The state's Department of Public Health on Monday issued a seven-page response to Steward Health Care's plan to close Carney Hospital in which state officials conclude that while Carney Hospital "is in fact an essential service necessary for preserving access and health status within the Hospital’s service area," it does not have "the power to mandate that the Hospital remain open."

The Aug. 19 letter — part of an expedited response by the Healey administration to close Carney Hospital by Aug. 31— was sent to Dr. Octavio J. Diaz, who is the Chief Medical Officer of Steward Health Care's Northeast Region. The DPH notes that Steward provided the state with its plan for closing Carney on Aug. 13 and held two public hearings on the closure plan on Aug. 13 and 14.

While DPH insists that it cannot force Steward to keep Carney open past Aug. 31, it itemizes improvements to the closure plan in a 17-step comment section that includes "directives" on how the state wants Steward to proceed before closing.

State Sen. Nick Collins, who has reviewed the DPH response, called it "unbelievable and factually untrue" that the Healey administration could not intervene to halt the Carney's closure. Collins, like many other elected leaders in Boston, have called for Gov. Healey to seize the Carney by eminent domain and install a new operator to prevent interruptions to the hospital's essential services.

“With this declaration, it is impossible for DPH to say that it wouldn’t be a public health emergency if Carney were to close," Collins told the Reporter. "We know state health officials have the power to take the facility by eminent domain as they are doing with St. Elizabeth’s right now."

Collins added: "And state health officials have made clear they have the resources to subsidize necessary capital investments and operations during a transition period. So for DPH to say they don’t have the power to do so for Carney is unbelievable and factually untrue.”

Among the tweaks that the DPH wants Steward to make before allowing them to shut the Carney's doors in roughly ten days are "a comprehensive assessment of the location and service capacity of alternative delivery sites for each of the licensed services, including all ambulatory services, which may include transferring services to the Seton Medical Office Building." The DPH says it "expects the Hospital to provide a detailed assessment of the travel needs of its current patients and the community post discontinuance and solutions to meet those needs."

DPH also says it's "concerned that the [Steward] plan lacks detail as to what, how, and when current patients will receive information about options for care available to them, what resources are and will be available to patients to ensure the patients are able to navigate the change and answer any care continuity questions."

DPH also asks Steward for more "information regarding relocation plan for the Boston EMS Paramedic truck housed in a garage on the Hospital’s grounds" and their "plan to remove/relocate EMS/public safety radio/communication equipment located on the roof of the Hospital."

DPH officials also press Steward for "specific data on Hospital employees that have been offered employment with other Steward facilities to date" and about how many residual staff will be kept on site at Carney after it closes to the public on Aug. 31. The letter also asks for more information on how the building will be secured and monitored after operations end.

The Massachusetts Nurses Association once again aimed criticism at Gov. Maura Healey and her deputies for their repeated insistence they are unable to use state government's powers and resources to force the Steward-owned Carney and Nashoba facilities to remain open.

"After three hours of testimony from dozens of residents, first responders, policymakers and advocates from all segments of the community at a jam-packed public hearing last week, it was inevitable that [the Department of Public Health] would find that Carney is indeed an essential service for protecting the public health; yet as they have done in so many other instances, they claim they can't do anything to protect the public health from the loss of this vital service to a community of 122,000 people," MNA spokesperson David Schildmeier said in a statement.

"The finding in this case is even more ludicrous, given that it calls for extensive changes to Steward's closure plan, yet appears to allow the corporation to proceed with the closure in just eight days, in direct violation of its own requirement to provide 120 days' notice," Schildmeier said about Carney. "Instead [of] continuing to embarrass itself with this impotent charade of oversight, we join a growing number of policymakers calling for the Governor and the state to take bold steps to save Carney and Nashoba Valley Medical Center, including seizing the hospitals by eminent domain, as it has done with St. Elizabeth's Medical Center to prevent what will be a public health disaster if these hospitals are allowed to close."

State House News Service contributed to this report.