Steward Health Care’s bankruptcy: one year later

One year following Steward Health’s bankruptcy, hospitals, patients, and workers are still facing risks and challenges

May 6, 2025 marks the one year anniversary of Steward Health Care’s historic Chapter 11 bankruptcy filing. In the initial aftermath of the filing, policymakers and elected officials found themselves scrambling to preserve access to care for thousands of patients as Steward tried to locate buyers for its struggling hospitals. While the majority of Steward’s hospitals have transitioned to new owners and have remained open, five hospitals have closed since last May, resulting in the layoffs of approximately 2,400 workers and the loss of critical healthcare services for communities across Massachusetts, Florida, and Ohio.[1]

Steward was a multistate hospital system that was owned by private equity firm Cerberus Capital Management from 2010 to 2020, and its 2024 bankruptcy was one of the largest hospital bankruptcies in decades. In Steward’s bankruptcy filing, it reported over $9 billion in liabilities, including $290 million in unpaid employee wages and benefits, nearly $1 billion in unpaid bills to vendors and suppliers, and $6.6 billion in long-term rent obligations to its landlord, Medical Properties Trust (MPT).^[2]

In the six years leading up to Steward’s bankruptcy, Steward closed six hospitals across the US, resulting in the layoffs of at least 2,650 workers and reduced access to care for the communities they served. Steward also cut important service lines, such as obstetrics, behavioral health, and cancer care, at others. Two of the hospital closures happened in 2024 when the health system was on the eve of bankruptcy.

How could a health system in the United States fail so spectacularly? The answer lies in corporate greed and an industry-friendly regulatory landscape that has allowed for-profit businesses and investors to loot hospitals. Those that end up paying the price are patients, workers, and the communities that these hospitals serve.

In the case of Steward – a more specific answer lies in how a private equity firm, Cerberus Capital Management, partnered with a hospital landlord, Medical Properties Trust, to siphon money out of Steward’s hospitals and help finance investor payouts to Cerberus Capital Management and Steward executives. All in all, Cerberus and former Steward CEO Ralph de la Torre reportedly extracted approximately $1.3 billion from Steward.^[3]

Around the time of Cerberus’ exit, Steward paid out a $111 million dividend to its owners, including de la Torre.^[4] Not long after, de la Torre bought himself a $40 million yacht. The company also bought two private jets and a private suite at Dallas’ AA arena.^[5]

On September 12, 2024, the Senate Health Education Labor and Pensions (HELP) Committee held a hearing to examine Steward Health Care’s bankruptcy and the role of management decisions in impacting patient care.^[6] Chairman Bernie Sanders (D-VT) opened the hearing describing how Cerberus Capital Management, Medical Properties Trust, and executives like CEO Ralph de la Torre had pillaged the company, even as patients were put at risk and sometimes harmed, and even as hospitals were closing.[7] He juxtaposed Steward’s financial distress with Ralph de la Torres financial situation, highlighting the millions of dollars de la Torre received while Steward was struggling. In the backdrop, a staffer displayed photos of de la Torre’s $40 million yacht and $15 million custom-made luxury fishing boat.[8] Sanders’ remarks put private equity at the center of the conversation, arguing that private equity is playing a damaging role in our healthcare system.[9]

In July, the HELP Committee had issued a subpoena to Ralph de la Torre to testify to the Committee.^[10] A week before the hearing, de la Torre sent a letter via his attorney to the committee’s chair, Sen. Bernie Sanders (D-VA), stating that de la Torre would not attend.^[11] The Senate gave unanimous consent to hold him in contempt after de la Torre was absent at the hearing, and in late September, De la Torre sued the HELP Committee alleging they violated his fifth amendment rights. He also resigned from Steward Health Care, effective October 1, 2024.[12]

In the months leading up to and following the bankruptcy, investigative journalists have unearthed more detailed information about the financial engineering and profits extracted by Steward’s executives, Cerberus, and MPT, as well as uncovered tragic details about patients who suffered as a result. Journalists have also reported on how elected officials in Massachusetts enabled Steward’s rise and fall, suggesting that the close relationships between elected officials and Steward executives may have played a role in the regulatory failures that led to Steward’s collapse.

Since the bankruptcy filing, most Steward hospitals have been able to transition to new owners, although some of these buyers have their own troubling histories that raise concerns for the futures of these hospitals. In a story that is becoming all too familiar, struggling and bankrupt hospitals that are lucky enough not to close are simply punted from one investor-owned company to another, with little oversight or conditions from regulators to protect patients and community access to critical healthcare services.

In the year since Steward’s bankruptcy filing, five former Steward hospitals across Massachusetts, Florida, and Ohio have closed and laid off approximately 2,400 workers,[13] and hospitals in Pennsylvania and Arizona temporarily closed before later reopening. Additionally, one hospital in Massachusetts that had already been temporarily closed at the time of Steward’s bankruptcy faces uncertainty as it searches for a buyer.

The table below summarizes the Steward-related hospital closures that have occurred since the bankruptcy filing. Note that St. Luke’s and Sharon Regional were temporarily closed and have since reopened.

Table 1: Steward-related hospital closures and layoffs since its May 2024 bankruptcy

Massachusetts

Massachusetts has seen  two hospitals close permanently and another extend its temporary closure due to Steward’s financial distress and bankruptcy.

