Steward Health Care

Steward Health Care

Company type	Private
Industry	Healthcare
Founded	2010
Founder	Ralph de la Torre, MD
Headquarters	Dallas , United States
Area served	United States, Colombia, Saudi Arabia, United Arab Emirates, Malta
Key people	Ralph de la Torre, MD (founder and former CEO)
Products	Hospital management, primary care centers, managed care operations, health insurance
Number of employees	33,000 (early 2024); approx. 42,000 (at peak)

Steward Health Care was a prominent private, for-profit healthcare organization based in Dallas, Texas. It implemented an integrated care approach that spanned its hospitals, primary care centers, managed care operations, and health insurance offerings. At the beginning of 2024, Steward managed 33 hospitals and employed approximately 33,000 staff members across the United States, although these numbers significantly dropped after its bankruptcy declaration in May 2024. Its global footprint extended to Steward Colombia, operating four hospitals, and Steward Middle East, active in both Saudi Arabia and the United Arab Emirates.

At its height, Steward stood as the largest private hospital network in the United States, encompassing 37 hospitals with close to 8,000 inpatient beds, more than 25 urgent care facilities, 42 skilled nursing homes, and an extensive physician network. The company employed about 42,000 individuals throughout the U.S. and Malta.

Established in 2010 following the acquisition of the financially troubled non-profit Caritas Christi Health Care by private equity firm Cerberus Capital Management, Steward was led by founder and CEO Ralph de la Torre, MD, a former cardiac surgeon who stepped down in October 2024. The organization expanded nationally through leveraged mergers and acquisitions starting in 2016, primarily financed by sale-leaseback deals with its main landlord, Medical Properties Trust (MPT). This "asset-light" strategy involved acquiring hospital operations while selling their real estate assets to MPT to recover capital and support expansion, coupled with triple-net lease agreements.

Cerberus exited its investment in 2020 by exchanging its shares in Steward for a $350 million convertible bond held by a consortium of Steward physicians headed by de la Torre. Currently, physicians own 90% of Steward, with MPT retaining a 10% stake. Although Steward asserted this model prioritized patient care improvements, analysts associated it with financial instability that adversely affected patient safety standards. After enduring prolonged financial difficulties and accumulating billions in unpaid obligations, Steward filed for Chapter 11 bankruptcy protection on May 6, 2024.

On the international front, Steward was embroiled in a significant corruption controversy in Malta connected to a failed public–private partnership intended to manage public hospitals. This scandal resulted in criminal charges against former government officials. In May 2024, Maltese investigators recommended bribery and money laundering charges against CEO de la Torre and other executives. Separately, Steward International operates two hospitals in Colombia and provides consulting services in the Middle East, including plans for a hospital project in Saudi Arabia.

History

Steward Health Care originated in 2010 after the sale of Caritas Christi Health Care to New York-based private equity firm Cerberus Capital Management. Ralph de la Torre, previously CEO of Caritas and a cardiac surgeon at Beth Israel Deaconess Medical Center, remained as CEO under the new ownership.

Pre-Steward

Caritas Christi Health Care was founded in 1985 under the auspices of the Archdiocese of Boston as a non-profit system comprising six hospitals across Eastern Massachusetts along with various non-acute care facilities throughout southern New England. After enduring years of financial challenges, the Archdiocese sought to divest from the system; a notable but unsuccessful attempt was made to sell to Catholic health organization Ascension in 2007. Massachusetts Attorney General Martha Coakley commissioned an independent review that recommended transferring governance to an autonomous board while maintaining only religious oversight from the Archdiocese. Although an independent board was established, Caritas lacked a CEO following the resignation of its prior leader amid misconduct allegations.

In 2008, Ralph de la Torre was appointed CEO. He restructured Caritas effectively, transforming a $20 million deficit into a $31 million surplus by 2009 despite the broader economic downturn. Nevertheless, de la Torre recognized that substantial capital investments were necessary to sustain operations and address an unfunded pension liability.

By 2009, private equity firms showed heightened interest in healthcare due to expected reforms from the Affordable Care Act (ACA), which shifted reimbursement models from fee-for-service toward capitated and bundled payments—emphasizing cost efficiency and quality outcomes. These regulatory changes attracted investors aiming for returns through operational improvements and increased patient throughput.

