LEWISTON – Prime Healthcare Foundation has announced plans to acquire Central Maine Healthcare and its three hospitals, including Central Maine Medical Center, in an agreement that is anticipated to close this summer.

Among the key terms of the acquisition are that Prime Healthcare Foundation must invest $150 million in CMHC facilities, team members and technology over five years and offer all current staff a position, according to CMHC CEO Steve Littleson, who will keep his position.

CMHC will keep its tax-exempt status.

“This is a huge investment in health care in the state of Maine,” Littleson told the Sun Journal.

“We have to go through a regulatory process,” Littleson told members of the media at a gathering Wednesday afternoon. “This transaction must receive approval from the federal government and the state government, and that process is expected to take a number of months.”

He said it will take several months before any change is felt.

Central Maine Medical Center reported a nearly $20 million deficit in 2023, according to the hospital’s tax document. Though it reported roughly half a billion dollars in revenue, its expenses exceeded that by nearly $20 million. The hospital has been operating in a deficit for several years, with revenues from Central Maine Healthcare helping keep it afloat.

At the end of its 2023 fiscal year, Central Maine Medical Center reported it had roughly $283 million in assets and roughly $184 million in liabilities, according to its tax document.

According to Littleson, early plans call for investments on clinical equipment, infrastructure and buildings.

“Within the next five years, (investments) will total at least $150 million. That is bound to impact the care that our patients receive and notice across our hospitals,” he added. “The money that the Prime Healthcare Foundation will invest will be spread across our system and felt by everybody.”

The CMHC board will be dissolved upon closing the deal, and Prime Healthcare Foundation will appoint a new board, Littleson said. He said he has confidence there will be local representation on that new board, as proven by the foundation’s track record in its other hospitals.

When considering Prime Healthcare Foundation’s proposal, Littleson and the board were impressed with the company’s track record of keeping the management of its hospitals local.

“Prime Healthcare believes in … local board leadership and local management,” he said. “Something that they believe in that we were attracted to.”

In the roughly five years that Littleson has been with CMHC, he has looked for ways to bring financial capital into the hospital, he said. Prime Healthcare Foundation’s acquisition proposal is the only one that has made it so far as to be signed.

The nonprofit based in Ontario, California, owns 16 not-for-profit hospitals, with CMMC, Bridgton Hospital and Rumford Hospital bringing that number to 19, if the acquisition clears legal hurdles.

“Prime Healthcare Foundation is a steward of a mission to improve lives and uplift communities by ensuring access to the highest quality, compassionate care when people need it the most,” Kavitha Bhatia, president and chairperson of the organization, said in a news release Wednesday. “We look forward to welcoming the staff, physicians, patients, and communities to the Prime family.

“Through our dedication to health equity, clinical quality and patient-centered, physician-led care, we are deeply committed to ensuring the CMH legacy continues for generations to come.”

According to Littleson, the new leadership has committed to hire everybody employed by Central Maine Health Care at the time of closing, though existing employees will have to fill out an application and go through a background check.

“All of our team members will have to fill out an application. They’re not going to have to apply for jobs. They’re just going to have to pass a background check and that’s really it,” Littleson said.

Following the background check, he said “everybody will be given a job doing what they do now essentially at the same wage and benefit level that they have enjoyed.”

Employees can expect slightly improved benefits, Littleson said. “If there are any changes, we actually expect them to be better. We’ve taken a preliminary look at the benefits package. What we’ve learned so far about our new parent owner is that the benefits are a little bit better than the ones we offer today.”

Littleson said he is committed to communicating with the public during the acquisition.

The acquisition has been in the works since March 2024, Littleson said, with the company actively seeking interested parties.

“(Our board of directors) did engage in a strategic planning process over a year ago,” Littleson noted. We really assessed our future. And that’s when we came to the conclusion that we just needed to be part of a bigger system with more resources, really, to sustain our future.”

Before it came to Prime Healthcare Foundation, Central Maine Healthcare considered smaller partners. During that process last March, Prime Healthcare approached the board.

“And we were intrigued by what they had to say,” Littleson said. “And we did our homework and we entered into a letter of intent back in the summertime and negotiated the agreement that we just signed over the summer and into the fall.”

Littleson said the company was not “sold,” but rather joined with a partner. “We didn’t sell our health system. We signed an agreement with a partner who has made commitments over a period of years.”

Some minor changes

Patients and staff will likely have some concerns over a transition like this. But Littleson explained the biggest change will be how patients access their records.

“The biggest change internally is going to be the conversion of the electronic health record from the system that we currently use to the Epic system that’s used by all of the Prime Healthcare Foundation hospitals,” Littleson said. “That will be a significant change. Prime Healthcare Foundation has gone through the transition of electronic health records with a lot of their hospitals as they acquired them, so they know how to do it. But patients will get access to their medical records through a different system, and we’ll have to educate them and support them through that transition.

“Other than that, we’ll still accept all the insurances that we do now, provide all the services that we do now. It should be seamless for (everybody), especially the patients. And other than filling out an application to get on to the Prime Healthcare Foundation HR system, it should be rather seamless for our team members,” Littleson said.

Next steps

The acquisition must receive approvals from the Federal Trade Commission and the Department of Health before it can move forward. There will be a public hearing during this process to allow for comment. The health care system will also seek approval through Maine’s certificate of need process through the Department of Health and Human Services.

Should the acquisition fall through, the hospital system will not get much needed investment, Littleson said.

“It would be just really unfortunate,” he said. “Here we have an opportunity to improve access to health care and the quality of health care not just in Lewiston but across central Maine and that just wouldn’t happen. We don’t have the ability to do it on our own, which is why we looked for a partner.”