The two Steward hospitals that shuttered in August 2024 closed after they reportedly received no qualified bids during the bankruptcy auctions.[22] The closures resulted in the layoffs of 1,243 workers.[23]

Despite calls from workers, community members, and elected officials[24] for Governor Healey’s administration to provide the financing and use every possible measure—including eminent domain[25] – to keep the hospitals open, Carney Hospital and Nashoba Valley Medical Center ultimately closed on August 31, 2024.[26]

Elected officials at an August 28 rally in support of the hospitals argued that Carney and Nashoba should get the same treatment that the Healey administration provided to St. Elizabeth’s Medical Center in Brighton. State Senator Nick Collins told a reporter for the State House News Service that there were interested parties for the hospitals but that “they just want the same deal the others have had. State health officials should do exactly what they did with St. Elizabeth’s, taking the property with eminent domain, offering bridge funding and capital resources up front to get the facilities up to snuff.”[27]

In September, the Healey administration did seize St. Elizabeth’s Medical Center via eminent domain from Apollo Global Management,[28] a private equity firm that was initially a lender to Steward’s hospital landlords in Massachusetts and took control of the real estate during the Steward bankruptcy.[29]

For more information on how Apollo came to be involved with Steward, see PESP’s June 2024 report, “The Pillaging of Steward Health Care.”

Shortly after Steward filed for bankruptcy, the Massachusetts Nurses Association had warned “that the administration may consider it acceptable collateral damage if some of the hospitals do not survive,” in reference to Carney, Nashoba, and Haverhill’s Holy Family Hospital.[30] As Steward’s bankruptcy played out, so too did a politics of scarcity as the Massachusetts government extended a lifeline to some hospitals that it did not extend to others, including Carney and Nashoba.

Rather than facilitating the financing and resources needed to keep Nashoba and Carney open, the Healey administration created two “working groups,” intended to focus “on stabilizing and revitalizing health care in communities impacted by Steward Health Care’s closure of Nashoba Valley Medical Center in Ayer and Carney Hospital in Dorchester.”[31]

Closure impacts in Massachusetts

Nashoba Valley Medical Center, which served a population of 115,000 residents in a rural area of Massachusetts, was a 77-bed hospital that received approximately 16,000 emergency room visits annually. Worcester Business Journal reported how the closure was predicted to strain the region’s health system, specifying it would lead to extended emergency room wait times at neighboring hospitals, quadruple ambulance turnaround times, and could even lead to “the potential collapse of a healthcare system already spread thin.”[32]

In December 2024, thirteen fire chiefs alongside town administrators and managers in the Nashoba Valley, as well as state legislators, wrote to Governor Healey requesting $9.6 million in funding to secure the emergency medical response system in the region. They wrote,

“Emergency Medical Services in the NVMC area are on the verge of collapse. In addition to 150,000 people of our region losing health care services from the NVMC, the closure of the NVMC has created a crisis situation for Emergency Medical Services on multiple fronts due to the increased distances and times for ambulances and first responders to travel outside of the Nashoba Valley …This has created a crisis situation on multiple levels: A troubling scramble for emergency medical response via mutual aid while town EMS are on longer and longer medical transports due to these increased distances; an imminent financial crisis due to unparalleled overtime; and most alarming, our first responders’ mental health as they work on trucks longer and now with sicker patients who have often delayed care because they no longer have their community hospital to rely on.”[33]

In February 2025, the Select Board from the town of Ayer located in the Nashoba Valley,  wrote to Governor Healey’s office, noting that neither the town nor fire chiefs following their December 2024 request, had received any updates or official communication from the governor’s office.[34] They wrote:

“We remain fundamentally concerned, that the Region has not received direct leadership, State resources, and a public commitment from you to secure the NVMC site. We expect and deserve the same level of State resources and commitments that you and your Administration have given to the other hospitals in the Commonwealth…Over the last six months the health care void created by the closure of NVMC has only expanded with little to no action from the State in terms of substantive action to resolve the crisis, and equally disappointing, no direct public communication to the 150,000 residents regarding a plan to resolve the crisis.” [35]

In March 2025, the Nashoba Valley Health Planning Working Group released its final report.[36] The group highlighted the actions that had been taken to date to improve access to care in the region, as well as planned actions, but noted that “While there is strong community interest in reopening a full acute care hospital, this was beyond the group’s scope, and to date no operator has stepped forward to pursue it.”[37]

The surrounding communities to Carney Hospital, located in Dorchester, MA, have also faced troubling impacts following the August 31 closure of the facility and layoffs of 753 workers.[38]

Leading up to the closure, Stephen Wood, an acute care nurse practitioner at Carney, told The Boston Globe, “[Massachusetts is] not investing in these low-income communities, and that’s a huge problem in this state, is that we haven’t invested our health care dollars equitably. You’re now leaving an absolute health care desert in Dorchester, Roxbury, Mattapan, with no thought to what’s going to happen to those communities when this hospital goes away… This is an absolute atrocity that [Healey] would let this kind of thing happen to this community.”[39]

Carney Hospital saw approximately 30,000 emergency room visits annually prior to its closure, the sixth highest volume for Boston-area emergency departments.[40] Following Carney’s closure, Boston Emergency Medical Services (EMS) saw a 20% increase in transport times, and surrounding emergency departments saw increased volumes and crowding.[41]

In April 2025, the Dorchester Health Planning Working Group released its findings, noting that the shuttered Carney Hospital should be used to provide health services and social services to the surrounding communities.[42]

Norwood Hospital’s ongoing closure

One of Steward’s Massachusetts hospitals was temporarily closed following a catastrophic flooding event in 2020. The damage was so severe the hospital had to close, furloughing at least 829 workers.[43] The facility was demolished, and construction began on the replacement.[44]