De la Torre engaged with Cerberus executive Robert Nardelli, culminating in Cerberus’ proposal to acquire Caritas and transition it into a for-profit entity. State Attorney General approval was required and granted under conditions: Cerberus had to retire $275 million of debt, assume $200 million in pension obligations, invest $400 million into capital projects, maintain majority ownership without closing or selling hospitals for three to five years, and avoid distributing dividends financed by debt. The total transaction value approached $895 million.

Steward also entered into a "Stewardship Agreement" with the Archdiocese designed to uphold Catholic values within its hospitals by appointing a Vice President for Mission and sustaining ethics committees. Termination of this agreement would necessitate removal of Catholic symbols from facilities and require a $25 million donation to a designated charity within Massachusetts. This agreement applied solely to the original Caritas hospitals.

As one of the few for-profit healthcare organizations operating within Massachusetts’ predominantly non-profit market landscape, Steward faced criticism. De la Torre emerged as a strategic leader focused on expanding nationally while heavily investing in facilities serving economically disadvantaged communities. Despite initial financial setbacks and unsuccessful expansions beyond Massachusetts borders, Steward concentrated on growth within Massachusetts before broadening its market presence more widely.

2010–2015: Initial acquisitions and facility closures

In September 2011, Steward received approval from the Attorney General to acquire Morton Hospital in Taunton and Quincy Medical Center, both previously nonprofit institutions facing potential shutdowns due to financial difficulties. The agreement mandated that these hospitals remain operational for a minimum of ten years.

By November 2011, Steward commenced a series of sale-leaseback transactions, placing 11 medical office buildings on the market with plans to lease them back. The funds generated were allocated to support hospital operations. In 2012, thirteen properties were sold to Healthcare Trust of America for $100 million under triple-net lease agreements, transferring property-related costs to the physicians and hospitals occupying the spaces. Steward defended this strategy by emphasizing its focus on hospital management rather than real estate holdings.

Contrary to the 2011 commitment, Steward announced the closure of Quincy Medical Center in November 2014, attributing the decision to operational losses caused by surplus bed capacity and patient referrals diverting to neighboring hospitals. However, an arrangement with the Massachusetts Department of Public Health ensured the emergency department remained open until late 2015, with operations ultimately extended through November 2020.

Following Quincy’s shutdown, Carney Hospital in Dorchester absorbed many displaced employees and experienced a 16% increase in inpatient admissions alongside a 21% growth in outpatient visits during 2015. Walter J. Ramos, the newly appointed hospital president, anticipated achieving financial breakeven after previous deficits.

2015–2020: Expansion and financial growth

Steward reported its first profitable year in 2015, largely due to cost reductions. The conclusion of the Attorney General’s five-year oversight granted the company enhanced operational and fiscal autonomy.

In September 2016, Steward partnered with Cerberus Capital Management to execute a $1.25 billion sale-leaseback agreement with Medical Properties Trust (MPT). This involved selling hospital properties for $1.2 billion plus an additional $50 million in exchange for a 5% equity stake in MPT. The influx of capital was utilized to reimburse Cerberus’ initial investment and eliminate $400 million in debt, facilitating substantial dividend distributions and supporting nationwide expansion efforts. Completed by September 2017, this approach accelerated growth but later contributed to financial strain due to escalating lease obligations with built-in increases; meanwhile, hospitals received minimal proceeds from property sales. By 2024, company executives distanced themselves from accountability regarding these transactions.

In 2017, Steward broadened its footprint beyond Massachusetts by acquiring eight hospitals from Community Health Systems located in Ohio, Pennsylvania, and Florida. This was followed by the acquisition of Iasis Healthcare based in Tennessee, adding eighteen hospitals across states including Utah, Arizona, Texas, Louisiana, Arkansas, Colorado, Florida, and Nevada. These expansions increased Steward’s network to 36 hospitals with estimated revenues around $8 billion, establishing it as the largest private for-profit hospital operator nationwide. Additionally, the company ventured internationally by securing a contract to manage and renovate hospitals in Malta.

In February 2018, Steward shifted its corporate headquarters from Boston to Dallas, Texas.

