U of L gets grant to expand doctor training for under-served areas

The U of L medical school is the state's oldest. (WDRB image)

The University of Louisville has received a $16 million federal grant help train more primary-care physicians in rural and urban areas that need more doctors who focus on family medicine, general internal medicine, pediatrics and internal medicine.

The goal of the four-year grant is to encourage young doctors with those specialties to consider practicing in under-served communities, which most Kentucky communities are.

"We know that students who train in these rural locations are more likely to practice there, and our hope is that by strengthening these programs, we'll be able to immerse students in these communities and increase the number of primary care physicians in underserved regions across the commonwealth," Kelli Bullard Dunn, vice dean of community engagement and diversity for the U of L School of Medicine, said at Monday's announcement.

"We have such a need in Kentucky and all over," said Faye Jones, associate vice president for health affairs and diversity initiatives at the UofL Health Sciences Center.

Most of the state's 120 counties, and at least some portion of 113 of them, including parts of Jefferson County, are designated by the federal government as as Health Professional Shortage Areas. "Recent projections rank Kentucky lowest among the states in meeting the need for primary care physicians by 2025," Darby Beane reports for WDRB.

The grant will expand U of L's path for students to help under-served areas. The medical school will create a new program to train medical students in west Louisville and other urban communities.

The progran will be modeled on the school's Trover Rural Track, which offers primary-care clinical training in conjunction with its family-medicine residency programs in Glasgow and Owensboro. Students in the program complete their final two years of medical school at the Trover Campus in Madisonville, part of Baptist Health Deaconess Madisonville.

"According to the school, of the 170 physicians who have graduated from the Trover Rural Track so far, 75% practice primary care and 43% practice in rural communities," WDRB reports.

"The project also plans to enhance a university program that prepares individuals with a bachelor's degree in a different field to enter medical school. In addition, the grant will also help provide scholarships to support students in these programs."

The grant comes from the Health Resources and Services Administration.

University of Louisville gets $6.1 million in federal grants to study possible cause of serious illness and death from Covid-19

University of Louisville diagrams show levels of neutrophil immune cells in various types of patients. Data analysis by Corey T. Watson, Ph.D., David Tieri, Ph.D., and M.D./Ph.D. student Anne Geller.

By Sarah Ladd
Kentucky Lantern

University of Louisville researchers announced Friday that three federal grants totalling $6.1 million will allow them to further study immune-system dysregulation, which they say causes serious illness and death in some patients who have Covid-19.

The funding from the National Institutes of Health comes after UofL researchers “discovered that a specific type of immune cells, low-density inflammatory neutrophils, became highly elevated in some Covid-19 patients whose condition became very severe,” a university news release said. (Neutrophils are white blood cells in the immune system that play a role in fighting infections). The researchers published those findings in 2021.

“At one time we had over 100 patients with Covid in the hospital. Once they were on a ventilator, mortality was about 50%,” Dr. Jiapeng Huang, an anesthesiologist with UofL Health, professor and vice chair of the Department of Anesthesiology and Perioperative Medicine in the UofL School of Medicine, said in a statement. “We were looking at this issue to see why some people would do well while some developed bad lung disease and did not do well or died.”

Immunologist and lead researcher for the 2021 study, Dr. Jun Yan, said the new federal funding could help with development of a therapy. “That’s why we do this research,” Yan said. “Eventually we want to benefit the patients.”

The funding comes from three grants:

• A four-year $2.9 million grant to UofL. Researchers will use this to better understand acute respiratory distress and work to prevent those complications, UofL said.
• A five-year $2.9 million grant to UofL. Researchers will use this to “characterize different subsets of neutrophils and measure their changes over the course of Covid-19 disease progression.”
• A one-year, $306,000 grant to Degranin Therapeutics and UofL. Researchers will use this to study the effectiveness of a compound to reduce immune dysregulation.

“The knowledge gained through these studies may benefit not only Covid-19 patients, but those with other conditions in which immune dysregulation can occur,” UofL said. Those include “other types of viral and bacterial pneumonia and autoimmune diseases, and patients undergoing cancer immunotherapy and organ transplantation.”

Opinion: U of L Health should repay all its state loan, not just half

By Jim Waters
Bluegrass Institute for Public Policy Solutions

The University of Louisville Cardinals men’s basketball squad gave its fans a timely stocking stuffer Dec. 14 with the team’s first win of the season, beating the Western Kentucky Hilltoppers at the KFC Yum Center.

U of L’s health-care system should follow suit and offer taxpayers some Christmas joy by fully repaying the $35 million borrowed from the Commonwealth under the auspices of needing the money to purchase Kentucky One Health’s assets, including Jewish Hospital.

The money was neither needed nor used for these purchases.

In previous columns, we urged lawmakers to “invite the university to either pay for this project out of its already-flush-with-cash pockets or seek a loan from the private sector.”

Kentucky’s taxpayers “should be outraged that U of L lobbied heavily for this loan even though the university is flush with hundreds of millions in cash and is more than capable of making this acquisition without one red cent from Frankfort’s coffers,” we opined.

But taxpayers’ voices were drowned out by the Santa-sized claims of former U of L President Neeli Bendapudi, who doubled down on her assertions that the loan was “vital” to purchasing the additional facilities and that there was no other way for the university to absorb Kentucky One Health’s operating losses.

Documents obtained by the Bluegrass Institute Center for Open Government reveal that not only was U of L capable of acquiring the funds to make needed improvements to the previously faltering Kentucky One Health system without the government loan, but that the monies were used for a variety of capital purchases, including upgrades to the system’s emergency medical records platform, computer replacement/remediation and even a new roof at Jewish Hospital.

Such outlays can improve a hospital’s ability to provide quality care, but were they so “vital” that UofL needed a subsidized, partially forgivable taxpayer-backed loan from state government to purchase them?

“Partially forgivable”? This health-care giant is only required to pay back half the loan even though the enterprise reaped year-over-year total operating revenues of $2.2 billion while holding more than $1 billion worth of total assets during the most recent fiscal year, according to audited financial statements obtained by the Center for Open Government via the open-records law.

In their annual report to the Legislative Research Commission, officials indicated they anticipated paying back “the obligated portion of the loan” ($17.5 million) ahead of schedule.

Bluegrass Institute Visiting Policy Fellow Andrew McNeill instead urges the company to “meet this moment by respecting Kentucky’s working families and taxpayers who ponied up for what has proven to be an unnecessary loan” by going beyond what’s statutorily required and repaying the entire loan.

New U of L President Kim Schatzel, whose administration officially begins in February and who has extensive business and private sector experience, should appreciate what a welcome gift that would be for the Commonwealth. Perhaps she could help spread some needed holiday cheer by voicing her own support for full repayment.

