Steward Health Care

in Brighton, MA, which served as Steward's flagship hospital until it was sold in 2024 Steward Health Care was founded in 2010, when Caritas Christi Health Care was sold to New York private equity firm Cerberus Capital Management, with Caritas CEO and former Beth Israel Deaconess Medical Center heart surgeon Ralph de la Torre continuing as CEO of the new company. In 2021, Steward issued a dividend of $111 million to its investors. De la Torre received $81.5 million of the dividend. Later that year, Steward paid $1.1 billion to purchase five hospitals in Miami from Tenet Healthcare. Following bid deadlines, Steward revealed in a court filing that they would be cancelling auctions on three hospitals in Ohio and Pennsylvania after they received no qualified bids. The plan for the facilities—Sharon Regional Medical Center, Hillside Rehabilitation Hospital, and Trumbull Regional Medical Center—was not immediately known. Bloomberg on July 22 reported that Steward had found buyers for at least two hospitals: Wadley Regional Medical Center in Hope, Arkansas and Glenwood Regional Medical Center in West Monroe, Louisiana would be purchased by Pafford Health Systems and American Healthcare Systems respectively, pending a mandated hearing in bankruptcy court. On July 25, the United States Senate Committee on Health, Education, Labor and Pensions voted 16–4 to subpoena Ralph de la Torre for testimony before the committee on September 12, following multiple declined invitations to voluntarily testify in previous months. According to The Hill, this marked the committee's first ever subpoena to compel testimony. Further, the governor of Massachusetts shared that Steward had received bids on all of its hospitals in that state. Despite this, Steward said in a statement on July 26 that two of these hospitals, Carney Hospital in Dorchester and Nashoba Valley Medical Center in Ayer would close on August 31, having received no "qualified" bids. The closures were approved by bankruptcy court in an emergency hearing on July 31. In the same hearing, the court also approved a request by Steward to nullify its master lease with MPT, which bound the Massachusetts hospitals to $100 million lease payments until 2040 – allowing new operators the opportunity to negotiate new lease terms. – however, Governor Maura Healy later stated that "there is nothing I can do to stop the closure of the two hospitals." It was later revealed that Massachusetts, as part of a tentative agreement with Steward, would advance $30 million in Medicaid payments owed to Steward toward funding hospital operations in the state. $11 million would be paid on August 1, and the remaining $19 million in mid-August. Stipulations in the agreement were expected to require that the provided money be used solely on hospital operations, prohibiting use on rent, debt, or executive compensation, and that the funds were contingent on milestones based on ensuring an orderly transition of hospitals to new operators and orderly closure of those without buyers. Following the nullification of their Massachusetts lease, MPT and Macquarie Infrastructure Partners turned over the properties to Apollo Global Management, leaving Apollo to handle potential leases or sales of the properties with hospital buyers. While the parties didn't disclose the cost of the transaction, court filings indicated that the tentative price would be $245 million. On the 14th, Steward and Orlando Health entered into an agreement designating the latter as a stalking horse bidder for Steward's Northern Florida hospitals, including Rockledge Regional Medical Center, Melbourne Regional Medical Center, Sebastian River Medical Center, and its local physicians group. On August 16, the Massachusetts governor's office announced that deals had been finalized to transfer five hospitals to new operators. Merrimack Health (formerly Lawrence General Hospital) is expected to take over Holy Family Hospital's two campuses in Methuen and Haverhill, and Brown University Health (formerly Lifespan Health System) of Rhode Island will enter the state for the first time to take over Morton Hospital and Saint Anne's Hospital. Further, the office stated that the state will take Saint Elizabeth's Medical Center by eminent domain for eventual transfer to Boston Medical Center Health System, which would also purchase Good Samaritan Medical Center. Apollo was expected to challenge the eminent domain seizure, citing a property value assessment of more than $200 million. The first two permanent closures to result from Steward's bankruptcy occurred on August 31, when Carney Hospital and Nashoba Valley Medical Center, both of Massachusetts, shut down. Carney Hospital, originally a part of predecessor Caritas Christi, was one of Steward's first hospitals, and having been founded in 1863 was the oldest hospital Steward operated. In September, a deal was announced and tentatively approved by bankruptcy court settling related litigation between Steward and MPT. As part of this deal, Steward agreed to relinquish control of certain of its remaining unsold hospitals to interim operators secured by MPT in exchange for MPT releasing all claims against Steward for overdue and long-term future lease obligations. MPT in a press release identified these operators as Healthcare Systems of America (for facilities in Southeast Florida, East Texas, and Louisiana), HonorHealth (Arizona), Quorum Health (West Texas), and Insight Health (Ohio). These operators, starting September 11, would be "the beneficiaries of operating revenue and have responsibility for the expenses of the hospitals each will manage" until Steward reaches purchase agreements with new permanent operators. Of the