State officials step up monitoring of ailing Steward Health Care

Massachusetts officials are stepping up monitoring of Steward Health Care as they plan for the potential closures of facilities operated by the embattled for-profit hospital that many vulnerable patients rely on.

Steward, the third-largest hospital owner in Massachusetts, said last month that financial challenges are jeopardizing its ability to continue providing services.

"I am frustrated with where we are right now as a state, and what Steward has done," Gov. Maura Healey said Wednesday at a virtual meeting of the Public Health Council.

Healey said her administration is working to protect patients, hospital employees and the stability of the state’s health care system.

Dr. Robbie Goldstein, the state public health commissioner, said facility closures appear likely.

"The bottom line is at this time, we do not know what the future of Steward hospitals will be," he said. "There will need to be some reorganization, reconfiguration, transition and potential closures for Steward hospitals and the health care they deliver."

Goldstein said Department of Public Health regulators have already been visiting four Steward sites daily: St. Elizabeth’s Medical Center in Brighton, Good Samaritan Medical Center in Brockton and Holy Family Hospital in Methuen and Haverhill.

This week, state officials expanded monitoring to Carney Hospital in Dorchester and Morton Hospital in Taunton. By next week, Goldstein said, officials will be in all Steward hospitals regularly.

"Our monitors are looking at staffing, services, supplies and equipment to assess that the hospital has what it needs — and is required to have — to deliver safe and high-quality care," he said.

The department is investigating "any specific quality or safety concern that arises, and we're working with federal regulatory agencies to address issues as appropriate," Goldstein added.

Steward, which was founded with private equity backing in 2010, has had financial challenges for years. But the company has used its status as a privately-owned entity to conceal details about its finances and business. It is appealing a court decision compelling it to turn over financial reports to Massachusetts officials — something all other hospital companies routinely do.

Concerns about Steward’s future have roiled communities that rely on its hospitals. And health care leaders across the state are grappling with the implications of potential hospital closures at a time when the health care system is already stressed.

Many hospital emergency departments are so full that they’re treating patients in hallways, and primary care offices are struggling to manage backlogs.

Goldstein acknowledged the looming uncertainty amid this health care capacity crunch. He said Steward must address its financial challenges, develop a reasonable plan, and then "work with us to move the process forward."

Steward officials have blamed pandemic-related costs and low reimbursements from Medicare and Medicaid — programs that cover roughly 70% of their patients — for the company's financial struggles. They also have said they’re losing money providing care to immigrants.

Steward officials are moving to close New England Sinai Hospital in Stoughton, but they said Wednesday that they have no immediate plans to close additional hospitals.

"We are working closely with local, state, and federal officials, including the Massachusetts Department of Public Health, and will continue to do so," the company said in a statement. "We are committed to providing safe, high-quality care in each of our facilities, and will continue to serve our patients and communities.”

Steward sold its real estate to an investment trust in 2016, then rapidly expanded nationally and internationally. Over the years, it stopped paying vendors for supplies and services, according to lawsuits, interviews and news reports.

Many public officials and health care leaders, privately and publicly, have questioned Steward's business decisions and accused company executives of putting profits ahead of patient care.

Lissette Blondet, a member of the Public Health Council, said she hopes Steward will face legal consequences for its "irresponsible practices."

"People are anxious," she said, "especially people with chronic conditions, about where they are going to get their continued care, where they are going to go for the diabetes or high blood pressure checks."

She said Steward has put the entire Massachusetts health care system in a "humongous crisis."