McNeill wrote in a letter to Interim Joint Appropriations and Revenue Committee members that such a gesture “would make an immediate and positive impression with Kentucky’s taxpayers, especially those from outside of Jefferson County.”

Exposure to electronic-cigarette aerosols cause irregular heartbeats in mice, University of Louisville researchers report

 Mathew Nystoriak, associate professor of medicine,
watches assistant professor Alex Carll. (UofL photo)

By Melissa Patrick
Kentucky Health News

Exposure to electronic-cigarette aerosols can cause heart arrhythmias in mice — in both premature and skipped beats, according to a University of Louisville study. 

Published in the peer-reviewed scientific journal Nature Communications, the study suggests that exposure to specific chemicals in e-cigarette liquids promote irregular heartbeats and cardiac electrical dysfunction, which could increase the risk for atrial or ventricular fibrillation and heart attacks. 

“Our team’s findings that specific ingredients in e-cigarette liquids promote arrhythmias indicates there is an urgent need for more research into the cardiac effects of these components in both animals and humans,” lead researcher Alex Carll, an assistant professor in the UofL Department of Physiology, said in a news release.

The researchers looked at the cardiac effects of inhaled aerosols generated from e-cigarette liquids with and without nicotine . 

"For all e-cigarette aerosols, the animals’ heart rate slowed during puff exposures and sped up afterwards as heart rate variability declined, indicating fight-or-flight stress responses," they write. "In addition, e-cigarette puffs from a menthol-flavored e-liquid or from propylene glycol alone caused ventricular arrhythmias and other conduction irregularities in the heart." 

The study was conducted in collaboration with Daniel Conklin and Aruni Bhatnagar, professors in the UofL Division of Environmental Medicine. 

"The findings are important because they provide fresh evidence that the use of e-cigarettes could interfere with normal heart rhythms — something we did not know before," Bhatnagar said in the release. "This is highly concerning given the rapid growth of e-cigarette use, particularly among young people."

The release said the research adds to a growing body of knowledge on the potential toxicity and health impacts of e-cigarettes reported by the American Heart Association Tobacco Regulation and Addiction Center, for which UofL serves as the flagship institute.

This research contributes to the ongoing debate of whether e-cigarettes are safer to use than combustible products.

For example, the release notes that while vaping does not involve combustion, thus exposing users and bystanders to little if any carbon monoxide, tar or cancer-causing nitrosamines like traditional cigarettes, e-cigarettes can deliver aldehydes, particles and nicotine at levels comparable to combustible cigarettes. 

Proponents of e-cigarettes contend that vaping helps smokers quit smoking traditional cigarettes, but the appeal of the products and their addictiveness have led to increases in youth vaping, even as the long-term risks of the products have not yet been determined.

Norton Children's Hospital gets $15 million for diabetes institute

Norton Children’s Hospital and the Lift a Life Novak Family Foundation today announced the creation of the Wendy Novak Diabetes Institute. 

The foundation has given the hospital $15 million as the starting point of a $60 million plan to expand diabetes care for children and adults, as well as build the top diabetes institute in the country, a news release said. The institute will enhance services already available through the current Wendy Novak Diabetes Center. 

Nearly half a million children and adults in Kentucky have Type 1 or Type 2 diabetes, a rate of 14%, making Kentucky the eighth worst in the nation, according to the Centers for Disease Control and Prevention. 

The goal of the Wendy Novak Diabetes Institute is to become a national center of excellence by expanding and elevating diabetes care across the region, while helping children and adults with diabetes manage their conditions, and making it easier for patients to transition from pediatric to adult care. 

 “We are confident that with the strategic partnership with Norton Children’s and Norton Healthcare, and the outstanding leadership of Dr. Kupper Wintergerst, one of the most renowned endocrinologists in the world, we can continue to climb the rankings and become the best practice institution others will want to emulate,” David Novak, founder of the foundation, said in the release. “We see this impacting not only Louisville, but the world.” 

One of the first initiatives of the institute will be to provide more patient support through expansion of the diabetes education program. "Living with diabetes is an enormous burden, and educators are able to help each child and adult face every one of life’s challenges.” Wintergerst said in the release. 

Wendy and David Novak with daughter Ashley
(Photo by Pat McDonogh, The Courier Journal)

Wintergerst is a pediatric endocrinologist with Norton Children’s Endocrinology, which is affiliated with the University of Louisville School of Medicine, where he is the Wendy L. Novak Chair of Pediatric Diabetes Care and Clinical Research.

Norton Healthcare says it provides care for more than 69,000 patients with diabetes, spanning 137 counties in Kentucky and Southern Indiana. About 1,400 of the patients are children, says the release.

Looking forward, the Norton Children’s Hospital Foundation and Norton Healthcare Foundation have committed to raising another $12 million for a total $27 million investment. So far, $2 million has been raised. In the coming years, the goal is to raise additional funds to reach the $60 million vision.

The Lift a Life Novak Family Foundation was established in 1999 through a charitable trust by David and Wendy Novak. It funds innovative, high-impact projects that are led by passionate leaders committed to outstanding execution. Wendy Novak has had Type 1 diabetes since she was 7 years old, reports Maggie Menderski of the Louisville Courier Journal.

Former state public-health commissioner Jeff Howard is interim director of Metro Louisville Department of Health and Wellness

Dr. Jeffrey Howard

Dr. Jeffrey Howard, the longest-serving of three public-health commissioners in the previous state administration, has been named acting director of the Louisville Metro Department of Health and Wellness.

Howard succeeds Dr. Sarah Moyer, who will become chief medical officer for Humana Healthy Horizons, the new name for the health-insurance company's Medicaid plan in Kentucky. She will remain an adviser until June 30, the end of the the fiscal year, and start her new job on July 5.

Howard's "commitment to equitable health outcomes, paired with his experience at the state and federal levels makes him the right person to lead our health department at this critical time," Mayor Greg Fischer said.

Howard has been the department's contracted medical director since October. He told Kentucky Health News he still plans to leave to become a general surgeon at Louisville's Norton Healthcare in August.

Howard, a native of Harlan County, was health commissioner in 2017-19, during the term of Republican Gov. Matt Bevin. He left to become a White House fellow for a year, then returned to complete his residency at the University of Louisville.

U of L says it will spend $144 million to upgrade hospital

Artists' rendering from University of Louisville Health

The University of Louisville plans to expand and renovate its 40-year-old hospital in Kentucky's largest city.

