Terre Haute Regional Hospital’s owner says it could close if COPA is denied
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Terre Haute Regional Hospital’s history dates back to 1882, but its future could be in jeopardy if a Certificate of Public Advantage, or COPA, supporting a proposed merger with Union Health isn’t approved by the Indiana Department of Health.
Union Health is currently waiting to find out if its second COPA application to merge with Terre Haute Regional Hospital will get the green light.
In a letter to Indiana State Health Commissioner Dr. Lindsay Weaver, Monica Cintado, senior vice president of Terre Haute Regional Hospital parent HCA, expressed concern over the hospital’s future.
“If the COPA application is denied, then market conditions are such that HCA will need to seriously consider ending services or closing the hospital,” the letter reads.
The 2025 COPA application states that “Regional Hospital has faced significant operational challenges for a number of years which have led to a decrease in patient volumes, a reduction in service lines, and a significant decline in competitive viability.”
“Union Hospital, Regional Hospital, and community leaders believe that the merger is the only model that will allow the community to achieve the goals set forth in the Community Plan and preserve access to a high-quality and cost-effective health system long-term,” the health system says in the application.
Plans for the two Terre Haute hospitals to merge have been in the works since September 2023, when Union Health applied for a COPA, which allow hospital mergers that the Federal Trade Commission otherwise considers illegal because they reduce competition and often create monopolies.
The FTC opposed the plan, and Union Health withdrew its application last November. However, the health system filed a new COPA application in February, which again drew opposition from the FTC. It warned that the merger poses substantial anticompetitive risks such as higher health care costs for patients and lower wages for hospital workers.
Cintado’s letter was sent after Indiana Attorney General Todd Rokita wrote a letter expressing his opposition for the proposed merger.
In his letter, Rokita said the consolidation of the two hospitals would “lead to the monopolization of Terre Haute hospital systems that (would) be unchecked in raising health care costs, stifling innovation, suppressing wages, and reducing access to care for the citizens of Terre Haute and the surrounding community.”
An analysis from Yale University released last month found the proposed merger of Union Health and Terre Haute Regional Hospital would result in a 10%-30% increase health care prices and a 3%-10% increase in insurance premiums, in addition to lower wages for nurses.
WTWO also reports that Cintado’s letter said Regional Hospital’s finances are declining and mentioned possible efforts to sell.
“HCA’s extensive search included Morgan Stanley approaching at least six potential purchasers beginning in 2019-2020. Specifically, outreach was conducted to solicit interest from: Indiana University Health, Ascension Health, Franciscan Health, Community Health Network, Hendricks Regional and OSF Healthcare. None of these health systems expressed interest in a transaction,” the letter said.
She went on to add that at that point “HCA only then re-engaged with Union about a transaction when it was clear there were not alternative purchasers.”
The Indiana General Assembly passed a law in 2021 allowing COPAs, but if this one is denied, neither health care system would be able to re-apply.
The original bill was co-authored by Sen. Ed Charbonneau, R-Valparaiso, who has since reversed course and co-authored a bill this year that prohibits submitting applications for a certificate of public advantage after May 13, 2025. The bill was signed into law by Gov. Mike Braun.
In a statement after this year’s legislative session, Charbonneau said he “championed several pieces of legislation aimed to improve health care accessibility and affordability,” including the COPA bill.
“These initiatives will help Hoosiers throughout the state receive more efficient health care services at reasonable prices,” the statement read.
A ruling from IDOH is expected in June.
Inside INdiana Business reporter Alex Brown contributed to this report.