Steward’s declining financial situation ahead of its bankruptcy[45] resulted in the construction project stalling. Steward’s hospital landlord, Medical Properties Trust, has since taken over the construction which is nearing completion. However, the hospital still needs an operator. The community has experienced long term “significant” impacts from the nearly five year closure, including longer emergency transport times, according to Norwood General Manager Tony Mazzucco, as reported by Boston 25 News. [46]

While the hospital itself has not been operational, four outpatient clinics continued to operate under the hospital’s license. Following Steward’s bankruptcy, Brown University Health received approval last fall to operate two of these sites.[47]

In February 2025, the Town of Norwood, MA created a working group at the direction of Governor Healey with the goal of reopening Norwood Hospital.[48]

Massachusetts passes legislation in response to Steward crisis

In the eleventh hour of 2024, the Massachusetts legislature passed legislation aimed at increasing healthcare oversight and regulating private equity.^[49] On January 8, 2025, Governor Maura Healey signed the bill into law.^[50]

Overall, the new law increases transparency and oversight of healthcare providers that participate in the Massachusetts’ health system – and importantly – their investors. The law also expands the amount of and types of information these entities may need to provide to regulators both routinely and upon request. Importantly, it makes Massachusetts the first state to effectively prohibit the future sale-leasebacks of certain types of hospital real estate.

The eleventh hour legislation came outside of the formal 2024 legislative session^[51] and on the heels of multiple critical articles about Massachusetts’ regulators and policymakers’ failure to address the Steward crisis – both leading up to and after its bankruptcy. ^[52]

Ultimately, this bill is a victory for more robust regulation of not just private equity-owned healthcare facilities and providers, but the for-profit health industry more generally.

However, legislation can and should go further. While transparency and increased disclosures are critical, state and federal legislation should go above and beyond transparency and disclosure measures to actually limit or ban the extractive business practices that should have no place in healthcare. This includes limiting or banning sale-leasebacks for all hospitals, prohibiting hospital investors from paying themselves debt-funded dividends from health systems (also called dividend recapitalizations), and limiting the amount of debt that can be used to finance hospital and other healthcare facility acquisitions.

Florida

Nonprofit system Orlando Health purchased three of Steward’s eight Florida hospitals in October 2024 for $439.42 million: Melbourne Regional Medical Center, Rockledge Hospital, and Sebastian River Hospital.[53]

In February 2025, Orlando Health announced it would be closing the 298-bed Rockledge Hospital. As reported by Becker’s Hospital Review, the system said that “Following in-depth inspections that could only occur after acquisition, it was determined that the cost to repair and renovate Rockledge Hospital far exceeds the cost of a new, state-of-the-art hospital. Accordingly, a decision has been made to close the facility. This decision is necessary to ensure the safety of patients and team members.” According to Orlando Health, the hospital’s electrical, HVAC, and plumbing systems were failing.[54]

The hospital serves a population between 60,000 and 70,000.[55]  Orlando Health plans to demolish the facility and sell the land for redevelopment,[56] but has alluded to plans to spend more than $750 million on a new hospital, freestanding emergency departments, and outpatient offices throughout Brevard County.[57]

The hospital officially closed on April 23, 2025. Emergency transport times in the community are expected to double or triple, as the nearest hospitals are between 8 and 20 miles away, and community members will have reduced access to primary and preventative care.[58] The system originally notified that state of its intent to lay off 940 employees,[59] but 429 employees accepted jobs at other Orlando Health locations and 39 accepted a retirement package, bringing the layoff total to 472 workers.[60]

Rockledge Hospital made headlines leading up to Steward Health’s bankruptcy following reports that it in 2023 it had been infested with thousands of bats and their accompanying bat guano, including on the floor that housed the intensive care unit (ICU).^[61] The exterminator hired to address the issue sued the hospital in 2023 alleging Steward had $1.6 million in unpaid bills.^[62]

Healthcare Systems of America

In October, the bankruptcy court approved Healthcare Systems of America’s (HSA’s) purchase of the remaining five Florida hospitals from Steward: Coral Gables Hospital, Florida Medical Center, Hialeah Hospital, North Shore Medical Center, and Palmetto General Hospital.[63]

HSA is an affiliate of American Health Systems and has the same CEO, Michael Sarian.[64] Sarian is a former executive of Prime Healthcare,[65] a health system with a troubling past and with ties to Steward’s landlord and business partner MPT. [66] In fact, Prime and AHS both have pre-existing relationships with MPT.[67]

AHS has a poor track record at hospitals it has managed, including being behind on a debt payment at one of its facilities, unpaid bills to vendors across three hospitals, and issues around inadequate staffing and supplies to treat trauma patients at another hospital, according to an October 2024 investigation by the Wall Street Journal.[68]

HSA or its affiliates have also purchased two Steward hospitals in Texas and were named as interim manager of a Steward hospital in Louisiana.[69]

Ohio

Ohio’s two Steward hospitals – Hillside Rehabilitation Hospital and Trumbull Regional Medical Center, both in Warren – were set to close in September 2024, resulting in the layoffs of 944 employees.[70] As reported by the American Prospect, a Trumbull county commissioner, Niki Frenchko, was concerned at the time about MPT’s continued involvement as hospital landlord, noting that the Trumbull hospital’s $7 million per year rent and MPT’s valuation of the property could be a barrier in selling the complex. [71]

To Frenchko, a possible solution was to declare a public health emergency and have the county seize the hospital by purchasing it at fair market value through eminent domain. At a public meeting in August 2024 she received pushback for her criticism of MPT from another county commissioner, who called her a “negative Nancy,” and she was subsequently shut out of backroom conversations around identifying a new operator. [72]