Officials say the $144 million project will include a seven-story tower with 20 new patient rooms, for a total of 360 private rooms at the hospital; four new operating rooms; a 24-bed observation unit to ease strain on the emergency department and reduce wait times; and a new lobby and waiting area, with renovations to the gift store and coffee shop.

Officials hope the expansion will be done by 2024. They said it will add 325 new jobs – nurses, clinical and nonclinical staff.

U of L Health CEO Tom Miller said Thursday the upgrades are much needed as more people seek specialty care at the region's only Level 1 trauma center. "Level 1 trauma centers provide the most comprehensive care for serious injuries that require a fast response, according to Medical News Today. They often have surgeons on staff 24 hours a day," WFPL reports.

“Every day this past year, 40 patients a day didn’t get a room in our hospitals [and] had to stay overnight in the emergency departments or in our recovery areas,” Miller said. “Today is the day to prioritize the health of this community. And I will tell you as an academic health care facility, we take that responsibility to heart.”

Gov. Andy Beshear, Louisville Mayor Greg Fischer, U.S. Rep. John Yarmuth and acting U of L President Lori Gonzalez also spoke at the news conference. Beshear praised U of L for its Covid-19 response and vaccine rollout.

“This expansion is great news for the commonwealth because you treat patients from all 120 counties,” Beshear said. “Now you’ll be able to serve even more people and hopefully we can put this pandemic behind us and then address so many challenges in health that afflict our people.”

U of L will pay for the project with its own funds, private donations and borrowing through tax-free bonds and revenue bonds, a news release said.

UofL Health to retire loan used to buy Jewish Hospital and other facilities of defunct KentuckyOne Health in four years, not 15

Jewish Hospital has kept its name but is now clearly a subsidiary to the UofL Health brand. (UofL photo)

The University of Louisville's hospital operations are doing so well that UofL Health had adopted an accelerated repayment schedule for a $35 million loan it got from state government to buy the assets of KentuckyOne Health, including Louisville's Jewish Hospital.

The 15-year repayment schedule is now four years, ending in April 2025, under a new deal approved Thursday by the Kentucky Economic Development Finance Authority and announced by Gov. Andy Beshear.

“I want to congratulate UofL Health on its recent success,” Beshear said in a press release. “It is great to see their facilities have benefited from the funds issued last year, and I hope to see this positive trajectory continue well into the future. We know now more than ever how vital our health care facilities are to our state’s continued growth. This is tremendous news for the Louisville area and the commonwealth.”

The loan, first conceived in the closing months of the Matt Bevin administration, was to be $50 million. The Beshear administration and the General Assembly agreed on $35 million in March 2020 to absorb short-term operating losses and capital improvements, including:

• Replacement of information-technology infrastructure to support electronic medical records
• A geropsychiatric unit and redevelopment of an epilepsy unit
• A catheterization lab and detox unit at Mary & Elizabeth Hospital
• Addition of 10 beds at Frazier Rehabilitation Institute
• Air-conditioning upgrades for UofL Health-Shelbyville Hospital.

Since absorbing KentuckyOne, UofL Health has done well financially, ending the last fiscal year with higher patient admissions and net income of $96.5 million. UofL Health has more than 1.5 million patients a year and has more than 7,900 full-time employees. Jewish Hospital has long been an essential part of its medical-education and transplant programs.

Other details of the deal remain, including the ability to forgive up to half of each annual loan payment based on UofL Health meeting either of two options: keeping 5,880 full-time, Kentucky-resident jobs with an average hourly wage, excluding benefits, of at least $35; or meeting two requirements in Louisville's officially designated Medically Underserved Areas: Continue operating existing facilities and open at least one additional facility in the MUA or in close proximity to serve the MUA, and increase the number of family-medicine access points from 10 to 14.

"In the past year, UofL Health opened two new Urgent Care Plus locations in underserved areas, and 107 physicians have been recruited to improve care for the underserved population," said a news release from Beshear's office.

“Our UofL Health system [has] never better staffed, funded and appreciated," President Neeli Bendapudi said in a news release announcing that she would become president of The Pennsylvania State University.

UofL Health CEO Tom Miller said in the release, "UofL Health would not have come into being without Neeli's leadership. She led the charge that saved Jewish Hospital and ensured the future of a thriving health care system in Louisville’s downtown just before the Covid crisis swept the globe. The UofL Health family extends our thanks to Neeli for her leadership and we will be forever grateful for her historic impact on the city and the university."

UofL Health-Jewish Hospital team is second in U.S. to implant a new type of artificial heart; Indiana man 'doing well' after 5 days

The University of Louisville announced Wednesday that UofL Health-Jewish Hospital had implanted a new type of artificial heart in a Southern Indiana man, making it the second U.S. hospital to implant the French-made device.

Mark Slaughter, M.D. (University of Louisville photo)

The heart was implanted Aug. 20 by a surgical team led by Dr. Mark Slaughter, the lead cardiothoracic surgeon at the hospital and chair of cardiovascular and thoracic surgery in the U of L School of Medicine. "The recipient, whose identity is being withheld upon request . . . is doing well," a U of L news release said.

The Aeson heart "serves as a bridge to transplant for patients with end-stage biventricular heart failure – heart disease affecting both left and right sides of the heart – allowing more time for the patient to receive a permanent heart organ transplant," the release said. "The new device is designed to solve the limitations of left-ventricular assist devices, which pump blood in just one chamber, by pumping blood in both heart chambers."

It also has sensors that detect blood pressure and position and adapt blood output accordingly, and has an external power supply, the release said: "The device is medically approved in Europe, where approximately 20 devices have been implanted. The first Aeson artificial heart in North America was implanted in July at Duke University," in a 39-year-old man from North Carolina.

The release noted past pioneering cardiac efforts at U of L and Jewish, which the university took over in 2019 "to preserve its storied organ-transplant program," notes Deborah Yetter of the Courier Journal. "On July 2, 2001, U of L cardiothoracic surgeon Laman Gray led the surgical team that implanted the first self-contained artificial heart in the United States at Jewish Hospital," the release said. "The AbioCor artificial heart was implanted into Robert Tools, who lived five months on the device. The UofL surgical team also performed the first heart transplant in Kentucky at Jewish Hospital in 1984."

Mayfield wastewater testing shows promise for more targeted measures to thwart coronavirus infections, foundation says

Jeff Kelly of Mayfield Water and Electric Systems pulls

a sample of wastewater at treatment plant for analysis.

A wastewater testing project in Mayfield is helping pinpoint outbreaks of the novel coronavirus even before residents experience symptoms, and thus could allow more narrowly targeted measures to prevent further spread of the virus, the Foundation for a Healthy Kentucky said in a news release.

