PROVIDENCE – The convoluted web of news being spun around hospitals in Rhode Island got a bit stickier last week.

NTK Network, an apparent “fake” news network linked to a Republican opposition research group in Arlington, Va., began buying digital ads in The Providence Journal and placements on Twitter in Rhode Island.

NTK Network was identified by Politico in an Oct. 10, 2016, story as being run by “operatives connected to Republican opposition research firm American Rising.”

Joe Pounder, co-founder and CEO of America Rising, launched NTK Network, according to the Politico story. The two organizations shared a workspace, according to the Politico story.

On its website, America Rising Corporation described itself as: “An opposition research and communications firm whose mission is to help its clients defeat Democrats. We do this by providing top-notch opposition research, video tracking, rapid response consulting, and earned media communications through on-demand and subscription-based plans and platforms. Our blueprint to winning elections involves the relentless pursuit of original and effective hits against Democrats.”

The America Rising website continued: “Founded in 2013, America Rising has worked with more than 100 different Republican and conservative organizations over two election cycles to defeat Hillary Clinton and win races up and down the ballot nationwide.”

On its website, America Rising proudly took credit for helping to defeat numerous Democratic candidates in 2016 and 2017, including: Jon Ossoff in Georgia and Rob Quist in Montana running for Congressional seats in 2017; and Patrick Murphy in Florida, Deborah Ross in North Carolina, Russ Feingold in Wisconsin and Ted Strickland in Ohio, running for Senate seats in 2016.

On Facebook, NTK Network described itself as “a news aggregator website focused on featuring and connecting all the different stories that are driving the daily news cycle,” with no mention of its relationship to America Rising.

Who’s paying for NTK digital placements?
Exactly whom the likely Republican political client was that NTK Network is apparently working with has not yet been identified. The same open-ended question exists for which Democratic candidate is being targeted?

The story being peddled as legitimate “news” took snippets from Rhode Island news sources, including The Providence Journal, WPRI, and even a photo from The Providence Business News, and constructed them into an apparent manipulative fashion.

The lede in the “slanted” news story being promoted by NTK Network sought to use quotes from Pawtucket Mayor Donald Grebien to pin the blame on Partners Healthcare for the demise of a pending deal between Care New England to sell Memorial to Prime Healthcare.

“Pawtucket Mayor Donald Grebien has expressed suspicion about whether Care New England’s decision to close Memorial Hospital was driven by pressure from Partners HealthCare, the larger entity attempting to acquire Care New England,” according to the NTK Network story.

Of course, when outsiders try to make sense out of Rhode Island politics, they often swing for the fences and miss.

Both Lifespan and Care New England, the two largest hospital systems in Rhode Island, told ConvergenceRI that they had no knowledge of the advertising campaign by NTK Network or its motive.

The real news
Still, there was plenty of real news occurring in Rhode Island around the future health of hospitals.

First, on Oct. 30, as a kind of early Halloween trick or treat, Prime Healthcare, the for-profit owner of Landmark Medical Center in Woonsocket and the Rehabilitation Hospital of Rhode Island in North Smithfield, agreed to pay a $1 million fine in a consent decree with the R.I. Department of Health for illegally transferring the assets to its nonprofit foundation in December of 2016 without first getting state approval. [See link to ConvergenceRI story below, “Prime Healthcare fined $1 million for hiding its transfer of Landmark to its nonprofit foundation without state approval.”]

Then, on Nov. 2, Care New England filed its application to close down Memorial Hospital with the R.I. Department of Health, as required by the state Hospital Conversions Act.

The decision to close down Memorial was precipitated by the breakdown of talks between Prime to buy Memorial Hospital from Care New England, for still unexplained and unshared reasons. [See link to ConvergenceRI story below, “As Memorial Hospital dies, officials appear to be in denial.”]

In the news release, Care New England said that the filing advises the agency that Memorial Hospital plans “to cease operations as a licensed inpatient hospital,” requesting approval for the elimination of the hospital’s Emergency Department and certain other services. No date was given for the planned cessation.

In its application, Care New England said that it intended to provide certain community-based primary care and specialty care services in Pawtucket but did not provide details.

There are two residency programs with the Warren Alpert Medical School at Brown University that are currently located at Memorial Hospital, including the Family Medicine program and the Internal Medicine program. Funded through the federal Center for Medicare and Medicaid Services, they provide more than $7 million in annual revenue to the hospital, according to sources. Combined, the two three-year programs place about 25 residents a year at Memorial.

Care New England did meet last week with Blackstone Valley Community Health Center to begin preliminary discussions about the potential ways that the community health center might become involved in the transfer of some primary care patients from Memorial.

What happens next?
What actually caused the breakdown in negotiations between Prime and Care New England has not been discussed by either health system, in part because of confidentiality agreements.

A number of sources – none from either Prime or Care New England – have speculated to ConvergenceRI about what some of the barriers were to “getting to yes” on a deal. Beyond which health system would control the Brown medical school residency programs moving forward, the sources told ConvergenceRI there were alleged disagreements about the length of the management contract after Memorial was sold: Prime apparently wanted a six-month contract; Care New England a contract for a year, according to sources.

Another alleged bone of contention in the negotiations, the sources indicated, was the length of time Prime had to back out and renege on the deal.

At some point, the discussion will pivot to what happens next in regard to the future of Memorial and its dedicated caregivers. Dr. Michael Fine at Blackstone Valley Community Health Care has floated the idea of creating four Neighborhood Health Stations to serve Pawtucket, similar to the one now operating in Central Falls.

Brown University President Christina Paxson told ConvergenceRI in a recent interview: “Obviously, we can’t be a first-rate medical school without a family medicine program. It is one of the crown jewels of the Brown medical school. We are engaged in discussions about where we can move that program. We will find a new home for that program. It’s critically important.” [See link to ConvergenceRI story below, “One on one with Brown President Christina Paxson.”