As 5 Utah hospitals change hands, will it mean less reproductive care?

State health officials have no “mechanism” to track the procedures Utah hospitals perform, leaving consumers largely in the dark, The Tribune found.

(Francisco Kjolseth | The Salt Lake Tribune) Salt Lake Regional Medical Center is one of five Wasatch Front hospitals currently being acquired by a Catholic-affiliated health care system, a move that could mean five fewer treatment facilities for Utahns seeking reproductive health care services, including vasectomies and in vitro fertilization.

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Five Utah hospitals recently acquired by a nonprofit, Catholic-affiliated health care system won’t provide elective abortions, vasectomies, tubal ligation, in vitro fertilization and other reproductive health services in order to align with their new owner’s “ethical and religious directives.”

Once the acquisition is finalized, the move could mean five fewer treatment facilities for Utahns seeking reproductive health care services in 2024, when a new law will close the state’s six abortion clinics and shift such care to hospitals.

But whether or not any loss in reproductive health care options will actually unfold at these five hospitals is unclear. Steward Health Care, which currently operates Salt Lake Regional Medical Center and the four other Wasatch Front facilities, declined to answer whether the hospitals already provide such care.

Centura Health, which is acquiring the hospitals with its joint operating sponsor CommonSpirit Health, declined to answer whether bringing the facilities under their umbrella would constitute a change in access.

And statewide, the Utah Department of Health and Human Services has no “mechanism” to track the procedures that any hospitals offer — because “it can be a long list and can be changed at any time,” spokesperson Charla Haley said.

The lack of transparency means consumers can be left without the knowledge they need to make an informed decision about where to go in Utah for a procedure — unless a facility voluntarily discloses that information, The Salt Lake Tribune found.

[Help The Tribune investigate: Have you been treated in the last three years at a Steward hospital?]

Colorado lawmakers want to make hospitals disclose

(RJ Sangosti | The Denver Post via AP) Colorado Rep. Brianna Titone speaks to the media supporting a package of bills to protect abortion and reproductive rights during a news conference in the West Foyer at the Colorado State Capitol, Thursday, March 9, 2023, in Denver.

Lawmakers in Colorado last month proposed legislation to increase transparency around what services and procedures hospitals in the state choose to restrict.

The Colorado bill would create a system where hospitals must disclose the services they don’t provide to patients “when the refusal is for nonmedical reasons.”

It was drafted after Centura and CommonSpirit quietly rolled back access to reproductive health care at the only hospital in the city of Durango with a maternity ward, The Colorado Sun reported.

One of its sponsors, Colorado Rep. Kyle Brown, a Democrat, told The Tribune that the bill was crafted after reading “troubling” reports of people showing up at facilities to get a certain treatment and being turned away.

Without this proposed law, patients would have no way of knowing what health care to expect unless the hospital or their doctor disclosed it. For instance, a pregnant person could go to prenatal appointments at a hospital and deliver their baby there, only to find out then that the facility doesn’t offer the tubal ligation that they expected, he said.

Brown and Colorado Rep. Brianna Titone, another sponsor, “have worked together to craft some legislation that I think provides the bare minimum of consumer protection, which is that folks should know, before they end up in the hospital, whether or not the services that they need are going to be provided,” he said.

The bill notes that keeping this information secret “is inconsistent with the underlying principle of informed consent” and can have long-term impacts, such as greater costs to consumers and impacts on quality of life, including by causing injury, disability or death. He said hospital systems in Colorado, including CommonSpirit, have been supportive of their efforts.

But Utah DHHS currently has no plans to track the types of procedures that hospitals in the state perform, Haley, the agency’s spokesperson, said.

“At this point we do not have any intention to change our processes for hospital licensing,” Haley wrote in an email. “Licensing does not track procedures that occur in licensed facilities.”

What the health system acquiring Steward hospitals has said

(Trent Nelson | The Salt Lake Tribune) Jordan Valley Medical Center in West Jordan is one of five Wasatch Front hospitals currently being acquired by a Catholic-affiliated health care system, a move that could mean five fewer treatment facilities for Utahns seeking reproductive health care services, including vasectomies and in vitro fertilization.