The partnership between the Graves County Health Department, the City of Mayfield, Murray State University, the University of Louisville Co-Immunity Project and the foundation began in early November.

"The project is essentially an early-warning system that gives health officials and policymakers the information they need to focus additional testing and treatment where there are specific outbreaks, thus helping avoid the need for more countywide or statewide shutdowns," said Ben Chandler, president and CEO of the foundation. "Wastewater testing can help more of us get back to normal more quickly by identifying where outbreaks are most prevalent over time."

The foundation paid for equipment to analyze samples, as part of a $60,000 grant to the Co-Immunity Project. While early data is still sparse, the project already has identified spikes in infections ahead of the traditional clinical and testing models. 

Samples are being taken from the wastewater treatment plant in Mayfield. Murray State chemistry and biology labs, led by Assistant Professor Dr. Bikram Subedi and Associate Professor Dr. Gary ZeRuth, respectively, analyze the samples to count copies of the RNA (ribonucleic acid, a genetic material) of the virus and look for changes.

Subedi said, “The virus that causes Covid-19 has been shown to be shed into the wastewater from infected persons regardless of whether they exhibit symptoms,” so wastewater sampling “serves as a comprehensive, non-invasive, near real-time, and cost-effective approach to monitoring Covid-19 infection within communities that is not dependent on individuals submitting to testing.”

Graves County Health Director Noel Coplen said, "This is similar to the practice of having canaries in a coal mine," which were once used to detect dangerous concentrations of methane. "It shows us that there is an infection in our community before symptoms present themselves in individuals."

Wastewater-based epidemiology has been used for many years to detect diseases in communities, but this is the first time it has been used in Western Kentucky to detect the novel virus.

“It’s a non-traditional partnership and we are proud to have the opportunity to do our part to slow the spread of Covid in our community," said Marty Ivy, general superintendent at Mayfield Electric and Water Systems.

Such testing was already being done in Louisville and Northern Kentucky as part of the Co-Immunity Project. That work has found that wastewater infection levels reflect community infection levels, said  Dr. Ted Smith, director of the Center for Healthy Air, Water and Soil at U of L's Envirome Institute. The University of Kentucky is also sampling campus wastewater to detect outbreaks.

Studies forecast new restrictions could save lives, reduce hospitalizations; Beshear warns hospitals at 'tipping point'

University of Louisville graph, relabeled by Ky. Health News; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

A new study predicts that compliance with Kentucky's new emergency orders to thwart the coronavirus could save up to 1,000 lives in the Louisville region, and presumably have similar results across Kentucky.

Department for Public Health map,
adapted by Kentucky Health News

As he made perhaps his strongest plea yet for compliance, Health Commissioner Steven Stack went over two University of Louisville studies that forecast deaths and hospitalization trends in Jefferson County and the 14 other counties in the Louisville hospital region, based on differing levels of compliance.

One study projects that by mid-January, a high level of compliance would prevent about 1,000 deaths in the 15 counties and low compliance would still prevent more than 500 deaths. 

The study also forecasts 1,689 active hospitalizations in mid-January with little to no compliance, up from about 350 now. High compliance would reduce hospitalizations to about 100, the study predicts.

University of Louisville graph, relabeled by Ky. Health News; for a larger version, click on it.

"This is substantial," Stack said. "Those measures, if they're followed, could have a profound impact and could really change the trajectory of this, and completely avert the crisis of health-care staffing and the harm that is caused to other people without covid who aren't able to get care because covid fills the hospitals, consumes all the resources and also causes health-care workers to go out sick. " 

Stack noted that for three weeks, the state made recommendations that public-health officials said would have brought down Kentucky's infection rates if they had been followed. Stack said Kentucky health officials were "asking, urging, begging, pleading, trying to persuade with facts and figures, and also appeals to people's better angels" to try to get people to comply, but it didn't work.  

"And as a result, because we can't stand by idling and let Kentuckians who can't otherwise protect themselves who are vulnerable, pay with their lives, literally. . . . The additional measures became necessary," he said. "And if we were just to comply fully with the mask mandate, that alone probably would help to contain this virus and get us back to reopening all these different things that are now shuttered. So ultimately, it's the public's choice, how we're going to respond." 

Steven Stack, M.D. (April 2020 photo)

Stack, a physican, called on local leaders and individuals to step up and do their part to improve compliance  in their communities. He also urged Kentuckians to not celebrate Thanksgiving with anyone who is not in their households, calling it an "assured recipe for disaster."

"This is really important. This is a defining moment. And we're gonna have a dark winter if we don't pull it together," he said. "And we want to lift as many of these restrictions as fast as we can, as soon as we can feel more confident that it won't be paid for with large-scale loss of human life and harm to other people who need medical and hospital care who don't have covid." 

Last week, Beshear banned in-person schooling and indoor service in bars and restaurants, limited indoor gyms and recreation facilities to one-third capacity, with no group classes; placed a limit of 25 people in all venues, event spaces and theatres; limited professional spaces to one-third capacity along with a call for them to allow people to work at home or to close altogether if at all possible; and limited sizes of gatherings to eight people from a maximum of two families. Beshear also asked churches to stop in-person worship. In addition, the mask mandate remains in effect. 

University of Louisville graph, adapted by Ky. Health News

The second study Stack discussed looked at compliance with the mask mandate in Jefferson County. It found that men aged 19 to 44 were the least likely to wear a mask. Researchers who observed 191 public areas found that men made up 82% of unmasked staff and 75% of unmasked visitors, and more than half of the incorrectly masked visitors.  

The study also compared mask compliance in small, medium and large public areas and found that compliance was worst in small areas; 35% of such areas had at least one unmasked visitor, compared to 23% in medium-sized areas and 14% in large areas. Large areas had the highest rate of at least one visitor wearing their mask incorrectly, 61%. 

Daily data, threat to hospitals: Beshear announced 2,135 new cases of the coronavirus, another record for a Monday, a day that is typically low because of limited laboratory work on weekends. This follows the highest week for cases yet, up 22 percent from the week before.

"With what we're going to see happening over Thanksgiving, we're headed to an even darker place than we are right now," Beshear said. "That's why we're taking the steps that we're taking, to put up a fight against a virus that wants to take those we love. And it's our job to fight for those individuals. " 

The share of Kentuckians testing positive for the virus in the past seven days dropped a bit, to 8.97%. It had been above 9% since Tuesday, Nov. 17.

The state reported another day of highs for covid-19 hospitalizations and intensive-care-unit beds: 1,573 and 391, respectively. Of the ICU patients, 203 were on ventilators.

Beshear was asked if Kentucky hospitals have enough specialists to operate the ventilators around the clock for an extended period of time if they reach or extend beyond capacity, a worry in some other states.