2020–present: Decline and bankruptcy

In June 2020, Steward’s founder del la Torre spearheaded a physician-led acquisition of a 90% controlling interest in the company, purchasing Cerberus' stake by securing $335 million in financing from Medical Properties Trust (MPT), which maintained a 10% share. Cerberus had realized an $800 million gain during its tenure as owner. The following year, MPT partnered with Macquarie Infrastructure Partners to form a joint venture, divesting half of its interest in Steward’s Massachusetts real estate portfolio and obtaining a mortgage facility through Apollo Global Management.

Downsizing and Financial Challenges

Beginning in 2023, Steward initiated a process of contraction. A prior attempt in 2021 to transfer its Utah hospital assets to HCA Healthcare was thwarted by an antitrust lawsuit filed by the FTC. Subsequently, Steward divested its entire Utah network to CommonSpirit Health, encompassing five hospitals, more than 35 clinics, imaging centers, and outpatient services. Additionally, Texas Vista Medical Center was shuttered due to insufficient reimbursement rates combined with substantial unpaid patient accounts; vendor liabilities surpassed $650,000. New England Sinai Hospital was scheduled for closure in 2024 after incurring operational losses totaling $22 million.

An investigative report by The Boston Globe in January 2024 exposed Steward’s acute financial distress, highlighting $50 million in overdue rent owed to MPT alongside unsettled debts to contractors and suppliers. In response, MPT engaged legal and financial advisors to devise a recovery strategy involving a $60 million bridge loan coupled with partial rent forgiveness. This plan hinged on Steward divesting non-essential assets and selling certain hospitals, though MPT warned that full financial recovery was not assured.

In February 2024, U.S. Representative Stephen Lynch disclosed that Steward intended to expedite the sale of four out of its nine Massachusetts hospitals: St. Elizabeth's Medical Center, Holy Family Hospital campuses, Nashoba Valley Medical Center, and Norwood Hospital—the latter having its reconstruction efforts suspended.

The repossession of medical equipment by vendors at St. Elizabeth's Hospital contributed to a patient fatality in October 2023. Steward asserted that supply levels remained sufficient despite variable demand. However, the Massachusetts Department of Health determined that the hospital lacked direct oversight over vendor payments, which were controlled by corporate management.

Construction halts also plagued major projects due to unpaid invoices: the $227 million new facility for Wadley Regional Medical Center in Texarkana was paused after subcontractors received stop-work orders linked to absent funding confirmation; similarly, work on Norwood Hospital’s replacement was suspended over payment defaults.

On February 2, 2024, Steward announced it had secured a "significant financial transaction" intended to sustain operations at its Massachusetts hospitals while pursuing potential sales. Subsequent disclosures revealed refinancing arrangements including a $600 million loan obtained in 2023 and a $150 million bridge loan secured in January from asset managers such as Sound Point Capital Management and Oaktree Capital Management. These loans required Steward to submit a comprehensive debt repayment plan by April 30.

In March 2024, Steward reached a preliminary deal to sell its physician network, Stewardship Health, to Optum—a subsidiary of UnitedHealth Group. However, Optum withdrew from the agreement in June amid regulatory scrutiny and legislative calls for further examination.

By May 3, 2024, with no indication that the April deadline had been met, Massachusetts’ Executive Office of Health and Human Services activated the Incident Command System to prepare for potential disruptions across the state’s healthcare system.

Chapter 11 bankruptcy

On May 6, 2024, Steward Health Care initiated a Chapter 11 bankruptcy filing, attributing the move to escalating expenses, inadequate income, and cash flow challenges. This case ranks among the most significant hospital bankruptcies recorded in the United States. Steward obtained $75 million in debtor-in-possession financing from Medical Properties Trust (MPT), with the possibility of accessing an additional $225 million contingent upon meeting specified criteria. The company reported total liabilities near $9 billion, including $6.6 billion in long-term lease commitments, $1.2 billion in outstanding loans, close to $1 billion owed to suppliers, and $290 million in unpaid employee wages and benefits. The organization intended to auction off all 31 of its hospitals during the summer months.

In July 2024, investigations uncovered that Steward had allocated millions toward surveillance efforts targeting its critics, prioritizing payments to private intelligence firms despite operational deficiencies in staffing and equipment. Legal analysts noted that such tactics are unusual within hospital systems; however, Steward denied engaging in any unlawful conduct.

Federal authorities launched probes into Steward for potential fraud and violations of the Foreign Corrupt Practices Act. After bid submission deadlines lapsed, auctions for three hospitals located in Ohio and Pennsylvania were canceled due to a lack of qualified bidders. Conversely, purchasers were identified for facilities in Arkansas and Louisiana.

