PROVIDENCE — For more than a year, specific details regarding the proposed sale of two Rhode Island-based hospitals owned by Prospect Medical Holdings have been shielded from the public.
But on Monday morning, state regulators released pages of the systems’ Hospital Conversion Act application, which offers some new information about what the two hospitals might look like in Rhode Island if they are sold to The Centurion Foundation.
Los Angeles-based Prospect Medical Holdings owns Roger Williams Medical Center in Providence and Our Lady of Fatima Hospital in North Providence, which are two hospitals state regulators said are underfunded. The Centurion Foundation, a private nonprofit in Atlanta, Georgia, has worked to purchase the two Rhode Island hospitals since late 2022.
The public can access the documents on the Attorney General’s website. State regulators have until June 11 to either approve, deny, or approve the deal with conditions.
Many of the documents have been redacted before being released to the public, but after examining some of the pages, here are some answers to patient questions on the proposed sale.
Q: If The Centurion Foundation purchases the two hospitals, what will the new system be called?
Roger Williams Medical Center in Providence and Our Lady of Fatima Hospital currently operate under the name CharterCARE, which is a subsidiary of Prospect Medical Holdings. It does not appear as though this name would go away under Centurion’s ownership. If the deal is approved by state regulators, CharterCARE Health of Rhode Island, Inc., which will serve as the parent company. In multiple times throughout the application to regulators, executives also referred to the proposed health system as the “New CharterCARE System.”
Who would control the new CharterCARE under the proposed deal?
According to the application’s documents released Monday, The Centurion Foundation will be the sole member of the parent company that operates Roger Williams and Fatima hospitals.
What areas of medicine does the Centurion Foundation claim to want to invest in?
The new system plans to grow its network of primary care providers in new and existing locations, such as in Cranston, Smithfield, and North Smithfield. Centurion anticipates hiring more physicians in urology, general surgery, emergency room services, bone marrow therapy, and surgical oncology, according to the application.
Also, the Centurion Foundation said it needs to reposition itself as a leader in the marketplace for cancer care by investing in its clinical offices. The Roger Williams Medical Center had a federal designation for its cancer center for nearly two decades, until the early 1990s when federal regulators said the quality of care had wavered.
Where in Rhode Island might the Centurion Foundation add offices?
Other than boosting its network of primary care providers, the Foundation said it plans to invest in developing its outpatient care facilities in Johnston, R.I., which it calls a “key market.”
The hospitals are currently places where patients who cannot afford medical expenses can go for emergency care. Will that still be the case?
Yes. The new system under Centurion will continue to provide emergency medical services “to all individuals regardless of their ability to pay without discrimination,” the application said. Also, the system will use “fair and equitable financial assistance” and “discounted practices” for eligible patients who are unable to afford other medical expenses. This will be done using a scale or partial assistance thresholds and discount amounts — but specific dollar amounts were redacted from the application.
What don’t we know about this proposed sale?
Prior to releasing documents to the public on Monday, hundreds of pages were redacted. The items in these redacted pages included financial information, conflicts of interests between Prospect Medical and The Centurion Foundation, business strategy and operations information, patient statistics, integration and transition plans, patient satisfaction survey results, governmental investigations, and more. Agendas and meeting minutes from the hospitals’ board of directors and The Centurion Foundation were also redacted from the public documents.
Does Centurion own any hospitals?
“While Centurion owns certain real property for various licensed facilities across the country, it does not operate facilities or have any ownership interest in licensed operators,” the application said. Centurion and its subsidiaries “do not currently own or operate any hospitals.”
Does Centurion have any experience with hospitals?
The Centurion Foundation is based in Atlanta, and was founded in 1996. For three decades, Centurion has worked on developing, acquiring, and financing nonprofit health care projects, according to the HCA application. To date, the firm has completed more than 20 transactions, financing 31 facilities nationwide. Centurion executives claim these transactions total approximately $1 billion, which includes deals with Texas-based Ascension Seton, Alabama-based Infirmary Health System, and Washington-based MultiCare.
How much is this transaction worth?
The Centurion Foundation will purchase the two hospitals and other CharterCARE’s other entities and offices for $160 million. If the deal is approved by the state, Centurion plans on placing $80 million of cash on CharterCARE Health of Rhode Island’s balance sheet.
Does the Centurion Foundation plan on adding new services at Roger Williams or Fatima Hospital?
No. The Foundation’s plans include “expansion and improvement of existing services,” which include home health, behavioral health, surgery center, and emergency department services.
If the deal goes through, where does Centurion say it will invest in?
Also, Centurion plans on converting the system back to not-for-profit status, which could result in an economic benefit of “up to $20 million” in reduced expenses, as well as increased capital in the form of access to grants and research funding, executives wrote in the application.
The Centurion Foundation said there are specific areas that are in need of capital. These include the overhaul of the emergency room at Fatima Hospital, upgrades, new imaging equipment and robotic survey equipment, and parking lot improvements.
Does the Centurion Foundation plan on reducing services at Roger Williams or Fatima Hospital?
The parties “have no plans for any reduction of existing services and/or facilities associated with the proposed transaction,” the application documents said.
Are there any plans to reduce staff at either hospital?
No. The Centurion Foundation has “no plans to reduce staffing levels.”
According to its application to state regulators, Centurion executives said they plan on returning certain departments and functions to the local, hospital level. These departments include IT, billing, human resources, and other departments — which are all currently staffed by the corporate office of Prospect Medical Holdings in California. This could add new jobs in Rhode Island, executives said.
If the deal is approved, the new system “will add an estimated 200 positions to the Rhode Island market,” Centurion executives wrote in their HCA application. “By filling these positions locally, the new CharterCARE system will create approximately $19.5 million in additional salary income within the state.”
Who will lead the new system if the hospitals are purchased by Centurion?
Jeffrey H. Liebman will remain CEO of Roger Williams and Fatima hospitals, according to the application. The health system will be managed by a board of directors comprised of local community members, as well as representatives of Centurion. Each of the hospitals will be managed by an advisory board, which will be comprised of “local community members and stakeholders.”