An operator ended up stepping in at the eleventh hour to buy the hospitals;[73] Insight Health was approved to purchase the hospitals out of bankruptcy and took over operations on November 4, 2024.[74]

American Prospect’s reporting shows that rather than the savior Insight initially appeared to be, it had quite a concerning track record at other hospitals it had operated. One former Insight hospital administrator told the Prospect, “Dollar signs are what Insight sees. They do not know how to run a hospital, and they don’t care that they don’t know.” [75]

Within two weeks of purchasing the Ohio hospitals, Insight laid off an undisclosed number of employees, claiming the layoffs were necessary for “long-range viability.”[76]

On March 27, 2025, Insight abruptly halted operations at both hospitals,[77] resulting in the layoffs of nearly 700 employees,[78] 143 of which were located at Hillside Rehabilitation.[79] Senator Bernie Moreno (R-OH) sent a letter to Steward Health Care, Medical Properties Trust, and Insight Health Systems accusing the companies of “predatory and potentially illegal actions.”[80] The senator also noted the closure of the Hillside Rehabilitation Center was a threat to the Trumbull County 911 Dispatch Center, which reportedly relies on the hospital’s utilities. [81] According to Moreno’s letter, Hillside Rehabilitation and Trumbull Regional serve over 200,000 people.

Insight’s website blames the “abrupt developments in Steward Health Care’s bankruptcy proceedings and the mounting lack of transferred dollars owed for healthcare services delivered to patients at Trumbull and Hillside hospitals” as the reason for the sudden closures.[82] These closures have been characterized as “temporary” and the layoffs as “furloughs” in some news coverage,[83] but there is limited information available as to whether and how these hospitals will be able to reopen.

On April 2, 2025, a Hillside employee filed a class action lawsuit alleging that Insight had violated the WARN Act by not notifying employees 60 days in advance of their layoffs. At an April 3 press conference, the mayor of Warren, OH called for a criminal investigation into Steward regarding potential Medicare fraud: “I’m calling on our federal delegations, senator Husted, senator Moreno and Congressman Joyce, and all of those federal authorities, to investigate criminally, where the Medicaid and Medicare dollars went,” he said.[84]

Ohio went through another Steward-related hospital closure in 2018. Northside Regional Medical Center, a former Steward hospital in nearby Youngstown, OH, located just across the county border from Warren, closed that September, laying off at least 468 workers^[85] and shuttering the city’s only labor and delivery unit.^[86]

Arizona and Pennsylvania see temporary hospital closures

As Steward’s bankruptcy has played out, two hospitals temporarily closed before reopening again.

In Phoenix, Arizona, the state health department shut down Steward’s St. Luke’s Behavioral Health in August due to a broken air conditioning system and other health and safety violations. More than 200 employees were furloughed. [87]  The 127-bed hospital reopened at reduced capacity in December 2024, with just one 26-bed inpatient unit open. The new operator is College Health Enterprises, which reported in December 2024 that it had rehired some of the furloughed employees.[88] It is unclear when the hospital will fully reopen and if there will be positions for the remaining furloughed employees.

In Pennsylvania, Sharon Regional Medical Center closed in early January 2025 amidst negotiations between Tenor Health Partners and MPT for Tenor Health to purchase the hospital operations.[89] Approximately 700 workers lost their jobs. The hospital was the only one in Mercer County, PA that offered emergency heart catheterization care, the most effective treatment for heart attacks.[90]

Tenor Health was ultimately able to acquire the hospital’s operations, and began reopening the hospital in March. The hospital real estate continues to be owned by hospital landlord MPT. As of April 2025, the hospital was offering all previous services,[91] but reportedly only retained 600 of its former 700 employees.[92]

Sharon Regional is located at the Pennsylvania/Ohio border and is about 25 minutes driving from Insight Trumbull. As noted above, this area of Pennsylvania and Ohio has seen temporary or permanent Steward-related hospital closures since 2018 – one in 2018 and three in 2025.

PE-owned Quorum Health buys two Steward hospitals in West Texas

As discussed above, some of Steward’s hospitals have been sold to operators with troubling histories and finances. In Texas, two former-Steward hospitals have been sold to a private equity-owned^[93]  health system, Quorum Health Corporation.^[94]

Quorum is at risk for default as of October 2024, according to Moody’s Investors Service, which points out that Quorum could offset its challenges by selling hospital assets.^[95]

MPT continues to own the real estate of Odessa Regional and Scenic Mountain Medical Centers following Quorum’s acquisition of the operations.^[96] Quorum’s acquisition marks the second time Scenic Mountain has been owned by a private equity firm, and the third time for Odessa Regional. Prior to Steward’s ownership, Odessa was owned by TPG-backed IASIS, which siphoned hundreds of millions of dividends out of the health system before merging it with Cerberus-owned Steward.^[97]

Quorum Health was a publicly traded company with 22 hospitals across 13 states that itself underwent a Chapter 11 bankruptcy in 2020. When it first went public in 2016, it had 38 hospitals, but closed three and sold 11 by the time it filed for bankruptcy.^[98] According to HealthcareDive, at the time of Quorum’s 2020 bankruptcy, private equity firm KKR was the largest holder of the company’s debt and owned 9% of the company’s shares.^[99]

Two of the company’s other debt holders, private equity firms Davidson Kempner Capital Management and Goldentree Asset Management,^[100] established control of the company out of bankruptcy.^[101] Quorum Health was no longer publicly traded and as of August 2024, Goldentree owns the majority stake.^[102]