The U.S. Senate Health Committee issued a subpoena to CEO Ralph de la Torre to provide testimony concerning the bankruptcy and associated matters—marking the first instance the committee compelled testimony via subpoena.

In Massachusetts, bids were received for all Steward hospitals; nonetheless, two facilities—Carney Hospital and Nashoba Valley Medical Center—were scheduled for closure after failing to secure qualified offers. Bankruptcy court authorized these shutdowns and annulled a master lease agreement with MPT that obligated approximately $100 million in lease payments through 2040, enabling new operators to negotiate fresh terms. The state committed to advancing $30 million in Medicaid funding to sustain hospital operations under strict conditions prohibiting use of these funds for rent or executive salaries.

Following the lease termination, MPT transferred ownership of Massachusetts properties to Apollo Global Management for potential disposition through sale or lease agreements.

In August 2024, Rural Healthcare Group, a subsidiary of Kinderhook Industries, agreed to acquire Steward’s medical group for roughly $245 million. Additionally, Steward designated Orlando Health as the stalking horse bidder for its Northern Florida hospital assets.

Massachusetts completed transactions transferring five hospitals to new management entities, including Lawrence General Hospital and Rhode Island’s Lifespan Health System; furthermore, the state planned to acquire Saint Elizabeth's Medical Center via eminent domain for transfer to Boston Medical Center. Apollo Global Management contested this seizure on grounds that the property’s valuation exceeded $200 million.

The earliest permanent closures under bankruptcy proceedings occurred on August 31 with the shutdown of Carney Hospital and Nashoba Valley Medical Center; notably, Carney was Steward’s longest-standing hospital.

In September 2024, Steward and MPT reached a settlement whereby MPT agreed to relinquish claims on delinquent lease obligations in exchange for control over unsold hospitals through interim management firms such as Healthcare Systems of America and HonorHealth. These interim operators assumed responsibility for all revenues and expenses while permanent sales were arranged. MPT underscored its dedication to safeguarding hospital operations and preserving real estate value by facilitating strategic transitions in management.

Future prospects and individual facility status

The outlook for Steward remains unclear following its bankruptcy declaration in May. Massachusetts legislators rejected a bailout proposal, referencing the earlier $54 million in COVID-19 relief funds already provided and Steward’s failure to submit mandatory financial disclosures, which hindered additional state assistance. Medical Properties Trust (MPT) disclosed a $664 million operating loss for the fourth quarter of 2023, predominantly attributed to Steward, and postponed full rent collection until June. Steward’s bridge loan from January 2024 stipulated debt repayment capability by April 30; however, analysts question its viability due to high debt levels, predicting probable bankruptcy despite intentions to divest its physician network.

The status of individual hospitals is as follows:

• Arizona
  • Florence Hospital, Mountain Vista Medical Center (Mesa), Tempe St. Luke's Hospital: HonorHealth has taken over temporary operational control through a settlement agreement with MPT.
  • St. Luke's Behavioral Health Center (Phoenix): Closed following HVAC system failure and license suspension; no public sale offers have been announced.

• Arkansas
  • Wadley Regional Medical Center at Hope: Anticipated license acquisition by Pafford Health Systems; property ownership expected to transfer to 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): Acquired by Healthcare Systems of America after approval from the bankruptcy court.
  • Melbourne Regional Medical Center, Rockledge Regional Medical Center, Sebastian River Medical Center: Purchased by Orlando Health for $439 million.

• Louisiana
  • Glenwood Regional Medical Center (West Monroe): Temporarily operated by Healthcare Systems of America under a settlement with MPT.

• Massachusetts
  • Carney Hospital (Dorchester) and Nashoba Valley Medical Center (Ayer): Permanently closed with no qualifying bids received.
  • Good Samaritan Medical Center (Brockton): Transferred to non-profit Boston Medical Center.
  • Holy Family Hospital (Haverhill & Methuen): Sold to non-profit Lawrence General Hospital.
  • Morton Hospital (Taunton) and St. Anne's Hospital (Fall River): Purchased by non-profit Lifespan Health Systems for $175 million.
  • Norwood Hospital: Closed since flooding in 2020; a new facility is under construction; excluded from bankruptcy asset sales.
  • Saint Elizabeth's Medical Center (Brighton): Taken over by the state through eminent domain; operational control sold to Boston Medical Center; property ownership contested by Apollo over valuation disputes.