It remains unclear if Steward hospitals in Utah currently offer abortion services, surgical contraception, in vitro fertilization or other procedures typically restricted by Catholic health care systems. Websites for the system’s five Utah hospitals don’t mention the procedures.

One of the facilities, Salt Lake Regional Medical Center, recently closed its maternity ward in September. The four others include Davis Hospital and Medical Center (in Layton); Jordan Valley Medical Center (in West Jordan); Jordan Valley Medical Center’s West Valley City campus; and Mountain Point Medical Center (in Lehi).

When asked about what’s currently offered, Josie Martin, the hospital system’s vice president of strategic communications, said: “At the moment, we have no comment in response to your questions.”

Once the hospitals are officially acquired by Centura and CommonSpirit later this year, the answer is more explicit.

While Centura and CommonSpirit Health didn’t respond to The Tribune about which procedures they may choose to restrict, the most recent copy of the “Ethical and Religious Directives for Catholic Health Care Services” states, “Catholic health care institutions are not to provide abortion services.”

The directives define abortion as “the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus.” It further states that “every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.”

According to Healthcare Dive, which reports on the health care industry, CommonSpirit follows these directives and also bars services including surgical contraception, in vitro fertilization, gender-affirming surgery and physician-assisted suicide.

In a written statement, the health care system told The Tribune, “Centura Health and CommonSpirit Health are excited to bring our healing ministry to Utah.”

“As a not-for-profit, faith-based health care system, we will bring patients new clinical care options, collaborate with the community to have a greater impact on the future of health care and provide care that is guided by our Catholic values,” the statement continued, “which includes a commitment to serving the poor and vulnerable and holistically caring for the whole person.”

The statement noted that patients and providers will see “no changes to the services provided” ahead of the acquisition’s close.

“We plan to partner first with the caregivers and other key stakeholders in the community around how we can best meet the community’s needs,” the statement continued, “and provide care that is consistent with our mission and values.”

What procedures do Utah hospitals disclose?

The Tribune reached out to other hospital systems in Utah in an attempt to learn what procedures they do and don’t offer. Intermountain Health, the University of Utah Health and MountainStar Healthcare declined individual interviews and responded in a statement from the Utah Hospital Association, which represents the policy interests of hospitals throughout the state.

Jill Vicory, the association’s vice president of member and community affairs, said in general, hospitals in Utah do not offer elective abortions, but those select health care systems do provide surgical contraception and in vitro fertilization. She added that they also offer some gender-affirming surgeries for adults. The Utah Legislature in January banned such surgeries for minors, and Gov. Spencer Cox later signed the bill into law.

Vicory noted that those hospitals don’t offer physician-assisted suicide, which isn’t legal in Utah.

As for how Utah hospitals will adapt to the new law that shifts abortion services to hospitals next year, and whether providers have concerns, Vicory said each health care system in Utah will “need to determine how to respond” to the bill’s passage.

New data shows only 1% of abortions in Utah in 2020 were performed in hospitals, The 19th News reported. Vicory later added, “all Utah hospitals will follow state law.”

Intermountain Health, which operates around half of the hospitals in the state, offered additional information on their website, stating that they currently restrict elective abortion procedures to pregnancies that result from rape or incest (and only if “the event has been properly and completely reported to law enforcement”), or in cases where two maternal-fetal medicine subspecialists have determined a fetus won’t survive “until or beyond birth.”

While the University of Utah Health family planning website stated earlier this month that clinicians “provide a full range of contraceptive and abortion services,” Kathy Wilets, director of media relations, confirmed that they do not provide elective abortions and said the system would be updating its website to reflect that. It now states: “We provide abortion services and a full range of contraceptive services.”

The state’s two LifePoint Health hospitals — Castleview Hospital in Price, and Ashley Regional Medical Center in Vernal — don’t mention abortion services on their websites, and a spokesperson declined a request for comment.

Correction • March 27, 3:25 p.m.: The story has been updated to correct the description of a hospital in Durango, Colorado.