Since exiting bankruptcy, Quorum Health has continued to face financial issues, closing and selling hospitals in recent years. By March 2024, it had only 10 hospitals, down from the 22 it held at the time of its 2020 bankruptcy.^[103] It also sold off its hospital management and advisory subsidiary, QHR Health, to private equity firm Grant Avenue Capital in June 2021.^[104] QHR Health has since been rebranded to Ovation Health.^[105]

In August 2023, Quorum closed Martin General Hospital, a rural hospital in eastern North Carolina that it leased from Martin County. It cited $30 million in losses since 2016, $13 million of which occurred in 2022, as the reason for closure.^[106] After the closure, it came out that Martin General had not submitted annual compliance reports, as required by the state, for five years.^[107]

The private equity firms behind Quorum Health have prior ties to MPT. Under the ownership of Davidson Kempner and two other firms, hospital chain Pipeline Health sold four California hospitals to MPT in 2021 in a $215 million sale-leaseback transaction.^[108] Pipeline Health declared Chapter 11 bankruptcy the following year.^[109]

Where do we go from here?

In the years leading up to its bankruptcy, Steward closed six hospitals, resulting in the layoffs of at least 2,650 workers.[110] Since its May 6, 2024 bankruptcy filing, five more hospitals have closed, resulting in the layoffs of approximately 2,400 workers and reduced access to medical care for communities across Massachusetts, Florida, and Ohio. Altogether, eleven hospitals have closed as a result of Steward’s financial mismanagement that later resulted in a system-wide bankruptcy.

Two former Steward hospitals in Pennsylvania and Arizona also temporarily closed following the bankruptcy before reopening months later, causing disruptions to care and temporary job losses for workers. Some of these employees, including 100 in Pennsylvania, permanently lost their jobs upon the reopening of their former hospitals.

And of the former Steward hospitals that have not closed, some are now in the hands of for-profit operators with troubling finances and track records of their own.

Unfortunately, another former equity-owned health system filed for bankruptcy in January 2025, less than one year after Steward’s bankruptcy; Prospect Medical Holdings, a safety net hospital system with 16 hospitals across California, Connecticut, Pennsylvania, and Rhode Island,^[111]was majority-owned by private equity firm Leonard Green & Partners from 2010 to 2021.^[112]

Over the course of its ten-year ownership, Leonard Green took approximately $437 million in debt-funded dividends and fees from the safety net hospital chain in part by saddling it with debt and using the proceeds of the loans to pay themselves.[113] They collected this money out of Prospect even as many of its hospitals suffered deteriorating financial conditions.[114]   In July 2019, Prospect sold the real estate of its California, Connecticut, and Pennsylvania hospitals in a sale-leaseback transaction with Medical Properties Trust (MPT), a real estate investment trust, for $1.55 billion.[115] The transaction replaced debt with lease liabilities and left Prospect with fewer assets.

Following Prospect’s January bankruptcy filing, its subsidiary Crozer Health, a safety net health system with hospitals in eastern Pennsylvania, is shuttering operations at its remaining two hospitals and various outpatient locations. It is laying off 2,651 workers.^[116] Crozer’s health facilities serve an estimated 200,000 people,[117] and the closures will have far reaching effects on healthcare access in the region, including reduced access to timely emergency services.[118]

Prospect’s January 2025 bankruptcy and the associated closure of Crozer Health hospitals in Pennsylvania, alongside Steward’s own tragic collapse and associated hospital closures, are stark reminders of the policy failures within the US healthcare system. Profit-hungry investors can raid critical healthcare infrastructure and siphon out hundreds of millions of dollars while patients, workers and communities pay the price. If we do not want to see another tragedy like Prospect or Steward, then legislators must act now to pass robust legislation that protects the healthcare infrastructure on which we all rely from private equity extraction.

Resources from PESP on Steward Health Care

Report—The pillaging of Steward Health Care: How a private equity firm and hospital landlord contributed to Steward’s bankruptcy – June 26, 2024

Blog posts and press releases

• Massachusetts passes healthcare oversight legislation in response to Steward Health Care crisis – January 21, 2025
• Two Steward hospitals acquired by private equity-owned system – October 31, 2024
• Senate HELP Committee holds hearing on Steward’s bankruptcy – September 18, 2024
• PESP testimony to Senate HELP Committee regarding Steward Health Care bankruptcy – September 12, 2024
• S. healthcare industry should be wary of private equity’s acquisition of Steward Health Care physician network – August 15, 2024
• In the wake of the Steward Health bankruptcy, Senator Warren introduces bill to penalize hospital looting, claw back unjust enrichment – June 21, 2024
• PESP director testifies at Senate HELP committee hearing – April 5, 2024
• Steward Health Care Reaches $4.7 Million Settlement to Resolve Allegations of False Claims Act Violations – July 22, 2022

[1] Carney Hospital, MA – 753 workers; Nashoba Valley Medical Center, MA – 490 workers; Rockledge Regional Medical Center, FL – 472 workers; Hillside Rehabilitation (143) and Trumbull Regional Medical Center (550), OH – approx. 700 workers. See Table 1.

[2] Ashley, Madeline. “Steward Plans Sale of All Hospitals, Reports $9B in Debt.” Becker’s Hospital Review, May 7, 2024. https://www.beckershospitalreview.com/finance/steward-plans-sale-of-all-hospitals-reports-9b-in-debt.html.

