Catholic health care is in a period of transition. A lot has changed since religious congregations began hospitals and clinics in America in the 19th and early 20th centuries.

Catholic health care institutions face financial challenges as they serve more uninsured patients, and challenges to their mission and identity as lay leaders fill roles once filled by vowed religious.

St. Francis Hospital and Health Center has been serving the community of Blue Island for more than 100 years. In June, SSM Health Care, the owner of St. Francis, announced that it would seek an outside buyer for the hospital. Colleen Kannaday, the president of St. Francis, said the first preference would be a Catholic buyer, but the hopsital will consider other offers. The decision will be made in the next few weeks.

According to a press release, SSM–a health system sponsored by the Franciscan Sisters of Mary–attempted to strengthen and expand St. Francis with plans for a satellite hospital in Orland Park. The Illinois Health Facilities Planning Board turned down the proposal for the second hospital two years ago.

Kannaday said financial challenges were part of the reason that SSM chose to sell the hospital. “This is not just St. Francis but this is all of Catholic health care,” Kannaday said about the financial difficulties. “We are challenged to remain true to our ministry’s commitment of caring for all of those who come to us regardless of their ability to pay.”

More Americans are uninsured and fewer employers are providing insurance, said Phil Karst, the executive director of Illinois Catholic Health Association. He added that Medicare and Medicaid both tend to underpay hospitals.

“To run a high-quality, high-performing institution requires a good deal of money,” Karst said. “With the uninsured, among other presentable problems, how can you provide them with the highest quality care at a time when nobody really wants to pay for it?”

Caring for communities

Catholic health care institutions also serve the poor and uninsured through community programs.

The national Catholic Health Association began the Community Benefit Inventory for Social Accountability (CBISA) program several years ago as a way for Catholic health care institutions to document their community work. This is a way for non-profit hospitals to justify their tax-exempt status, but most hospitals use these programs as a way to address a specific health need in the community.

For example, St. Bernard Hospital in Englewood began a pediatric mobile health unit, providing physical, dental and vision exams, along with vaccinations for the children in the neighborhood.

St. Anthony Hospital on the Southwest Side offers several community classes on diabetes, prenatal care, women’s health and health insurance for children.

Provena Health, a Catholic health system in Illinois, started a diabetes clinic in Aurora, where patients can receive medicine and nutrition information for a small fee. Thomas Nehring, the vice president for mission and leadership development at Provena, said these programs are matched to community needs. “It is not just random acts of kindness; it is really a planned activity to address an unmet need,” he said.

Changing sponsorship

Catholic health care is facing other challenges as fewer religious congregations are sponsoring health care institutions.

When religious congregations started hospitals, they had more members who served as nurses, chaplains and administrators, said Father William Grogan, the cardinal’s delegate for hospitals.

Now, many Catholic health care administrators, as well as nurses and chaplains, are lay men and women. The challenge, Karst said, is to train these lay leaders. They need more than just a business administration background. They need training on Catholic identity and the mission of Catholic health care, he said.

At Provena, Nehring said they hold a leadership development program, where lay leaders are exposed to basic theology, Catholic social teaching and the ethical religious directives for health care.

As president of St. Francis Hospital, Kannaday said, “I feel a greater obligation and sense of responsibility in stepping into a role as a lay person that used to be so dominated by the religious women.”

In order to build on the foundation that the sisters set out for the hospital, Kannaday said she must stay focused on the mission. “The mission and values drive our decision making,” Kannaday said. “The majority of our employees could tell you what our mission is, what our values are, and how the work they do helps to fulfill our mission.”

The mission and the Catholic identity of the hospital should be visible to patients, Grogan said. While a surgical procedure would be the same at a Catholic or non-Catholic hospital, Grogan said, the hope is that the care at the Catholic hospital would be distinct.

Chaplains and pastoral care givers should be just as important as nurses or doctors in the care of patients, Nehring said. “We are here to meet not only your physical needs, but your emotional needs, your spiritual needs, your relational needs,” Nehring added.

The availability of the Eucharist is also significant. “Reception of the Eucharist is the first and most important medicine that the sick can receive,” Grogan said.

Catholic health care is distinct because it gives people a sign of hope, Nehring added. “What we offer people is the sense that God is there for you,” he said.

Catholic health care cannot lose this distinction. “We have to be signs of the reign of God in the world today,” Nehring said. “If we stop being that then there is no reason to have Catholic health care.”

The future of Catholic health care is uncertain. Catholic hospitals may be struggling with financial difficulties, but Grogan pointed out that there is growth in other Catholic health care services, such as nursing homes, clinics and laboratory services.

“We see an explosion of all the areas except Catholic hospitals. So the fact that a hospital changes hands does not mean there’s a failure,” Grogan said. “If Catholic hospitals don’t want to pick up a hospital and it is sold to other non-profits or a for-profit, that is the church telling us that this is not an activity essential to the Catholic mission.”