• Ohio
  • Hillside Rehabilitation Hospital (Warren): Planned closure reversed; interim management assigned to Insight Health via settlement.
  • Trumbull Regional Medical Center (Warren): Closure postponed; community-driven acquisition efforts ongoing, requiring approximately $30 million in donations; temporary operation managed by Insight Health.

• Pennsylvania
  • Sharon Regional Medical Center: Potential buyer Meadville Medical Center has shown interest; state officials are considering funding options amid closure threats by Steward; court has ordered postponement of closure announcements pending funding arrangements.

• Texas
  • Medical Center of Southeast Texas (Port Arthur), St. Joseph Medical Center (Houston): Purchased by Healthcare Systems of America.
  • Odessa Regional Medical Center, Scenic Mountain Medical Center (Big Spring): Temporarily operated by Quorum Health under settlement terms.
  • Wadley Regional Medical Center (Texarkana): CHRISTUS Health designated as stalking horse bidder.

These actions illustrate Steward’s ongoing reorganization process during bankruptcy, involving asset divestitures and temporary management agreements intended to maintain operational stability throughout its hospital network.

Steward Health Care International

Steward Health Care International serves as the global division of Steward Health Care, with its headquarters located in Madrid's Salamanca neighborhood, Spain. This branch oversees the company’s healthcare ventures outside the United States and currently operates four hospitals situated in Colombia, Saudi Arabia, and the United Arab Emirates. The organization is under the leadership of CEO and President Armin Ernst, having been originally founded by Ralph de la Torre.

Malta

Steward initiated its international growth strategy in late 2017 by acquiring Vitals Global Healthcare (VGH) in Malta, a transaction completed in February 2018 that led to the creation of Steward Health Care International. VGH had previously entered into a contentious public-private partnership in 2015 to manage three hospitals in Malta under a 30-year concession agreement, which attracted criticism due to concerns over ceding government control and VGH’s limited healthcare management experience.

Following accusations of collusion, halted hospital refurbishments, and financial irregularities, Steward acquired VGH for a nominal sum of €1 in 2018. Concurrently, the Maltese government compensated VGH with €50 million to facilitate the transfer. This arrangement provoked strikes among Maltese healthcare workers and remained unpopular until 2023 when judicial rulings invalidated the contract amid ongoing fraud investigations and unsatisfactory hospital improvements, resulting in management reverting to government control.

In May 2024, authorities in Malta proposed criminal charges against 34 individuals connected to VGH, Steward, and Swiss company Accutor—including Steward’s CEO de la Torre—for offenses such as conspiracy, influence trafficking, embezzlement of public funds, fraud, money laundering, and bribery. The allegations describe a bribery scheme involving a €1 million secret fund intended to secure and sway governmental contracts involving Maltese officials including former Prime Minister Joseph Muscat. While Steward denies any misconduct, internal documents suggest plans to back political initiatives. Investigators also highlighted that former government officials became remunerated consultants for Accutor after their tenure ended.

An investigative piece published by The Boston Globe in June 2024 brought these issues to light, featuring an interview with Muscat who criticized Steward for failing to fulfill concession commitments despite initially trusting their U.S. healthcare expertise. Although Steward’s American operations have publicly distanced themselves from this international division, investigations uncovered some operational connections and financial dealings routed through U.S.-based accounts. As of mid-2024, no executives based in the United States have been formally charged.

Colombia

Steward entered the Colombian healthcare sector in late 2020 by acquiring three hospitals: Hospital Universitario Clínica San Rafael and Clínica Centenario located in Bogotá, along with Clínica Los Nevados in Pereira. CEO Ralph de la Torre announced an investment totaling COL$102 billion (approximately US$28 million), with primary emphasis on reopening Clínica Los Nevados after its closure due to earthquake damage. The company expressed ambitions to expand its network to between 10 and 15 hospitals within Colombia. By 2023, Steward inaugurated a new Clínica San Rafael facility in Popayán and completed extensive renovations at Clínica Los Nevados.

