By JOSEPH FITZGERALD

WOONSOCKET — If financially troubled Landmark Medical Center were to find a buyer today, it would find itself eventually bogged down in a mandatory and lengthy state review process under the state Hospital Conversion Act — a process that would take up to a year and effectively shut down the hospital.

To make sure that doesn’t happen, two state legislators have filed legislation that would help expedite the state review process for any acquisition of the hospital.
The bill, sponsored by Sen. Roger A. Picard and Rep. Jon D. Brien would create within the Hospital Conversion Act a category for financially stressed hospitals such as Landmark, so that if the hospital is able to attract a potential buyer, it would not be required to undergo the HCA process review. Instead, it would be subject to what is being called a “change of effective control” review, in which the Department of Health and Attorney General would have to render a decision within 90 days of acceptance of an application.
A hearing on the House version of the bill is scheduled for today in the House Committee on Corporations.
“This legislation is critical to finalizing an agreement with any purchaser,” Richard Charest, president of Landmark Medical Center, said Monday. “When the Hospital Conversion Act was adopted 10 years ago, it never envisioned a hospital having to endure the conversion process while experiencing significant financial difficulties. We require an expedited review to survive.”
Landmark has been aggressively seeking a potential buyer and most recently has been negotiating with Memorial Hospital of Rhode Island whereby Landmark could become part of Memorial, a move officials for both hospitals believe will preserve continuous health care for the region.
But according to the way the HCA is written now, if a purchaser were to acquire Landmark today, it would trigger a mandatory review that would take up to a year to complete. And because of Landmark’s tenuous financial situation, the hospital would not be able to sustain operations while the review is completed, regardless of whether the state ultimately approves the transaction. The HCA was passed by the General Assembly 10 years ago to protect small community hospitals from out-of-state for-profit corporate entities.
“We are working diligently with the Department of Health, Rhode Island Attorney General, the Governor’s office and members of the House and Senate to craft a solution that will help to preserve Landmark,” Charest said. “While we have great respect for the authorities and reviews of both agencies, we are asking decision makers to weigh those current authorities against the closure of the only hospital serving the northern Rhode Island community.”
The bill filed by Picard and Brien recognizes the financial situation of Landmark, which is the only hospital in Rhode Island in a “negative net asset” position. The situation is so bad, that hospital executives anticipate closing the facility by the end of the year unless they can find a buyer. If a buyer is found, an expedited review process would allow negotiations to proceed and for continuous care to remain in place at the hospital.
Despite continued efforts over the past three years to partner with stronger institutions, to improve insurance reimbursements and to reduce costs, Landmark has been struggling under severe financial distress.
“It is paramount that we do everything we can at this point to save Landmark from closure,” Picard said. “This bill allows the state to still review any potential acquisition of Landmark, but does so in a manner that recognizes the fragile nature of the hospital’s financial situation.”
According to Brien, if Landmark, which has the third busiest emergency department in the state, were to close, more than 1,000 jobs would be lost and a safety net for uninsured and underinsured providing $8.5 million annually in uncompensated care will cease to exist.
“It is crucial that the northern Rhode Island community has access to quality hospital care,” he said. “Landmark has provided high quality healthcare to the greater Woonsocket community for 135 years and it is imperative that they continue to deliver these vital services.”
State Sen. Marc A. Cote and Rep. Lisa Baldelli-Hunt are also throwing their support behind the bill.
Last month, Landmark Medical Center received state permission to retreat from full cardiac surgery services at its Cass Avenue campus. As a result, Landmark stooped offering high level cardiac surgeries such as coronary artery bypass, heart valve replacement and other surgical interventions as of  June 1. Instead, the hospital will concentrate on maintaining its related coronary artery balloon angioplasty and diagnostic cathererization services.
The hospital won state authorization to offer the complex heart services in 2000 but has not met the goals set at that time for a specified number of heart surgeries each year.
The realignment of cardiac efforts at Landmark comes as the hospital continues to struggle with declining insurance reimbursements and a heavy burden of uncompensated care from low to moderate income patients in its Northern Rhode Island market.
The hospital is currently in merger talks with Memorial Hospital in Pawtucket as a way to stem its continuing losses and address other pending market changes expected with a possible merger of the large Lifespan and Care New England hospital networks in the state.
In a new development regarding that possible merger, the attorney general’s office and the state health department Monday said an application filed by  Lifespan and Care New England to merge was inadequate. According to state officials, the companies were supposed to sign a standard clause swearing the application was complete and accurate. Instead, the companies drafted their own, different clause.
Annemarie Beardsworth, a spokeswoman for the state health department, said the department had used the same template clause for the last 10 years. She said it was now up to the companies to resubmit their application.
Lifespan includes Rhode Island Hospital, Hasbro Children’s Hospital and Miriam Hospital in Providence, Newport Hospital and the children’s psychiatric Bradley Hospital in East Providence. Care New England includes Women and Infants and Butler hospitals in Providence and Kent Hospital in Warwick. The companies have said the merger would allow them to economize and cut costs, particularly as they anticipate cuts in Medicare and Medicaid funding.
In the meantime, State officials are reviewing a proposal to convert ownership of the Landmark Medical Center-owned Rehabilitation Hospital of Rhode Island on Eddie Dowling Highway to a Missouri-based company that provides physical rehabilitation program management services.
In March, the Department of Health and Attorney General’s Office received an application for a sale of the ownership of the hospital from RehabCare Hospital Holdings and Landmark Medical Center doing business as Northern Rhode Island Rehab Management Associations (NRIRMA). This is the first hospital conversion application to be filed with the state and basically entails an out-of-state for-profit entity — RehabCare —buying an in-state hospital.
Rehabilitation Hospital of Rhode Island, an 82-bed hospital which provides acute inpatient and outpatient rehabilitation services, is housed in Landmark’s Fogarty Unit at 116 Eddie Dowling Highway. The joint venture between Landmark and RehabCare would pave the way for a 41-bed long-term acute care hospital at the facility. Under the agreement, RehabCare will own 80 percent of the joint venture.
Landmark approached RehabCare last year and an agreement was struck last August. RehabCare Group is a leading provider of contract therapy and program management services for hospital inpatient rehabilitation, skilled nursing units and outpatient therapy programs in conjunction with more than 890 hospitals and skilled nursing facilities in 37 states, the District of Columbia and Puerto Rico.
If the application is approved, it would pave the way for a newly-created 41-bed Rehabilitation Hospital Center at the Eddie Dowling facility and operate as a newly-created for-profit limited-liability company. The company will be owned 20 percent by Landmark Medical Center and 80 percent by RehabCare Hospital Holdings.