LACONIA — Leaders of Concord Hospital have invited city officials to discuss their future in the city at a time when concerns about local health care are high. A meeting is planned for the end of March.

Mayor Andrew Hosmer hopes to learn about the strategic plan for operations and how it benefits the hospital in Laconia, he said Tuesday afternoon.

At the city council’s meeting on Feb. 10, a wide-ranging discussion regarding the hospital ended in suggestions the city seek the legal advice of a firm specializing in relations with health care organizations. Much of the uncertainty stems from conditions set forth in the hospital’s agreement with the former LRGHealthcare, approved by the state’s charitable trust division four years ago.

According to the agreement, Concord Hospital committed to continued operation of the hospitals in Laconia and Franklin for a period of five years, “providing at least the level of service which exists as of the [closing]” so long as the hospital maintained a reasonable operating margin, enough to cover expenses.

The Charitable Trusts Unit of the Attorney General’s Office approved the $30 million transaction in 2021, following about a decade of financial hardships experienced by LRGHealthcare. In the report, the Charitable Trusts Unit points to significant investments made by LRGHealthcare in inpatient services and the purchase of an expensive license for a new electronic health records management system as aggravating factors for financial challenges they experienced.

Following the realization of those expenses, the hospital’s inpatient census declined and costs grew substantially. After several years of negotiations between the hospital and its lenders, LRGHealthcare was short on cash. The sale of its assets became the only viable option after filing for bankruptcy on Oct. 19, 2020.

It’s the five-year condition within the purchase agreement which proved the source of councilors’ anxieties at their Feb. 10 meeting. Ward 1 Councilor Bruce Cheney referred to that condition, noting it’s little more than a year away, and hoped the city may receive some assurances from Concord Hospital that their services to the city would remain.

“This is a critical issue to this city,” Cheney said in an interview.

But retaining a health care-specific law firm to represent the city’s interests may not be necessary.

Hosmer said he has in the past had the opportunity to meet with Concord Hospital Health System President and Chief Executive Officer Robert Steigmeyer, board of trustees Community Representative Jeanie Forrester and other medical professionals, and introduced them to the Greater Laconia Ministerial Association.

He’s been assured by Concord Hospital leadership they intend to stay in Laconia for the long-term.

“Right now, I take them at their word,” Hosmer said, noting hospital leadership has expressed an understanding of the potential devastating effect which could occur if Concord Hospital were to close facilities in the city.

And according to tax information filed by the hospital, it appears they’ve managed to improve financial viability since their initial acquisition of LRGHealthcare.

In 2021, Concord Hospital-Laconia reported $53.2 million in revenue and $60.7 million in expenses. Its assets totaled $50.4 million against $16.1 million in liabilities. According to its September 2023 tax filing, revenues had bloomed to $140 million, but so did its expenses: to $151 million. Total assets greatly exceeded liabilities at $60.1 million to $24.7 million.

A significant financial burden which existed at the time LRGHealthcare filed for bankruptcy was the cost of servicing outsized debt, including a $111 million mortgage owned by Key Bank and insured federally. Bankruptcy allowed that debt to be discharged.

Health care systems face different challenges depending on where they operate. Those in affluent communities do not face the same challenges as others who operate in underserved communities, areas where a hospital may rely on payments from Medicaid to a higher extent, for example.

Hosmer said he thinks the city should be cautious regarding spending money, and wants to make sure any funds spent on legal services on the matter are well-invested so the city would garner tangible benefits.

“The city council and I have very strong ideas and feelings about what a robust health care system in our city means,” Hosmer said.

Noting the hospital is a major employer in Laconia and throughout the Lakes Region, and serves many individuals with disabilities or who are part of an aging population and require high-quality care, Hosmer said his desire is to maintain a strong health care network here.

The purpose of the meeting in March is principally to learn about Concord Hospital’s strategic plan, their forecasts and projects and how those items benefit Concord Hospital-Laconia long-term.

“I am very interested in that,” Hosmer said.

In their interactions thus far, Hosmer added that Steigmeier, members of the board of directors, and other hospital leaders have been responsive and open to inquiry.

“Words only go so far, it’s the actions that are most important,” Hosmer said.