By Anemona Hartocollis

One of New York City’s largest hospital systems has made an offer to take over the financially struggling St. Vincent’s Hospital in Greenwich Village, provoking opposition from elected officials who fear the loss of critical medical services, especially emergency care, for tens of thousands of patients who could be sent elsewhere.

The proposal by the hospital system, Continuum Health Partners, to take over St. Vincent’s and turn it into an outpatient center would mean the loss of the city’s last Catholic general hospital, at least in the form in which it has been known for more than 160 years.

St. Vincent’s treats a disproportionate number of poor, homeless and uninsured patients, who could be forced to go elsewhere for emergency and inpatient care, perhaps to the city-run Bellevue Hospital Center across town. St. Vincent’s acquired significance for many New Yorkers in the days after Sept. 11, 2001, when it became a gathering place for people searching for loved ones.

It has been looking for a financial lifesaver to help it stem millions of dollars a month in losses and to stave off the possibility of a second bankruptcy after emerging from its first in 2007. The Continuum proposal would turn the hospital into a walk-in health-care center that would maintain some emergency services but would no longer take 911 ambulance calls, the most serious cases. It also envisions maintaining St. Vincent’s well-known H.I.V. and psychiatric services.

If the deal goes through, Continuum could get tens of thousands of new patients. Depending on how the deal is structured, Continuum could take over St. Vincent’s valuable real estate, which could potentially be sold. There would be no exchange of money; Continuum would take on the hospital’s debt, said to be around $700 million, and try to restructure it with financial support from the state and creditors.

The proposal would not include other St. Vincent’s facilities around the metropolitan area, or its nursing homes and its psychiatric and substance abuse hospital in Westchester County.

A decision to sell is up to the board of St. Vincent’s, but the hospital is under pressure from creditors and the state to find a solution to its problems. Henry J. Amoroso, the president and chief executive of St. Vincent’s, sent a one-page memorandum to hospital physicians and staff members Tuesday confirming that the hospital had received a letter of interest from Continuum. Mr. Amoroso said he was writing in response to a report in The New York Post on Tuesday outlining some aspects of the proposal.

Mr. Amoroso said the hospital was in “serious discussion” with GE Capital and TD Bank, which hold some of its debt, “about how best to restructure the burdensome debt that we were left with when we emerged from bankruptcy.”

He said the hospital’s board was still trying to find “the best solution to allow St. Vincent’s to remain an acute-care hospital.”

Community reaction was strong. A united front of West Side politicians, including Christine C. Quinn, the City Council speaker; Scott M. Stringer, the Manhattan borough president; and Representative Jerrold L. Nadler, sent a letter to Dr. Richard F. Daines, the state health commissioner, saying that the proposed conversion was “unacceptable.”

They pointed out that it would leave much of the West Side without a hospital. Likely destinations for patients of St. Vincent’s, which has several buildings clustered around Avenue of the Americas, Seventh Avenue and 11th and 12th Streets, are St. Luke’s-Roosevelt Hospital Center, with components on West 59th and West 114th Streets, and Beth Israel Medical Center, on First Avenue and 16th Street, both owned by Continuum. Others are Bellevue, a few blocks north of Beth Israel, and New York Downtown Hospital, near the Brooklyn Bridge.

Ms. Quinn suggested that a state-sponsored bailout or restructuring might be in order. “No one’s cavalier about the seriousness of St. Vincent’s financial house,” she said in an interview. “But what we need is to come together and find a solution that keeps it open, not one that basically abdicates the state’s responsibility to have full-service health care infrastructure for the West Side of Manhattan.”

In a statement, Continuum said that it had been invited by St. Vincent’s to make a proposal to preserve the hospital in some form as “an alternative to financial liquidation.”

It added that if St. Vincent’s rejected the proposal and tried to continue on its own, “they have our full support.”

The State Health Department also issued a statement Tuesday painting a dire picture of St. Vincent’s financial condition and saying that Dr. Daines had been trying to help broker a deal that would “ensure that residents of the West Side of Manhattan continue to have access to quality health care services.”

But the department said that St. Vincent’s “is not competitive within its market.” The hospital has been losing $5 million to $10 million a month, according to the state.

Hospitals across the city have suffered from what they say are low reimbursement rates from the government and private insurers; large numbers of poor patients; and, more recently, the recession, coupled with state health-care cuts.

In what some health-care officials characterized as a last-ditch effort, St. Vincent’s has been hoping to stay in business by building a new hospital, which would free up a large part of its property to be sold for about $310 million to the Rudin Organization, which would develop housing.

The plans would require significant rezoning. Continuum’s proposal casts doubt on the future of those development plans, said Andrew Berman, executive director of the Greenwich Village Society for Historic Preservation.

Ana Marengo, a spokeswoman for the city’s Health and Hospital Corporation, said that Bellevue officials believed they would be able to handle their share of emergency and trauma patients from St. Vincent’s. She said Bellevue would have a harder time absorbing psychiatric patients, but Continuum’s proposal would keep psychiatric services running at the St. Vincent’s location.

Archbishop Timothy M. Dolan of New York said in a statement that it would be “sad and disappointing” if St. Vincent’s closed. Although the archdiocese does not have a role in the hospital, it said it was monitoring the situation and recognized how hard it was to run a hospital.

The hospital is sponsored by the Sisters of Charity, the Catholic order that founded the hospital in 1849, and the Diocese of Brooklyn, a consequence of a merger with Catholic hospitals in Brooklyn and Queens more than a decade ago. If the hospital were sold, the bishop of Brooklyn and the Sisters of Charity would have to decide whether to ratify the decision, said Msgr. Kieran Harrington, a spokesman for Bishop Nicholas A. DiMarzio. Monsignor Harrington said it “would be premature to comment now” on what the bishop planned to do.