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The next drama for Landmark

June 1, 2011

We have a joke here at the station that I only cover two things- medical marijuana and Landmark Medical Center.  That’s kind of true.  So, because at this point I’m addicted to writing about Landmark, I’m going to lay out the next steps for the struggling hospital.

Assuming that Landmark takes care of the last adjustments to Steward’s purchase agreement and signs the documents, the next hurdle is the Hospital Conversions Act or the HCA. It was created in 1997 to prevent exactly what’s happening now- the sale of a non-profit hospital to an out of state for profit entity.

Back when Lifespan and Care New England were applying for a merger (unsuccessfully for the second time) I made myself a cheat sheet on the HCA process.  Today I’m going to share it with you.

Application Process

Folks from Steward and Landmark  will submit an application to the Department of Health (DOH) AND the Attorney General.  This is usually a long application. I’m talking around 100,000 pages.  When Care New England and Lifespan submitted their application it took up an entire room.

Step 1– Submit the application to DOH and the Attorney General

Step 2– Within 30 days, DOH and AG have to IN WRITING tell applicants whether the application is complete

Step 3– If incomplete, hospitals have 30 days to send in additional materials

Step 4– DOH and AG have 10 days to determine if additional materials are acceptable

-If materials not acceptable, or hospitals don’t submit additional info within 30 days, application is rejected, with right to reapply.

-If materials are sufficient, DOH and AG notify hospitals of date of acceptance of completed application

Step 5– Informational public meeting must take place within 60 days (2 months)

Step 5-  AG and DOH have 180 days (6 months) after date of completed application to either approve, approve with conditions, or reject the sale of Landmark.

You might think, ok, I’ll just add up the numbers in the time-line and then I’ll know how long this process will last.  That’s a logical but bad idea. The length of this process can stretch out to eternity during the “is the application complete” portion of the HCA. Let’s say the application is missing something. Landmark responds, but it’s not exactly what the Attorney General wants. Then the process starts all over again.

Care New England and Lifespan spent about two years trying to apply for a merger.  John Hynes, the CEO of CNE called the process “expensive and time consuming.”

But then again, St. Joseph’s Health Services and Roger Williams Medical Center submitted their merger application in February of 2009 and received final approval that October.

The Care New England/Lifespan merger would have controlled 70% of the state’s health care system, so there was much more at stake for the regulators. It’s my guess Landmark’s time-line will be closer to what happened with St. Joe’s and Roger Williams.

What’s your bet as to how long this process will take?

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