multnomah, Washington, and parts of Marion County

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#5: PrimaryHealth

PrimaryHealth of Josephine

2014 Adult rating: 68.1

2014 Child rating: 77.3

2014 Overall rating: 72.7

Incorporates: Josephine and parts of Douglas County

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#4: PacificSource

PacificSource Community Solutions - Columbia Gorge

2014 Adult rating: 70.1

2014 Child rating: 75.9

2014 Overall rating: 73

Incorporates: Hood River and Wasco Counties

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#3: Intercommunity

Intercommunity Health Network CCO

2014 Adult rating: 67.9

2014 Child rating: 79

2014 Overall rating: 73.5

Incorporates: Benton. Lincoln, and Linn Counties

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#2: Jackson Care Connect

Jackson Care Connect

2014 Adult rating: 69.9

2014 Child rating: 78.3

2014 Overall rating: 74.1

Incorporates: Jackson County 

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#1: Willamette Valley

Willamette Valley Community Health (WVCH)

2014 Adult rating: 72.1

2014 Child rating: 78.3

2014 Overall rating: 75.2

Incorporates: Polk and Marion Counties


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