Fernanda Lopes

Hospital Conversions / Mergers Program


Assure the viability of a safe, accessible and affordable healthcare system that is available to all of the citizens of the state.

Hospital Merger / Conversion Review Process

Proposals Subject to Review

Since 1997, transfers of 20% or more of ownership, assets, membership interest, authority or control of a hospital in Rhode Island require approval by both the Department of Health and the Rhode Island Department of the Attorney General (RIAG) under the authority of the Hospital Conversions Act (HCA). more

Review Criteria

The Department of Health reviews completed application in consideration of nine statutory criteria:

  1. Satisfactory character, commitment, competence, and standing in the community;
  2. Sufficient safeguards to assure the affected community continued access to affordable care;
  3. Clear and convincing* evidence to provide health care and access for traditionally underserved populations in the affected community;
  4. Procedures or safeguards to insure that ownership interests will not be used as incentives for hospital employees or physicians to refer patients to the hospital;
  5. Commitment to assure the continuation of collective bargaining rights and workplace retention;
  6. Estimated future employment needs under the conversion, and retraining of employees who may be impacted by the proposed restructuring;
  7. Demonstration that public interest will be served, including access to essential medical services needed to provide safe and adequate treatment, and assurance of a balanced health care delivery system;
  8. Issues of market share, especially as they affect quality, access, and affordability of services; and
  9. Applicants must meet the Conditions of Approval for any previous Conversion under the Act (For-Profit conversions only)

*for non-profit corporations the consideration is ‘satisfactory’ rather than ‘clear and convincing’


Upon submission of an application, the Department of Health reviews the submission to determine if it is complete. If the application is determined to be incomplete, the applicants are advised of the additional information required to complete the application.Once the application is complete, the Department of Health reviews the application in consideration of statutory criteria. Public input is sought through written comment and informational public meetings, as applicable.


The Director of Health's decision may be:

  • To approve the application
  • To reject the application, or
  • To approve the application with conditions

Centurion - Prospect HCA Application

Hospital Conversions Act Initial Application of The Centurion Foundation, Inc., CharterCARE Health of Rhode Island, Inc., CharterCARE Roger Williams Medical Center, Inc.; CharterCARE Our Lady of Fatima Hospital, Inc., Chamber, Inc., Ivy Holdings, Inc., Ivy Intermediate Holdings, Inc., Prospect Medical Holdings, Inc., Prospect East Holdings, Inc., Prospect CharterCARE, LLC, Prospect CharterCARE SJHSRI, LLC, and Prospect CharterCARE RWMC, LLC (the “Transacting Parties”)

Completed Decisions

Program Publications


Policy, Protocols, Requirements