Catholic Medical Center (CMC), a not-for-profit full-service acute care hospital in Manchester, New Hampshire, is considering merging with HCA Healthcare, the largest for-profit health system in the U.S., signing a nonbinding agreement to discuss the prospect.

The 330-licensed-bed hospital was formed in 1974 through a merger between Sacred Heart Hospital and Notre Dame Hospital, both of which were formed in 1892 and 1894, respectively. HCA Healthcare runs over 180 hospitals and more than 2,300 other medical facilities in the U.S. and U.K.

Despite becoming a for-profit, CMC would retain its Catholic identity and continue to provide care under the Ethical and Religious Directives for Catholic Health Care Services (ERDs).

HCA previously orchestrated a successful model when it acquired Mercy Hospital in Miami, which today goes by HCA Florida Mercy Hospital. The 488-bed provider retained its religious affiliation, which attracted CMC to the idea of a merger with HCA, according to Timothy Riley, chair of CMC’s Board of Trustees.

“We have been engaged in a thorough process to identify a partner who will help us ensure the needs of our community will continue to be met now and in the future, without compromising our Catholic identity,” he said in a statement.

CMC and HCA plan to create a nonprofit for Manchester and surrounding communities, and will, together, work to increase access to high-quality care and meet growing healthcare service demands in New Hampshire. HCA will provide CMC with new care capabilities, as well as scale and resources, to enhance its immediate and long-term financial viability, and will provide job training, educational opportunities, and new technologies for its staff members and clinicians.

CMC also owns hospitals in Portsmouth, Rochester, and Derry. It previously attempted to merge with Dartmouth Health, but the New Hampshire Department of Justice said this would harm competition and raise healthcare prices, concerns that have led state and federal regulators to scrutinize and crack down on potential large deals like this, according to nhpr.

It also entered another healthcare partnership with GraniteOne Health, a health system that was dissolved earlier this year by its hospitals.

No final agreement has been reached, and the two are still exploring the idea as a first step. If they move forward, further due diligence, negotiating final terms, and approvals will be required. Until then, patients will continue to receive the same care they have access to now at CMC.

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