Despite assurances from Steward International in May 2024 that its U.S. bankruptcy would not affect Colombian operations because of their operational autonomy, local reports highlighted financial difficulties within the Colombian hospitals, including unpaid suppliers and staff as well as shortages of emergency medical equipment. The president of Steward Colombia acknowledged these issues but attributed them largely to inadequate reimbursement rates from the national public health system rather than repercussions stemming from the U.S. bankruptcy.

Middle East

In 2022, Steward International established Steward Middle East through a partnership with Saudi Arabia’s venture capital firm Alfanar, creating the entity Steward alf Global Healthcare Company. During the same year, they secured an agreement with Red Sea Development Company to construct and manage a hospital within the Red Sea Project tourism initiative, also taking responsibility for emergency response coordination. Steward Middle East broadened its footprint in Riyadh and Dubai, and in 2023 announced intentions to expand into the Egyptian healthcare market.

Senior Leadership Team

Position	Holder	Notes
Chief Executive Officer	Ralph de la Torre	Served concurrently as board chair; stepped down on October 1, 2024
Chief Information Officer	David Colarusso
Chief Strategy Officer	Rubén King-Shaw, Jr.	Member of the board as well
Executive Vice President for Physician Services	Michael G. Callum	Also sits on the board
Chief Physician Executive, Steward Health Care Network	Joseph Weinstein
Executive Vice President, Human Resources	Patrick Lombardo

Board of Directors

Director	Notes
Ralph de la Torre (Chair)	Former CEO until resignation on October 1, 2024
John Boener	Ex-Speaker of the U.S. House of Representatives
Sister Vimala Vadakumpadan	Leads Steward's Saint Anne's Hospital; affiliated with Dominican Sisters of the Presentation
Carlos H. Hernandez
James J. Karam
Michael G. Callum	Also EVP for Physician Services
Rubén King-Shaw, Jr.	Also serves as Chief Strategy Officer

Business model

Steward functions as a for-profit comprehensive healthcare system integrating emergency care, inpatient and outpatient specialties, primary care, physician networks, and health insurance services to enhance patient retention and minimize external referrals.

Its growth approach is predominantly funded through debt and sale-leaseback arrangements mainly involving Medical Properties Trust (MPT), a healthcare real estate investment trust. Steward acquires hospitals or systems and promptly sells their real estate assets to MPT to recover acquisition expenses swiftly. For example, when acquiring eight hospitals from Community Health Systems in 2017 for $311 million, Steward offset most of this cost by selling the properties to MPT for $301.3 million, substantially lowering net expenses. The majority of Steward’s property holdings are under MPT ownership except in Massachusetts, where ownership is equally shared with Macquarie Asset Management.

Corporate financial management includes centralized control over vendor payments during periods when hospitals carry debt, reflecting consolidated fiscal oversight across its subsidiaries.

Services

Steward Health Care operates a network of hospitals spanning multiple states and runs subsidiaries that support its integrated healthcare framework:

• Steward Medical Group along with Steward Health Care Network deliver primary and specialty care services.
• Steward Health Choice provides a commercial Medicaid plan in Massachusetts; its Arizona operations were divested to Blue Cross Blue Shield of Arizona in 2020.
• Steward Health Care International manages global healthcare ventures.

Criticism

Steward has encountered scrutiny regarding its healthcare transparency and financial difficulties that surfaced in early 2024, prompting debates about the influence of private equity in the healthcare sector. In 2017, Steward initiated legal action against the Massachusetts Center for Health Information and Analysis (CHIA) to resist releasing financial data, arguing that such information contained proprietary business secrets. CHIA, which oversees hospital financial reporting, had levied penalties for noncompliance. A court decision in 2023 upheld CHIA’s right to mandate this disclosure; however, Steward’s appeal was still unresolved as of 2024. U.S. Representative Stephen Lynch remarked on the state’s unexpected awareness of Steward’s financial instability and the prospect of its withdrawal from the market.

The transfer of hospital properties by Steward to Medical Properties Trust has exacerbated fiscal pressures, with outstanding rent exceeding $50 million. Before shutting down Texas’ Vista Medical Center in 2023, Steward maintained that lease expenses were not a contributing factor despite internal initiatives aimed at minimizing lease liabilities.

