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As it considers hospital merger, CMC faces questions about religious identity and abortion

CMC in Manchester
Gaby Lozada
/
NHPR
Catholic Medical Center in Manchester, NH.

Editor's note: Catholic Medical Center is an NHPR underwriter. We cover them just like any other institution, and they have no role in our editorial decisions.


With Catholic Medical Center moving closer to a merger with for-profit company HCA Healthcare, some members of the public pressed for assurances that the hospital would preserve its religious identity – and particularly its opposition to abortion – during a public forum in Manchester this week.

The listening session Wednesday was the public’s first chance to weigh in on the proposed deal, which was announced last fall.

President and CEO Alex Walker said the hospital has struggled financially and is unlikely to survive long-term if it remains independent. He said joining HCA will allow the hospital to invest more in patient care – while maintaining its Catholic identity and following the same religious directives that it does now.

“Catholic health care in this transaction is not going away,” he said. “Catholic health care in this transaction is going to get bigger. It's going to be more successful. We're going to grow.”


Why is CMC pursuing this deal?

The possible deal – which was announced last year – would be the latest in a series of hospital consolidations in New Hampshire over the past decade. Health care executives say economic realities have made it increasingly hard to stay viable as a standalone hospital – though experts note that hospital mergers tend to reduce competition and drive up prices for patients.

A previous attempt by Catholic Medical Center to merge with Dartmouth Health failed in 2022, when the New Hampshire Attorney General’s Office blocked it over anti-trust concerns.

In seeking a new suitor, Walker said he and other leaders prioritized preserving the hospital’s Catholic identity, along with financial viability, access to care and local representation.

The goal is “not just getting by, but investing – investing in our building, investing in our people, investing in our technology,” he said.

State Sen. Lou D’Allessandro, who represents the section of Manchester where the hospital is located, said he sees the HCA deal as a way to make sure critical health services remain available locally.

“I recognize how vital the hospital is to the economic viability of our city, but indeed to the 2,000 people who work there, to the people who are served there,” said D’Allessandro, adding that he’s been a CMC patient himself. “And it is foremost in my mind that that service be maintained at the same level that it has been for all of all of these years.”

HCA, based in Tennessee, owns more than 180 hospitals in the U.S. and United Kingdom. That includes three in New Hampshire – Portsmouth Regional Hospital, Parkland Medical Center in Derry, and Frisbie Memorial Hospital in Rochester.

One speaker, who described himself as a CMC patient, said he was concerned about the hospital becoming a for-profit.

Walker described for-profit as a “tax status” and said the important thing is that CMC’s and HCA’s values align.

Bishop Peter Libasci, of the Diocese of Manchester, acknowledged there are people who want Catholic Medical Center to stay as it is. But changes in the health care industry, he said, have made that impossible.

“Who was it who once said, ‘It is not good for man to be alone; let us make a suitable partner for him? ’” Libasci said.


What would this mean for the hospital's Catholic identity?

If acquired by HCA, the hospital will remain Catholic and operate under the same Catholic ethical principles it does today, said Walker.

He said the deal would include a written agreement guaranteeing that, as well as a hospital vice president who would be appointed by the bishop to an “office of Catholic identity.”

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He and Libasci said they were impressed by HCA’s stewardship of another Catholic hospital, HCA Florida Mercy Hospital in Miami, which the company took over in 2011.

“HCA is making a statement not of mere toleration of Catholicism, but to respect, revere, ensure and pursue the adherence to our Catholic faith and its continued presence at CMC,” Libasci said.

Some in the audience expressed doubts.

Paul Galasso – a Meredith resident who said he’s involved with several Manchester organizations – said he wants more details on how the hospital would guarantee “respect for life be maintained – not just in not allowing abortions, but that we don't give guidance on abortions, we don't discuss alternatives to childbirth.”

Kathleen Souza – a Manchester resident and CMC patient who’s on the board of the advocacy group NH Right to Life – questioned how the Catholic hospital would co-exist with HCA’s three secular hospitals in New Hampshire. She said that could link Catholic Medical Center to abortions, even if it doesn’t perform them itself.

“It does concern me that the other three are not committed,” she said. “And a house divided usually falls. Committed to life, I should say.”

Joe Graham, a former CMC board chair, said it’s a “given” that abortions will still be prohibited under any deal the bishop approves. But he also urged people to take a broader view of Catholic identity, telling a story about the care he received after a stroke.

“This hospital has been very meaningful to myself, my family, and the Catholic identity is the care and compassion,” he said.


What comes next?

Walker said the hospital’s board will review feedback from Wednesday’s listening session, and could vote on whether to move forward within the next week or so. The bishop also needs to give his formal approval.

If that happens, the deal would go before regulators with the New Hampshire Attorney General’s Office.

Attorney General John Formella has said his office would scrutinize any such deal carefully – especially after HCA’s purchase of Frisbie Memorial Hospital in Rochester in 2020.

HCA agreed to keep the hospital’s labor and delivery unit open for at least five years – before announcing plans to close it in 2022, citing financial challenges and the inability to recruit enough providers.

“There's no question that prior experiences with an organization will inform a review of a future transaction, and trust is really important,” Formella told NHPR in an interview last fall. “So I think it is safe to say that HCA has some work to do to continue to rebuild trust with the state.”

But Jim Jalbert, who helped facilitate Frisbie’s sale as a member of the board, praised HCA’s management of the Rochester hospital at Wednesday’s event. He said the company had saved it from financial ruin and expanded key services, including mental health.

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at pcuno-booth@nhpr.org.
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