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Hospital License Talks Collapse

Posted on: Friday, 31 March 2006, 18:00 CST

By FELICE J. FREYER Journal Medical Writer

* The impasse casts a shadow over Roger Williams Hospital's efforts to move ahead with affiliation talks.

* * *

PROVIDENCE - Talks between Roger Williams Hospital and the state Health Department broke down yesterday, hours before a hearing on whether the state should impose conditions on the hospital's license.

As a result, the hoped-for quick resolution of the matter appears unlikely, casting a shadow over the hospital's efforts to move forward with affiliation talks and other changes in the wake of its federal indictment in January.

But the hospital's ability to provide care will not be affected.

The Health Department scheduled the unprecedented license hearing after federal authorities charged Roger Williams and three employees with hiring a state senator to advance its interests in the legislature. The hospital later reached a plea agreement in which it admitted criminal wrongdoing and agreed to new ethics rules.

The Health Department, which routinely renews hospital licenses every January, decided to take a closer look at Roger Williams this year, proposing a series of conditions that would give the state much tighter oversight. The two sides last month said they hoped to negotiate an agreement that would make the hearing unnecessary.

Officials devoted many hours to negotiating agreed-upon conditions, and had reached verbal agreement, hospital lawyer Stephen J. MacGillivray told hearing officer Catherine R. Warren yesterday. But when the Health Department faxed the final written document to the hospital on Tuesday, the hospital objected to what MacGillivray called "strange and confusing language" specifying that the agreement would leave open questions about whether the hospital violated two state laws. MacGillivray said the agreement should settle all such questions.

The hospital responded by faxing the Health Department, two hours before the hearing, a three-page request for documents. "This is not something that's in the spirit of trying to negotiate an amicable disposition of this matter," Health Department lawyer Joseph G. Miller told Warren. "This is a challenge to a full contested hearing."

Kenneth H. Belcher, the hospital's interim president, said in an interview afterward that he still hoped to reached a negotiated agreement. "We felt we were pretty close on this," he said. "We don't want to go through a full hearing. The sooner we can get these kinds of issues resolved, the better."

But Donald C. Williams, the Health Department's associate director of health services regulation, said that all previous agreements are now "off the table."

"I think we'll be going forward with the hearing," Williams said. "We're concerned that our best efforts to resolve this amicably seem to have fallen away."

Yesterday's proceeding was a pre-hearing conference at which Warren clarified the issues before her. The Health Department alleges that Roger Williams, when it changed its corporate structure in 1989, violated a law that requires state approval when a heath- care facility gets a new owner.

It also alleges that a 2001 decision reducing the size of the board of trustees of the Roger Williams Medical Center to just three people violated another law requiring extensive state scrutiny of changes in hospital ownership.

Miller said he would be filing additional documents accusing Roger Williams of misleading the state about the ownership of the hospital. There are two entities involved with the hospital, the Roger Williams Medical Center, and the Roger Williams Hospital, each with its own board of trustees.

In license-renewal filings the hospital listed the Roger Williams Medical Center as a "parent organization" that is "on top of the facility's control." The settlement with federal authorities states that the hospital is a "subsidiary corporation" of the medical center. But Roger Williams officials are now saying that the medical center and hospital do not have a parent-subsidiary relationship.

The question matters, Williams said, because the Health Department needs to know who was in charge when the wrongdoing took place.

ffreyer@projo.com/ (401) 277-7397

Source: Providence Journal

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