BOISE -- A federal judge ruled Thursday that St. Luke's Health System must immediately separate from Saltzer Medical group.

This is the latest development after Idaho's two largest hospitals went head-to-head in court in what some would call a turf war.

In January, a judge ruled in favor of Saint Alphonus and other plaintiffs, saying St. Luke's acquisition of Saltzer's facility in Nampa threatened to monopolize a broad series of healthcare markets in Idaho.

In that ruling, the judge ordered St. Luke's and Saltzer to part ways. So far, however, that has not happened.

St. Luke's filed for a stay until they could go through the appellate process, but U.S. District Judge B. Lynn Winmill denied that stay Thursday.

The denial means the hospital must follow the judge's order earlier this year to immediately divest.

But St. Luke's officials say they will appeal the descision again - this time to a higher court. They hope that will give them more time before they have to begin the separation process.

We're obviously disappointed, said St. Luke s spokesman Ken Dey. We were hoping that Judge Winmill would grant the stay at least pending our appeal with the Ninth Circuit.

This ruling by is the latest in a case that will likely take years to resolve.

This order sustains the impact of the original decision, encourages the timetable of the original decision and says that so long as there are appeals pending, so long as those appeals may take it does not matter, St. Luke's must act on the judge's original order to divest now, said attorney David Leroy.

But attorneys with St. Luke's see it differently.

We don't know if this means immediately, Dey said. It's not clear in the ruling that he gave today whether we have to divest immediately.

St. Luke's is considering whether to appeal the denial of the stay to the Ninth U.S. Circuit Court of Appeals. In the meantime, St. Luke's will keep working with Saltzer.

We have not divested in Saltzer at this point, said Dey.

And there's a plan to do that in the near future? asked KTVB.

We will develop a plan when we find out it has to happen, and we'll do that in an orderly way and in a way that least impacts the patients and the employees, said Dey.

More specifically, Dey says they have a general plan in place to divest - just not anything with a specific timetable.

Fortunately, when we put this in place, because we knew this was being challenged by the court, we decided to not fully integrate Saltzer, said Dey.

That means signs have not changed, and medical records and workflows have stayed separate. Dey says the latest ruling doesn't impact patients and employees day-to-day.

The long-term outlook for Saltzer that is still in limbo, as it has been since Winmill made his ruling in January.

Saltzer has gotten lost in a lot of this and that's unfortunate, Dey said. They're a really important group to the community. They've provided care for 50 years.

Saint Alphonsus officials said in a statement they were happy with the decision.

Here's what Saint Alphonsus President and CEO Sally Jeffcoat had to say:

We are very pleased with today's ruling. We will continue to work with all healthcare providers including Saltzer Medical Group to provide seamless access to healthcare for our communities.

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