"We talk about running out of staff before we run out of beds," he said. "We think it’s the same with ventilators." He said that if ventilator staff go out sick, hospitals "have to start bringing in people who don’t do it on a daily basis and our outcomes aren’t as good."

Beshear again warned that if cases continue to escalate, the state's health-care system will become overwhelmed, and said it is at "a tipping point." He asked Kentuckians whether they were willing to make sacrifices to ensure everyone has access to care when and if they need it, and said:

"We're taking action before we hit the point of no return, because that point is close, folks. If we don't take action now, what we're talking about will happen. Taking action before Thanksgiving is critical to make sure that the surge that we all expect to see afterwards, [to] make sure that we're as ready for it as we can [be]."

Beshear pointed to examples in other states as cases surge across the nation. He said New York has had to reopen a field hospital, the Mayo Clinic's Wisconsin hospitals have been forced to put beds in lobbies and a parking garage because they have exceeded capacity, and 22% of hospitals nationwide say they will face a critical staff shortage in the next week.

Because this surge is happening all across the nation, Beshear warned,  "There's nobody coming to help us. When our Kentucky providers run out, there's no one coming to our aid. We have to protect ourselves and the threat is so very real." 

In an open letter, hospitals and health departments in the Paducah area pleaded with the public to wear masks, wash hands frequently, and practice social distancing. “We’re under some pretty significant stress right now,” Murray-Calloway County Hospital CEO Jerry Penner told Murray's WKMS. “Our resources are getting tight and our beds are filling. . .. We’re getting ready to go into a significant holiday when people normally get together. Now all of a sudden we’re asking people to wear masks and in some cases, the governor is asking them not to have large groups at home. We can only imagine the two weeks after Thanksgiving, we’re gonna have another potential blossom of a number of cases. We just need everyone’s help to think about what they’re doing.

Beshear shared a video of health-care workers asking Americans to wear a mask, and his news release noted a recent study in Kansas from the U.S. Centers for Disease Control and Prevention that shows on average, counties that mandated mask-wearing saw a 6% reduction in cases; in contrast, the counties that opted out saw a 100% increase in cases.

The governor announced five more confirmed deaths from covid-19, bringing the state's death toll to 1,792: a 73-year-old Fayette County woman, a 73-year-old Harlan County man, a 77-year-old Webster County man and two McCracken County men, 85 and 88.

Beshear honored the life of LaTasha Benton of Lexington, who died of covid-19 complications at only 43. Beshear said she was a key member of the Lexington community, who worked on issues such as tenants’ rights, affordable housing and criminal justice reform.

Benton was featured in a New York Times series about people who have died of covid-19. In the article, her mother, Stephanie Pace, said that even after two kidney transplants, two strokes and two hip replacements, she never complained, saying, "She was my little bionic girl." Beshear said she tested positive for the virus at the end of October and died on Nov. 6. She is survived by her son, Daniel, her two brothers and her mother. 

"LaTasha, we are so sorry, and we grieve with your family," Beshear said. "I will wear my mask for you and I hope everybody else does, too." 

In other coronavirus news Monday:

• Counties with 10 or more new cases were Jefferson, 435; Fayette, 260; Madison, 110; Boone, 85; Kenton, 77; McCracken, 68; Warren, 54; Campbell, 39; Oldham, 38; Greenup, 32; Jessamine, 30; Daviess, 28; Graves, 26; Calloway, 25; Franklin, 24; Whitley, 23; Bullitt, 22; Montgomery, 22; Boyd, Logan and Powell, 21 each; Barren, Floyd and Shelby, 20 each; Henderson, 19; Pulaski, 18; Magoffin and Scott, 17; Caldwell 16 Grayson, 15; Breathitt, Muhlenberg, Owsley, Simpson and Spencer, 14 each; Boyle, 13; Bell, Carter, Hardin, Laurel and Mercer, 12 each; Garrard, Hopkins, McCreary and Russell, 11 each; Harlan, Letcher, Morgan and Taylor, 10 each.
• In long-term care, there were 6,065 active cases in residents and 5,437 among staff, with 138 new resident and 135 new staff cases reported Monday. Beshear said 37 more new resident deaths and one new staff death had been confirmed, bringing the toll attributed to covid in these facilities to 1,155 residents and seven staff.
• Beshear said 15 inmates have died from complications from covid-19, including two from the Kentucky State Reformatory who died this weekend. Two corrections employees have died from covid-19. 
• The college and university report shows 813 students and nine staff tested positive for the virus in the past 14 days. 
• More than 1,000 Kentucky parents, nine religious schools filed a brief supporting a lawsuit by Danville Christian Academy and Attorney General Daniel Cameron against Beshear's order to stop all schools from holding in-person classes. At a Monday hearing, "The judge said both sides made good arguments," WKYT reported.
• A London restaurant defied Beshear's order against indoor service, Bill Estep of the Lexington Herald-Leader reports: "The head of the Laurel County Health Department was not available Monday afternoon for comment on how the agency will respond to Smith’s decision." Beshear said "at most two" restaurants are defying his order; he said one is staying open though its food- service permit has been revoked; his office didn't respond to a request for details. 
  
  Read more here: https://www.kentucky.com/news/coronavirus/article247377849.html#storylink=cpy
• Kentucky funeral homes are divided about Beshear's limit of 25 people in a room, Kristen Shanahan reports for Louisville's WDRB.
• Drugmaker AstraZeneca  announced in a news release that clinical trials show its coronavirus vaccine is 90% effective in preventing covid-19 in one of the dosing regimens tested and less effective in another, the Associated Press reports. The vaccine is also reported to be cheaper and easier to store since it does not require ultra-cold storage, so it may become the vaccine of choice for the developing world. Earlier this month, Pfizer and Moderna reported that their late-stage trials showed their vaccines were almost 95% effective. Both vaccines require special storage. The Herald-Leader explores what it means for a vaccine to be over 90% effective. 
• The first two vaccines for the virus have been developed with a revolutionary kind of genetic technology, report Grace Schneider and Deborah Yetter of the Louisville Courier Journal after interviewing University of Louisville physician and researcher Jon Klein, who participated in one of the clinical trials. "He said if the Pfizer and Moderna vaccines win approval and prove successful, it would be a stunning turnaround time for development of a vaccine. Prior to that, the mumps vaccine held the record as the fastest developed — and it took several years. Still, Klein warned the vaccines won't be available in time to prevent what he sees as a pending covid-19 catastrophe, with rates soaring across the United States, as well as many parts of the world."
• Yetter also takes a deep dive into the struggles facing the state's nursing homes and senior living sites as they continue to get slammed with the virus, and no end in site as long as rampant community spread continues.