[3] Sharife, Khadija. “How Private Equity and an Ambitious Landlord Put Steward Health Care on Life Support.” OCCRP, October 9, 2024. https://www.occrp.org/en/investigation/how-private-equity-and-an-ambitious-landlord-put-steward-healthcare-on-life-support; Sabrina Willmer. “Cerberus Quadruples Money After Unusual Exit From Hospital Giant.” Bloomberg.Com, May 27, 2021. https://www.bloomberg.com/news/articles/2021-05-27/cerberus-quadruples-money-after-unusual-exit-from-hospital-giant.

[4] Weil, Jonathan. “The Private-Equity Deal That Flattened a Hospital Chain and Its Landlord.” WSJ, May 7, 2024, sec. Markets. https://www.wsj.com/finance/the-private-equity-deal-that-flattened-a-hospital-chain-and-its-landlord-3096747d; Tkacik, Maureen. “A Hospital Heist Seeks Protection in the Ponzi-Friendliest Court in America.” The American Prospect, May 6, 2024. https://prospect.org/api/content/a989ab44-0c1c-11ef-8071-12163087a831/.

[5] Tkacik, Maureen. “A Hospital Heist Seeks Protection in the Ponzi-Friendliest Court in America.” The American Prospect, May 6, 2024. https://prospect.org/api/content/a989ab44-0c1c-11ef-8071-12163087a831/.

[6] “Full Committee Hearing – Examining the Bankruptcy of Steward Health Care: How Management Decisions Have Impacted Patient Care.” Accessed September 12, 2024. https://www.help.senate.gov/hearings/examining-the-bankruptcy-of-steward-health-care-how-management-decisions-have-impacted-patient-care.

[7] From [15:20] of Senate HELP Hearing (9/12/24) – Steward Health Care Hearing. Accessed September 12, 2024. https://www.youtube.com/watch?v=B5PHPCDI6Kw.

[8] From [20:19] of Senate HELP Hearing (9/12/24) – Steward Health Care Hearing. Accessed September 12, 2024. https://www.youtube.com/watch?v=B5PHPCDI6Kw.

[9] From [23:18] of Senate HELP Hearing (9/12/24) – Steward Health Care Hearing. Accessed September 12, 2024. https://www.youtube.com/watch?v=B5PHPCDI6Kw.

[10] Kaplan, Michael, and Sheena Samu. “Senators Subpoena Steward Health Care CEO Ralph de La Torre to Testify Publicly – CBS News.” CBS News, July 25, 2024. https://www.cbsnews.com/news/steward-health-care-ceo-ralph-de-la-torre-senate-subpoena/.

[11] LaPook, Jon, Michael Kaplan, and Sheena Samu. “Senators Expected to Hold Steward Health Care CEO Ralph de La Torre in Contempt – CBS News.” CBS News, September 12, 2024. https://www.cbsnews.com/news/steward-health-care-ceo-ralph-de-la-torre-senate-contempt/.

[12] Muoio, Dave. “Steward CEO Resigns, Files Lawsuit against Senate HELP Committee.” Fierce Healthcare, September 30, 2024, sec. Fierce Healthcare Homepage,Finance,Hospitals,Regulatory. https://www.fiercehealthcare.com/providers/senate-help-committee-votes-unanimously-civil-criminal-charges-after-steward-ceo-dodges.

[13] See Table 1 for layoffs by hospital and Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[14] The system originally filed WARN notices to lay off 940 employees, but 429 employees accepted jobs at other Orlando Health locations and 39 accepted a retirement package, bringing the layoff total to 472 workers. See: Berman, Dave. “Rockledge Hospital Closing to Affect 940 Employees.” Florida Today, February 26, 2025. https://www.floridatoday.com/story/money/business/2025/02/26/rockledge-hospital-cloin940-employees-to-be-affected-by-orlando-health-closing-of-rockledge-hospital/80089485007/ and Berman, Dave. “Disappointed, Saddened Community Marks Death of Rockledge Hospital at Age 84.” Florida Today, April 20, 2025. https://www.floridatoday.com/story/news/local/2025/04/20/staff-community-mark-last-days-of-rockledge-hospital-with-sadness/83099233007/.

[15] Mario Pedersen, Joe. “Shuttered Rockledge Hospital Leaves Community without Its Emergency Department.” Central Florida Public Media, April 23, 2025, sec. Health. https://www.cfpublic.org/health/2025-04-23/shuttered-rockledge-hospital.

[16] Norris, Kelcey. “143 Employees at Trumbull County Hospital out of Work. | Mahoning Matters,” April 4, 2025. https://www.mahoningmatters.com/news/local/article303414141.html.

[17] The total layoffs for both hospitals in Warren were reported as “nearly 700 workers.” The layoff total at Hillside Rehabilitation was 143. Since there is not a readily available number for Trumbull Regional, this number is an estimate based on “nearly 700” minus 143. Gaunter, Mike, and Leslie Huff. “Senator Moreno Demands Answers about Insight Hospital Closures in Trumbull County.” Wfmj.Com, April 7, 2025. https://www.wfmj.com/story/52672104/senator-moreno-demands-answers-about-insight-hospital-closures-in-trumbull-county.

[18] Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[19] Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[20] Marshall, Micaela. “St. Luke’s Behavioral Health Center Reopens under New Ownership after Months in Limbo.” Https://Www.Azfamily.Com, December 8, 2024, sec. News. https://www.azfamily.com/2024/12/08/st-lukes-behavioral-health-center-reopens-under-new-ownership-after-months-limbo/.