deal, MPT said "[f]rom our initial underwriting of these properties, MPT has strongly believed in the mission critical nature of these hospitals as well as their cash flow potential under the right management. [...] By replacing Steward, we are better positioned to protect the critical function of these facilities for the benefit of their communities and the value of our real estate for the benefit of our shareholders." • Florence Hospital, Mountain Vista Medical Center (Mesa), Tempe St. Luke's Hospital: "Full operational ownership" taken over on an interim basis by HonorHealth as a result of a settlement agreement between Steward and MPT. • St. Luke's Behavioral Health Center (Phoenix): No publicly announced bids. Amid bankruptcy proceedings, St, Luke's was evacuated over the weekend of August 9, 2024 due to failure of its HVAC system which led to reported temperatures of inside the hospital. Subsequently, the Arizona Department of Health Services suspended the facility's license due to multiple issues, including the HVAC failure, kitchen issues, and staffing shortages. • Arkansas • Wadley Regional Medical Center at Hope: License expected to by purchased by Pafford Health Systems, real estate expected to be purchased by the City of Hope and Hempstead County. • Florida • Coral Gables Hospital, Florida Medical Center (Fort Lauderdale), Hialeah Hospital, North Shore Medical Center (Miami), Palmetto General Hospital (Hialeah): On October 25, 2024, a bankruptcy judge approved the sale of the hospitals to Healthcare Systems of America. • Melbourne Regional Medical Center, Rockledge Regional Medical Center, and Sebastian River Medical Center: Orlando Health was designated as a stalking horse bidder for the three hospitals. On September 10, 2024, a bankruptcy judge approved the sale for $439 million to Orlando Health. • Louisiana • Glenwood Regional Medical Center (West Monroe): To be taken over on an interim basis by Healthcare Systems of America as a result of a settlement agreement between Steward and MPT. • Massachusetts • Holy Family Hospital (Haverhill & Methuen): Sold on October 1, 2024, to non-profit Merrimack Health (formerly Lawrence General Hospital.) • Saint Elizabeth's Medical Center (Brighton): Seized by the state via eminent domain for subsequent transfer to ownership of non-profit Boston Medical Center. Property owner Apollo is expected to challenge the offered price of $4.5 million, citing an assessed combined property and building value of more than $200 million. • Hillside Rehabilitation Hospital (Warren): Slated to begin closure procedures on September 19, 2024, with no qualified bids. However, MPT later indicated this facility was to be taken over on an interim basis by Insight Health as a result of a settlement agreement between Steward and MPT. To be taken over on an interim basis by Insight Health as a result of a settlement agreement between Steward and MPT. The judge granted the AG's request on August 22, ordering Steward not to announce a closure of the hospital before August 31 and suggesting that Pennsylvania or Meadville Medical help provide interim funding, as it was "clear that the debtors just don't have the money to keep this going." 2025–present: Steward Health Care v. de la Torre, et al. In July 2025, Steward, under new management for its bankruptcy, filed an adversary case against de la Torre, other executives, some of their holding companies, and Tenet Healthcare alleging financial mismanagement in the service of personal gain while Steward was insolvent. Their suit alleged that since the time of Cerberus' exit from Steward, de la Torre and others, knowing that the company was insolvent, were involved in a concerted effort to extract large dividends and otherwise used the company to enrich themselves. ==Steward Health Care International==

Steward Health Care International is Steward's arm for its operations outside of the United States. Its headquarters are located in the Salamanca district of Madrid, Spain. Their investigation included an interview with Joseph Muscat, the day before he was formally charged, who placed blame on Steward for failing to deliver on the requirements of the concession. Muscat claimed that, at the time the deal was transferred to Steward, they seemed like an "obvious choice" given Boston's reputation for healthcare. local media reported that the hospitals there were facing many of the same issues the company was facing in the United States, including unpaid vendors, unpaid employees (in some instances behind by up to six months), and lack of emergency equipment. The president of Steward Colombia responded to those reports, confirming that they were experiencing these challenges, but reiterating that they were independent of the U.S. operation and attributing these issues not to the U.S. bankruptcy, but mainly to low reimbursement rates by the country's public health system. Middle East In 2022, Steward International created Steward Middle East, which partnered with Saudi Arabian venture capital company Alfanar to create a joint venture named Steward alf Global Healthcare Company. That year, they signed a contract with the Red Sea Development Company to build and operate a new hospital as part of the Red Sea Project, a massive tourism development under construction on the nation's coast. The company would also be responsible for emergency response planning for the site. Steward Middle East also reportedly included ventures in Riyadh as well as Dubai in the UAE. In 2023, a Steward representative expressed the company's interest in expanding into Egypt. ==Operations==