Randomized coronavirus and antibody testing in Louisville will determine 'true extent' of virus, could be extended to rest of Ky.

By Melissa Patrick
Kentucky Health News

A project aimed at finding out the true extent of the coronavirus in Louisville has moved into its second phase after receiving a $1.5 million donation from the James Graham Brown Foundation, with hopes that it will be replicated across the state and nation, and even the world.

"The project is a national model, and we hope the rest of the country will follow in the coming months," Aruni Bhatnagar, director of the University of Louisville Christina Lee Brown Envirome Institute, said at a news conference Monday, June 8.

The Co-Immunity Project is a collaboration of the Envirome Institute and the Louisville Healthcare CEO Council, along with Louisville’s three major health systems, Baptist Health, Norton Healthcare and UofL Health.

Bhatnagar said invitations bearing a U of L seal have been sent to 13,000 households in all parts of Louisville asking them to participate in free testing for both the coronavirus and its antibodies. Participants will be selected based on age, race, sex, background and location to create a sample that matches Jefferson County's demographics.

Illustration from UC Davis Health

The first phase of the project involved testing nearly 1,500 health care workers for the virus and its antibodies. Tests of the public began with 2,400 people. They will be followed by random tests every eight weeks, with about 22,000 being tested when the project is finished. The first round will be completed by June 20, with the results to be released 10 to 12 days later.

"It is our hope that through this type of regular, representative [testing] is that we will be able to calibrate a response with greater precision in risk group, in timing and in location," he said. "But to succeed, it will depend on the participation of our community."

Initial results from statewide testing in Indiana released in May found that the number of infections was about 11 times higher than had been reported at the time of the tests, and that about 45% of those who tested positive had no symptoms, Marcus Green reports for WDRB.

Bhatnagar explained that while testing capacity has greatly expanded across the state, these results are not representative of the entire population, because they only include people who choose to be tested and this type of testing does "not tell us about the true extent of the virus in our community."

"We need not only expanded testing, but smart and consistent testing," said Bhatnagar "We need to test a random sample of people who are representative of the entire community. Much like a well-designed political poll, we have to be careful to ensure that the  test results from a group of people mirror that of the larger population. Only this can give us a real picture of who has the virus, and who has had the virus."

Bhatnagar said the data from this study will best represent an urban setting, and that he hopes to eventually extend this project to the rest of the state: "It would be somewhat precarious to extrapolate the results from urban areas to rural areas, so I think if this model could be followed in the entire state of Kentucky, then we would in the future like to include both urban and rural locations."

The news release says scientists from around the world can use the data to study effectiveness of antibody therapies and to identify types of individuals who are better able to fight off the virus.

Beshear pleads for social distancing as Kentuckians flock to stores and recreation; Trump extends guidelines to April 30

Chart illustrates the spread of contagion with and without social distancing.

As news develops in Kentucky about the coronavirus and its covid-19 disease, this item will be updated. Official state guidance is at https://kycovid19.ky.gov.

By Al Cross
Kentucky Health News

It's yet to be proven that warm weather will be bad for the coronavirus, but it's becoming clear that it can be bad for fighting it. Gov. Andy Beshear warned at his daily conference Sunday that he may have to close places of outdoor recreation and home-improvement stores if they can't enforce the social distancing that health experts say is needed to limit spread of the virus.

"I know it was a beautiful weekend, but we can’t, if we’re gonna keep these open, have large groups of people, and a large group can be six of you very close together. We can’t allow any crowds in Kentucky right now," Beshear said.

"Where social distancing is not being followed, we’re gonna have to close golf courses and other places like it. . . . If two dozen if you are standing around the practice putting green, then you’ve frustrated everything you’ve done throughout the entire week. I know it’s beautiful outside, but folks, this is real."

Warm weather also fills home-improvement stores, which Beshear has allowed to remain open as essential, life-sustaining businesses. He said there have been reports, "mainly from home-improvement stores, that we’re gonna have to look into, and we’re gonna have to have calls with those that run those facilities. We’re gonna have to ask that either those stores find a way to enforce social distancing, or we’re gonna have to see how essential they are."

The governor said that under his social-distancing order, "If there are that many people in the store, you’ve gotta close the front door until the store thins out. This is an absolute requirement that ought to be met."

He said shoppers also have a responsibility to avoid crowded stores and be careful about getting close to others: "You ought to treat yourself as if you have the coronavirus, and you ought to treat them as somebody whose spouse works in a nursing home."
Beshear said keeping away from other people “is against everything that we feel, every way that we’re raised, pretty much every way our society is put together, but . . . I want everybody to start thinking about the fact that if they don’t follow the guidelines, then doing what they just think is social can result in real harm to another Kentuckian."

He acknowledged, "We’re never gonna be able to enforce our way into the type of behavior we need to protect people. Instead, we're gonna have to have to encourage people. . . . As the days get nicer and the weekends are incredibly pleasant, I need you to be incredibly strong."

Other news about the coronavirus and its covid-19 disease included:

• President Trump said the federal government's social-distancing guidelines, which were set March 16 and were set to expire Tuesday, will be extended to April 30.
• Dr. Scott Gottleib, who ran the Food and Drug Administration for Trump, said the guidelines should not be eased "until you see sustained reduction in the number of cases for 14 days."
• Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, estimated that it “would be a matter of weeks” before the guidelines could be relaxed. He also said testing speed must improve to provide better data for decisions.

Legislator questions state loan of $50 million to U of L for Jewish Hospital, notes at-risk rural hospitals don't get similar support

U of L Health CEO Tom Miller spoke
at the meeting. (Photo by Melissa Patrick )

By Melissa Patrick
Kentucky Health News

Kentucky lawmakers asked a University of Louisville official why the state should loan U of L $50 million to help it buy financially distressed Jewish Hospital, suggesting the state was picking "winners and losers" since many rural hospitals are in the red and the state isn't helping them out.

At the Sept. 9 Medicaid Oversight and Advisory Committee meeting, Sen. Stephen Meredith, R-Leitchfield, the co-chair, called the state loan "precedent setting." Meredith said he appreciated the desire to maintain the safety-net hospital, but some rural hospitals are experiencing similar plights.

He pointed to Pineville Community Healthcare in Bell County, which recently sold in a bankruptcy auction.

"Are we picking winners and losers when we participate in these kind of efforts?" he asked. "I guess very simply: Why should we spend $50 million for Jewish, but we're not going to do anything for Pineville Community?"

Meredith (WKYT-TV image)

Meredith might have picked any one of several Kentucky rural hospitals as an example.

