American Nursing Care

For Catholic Health Initiatives (CHI), returning sick people to good health is more than a business -- it's a mission. Formed in 1996 through the merger of three Catholic hospital systems, the giant not-for-profit organization is one of the largest Catholic hospital operators in the US. It operates more than 70 hospitals and 40 long-term care, assisted-living, and senior residential facilities in 20 states from Washington to Maryland. Its hospitals range from large urban medical centers (many with strong educational and research programs) to small critical-access hospitals in rural areas. All told, the health system has more than 14,000 acute-care beds. It is sponsored by a dozen different congregations of nuns.

In the years since its founding, the organization has grown through a number of affiliations and acquisitions. In 2012 CHI increased its stake in the Jewish Hospital & St. Mary's HealthCare (JHSMH) system when JHSMH merged with one of CHI's wholly owned divisions, Saint Joseph Health System. The two Kentucky entities merged under a newly formed parent organization, KentuckyOne Health, and became the largest health system in the state. CHI is investing $320 million in KentuckyOne, primarily on IT and equipment upgrades, to help the system strengthen its position in the increasingly competitive and economically challenged health care industry.

In addition, in 2010 CHI affiliate Centura Health added a new hospital when it acquired Mercy Regional Medical Center of Durango, Colorado. Both the Colorado and Kentucky transactions were part of CHI's regional unification strategy, which aims to create a more streamlined organization structure to allow for better coordination of patient care.

CHI has also increased its massive heft by opening new facilities. For example, in 2009 the organization opened the 112-bed St. Anthony's hospital in Washington and the Mercy Medical Center-West Lake with about 150-beds.

To expand its non-hospital operations, in 2010 the company acquired home health services provider Consolidated Health Services, which operates some 30 agencies in the Midwest, for some $43 million; CHI plans to expand the unit's operations into new regions. The previous year, CHI acquired a 25% stake in reference lab operator Pathology Associates Medical Laboratories from its majority owner, Providence Health, to expand into the medical testing market. The health care organization also has a subsidiary, Captive Management Initiatives, which was formed in 2008 to provide insurance administration, including bookkeeping, reporting, records management, consulting, and reinsurance services.

CHI is also working to improve its network-wide IT systems, primarily through the implementation of an electronic health record (EHR) database, called OneCare, which allows medical professionals to access patient information from all of its facilities. CHI is investing $1.5 billion to install the OneCare system over the course of five years, starting in 2011. The system also launched telehealth (remote patient monitoring) initiatives in 2011. The moves come in response to federal health reform mandates that encourage the use of IT initiatives to lower the overall costs of medical care in the US.

Of course, along with making acquisitions and launching new businesses, divestments of underperforming or noncore operations are also part of running a huge health care system. In 2010 for instance, CHI and Trinity Health consolidated a number of their hospitals into a new regional health system based in Ohio and owned by Trinity Health; as part of the deal, CHI sold three hospitals in Idaho and Oregon to Trinity Health. It is also exploring options for its Dayton Heart and Vascular Hospital in Ohio.