[21] Simonek, Erin. “Sharon Regional Medical Center Re-Opens – WFMJ.Com,” March 18, 2025. https://www.wfmj.com/story/52574399/sharon-regional-medical-center-reopens.

[22] “General Information FAQs about the Closure and Transition of Steward Facilities | Mass.Gov.” Accessed April 23, 2025. https://www.mass.gov/info-details/general-information-faqs-about-the-closure-and-transition-of-steward-facilities.

[23] 753 workers were laid off at Carney and 490 workers were laid off at Nashoba Valley. See Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[24] See Boston 25 News. “Nashoba Valley Medical Center Workers Rally to Keep the Facility Open amid Steward Health Crisis,” June 3, 2024. https://www.boston25news.com/news/local/nashoba-valley-medical-center-workers-rally-keep-facility-open-amid-steward-health-crisis/4UGKM3ZDGJA7HNVAKIJKQCY6LY/; Kmitt, Penny. “Protesters Want Massachusetts Governor to Save 2 Steward Hospitals Days before They Close – CBS Boston.” CBS Boston, August 28, 2024. https://www.cbsnews.com/boston/news/steward-carney-hospital-nashoba-valley-medical-center/.

[25] Beginning at 0:32 of Rally at State House to Keep Carney, Nashoba Open, 2024. https://www.youtube.com/watch?v=39cZmD5UgVA.

[26] Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[27] Drysdale, Sam. “At State House Rally, Urgent Calls for Healey to Rescue Carney and Nashoba | Dorchester Reporter.” State House News Service, August 29, 2024. https://www.dotnews.com/2024/state-house-rally-urgent-calls-healey-rescue-carney-and-nashoba.

[28] “Governor Healey Seizes St. Elizabeth’s Medical Center to Keep Hospital Open | Mass.Gov,” September 27, 2024. https://www.mass.gov/news/governor-healey-seizes-st-elizabeths-medical-center-to-keep-hospital-open.

[29] Randles, Jonathan. “Steward Gets $30 Million Lifeline Following Apollo Landlord Deal.” Bloomberg.Com, August 6, 2024. https://www.bloomberg.com/news/articles/2024-08-06/steward-gets-30-million-lifeline-following-apollo-landlord-deal.

[30] Markman, Joe. “As the Bankruptcy Process Unfolds MNA Calls for Commitment by Healey Administration to Ensure the Preservation of ALL the Steward Hospitals.” Massachusetts Nurses Association, May 21, 2024. https://www.massnurses.org/2024/05/21/as-the-bankruptcy-process-unfolds-mna-calls-for-commitment-by-healey-administration-to-ensure-the-preservation-of-all-the-steward-hospitals/.

[31] “Healey-Driscoll Administration Announces Working Groups Focused on Ensuring Health Care in Communities Impacted by Steward Closures | Mass.Gov,” September 25, 2024. https://www.mass.gov/news/healey-driscoll-administration-announces-working-groups-focused-on-ensuring-health-care-in-communities-impacted-by-steward-closures.

[32] Kanner-Mascolo, Mica. “Hospital Closure Impact: As the Final Days for Nashoba Valley Medical Center Ticked down, a Community Forsees a Looming Healthcare Crisis.” Worcester Business Journal, September 2, 2024. https://www.wbjournal.com/article/hospital-closure-impact-as-the-final-days-for-nashoba-valley-medical-center-ticked-down-a.

[33] “Urgent Need for $9.6 Million in Funding to Secure the Emergency Medical Response System of the Nashoba Valley Region.” ayer.ma.us, December 27, 2024. https://www.ayer.ma.us/sites/g/files/vyhlif2756/f/uploads/urgent_request_for_emergency_medical_response_systems_in_the_nashoba_valley_region_12272024.pdf.

[34] Pgs. 1-2 of “Letter to Governor Healey from the Ayer Select Board.” ayer.ma.us, February 28, 2025. https://www.ayer.ma.us/sites/g/files/vyhlif2756/f/uploads/letter_to_governor_healey_from_the_ayer_select_board_re_nashoba_valley_medical_center_2-28-2025.pdf.

[35] Pg. 2 of “Letter to Governor Healey from the Ayer Select Board.” ayer.ma.us, February 28, 2025. https://www.ayer.ma.us/sites/g/files/vyhlif2756/f/uploads/letter_to_governor_healey_from_the_ayer_select_board_re_nashoba_valley_medical_center_2-28-2025.pdf.

[36] “Nashoba Valley Health Planning Working Group Submits Report Outlining Regional Health Care Needs, Services, Strategies | Mass.Gov,” March 12, 2025. https://www.mass.gov/news/nashoba-valley-health-planning-working-group-submits-report-outlining-regional-health-care-needs-services-strategies.

[37] Pg. 4 of “Nashoba Valley Health Planning Working Group – Final Report.” mass.gov, March 2025. https://www.mass.gov/doc/nashoba-valley-health-planning-working-group-report-pdf/download.

[38] Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[39] Griswold, Niki. “‘I Don’t Know What I’m Going to Do’: Patients and Staff in Dorchester Are Devastated by Carney Hospital Closure.” The Boston Globe, August 28, 2024. https://www.bostonglobe.com/2024/08/28/metro/carney-hospital-closure-steward-human-impact/.

[40] Pg. 7 of “Dorchester Health Planning Working Group Report.” boston.gov, April 22, 2025. https://www.boston.gov/sites/default/files/file/2025/04/Dorchester%20Working%20Group%20Report%204.22.2025.pdf.