Issues related to unpaid vendor debts have raised patient safety concerns, leading Massachusetts authorities to plan deploying monitors within Steward-operated hospitals. Steward attributes much of its financial hardship to the impact of the COVID-19 pandemic and its service to predominantly low-income patients—approximately 70% are covered by Medicare or Medicaid—underscoring reimbursement challenges faced by community hospitals compared to larger academic institutions. Questions have also been raised about Steward’s management of $675 million received through federal pandemic relief programs.

In other regions such as Texas and Arizona, underutilization resulted in facility closures; for instance, St. Luke's Medical Center in Phoenix ceased operations in 2019 after operating with two-thirds of its beds vacant.

Massachusetts Governor Maura Healey criticized Steward’s handling of the crisis and its lack of openness, stressing the necessity for audited financial disclosures to properly evaluate hospital sustainability.

In response, Steward defended its transparency record by highlighting that it has supplied extensive financial reports to state regulators and pledged to enhance collaboration despite ongoing legal conflicts concerning data sharing.

Domestic (United States)

Comprehensive list of current and former Steward hospitals across the U.S.

Hospital	Location	State	Emergency department	Established	Status	Additional Information
Carney Hospital	Dorchester	Template:Abbrlink	Yes	1863	Closed August 2024	One of Steward’s initial facilities. Founded by Daughters of Charity of Saint Vincent de Paul and Andrew Carney. First Catholic hospital established in New England.
Coral Gables Hospital	Coral Gables	Template:Abbrlink	Yes	1926	Sold 2024	Originally Tallman Hospital; renamed following acquisition by Hospital Affiliates, Inc. in 1971. Acquired by Steward from Tenet Healthcare in August 2021.
Davis Hospital and Medical Center	Layton	Template:Abbrlink	Yes	1976	Sold 2023	Purchased by Steward through IASIS Healthcare acquisition in 2017. Later sold to CommonSpirit Health and rebranded as Holy Cross Hospital – Davis.
Florence Hospital	Florence	Template:Abbrlink	Yes	—	Sold October 2024	Temporarily managed by HonorHealth following bankruptcy proceedings.
Florida Medical Center	Fort Lauderdale	FL	Yes	1973	Sold 2024	Acquired from Tenet Healthcare in August 2021.
Glenwood Regional Medical Center	West Monroe	Template:Abbrlink	Yes	1962	Sold 2024	Obtained through IASIS Healthcare purchase in 2017.
Good Samaritan Medical Center	Brockton	MA	Yes	1968	Sold October 2024	Original hospital; renamed after merger in 1994. Transferred to BMC Health System amid bankruptcy.
Hialeah Hospital	Hialeah	FL	Yes	1951	Sold 2024	Acquired from Tenet Healthcare in August 2021.
Hillside Rehabilitation Hospital	Warren	OH	No	1963	Sold 2024	Purchased from Community Health Systems in May 2017.
Holy Family Hospital (Haverhill)	Haverhill	MA	Yes	1887	Sold October 2024	Original institution; previously Hale Hospital. Consolidated under Holy Family name in 2014. Sold to Lawrence General Hospital due to bankruptcy.
Holy Family Hospital (Methuen)	Methuen	MA	Yes	1950	Sold October 2024	Original facility; formerly Bon Secours Hospital. Transferred to Lawrence General Hospital amid bankruptcy.
Jordan Valley Medical Center	West Jordan	UT	Yes	1983	Sold 2023	Acquired via IASIS Healthcare purchase; sold to CommonSpirit Health and renamed Holy Cross – Jordan Valley.
Jordan Valley Medical Center – West Valley Campus	West Valley City, Utah	UT	Yes	1964	Sold2023	Acquired via IASIS Healthcare purchase; sold and rebranded as Holy Cross – Jordan Valley West.
Melbourne Regional Medical Center	Melbourne, Florida	FL	Yes	2002	Sold2024	Formerly Wuesthoff Medical Center; acquired from Community Health Systems in May 2017.
Morton Hospital and Medical Center	Taunton, Massachusetts	MA	Yes	1889	Sold October2024	Original facility; sold to Lifespan of Rhode Island amid bankruptcy.
Mountain Point Medical Center	Lehi, Utah	UT	Yes	2015	Sold2023	Acquired via IASIS Healthcare purchase; sold to CommonSpirit Health and renamed Holy Cross – Mountain Point.
Mountain Vista Medical Center	Mesa, Arizona	AZ	Yes	2007	Sold October2024	Acquired through IASIS Healthcare purchase; temporarily operated by HonorHealth due to bankruptcy.
Nashoba Valley Medical Center	Ayer, Massachusetts	MA	Yes	1965	Closed August2024	Formerly Nashoba Community Hospital; one of the original hospitals.
New England Sinai Hospital	Stoughton, Massachusetts	MA	No	1927	Closed April2024	Founded as Jewish Tuberculosis Sanatorium; acquired by Steward in 2012.
North Shore Medical Center	Miami, Florida	FL	No	1953	Sold2024	Purchased from Tenet Healthcare in August 2021.
Norwood Hospital	Norwood, Massachusetts	MA	Yes	(circa)1918	Closed2020	Original hospital evacuated and demolished after flooding. Replacement construction halted October 2024.
Odessa Regional Medical Center	Odessa, Texas	Template:Abbrlink	Yes	1975	Operations transferred to Quorum Health	Acquired through IASIS Healthcare purchase.
Hialeah | FL | Yes |1971 | Sold 2024 | Purchased from Tenet Healthcare in August 2021.
Woodland Park, Colorado |Template:Abbrlink |Yes |2006 |Sold2018 |Acquired via IASIS Healthcare purchase; sold to UCHealth.
Quincy, Massachusetts |MA |Yes |1890 |Closed2014 (ER remained open until2015) |Purchased through bankruptcy proceedings in2011.
Rockledge, Florida |FL |Yes |1941 |Sold2024 |Acquired via IASIS Healthcare purchase and rebranded by Steward.
Salt Lake City, Utah |UT |Yes |1875 |Sold2023 |Purchased through IASIS Healthcare acquisition; sold to CommonSpirit Health and renamed Holy Cross – Salt Lake.
Big Spring, Texas |TX |Yes|(circa)1975 |Sold2024 |
Sebastian, Florida |FL |Yes |1974 |Sold2024 |Acquired from Community Health Systems in May2017.
Sharon, Pennsylvania |Template:Abbrlink  |Yes  1896  Closed January 2025 due to safety issues. Purchased from Community Health Systems in May 2017.|
"St. Anne's Hospital"  Fall River, Massachusetts MA Yes 1906 Sold October 24 Original facility; sold to Lifespan amid bankruptcy.|
"St. Elizabeth's Medical Center"  Brighton, Boston MA Yes 1868 Sold October 24 Original facility; sold to BMC Health System amid bankruptcy.|
"St. Joseph Medical Center"  Houston, Texas TX Yes? (unspecified) Established circa1887? Acquired via IASIS Healthcare purchase; sold in 2024.|

