SUNY Downstate Medical Center is on life support.

Brooklyn’s fourth-largest employer is on the verge of insolvency because of mismanagement that included acquiring two other financially troubled health-care institutions, according to a scathing state audit.

SUNY Downstate would be broke already had it not received emergency loans from the State University, state Comptroller Tom DiNapoli said.

“SUNY Downstate’s fiscal condition is dire, and it needs all hands on deck if it’s going to survive,” DiNapoli said. “Management has made poor financial decisions that often times weren’t justified by economic conditions. As a result, the hospital is hemorrhaging millions of dollars every week.”

DiNapoli estimated that Downstate’s losses for 2012 could exceed $200 million.

He claimed that its acquisitions of Long Island College Hospital in 2011 and the former Victory Memorial Hospital in 2008 were mistakes.

A state panel had recommended the closure of Victory Memorial because it was underutilized.

LICH had massive operating losses, and consulting studies recommending Downstate’s merger with the hospital were based on “flawed and unrealistic business assumptions,” DiNapoli said.

But the report also said Downstate suffered from cuts in government aid, including Medicaid funding, which were out of the hospital’s control.

Downstate’s woes are another blow to Brooklyn’s health-care system. Most of its other hospitals — particularly Wyckoff, Brookdale and Interfaith — are financially distressed.

Downstate, which has 8,000 staffers and faculty, did not dispute the findings.

Downstate has a new leadership team that is “developing a comprehensive, fiscally responsible plan to ensure medical education and quality health care continues for the people of Brooklyn,” said SUNY Chancellor Nancy Zimpher.

Staffers at the Downstate network are concerned that retrenchment at the three facilities would trigger substantial layoffs.

But a source close to Gov. Cuomo’s Brooklyn hospitals task force said an overhaul is long overdue.

“You can’t merge three hospitals that aren’t making money. That’s absurd. We’ve been saying this for months,” the source said.

The Cuomo aide added Downstate’s medical college must be preserved because it trains doctors needed in underserved areas.

“The governor is probably going to have to step in here,” the source said.