A report by Navigant Consulting in February found that 16 of Kentucky's rural hospitals, one-fourth of the total, are at high risk of closing unless their financial situations improve. The hospitals are not listed by name. And since 2009, Kentucky has had five rural hospitals close, according to The Cecil G. Sheps Center for Health Services Research at the University of North Carolina.

U of L Health CEO Tom Miller said he couldn't speak to issues related to Pineville hospital, but said U of L wouldn't have moved forward without a partnership with the state and two foundations.

"We believed at the time and we still believe today that there is no one who can take care of these patients" if Jewish closes, he said, stressing that it is not just a Louisville hospital, but a regional facility. He said a third of its in-patient visits are from outside Jefferson County and over 40 percent of its physician visits are by patients from other counties. It also has Jewish Hospital Shelbyville.

Miller said Jewish sees 35,000 emergency patients a year and has between 200 and 250 in-patients a day, and if its heart-transplant program closed, heart patients, many of them very poor, would have to travel either to Lexington, Indianapolis or Nashville for a transplant.

Last month, U of L announced it would buy Jewish and its associated facilities, collectively known as KentuckyOne Health, with help from the state and two foundations. The state's committed portion is $50 million, through a first-of-its-kind loan from the Kentucky Economic Development Finance Authority. The loan must still be approved by the legislature.

Senate Minority Leader Morgan McGarvey, D-Louisville, voiced concerns that the loan far exceeds the existing KEDFA loan limit of $500,000 and doesn't meet the usual requirement to create jobs.

"This loan obliterates every single criteria of being a KEDFA loan," McGarvey said. "What happens if that's challenged and you all are not actually allowed to get the money from KEDFA?"

Miller said U of L is scheduled to close on the deal Nov. 1, even if the state doesn't furnish the $50 million loan. However, he said without the funding it would have to shift resources and cut back on capital improvements at Jewish.

After the meeting, Miller told reporters U of L will have to spend about $40 million a year to maintain the hospital, Morgan Watkins reports for the Louisville Courier Journal.

McGarvey referred to a secretly recorded transcript from a private meeting between Miller and KentuckyOne Health physicians. Chris Otts reported for WDRB that Miller told the doctors that U of L Health could "be successful" with the takeover even without the $50 million loan from the state.

The meeting included a discussion about a plan to expand U of L Hospital. "How are we supposed to think that this isn't just a way of financing a new expansion of U of L Hospital down the road, and you're going to close down Jewish Hospital and sell off the assets?" asked McGarvey.

Miller said the transcript was from an unreliable source. He said there was a discussion about a separate plan to expand the university medical center with the physicians at Jewish "if we didn't go forward with KentuckyOne and those plans have been put on hold."

Meredith cut off McGarvey's pointed questioning, but said the topic would be discussed again. "We've got some serious issues and reservations about this," he said. The leaders of the Republican majorities in the House and Senate have voiced support for the loan, favored by Gov. Matt Bevin.

Geriatric doctor offers tips for aging optimally; it's much-needed advice for Kentucky seniors, who rank 49th for seniors' health

Everydayhealth.com photo

As life expectancy for both men and women keeps rising, it's important to adopt a handful of healthy habits that include things like exercising and staying social to ensure that you "age optimally."

That was the main message of Dr. Christian Furman, a geriatric physician from Louisville, on an episode of "Kentucky Health" with Dr. Wayne Tuckson on Kentucky Educational Television, Patrick Reed reports for KET.

Furman is interim chief of internal medicine, palliative medicine and medical education at the University of Louisville. She is also medical director of U of L’s Institute for Sustainable Health and Optimal Aging.

She told Tuckson that while “geriatric” applies officially to those age 65 and older, the field of geriatrics provides much of its expertise around what she called the "older old," those over 80. She added that most people can stay with their primary-care physician until they are 75, but should consider switching over to a geriatric physician at that age.

As for tips on living a long life, Furman said her advice is to adhere to the habits that are responsible for good health in general. She also noted that those who follow a healthy lifestyle during their youth and middle age are more likely to have a high quality of life during their senior years.

Here are her tips for "optimal aging" as reported by Reed:

• Exercise: She said, “You don’t have to do major exercise, just move," which she said could involve walking around the neighborhood.
• Follow a well-balanced diet: This means eating a diet that is low in red meat, avoiding foods that are high in cholesterol, and eating more fruits and vegetables.
• Eliminate tobacco use.
• Adhere to only moderate alcohol intake.
• Stay socially engaged: Furman says research shows that social isolation has negative health effects. “It’s like smoking 15 cigarettes a day, which is a lot of cigarettes,” she says.
• Yearly physicals and preventive screenings: Furman encouraged seniors to keep up with their yearly doctor's visits and preventive screenings, such as mammograms and colonoscopies.
• Regularly re-visit the need for each of your medications: “There is research that shows, the more medications you take, the more problems you will have,” she said. “About five or six is the tipping point. Once you get to six medicines, you will have more side effects and adverse drug reactions and problems.”

Overall, Furman encouraged older folks to continue doing everything that they have always done that brings them pleasure and fulfillment, if they are able to -- including sexual relations, Reed writes.

“You want people to be sexually active,” she said. “Sometimes sexual activity is different for different people, sometimes it’s cuddling, being intimate through skin contact. Sometimes the actual intercourse is hard for older people, but it doesn’t have to be.”

Furman said the goal is to keep older folks as functionally independent as they can for as long as they can, recognizing that they will not be able to function at the same pace or intensity as they did when they were younger, Reed reports.

“They should still do the things they love, but take a rest,” Furman said. “Sit, recuperate, and get up and do it again. They can still cook dinner, or decorate for the holidays. But for people who used to decorate three rooms, three Christmas trees – well, just do one room, and one Christmas tree. Everything in moderation. It’s really very individualized, but it’s totally not based on their age.”

All of this advice is especially important for Kentucky seniors, who are among some of the most unhealthy seniors in the nation. According to the most recent America's Health Rankings Report, Kentucky ranks 49th for senior's health and has been in the bottom 10 states for this measure since 2013, the first year AHR did the report.

By 2030, the U.S. Census Bureau projects that one in every five people in the United States will be 65 or older and by 2035 older people are projected to outnumber children for the first time in U.S. history.

U of L moves to maintain heart transplants at Jewish Hospital

Doctors perform a heart transplant. (Photo from WBUR, Boston)

The heart-transplant program at Jewish Hospital in Louisville may continue after all, now that the University of Louisville plans to take over the facility on Nov. 1.