International Operations

Steward Healthcare Facilities Outside the United States

Facility Name	City	Country	Emergency Services	Year Established	Operational Status	Additional Information
Clínica Centenario	Bogotá	Colombia			Active
Clínica Los Nevados	Pereira	Colombia	Yes	Reopened 2023	Active
Clínica San Rafael de Popayán	Popayán	Colombia	Yes	2023	Active
Hospital Universitario Clínica San Rafael	Bogotá	Colombia	Yes		Active
Gozo General Hospital	Victoria	Malta			Operational
Karin Grecht Hospital	Pietà	Malta			Operational
St. Luke's Hospital	Pietà	Malta			Temporarily closed for renovation
Coastal Village Hospital	The Red Sea	Saudi Arabia	Planned	Future Development	Currently under construction; intended to support tourism with specialized emergency care including a hyperbaric chamber.

Additional Resources

• Appelbaum, Eileen and Batt, Rosemary. 2020. "Private Equity Buyouts in Healthcare: Who Wins, Who Loses?" Center for Economic and Policy Research. March 15.
• Appelbaum, Eileen; La France, Aimee; and Batt, Rosemary. 2021. "Hospital Ownership and Financial Stability: A Matched Case Comparison of a Non-Profit and Private Equity Owned Health System" Center for Economic and Policy Research. March 22.
• Batt, Rosemary; Appelbaum, Eileen; and Katz, Tamar. 2022. "The Role of Public REITs in Financialization and Industry Restructuring" Center for Economic and Policy Research. July 9.

Related Topics

• Medical Properties Trust
• Beth Israel Lahey Health
• Mass General Brigham
• HCA Healthcare
• Tenet Healthcare
• Community Health Systems