Caritas Christi Health Care Thursday said it plans to convert Landmark Medical Center of Woonsocket, R.I., into a Catholic hospital if its agreement to acquire the financially ailing 214-bed community hospital is approved by a Rhode Island judge and state regulators. The conversion would mean Landmark could no longer provide sterilization services - such as tubal ligation - barred by the ethical and religious directives of the US Conference of Catholic Bishops, the rules governing Catholic health care organizations. Landmark does not perform abortions, another procedure prohibited by the conference's ethical and religious directives. Maria Montanaro, chief executive of Thundermist Health Center of Woonsocket, whose doctors provide medical care at Landmark, said she disagreed with the change. If it takes place, she said, Thundermist physicians would perform the banned services elsewhere. 'Philosophically, we believe a full range of reproductive services should be available to women and to men,' Montanaro said. 'But it's not something we couldn't work around. It's not a deal breaker.' Landmark spokesman Bill Fischer didn't return phone calls requesting comment. The hospital is currently under supervision by a special master appointed by a judge in 2008 to oversee Landmark until it could find a buyer. Caritas is advising Landmark management. Caritas, the chain of six Catholic hospitals in Eastern Massachusetts, earlier this year agreed to be bought by New York private equity firm Cerberus Capital Management. The deal is awaiting approval by the state Department of Public Health and the Supreme Judicial Court. Attorney General Martha Coakley's office will make a recommendation to the court. Ralph de la Torre, the Caritas chief executive, has said the financial backing of Cerberus will allow the system to expand in Massachusetts and beyond under the umbrella of Steward Healthcare System LLC, a new holding company created by Cerberus. The move to convert Landmark into a Catholic hospital could set a precedent for other community hospitals that would join the system. After consulting with Cardinal Sean O'Malley Wednesday, de la Torre issued a written statement regarding the Rhode Island hospital. 'If Landmark Medical Center is acquired by Caritas Christi or by any company owning Caritas Christi hospitals, Landmark Medical Center will function within and abide by the ethical and religious directives,' he wrote. The statement did not address other potential Caritas acquisitions. De La Torre has held informal discussions with senior executives at Essent Healthcare Inc., owner of Merrimack Valley Hospital in Haverhill and Nashoba Valley Medical Center in Ayer, and Cambridge Health Alliance, which operates Cambridge Hospital, Somerville Hospital, and Whidden Memorial Hospital in Everett. Caritas spokesman Chris Murphy declined to speculate on prospective deals beyond Landmark. But he said, 'Any hospitals acquired by Caritas Christi will be Catholic.' Caritas has yet to decide, however, whether Landmark will provide pastoral care, have an on-site chapel, or administer sacraments under its ownership. If Massachusetts officials approve the Cerberus deal, Caritas hospitals would operate under the Steward holding company. It would be up to Steward's parent firm, Cerberus, to determine whether to convert future acquisitions to Catholic hospitals. Some hospital chains elsewhere in the country have established separate corporate affiliates to run their religious and secular hospitals. Timothy F. Price, managing director of Cerberus, did not return phone calls and e-mail seeking comment. The religious status of Caritas hospitals, which include Brighton's St. Elizabeth's Medical Center and Carney Hospital in Dorchester, has been a sensitive issue within the Catholic church. Though it is an independent system, Caritas was formerly owned by, and continues to be affiliated with, the Archdiocese of Boston, and three out of 12 board members are church representatives. In May, Caritas and the archdiocese struck a stewardship agreement, endorsed by Cereberus, to retain the Catholic identity of the Caritas hospitals. But Steward could terminate the agreement if it decided complying with Catholic ethical guidelines proved 'materially burdensome,' a term the agreement didn't define. In that case, Steward would have to pay $25 million to a charity chosen by the church and remove Catholic symbols from its hospitals. The archdiocese also could end the agreement if it determined the hospitals weren't following Catholic teachings. Some conservative Catholics oppose the sale to Cerberus, arguing the escape clause in the stewardship agreement means the Catholic identity of Caritas hospitals won't be maintained long term. In a letter sent this week to Rhode Island Superior Court Judge Michael A. Silverstein, who must approve the Landmark deal, a spokesman for the Boston-based Coalition to Save Catholic Health Care asked the judge not to rule until Caritas and Cerberus disclosed detailed plans and financial projections. During an interview, the spokesman, John O'Gorman, criticized the archdiocese for signing the stewardship agreement. 'If the aim of the archdiocese was for these hospitals to stay Catholic, they would demand that the Catholic identity remain permanently or they would hand it over to a Catholic group,' he said. 'Health care is a core activity of the Catholic church. This is where our faith is put into action.' 