Landmark in Limbo as Regulators Review Prime's Application, Once Again

Jun 26, 2013

Been wondering what's happening with Landmark Medical Center? So has Woonsocket's mayor, Leo Fontaine. He wrote a letter to Governor Lincoln Chafee, pleading with him to weigh in on the process, use his influence to somehow resolve it. Problem is, regulators say that won't help.

Credit Catherine Welch / RIPR

Here are excerpts of the mayor's letter to the governor, a copy of which he apparently emailed to several newsrooms, but not to the primary regulators involved in approving or denying Prime Healthcare's application to buy to Landmark Medical Center:

"Your Excellency:
I write to relay my tremendous concern over the ongoing delays and seemingly endless obstacles that have arisen in the review process associated with the purchase of Landmark Medical Center by Prime Healthcare Services. As this is of significant importance to Woonsocket and the entire northern part of the state, I implore you to take firm, decisive action to move this critical proposal through the state bureaucracy.
There is no mystery that the passage of time undermines the financial integrity of Landmark Medical Center. Mounting debt and severe operational constraints reduce northern Rhode Island's only hospital facility to a grave state of uncertainty and weariness, conveniently creating a self-fulfilling prophecy offered by those opposed to the transaction for their own self-interested reasons.

"Hundreds of Woonsocket residents work for Landmark. Nearly 95,000 people live within five miles of the hospital, a significant catchment area under any health care delivery system. The economic and health policy ramifications of the possible loss of this institution are too significant to contemplate. I should note that the economic impact would be devastating, not just to Woonsocket, but to every community in the surrounding area. As you know, these communities are already struggling to deal with the economic crisis brought upon us. What makes it even more difficult is that the people of Woonsocket, in the midst of the current fiscal crisis, have seen hospital conversions in other parts of the state sail through, yet Landmark has come up against one brick wall after another."

But here's the thing: what exactly could the governor do? According to the Attorney General, not much. Here's a statement from Peter Kilmartin's office, which I received via email:

"Without having the luxury or courtesy of receiving the letter Mayor Fontaine wrote to Governor Chafee regarding Landmark and Prime, we can only assume it is specific to the Department of Health’s regulatory role and not that of the Office of Attorney General, as Mayor Fontaine must be aware that the Office of the Governor has no oversight, formal or otherwise, over the Office of Attorney General and the critical role the Office plays in the regulatory review of hospital conversions. 

"Unfortunately, the Mayor has been conspicuously silent on this transactions for months.  Political expediency by him will not short circuit the common law and statutory duties of the regulators. 

"In the end, it is the long-term health of the hospital and its ability to provide quality care to Mayor Fontaine’s constituents and those of the region that we are most concerned about.  Mayor Fontaine should be calling on  Prime and the Special Master to completely answer all of the questions necessary in an effort to ensure the process moves forward.  We have afforded the transacting parties every opportunity, and continue to do so, to complete the necessary disclosure for the regulators to move forward with the process. The Office has been diligent in requesting information from the parties and has had a number of meetings with the parties to discuss the information necessary to deem the application complete.  The transacting parties have provided additional information as requested, which is under review to determine if it completes the application."

So, according to Kilmartin's spokeswoman Amy Kempe, the ball is in the Attorney General's and the Department of Health's court. But she says getting to this point hasn't been easy. She says Rhode Island agencies have been asking for additional information from Prime Healthcare for weeks, which they're currently reviewing to determine whether or not Prime's application is actually complete. Kempe declined to provide an estimated date for when that review would be complete.

Meanwhile, Landmark hospital spokesman Bill Fischer had some gentler words for Mayor Fontaine. But he says his client, Landmark, can't hold out for a deal forever.

"Mayor Fontaine has been a long-term supporter and loyal advocate of Landmark Medical Center. Along with his advocacy and the support of so many, including our loyal employees and the members of the greater Woonsocket community, we have been able to maintain operations under the protection of the court for the past five years. That being said, there is a tipping point and we are fast approaching it. We believe we have made significant progress with regulators these past few weeks and remain hopeful that they are close to deeming Prime Healthcare's application to purchase the hospital complete and allow the formal review process to begin.

"Landmark Medical Center is the second-largest economic driver in northern Rhode Island and has over 1100 employees. Clearly, Mayor Fontaine understands the importance of Landmark Medical Center to his community. Everyone involved in this process should contemplate the economic and health care fallout if Landmark were to close."

What's clear is that many of those involved in the deal seem to want to resolve it. That's no surprise. What information has been difficult to obtain from Prime Healthcare, or why it's taken so long, isn't so clear (note that this news organization has been reporting on the incomplete application since the beginning of this year). And why Woonsocket's mayor is speaking up now about the process is also unclear. He hasn't returned messages. So Landmark employees and the people of Woonsocket continue to wait for some answers.