Mass. health leaders concerned about effects of Steward bankruptcy

State health officials on Wednesday sought to assure health care leaders that they are working to preserve care at Steward Health Care's hospitals, despite the company's bankruptcy. But some hospital leaders expressed concerns about the ripple effects already becoming evident at facilities in Massachusetts.

"In spite of these hospitals remaining open, their level of intensity of care is clearly declining," said Dr. Eduardo Haddad, president of Lawrence General Hospital's medical staff, during a meeting of the state's Public Health Council.

Steward's Holy Family hospital has campuses in Methuen and Haverhill, near Lawrence General. While emergency departments are functioning, Haddad said, the facilities appear to lack providers in vital services like orthopedics, neurosurgery and, on weekends, dialysis.

"You need to have all of these other things to be able to care for these patients," Haddad said. "So what we are finding is that [patients] get in, they get evaluated, but then they get transferred out — and appropriately, because you don't want to admit them to a situation where they may not have an essential service."

Haddad said he worries declines in care will continue, placing a further strain on his hospital, and "at some point some injection of capital or a new operator will need to come on."

Dr. Robbie Goldstein, Massachusetts' public health commissioner, said the state is in constant communication with Steward and has appointed five "regional captains" to monitor the for-profit company's seven active hospitals in Massachusetts. (An eighth facility has been closed since severe flooding in 2020.) The captains also communicate with nearby health care providers, he said.

Steward has said it is seeking buyers for its Massachusetts hospitals, and has proposed holding an auction in late June.

In addition to the regional captains, state officials continue to run an incident command center to oversee Steward hospital operations. They also set up a dedicated Steward Health Care call center and website where members of the public can report concerns and find resources. State public health monitors have been monitoring care at all Steward hospitals since February.

"At this moment, while there may be shifts in individuals that are providing care at one facility or another, the hospitals are still able to provide the care that they were previously providing," Goldstein said.

Steward filed for Chapter 11 bankruptcy protection last week in the Southern District of Texas, saying the move was a necessary step to keep its facilities running. In addition to its operations in Massachusetts, Steward runs more than 20 hospitals in seven states.

“Steward Health Care has done everything in its power to operate successfully in a highly challenging health care environment," the company's CEO Ralph de la Torre said in a statement announcing the bankruptcy. "Filing for Chapter 11 restructuring is in the best interests of our patients, physicians, employees, and communities at this time.”

Goldstein said the bankruptcy proceedings will provide more transparency about Steward's finances and ensure that the company uses the court-approved financing to keep its hospitals operating.

At Wednesday's Public Health Council meeting, Dr. Edward Bernstein, professor of emergency medicine at Boston University, asked how long the bankruptcy process would continue and whether the company has enough resources to maintain care without utilizing other hospitals, many of which are already strained.

"We still have a serious capacity problem," Bernstein said. "I don't see how we can play the piano with just one hand — just pay attention to Steward — without the other hand on the overall thing that's been going on for quite a time, the crowding of our health care system and especially the impact on emergency care."

Goldstein assured health care leaders at the meeting the state is working closely with Steward and other hospital leaders and making decisions to preserve health care without overburdening other hospitals.

"There's no way to separate capacity and Steward," Goldstein said." It is the reality of where we are in Massachusetts right now. And so our incident command is set up to address longstanding capacity concerns. "

Goldstein also pointed to a recent bill introduced in the Massachusetts House that would give the state, and the Health Policy Commission specifically, more authority in health care oversight.