Governance Senior Leadership Team Board of Directors Business model Steward operates a for-profit health system generally consistent with the widely used model of integrated care, in which health systems acquire or otherwise affiliate with a diverse range of health services in order to keep patients in-system and avoid referrals to other providers where possible. • Steward Health Choice was a commercial Medicaid option offered in Massachusetts and Arizona. Steward Health Choice of Arizona was sold to Blue Cross Blue Shield of Arizona in 2020. Steward Health Choice of Massachusetts was sold to Revere Medical in 2024. • Steward Health Care International administers several ventures overseas. Criticism Steward has received criticism for its approach to health care and transparency, especially following the revelation of significant financial struggles in the beginning of 2024. Health care officials have pointed to the concerns which Steward's financial condition and operations has raised about the role of private equity in healthcare. In 2017, Steward sued the Massachusetts Center for Health Information and Analysis (CHIA) to avoid providing financial information to the agency. CHIA, an independent state agency charged with monitoring the financial condition of Massachusetts' hospital industry, had been in talks with Steward since the previous year in an attempt to reach a deal over its financial disclosures, and had been imposing fines of $1000 per week for delinquency. At the time, Steward was the only hospital system in the state to repeatedly fail to submit required company-wide financial statements, not having fulfilled the requirement since 2015. In its suit, Steward said that the financial statements "contain sensitive, proprietary business information related to long-term debt, relationships with investors, retirement plans, and significant transactions that is not otherwise publicly available [...] Steward keeps information contained in the notes [of its financial statements] confidential because releasing the notes would cause harm to Steward." Steward further stated that their concerns were related to CHIA's past publicization of their financial data, and argued that the agency had no authority to collect the information. In 2023, a judge ruled in favor of the state, confirming that CHIA had the authority to demand the information. Steward filed an appeal, which was still pending into early 2024 and which state officials have highlighted—U.S. House Representative Stephen Lynch said in January, "we had not had advance notice prior to a week ago that they were in difficulty, or that they were contemplating exiting the Massachusetts health care market." Many have pointed to Steward's sales of its acquired hospitals' properties to Medical Properties Trust over the years as a key factor in their current financial state, given at least $50 million of their debt is in past-due rent payments on these properties. In 2023, just before the closing of Steward's Texas Vista Medical Center, Steward officials stated that the lease payment on the hospital was $5 million per year, saying "[t]hat represents 3% of the annual operating budget and was absolutely not a factor in the decision to close the hospital." However, audio obtained by CBS News of a Steward leadership meeting revealed that the system was "trying to get out of lease obligations." Further, Steward's debts to outside vendors have raised concerns for patient safety, especially after multiple adverse incidents across its hospitals relating to staffing and equipment availability. Following several patient deaths and safety incidents alleged to have been avoidable at two Massachusetts hospitals, state officials in 2024 planned to place monitors at all Steward hospitals in the state to ensure quality care and safety. Steward has attributed much of its financial woes in Massachusetts to the COVID-19 pandemic, as well as their system mainly comprising community hospitals which serve low-income populations, where 70% of their patients are recipients of Medicare and Medicaid. They also complained of what they described as a gap between the reimbursement rates which public and private insurers pay community hospitals versus larger academic medical centers. State officials, in response, raised questions regarding the use of tens of millions of dollars in pandemic relief provided to the company by the federal government. Bloomberg reported in September 2020 that at the time, the amount Steward had received in federal grants and loans stood at $675 million. Elsewhere, such as in Texas and Arizona, Steward has pointed to under-utilization as a factor in closures. In Phoenix for example, St. Luke's Medical Center's former CEO said the hospital's 2019 closure came as two out of three beds were routinely unoccupied. Massachusetts Governor Maura Healey, in a February 2024 letter to Ralph de la Torre, criticized the system's handling of the crisis, what brought them there, and their seeming opacity with state officials throughout. Defending themselves, Steward responded in two press releases stating that they have "tried to be transparent, compliant and cooperative over the years in providing a significant amount of detailed and relevant financial documentation to various state agencies and regulatory bodies and moving forward it commits to do even better." They also stated that "[w]e have played with our cards face up on these data requests," and that "at their request, we have provided the Attorney General (AGO) and Executive Office of Health and Human Services (EOHHS) 613 megabytes—running across tens of thousands of pages—of financial and operating materials over the last two months," despite their earlier appeal to avoid providing complete information. == Hospitals ==

Domestic (United States) International == Further reading ==