KentuckyOne Health, which is selling the hospital and other facilities to the university, is asking the national organ-donor network to disregard its July 18 request that the program be put on long-term inactivation, Kentucky One and the university announced Friday. Letting the program go inactive could have required recertification by the Centers for Medicare and Medicaid Services, which would take more than a year and cost millions of dollars.

The university has collaborated for 35 years on the program, which is linked to its medical school.  “The heart-transplant program is simply too important for our university, our community and the patients who are depending on this life-saving procedure,” U of L President Neeli Bendapudi said in a news release. “We thank KentuckyOne for working with us to maintain the program. We are taking steps to shore up our efforts, and very soon we will have a plan in place to ensure the viability of the program for the future.” 

The release noted, "The first heart transplant in Kentucky took place on Aug. 24, 1984, at Jewish Hospital. Last year KentuckyOne and UofL celebrated a major milestone after the 500th heart was transplanted."  However, the number of transplants at the hospital has declined greatly; KentuckyOne blamed a change in how hearts are allocated by the United Network for Organ Sharing.

Jewish Hospital also performs lung, liver, kidney and pancreas transplants, "making it one of a select group of hospitals transplanting all five solid organs," the release said. However, kidney and liver transplants at the hospital have also become less frequent.

University of Louisville is buying Jewish Hospital after all, with the help of an unusual $50 million loan to be backed by Ky. taxpayers

The University of Louisville is buying Jewish Hospital and associated facilities after all, with help from the state and two foundations, to head off a threatened closure of the hospital, which is an important transplant center.

"U of L has searched for months for ways to save Jewish Hospital, which has been losing money for years but is also home to valuable clinical and research programs intertwined with U of L's academic mission," reports Grace Schneider of the Louisville Courier Journal.

KentuckyOne Health's "parent company, CommonSpirit Health, accelerated efforts by U of L and the state to save Jewish when the company's executives notified them early this month that they intended to shut down the facility in about two months – and to go public with the plans on Thursday, Aug. 15," Schneider reports. The school's trustees endorsed the deal Aug. 14.

U of L said in June that it had failed to find a necessary partner to buy the hospital. Now, instead of a partner, it has a friendly lender – the Commonwealth of Kentucky – and two philanthropic benefactors: a foundation controlled by CommonSpirit, and one created when the hospital was bought by the old Catholic Health Initiatives firm in 2012.

Because the hospital's main tower is estimated to have a life expectancy of only three years, U of L plans to merge Jewish with nearby University of Louisville Hospital. U of L will also own Sts. Mary and Elizabeth Hospital in south Louisville, Our Lady of Peace psychiatric hospital, Jewish Hospital Shelbyville, "four outpatient centers and a 740-employee medical group," the CJ reports. "The health system has operating losses of about $43 million a year in earnings before interest, taxes, depreciation and amortization."

"U of L will pay $10 million for the local KentuckyOne facilities and have CommonSpirit forgive a $19.7 million promissory note," Schneider reports. "The sellers, which include KentuckyOne and certain affiliates, are expected to provide $76.4 million in 'net working capital,' including accounts receivable," and the purchase price is to be adjusted if that amount is different, the CJ's Morgan Watkins reports in another story.

The two foundations "have committed a total match of $50 million toward the effort," Schneider reports. "The state is to loan U of L another $50 million," through an unusual loan from the Kentucky Economic Development Finance Authority.

The loan will be for 20 years, "with no principal payments or interest accrued for the first five years," and "is contingent on gaining the after-the-fact authorization for an additional appropriation from the fiscal 2019-20 budget with a bill prefiled at the start of the General Assembly's 2020 session," Schneider reports.

The authorization is needed because the loan amount "far exceeds the agency's maximum of $500,000," as does the length of the loan, and KEDFA "usually doesn't provide financing up front," Schneider reports. "Not all Kentucky lawmakers are on board, despite the insistence of House Speaker David Osborne, R-Prospect, that the plans have gained broad bipartisan support."

Gov. Matt Bevin "said U of L's search for an industry partner to help buy KentuckyOne's facilities led to a dead end because the prospective companies took a 'buffet' approach," Schneider reports. "They wanted to pick and choose properties they'd like to own and leave others, and that wasn't going to work, the governor said. Bendapudi acknowledged that the university's board of trustees had similar concerns about taking on a money-losing venture and turning it around."

However, a combined hospital run as "a true non-profit, not subject to the whims of the markets, should [be] less costly to operate and less pressured to post large profits, she said."

The combined operation will be huge, and the deal is "fueled by an ambitious vision to create a top-notch academic medical center," Schneider writes. "KentuckyOne's payroll is 4,539 employees and there are more than 3,100 working at U of L Hospital, for a total of 7,639. KEDFA listed full-time Kentucky resident jobs for the combined venture at 6,736. That doesn't include Hoosiers and people from other states who work at the facilities. The state list shows that between the years 2025 and 2039, the combined health system should have at least 5,880 full-time Kentucky resident jobs to meet the wage and payroll requirements."

Jewish Hospital quits heart transplants; U of L says there's less need for them, and can't start a program of its own right now

Jewish Hospital is in downtown Louisville.

Financially ailing Jewish Hospital, which was once a national leader in heart transplants but has done only one this year, says it is putting the program on "long-term inactivation" while maintaining other transplant programs.

Hospital President Ron Waldridge said in an email to employees that the Organ Procurement and Transplant Network, which directs human-tissue transplants in the U.S., "changed how heart donation are allocated" last October, Chris Larson reports for Louisville Business First. "The change resulted in fewer heart transplant cases being sent to Jewish Hospital. . . . Transplant programs must perform at least 10 heart transplant procedures over a rolling 12-month period to stay in compliance with federal standards."

The University of Louisville collaborates on the program. "U of L President Neeli Bendapudi and other U of L leaders who spoke to media downplayed the impact that stopping the program would have on the university's education mission or on U of L Health, the organization that oversees the clinical aspect of the school's medical endeavors," Larson reports.

Toni Ganzel, dean of U of L's School of Medicine, told Larson that many medical schools do not have transplant programs, "but we saw [the program] as a really valuable part of being an academic medical center."

Tom Miller, CEO of U of L Health, told Larson that advances in technology have diminished the need for heart transplants. "And he added that U of L doesn't have the space to add a heart transplant program to U of L Hospital, which is currently operating at capacity." Miller said, "That doesn't mean that we won't some time in the future —we just don't have that today." 

KentuckyOne Health and its new corporate parent CommonSpirit Health have been trying to sell Jewish Hospital and other facilities in Louisville and Shelbyville for more than two years. "U of L announced in June that it was abandoning its plan to buy assets from KentuckyOne, citing an inability to find a partner within the timeline KentuckyOne set for the talks," Larson notes.