LEWISTON — A sparse crowd gathered Tuesday afternoon at the Franco Center in Lewiston to hear a presentation and make public comments at Prime Healthcare Foundation’s hearing for its Certificate of Need application to acquire Central Maine Healthcare.

The state must give approval to certain changes hospitals want to make, whether it is a change of ownership, offering certain new services or buying certain types of expensive pieces of equipment. That is done through the Certificate of Need process, in which the Maine Department of Health and Human Services approves or denies the request after studying the request and getting public input.

Criteria include how fit the applicant is to provide the proposed services at the proper level of care, if it is financially feasible for the applicant, and if there is a public need for the proposed services, according to state statute. The statute also outlines the process for an impacted person to request a public hearing or reconsider a decision to approve or deny the application.

Five people spoke at the public hearing Tuesday, all in support of the acquisition. Four were past or current Central Maine Healthcare board members and staff. The fifth was a representative of Healthcare Purchaser Alliance of Maine.

Central Maine Healthcare officials laid out the dire straits the hospital will be in if the acquisition is not approved.

“What is happening in the hospital industry in Maine today is downright scary,” board Chair Devore Culver said.

“From my perspective and given its history, this might be one of the last chances to secure a significant capital investment, the management expertise and access to state-of-the-art information technology that Prime Healthcare Foundation has pledged,” former board Chair Debbie Avasthi said.

Prime officials gave a presentation at the beginning of the meeting outlining the nonprofit’s history, accolades and how the organization intends to turn CMHC’s financial situation around and make it profitable again.

Prime intends to switch CMHC to the Epic software system for more secure patient data storage and it will bring most services in house — meaning CMHC will staff departments for various services currently contracted out — and use existing services operated by Prime, according to Chief Financial Officer Steve Aleman.

Prime does charge its hospitals a management fee related to services it provides for things like information technology and human resources, Aleman said. That fee is monitored by a third-party on a periodic basis and approved by Prime’s board.

“The facilities are charged at the very low end of the scale,” he said. “It’s not there to make a profit; it’s just ultimately we have to pass some of these costs down some way.”

Prime Healthcare Foundation will invest $150 million in Central Maine Healthcare over the next five years if the deal goes through. The nonprofit is closely affiliated with Prime Healthcare, a for-profit national organization that owns 51 hospitals in 14 states, including hospitals operated under the Prime Healthcare Foundation.

Prime Healthcare Foundation earns the funds it invests in hospitals largely from other investments, according to Aleman.

Aleman said Prime is committed to keeping health care leadership local through physician-led management.

The public can still submit written, signed comments to be included in the review record until 5 p.m. Aug. 7. Those can be sent to the Department of Health and Human Services Division of Licensing and Certification, Certificate of Need, 11 State House Station, 41 Anthony Ave., Augusta, ME 04333.