J. DAVID RICHARDSON, MD, president of the American College of Surgeons, says the only solution is to "unwind" his hospital's management agreement with KentuckyOne Health.

The president of the American College of Surgeons is assailing the management of the University of Louisville (Ky.) Hospital, where he is vice chair of surgery, asserting that budget cuts are "destroying the hospital" and that conditions have "never been worse in the 34 years that I have been heavily involved with it."

In a searing e-mail to colleagues obtained by the Louisville Courier-Journal, J. David Richardson, MD, says the situation has developed into a "major patient safety issue."

KentuckyOne Health, which was formed in 2012 when 2 other Kentucky hospitals merged, took over day-to-day management of the still-public hospital in 2013, as part of an agreement with the state. KentuckyOne's majority owner is Denver, Colo.-based Catholic Health Initiatives.

Dr. Richardson says "virtually all of the experienced nurses" at the hospital were "fired or forced out" after the new management agreement was signed, and that other nurses have left because of "unsafe working conditions" or noncompetitive salaries. He tells the Courier-Journal that the only solution is to unwind the agreement with KentuckyOne Health.

The hospital, he complains in the e-mail, is poorly staffed at night, so patients are held in the emergency room until 9 or 10 the next morning, when "magically beds appear." This results, he says, in "emergency department crowding and dangerous situations." Meanwhile, patients in the ICU often can't be moved to more appropriate settings, he says, because while there are dozens of empty beds, they aren't staffed. Additionally, it has become "virtually impossible" to do research, Dr. Richardson says, adding that an approved study was recently canceled because of inadequate nurse staffing, which resulted in a "major embarrassment" for the hospital.

Dr. Richardson also expresses dismay over the departure of former hospital president Ken Marshall, who, he says, was forced out by KentuckyOne Health.

In an interview with the Courier-Journal, Dr. Richardson says his e-mail actually understates "how bad things are."

In an e-mailed statement to Outpatient Surgery, a spokesperson for KentuckyOne Health says "ULH is an excellent hospital with a dedicated and talented team of professionals that is staffed to meet the patient's needs." Its "focus and investment on quality and safety is generating positive trends on key performance measures," it adds, "particularly in comparison with other academic medical centers nationwide."

Jim Burger