What the Community Deserves to Know
By Dr. Chris Van hemelrijck
SCH leadership has described the arrangement as “transformational” and “non-traditional” — a clinical and digital partnership that would bring an Epic electronic medical records (EMR) system, artificial intelligence tools, and world-class clinical expertise to South County.
We are told that existing and future funds raised locally will remain with SCH and that local governance will not change. These are reassuring words. But words are not a governance structure, and reassurances are not contractual protections.
The unnamed partner is just one of several unknowns. Robinson has referenced “multiple partners” — strategic, AI, digital, and clinical — but has not identified the AI company involved, the clinical partner providing second opinions, or how any of these relationships would be structured.
Each of these entities may have its own financial interests and contractual claims. The public deserves to know who they are.
Understanding why SCH is pursuing this deal requires looking at the finances honestly. Three consecutive years of net losses — $4.6 million in 2022, $6.5 million in 2023, and $534,000 in 2024 — against total revenue of roughly $239 million tells a difficult story. Current net assets stand at approximately $72 million.
The Epic EMR system alone is estimated to cost $45 million — more than 60 percent of SCH’s net worth. Rhode Island’s reimbursement rates, already 25–30 percent below neighboring states, compound the pressure. SCH lost its competitive edge in high-margin orthopedic procedures as free-standing surgi-centers proliferated, and rising chemotherapy drug costs have eroded Cancer Center margins.
These are the conditions that make a deal feel necessary. Leadership credibility matters in a moment like this. A coalition of physicians, former board chairs, and community members has publicly called for the removal of both Robinson and Matthews, citing management practices they say have already harmed patient care and the hospital’s ability to recruit and retain staff.
These are not peripheral complaints. The collapse of the Cancer Center’s medical leadership, disaffiliation of the Cardiology group, and departure of primary care physicians all occurred under the current administration. That SCH has since reinstated a new Cancer Center medical director — the same physician Robinson terminated in 2020 — is noteworthy.
But a community being asked to trust its hospital’s leadership on the most consequential decision in the institution’s history has a right to ask whether that trust has been earned. The regulatory picture adds another layer of concern.
Since 1997, the Hospital Conversion Act (HCA) has required Attorney General and Department of Health oversight for any transfer of 20 percent or more of a Rhode Island hospital’s ownership, assets, or control. SCH leadership appears to be structuring this as a “partnership” specifically to remain below that threshold. But the 20 percent test is not the only trigger for oversight.
Two bills now before the General Assembly — S.2492 and H.7721 — seek to close loopholes in Corporate Practice of Medicine law, and H.7721 would explicitly prohibit Management Service Organizations from interfering with clinical autonomy inside physician practices.
As of January 28, 2026, Rhode Island also adopted a new rule requiring notification for transactions involving medical practice groups, extending the Attorney General’s reach well beyond traditional hospital deals. Has that office been notified? That is a question SCH should answer publicly.
We have watched similar arrangements go wrong. Prospect Medical’s acquisition of Roger Williams and Fatima hospitals ended in financial collapse, requiring $18 million in Rhode Island taxpayer funds to keep those institutions afloat. Steward Health Care’s comparable failure in Massachusetts closed two hospitals outright. When partnerships unravel, communities bear the cost — not the distant investors.
In video five of his public update series, Robinson acknowledged that governance arrangements “may change during the due diligence period.” That quiet caveat deserves far more scrutiny than it has received. What legal mechanisms actually protect SCH’s independence? Are there enforceable clawback provisions if the partner walks away after the EMR is installed? What happens to that $45 million investment if the relationship deteriorates?
South County Health is the last independent community hospital in
Rhode Island. That distinction matters — not as a point of pride, but as a
practical guarantee that care decisions for South County patients are made by
people accountable to South County. That accountability is precisely what is at
stake. The 120-day clock is running out. It is time for answers.