[41] Pg. 7 of “Dorchester Health Planning Working Group Report.” boston.gov, April 22, 2025. https://www.boston.gov/sites/default/files/file/2025/04/Dorchester%20Working%20Group%20Report%204.22.2025.pdf; Bienick, David. “Health Clinics See Spike in Patients after Carney Hospital Closure.” WCVB, September 13, 2024, sec. News. https://www.wcvb.com/article/health-clinics-see-spike-in-patients-after-carney-hospital-closure/62194531.

[42] Pg. 9 of “Dorchester Health Planning Working Group Report.” boston.gov, April 22, 2025. https://www.boston.gov/sites/default/files/file/2025/04/Dorchester%20Working%20Group%20Report%204.22.2025.pdf.

[43] Boston 25 News. “Norwood Hospital Employees Furloughed after Sunday’s Massive Storm,” July 2, 2020. https://www.boston25news.com/news/local/norwood-hospital-employees-furloughed-after-sundays-massive-storm/J37W6542EJC65GCEHZP7E6SCDQ/.

[44] WCVB. “Two Years after Catastrophic Flood, Hospital Is Being Demolished,” June 28, 2022. https://www.wcvb.com/article/norwood-hospital-demolition-two-years-after-flood-jan-28-2022/40448727; “Steward Health Care: Transition to the New Operators | Mass.Gov.” Accessed April 23, 2025. https://www.mass.gov/info-details/steward-health-care-transition-to-the-new-operators; Svenson, Alex. “Working Group Created with Goal of Reopening Norwood Hospital.” WCVB, February 1, 2025, sec. News. https://www.wcvb.com/article/norwood-creates-working-group-for-reopening-norwood-hospital/63639602.

[45] Bartlett, Jessica, and Suchita Nayar. “Norwood Hospital Construction on Pause as Vendors Await Payments from Steward – The Boston Globe.” The Boston Globe, February 21, 2024. https://www.bostonglobe.com/2024/02/21/business/steward-norwood-hospital-construction-non-payment/.

[46] “Norwood Hospital ‘Shell’ Nearing Completion but Search Continues for next Facility Operator – Boston 25 News,” April 15, 2025. https://www.boston25news.com/news/local/norwood-hospital-shell-nearing-completion-search-continues-next-facility-operator/T46B5PF76ZEIDEXB7EO7U3CAYM/.

[47] “Steward Health Care: Transition to the New Operators | Mass.Gov.” Accessed April 23, 2025. https://www.mass.gov/info-details/steward-health-care-transition-to-the-new-operators.

[48] Svenson, Alex. “Working Group Created with Goal of Reopening Norwood Hospital.” WCVB, February 1, 2025, sec. News. https://www.wcvb.com/article/norwood-creates-working-group-for-reopening-norwood-hospital/63639602.

[49] Senate Press Room. “Legislature Passes Major Health Oversight Legislation, Regulates Private Equity.” malegislature.gov, December 30, 2024. https://malegislature.gov/pressroom/detail?pressreleaseid=164.

[50] mass.gov. “Governor Healey Signs Laws Lowering Health Care Costs and Strengthening Oversight,” January 8, 2025. https://www.mass.gov/news/governor-healey-signs-laws-lowering-health-care-costs-and-strengthening-oversight.

[51] massbar.org. “The Legislative Process.” Accessed January 15, 2025. https://www.massbar.org/advocacy/legislative-activities/the-legislative-process.

[52] See Weisman, Robert. “Post-Steward, Lawmakers Struggle to Curb Private Equity in Health Care.” The Boston Globe, December 16, 2024. https://www.bostonglobe.com/2024/12/16/business/steward-private-equity-health-care-kinderhook/; Taylor, Sri. “Crackdown on Private Equity in Health Care Flops in State Houses.” BNN Bloomberg, December 22, 2024, sec. business/company-news. https://www.bnnbloomberg.ca/business/company-news/2024/12/22/crackdown-on-private-equity-in-health-care-flops-in-state-houses/; Serres, Chris, Liz Kowalczyk, Elizabeth Koh, and Brendan McCarthy. “Steward Health Care Regulation in Mass. What Happened?” BostonGlobe.Com, December 14, 2024. https://apps.bostonglobe.com/metro/investigations/spotlight/2024/09/steward-hospitals/regulators/.

[53] Orlando Health. “Orlando Health Completes Purchase of Hospitals and Physician Practices in East Central Florida – Orlando Health – One of Central Florida’s Most Comprehensive Healthcare Networks,” October 24, 2024. https://www.orlandohealth.com/content-hub/orlando-health-completes-purchase-of-hospitals-and-physician-practices-in-east-central-florida; Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[54] Condon, Alan. “Orlando Health to Close 298-Bed Hospital Acquired in October.” Becker’s Hospital Review | Healthcare News & Analysis, February 20, 2025. https://www.beckershospitalreview.com/finance/orlando-health-to-close-298-bed-hospital-acquired-in-october/.

[55] Mario Pedersen, Joe. “Shuttered Rockledge Hospital Leaves Community without Its Emergency Department.” Central Florida Public Media, April 23, 2025, sec. Health. https://www.cfpublic.org/health/2025-04-23/shuttered-rockledge-hospital.

[56] Condon, Alan. “Orlando Health to Close 298-Bed Hospital Acquired in October.” Becker’s Hospital Review | Healthcare News & Analysis, February 20, 2025. https://www.beckershospitalreview.com/finance/orlando-health-to-close-298-bed-hospital-acquired-in-october/.

[57] Ashley, Madeline. “Orlando Health Outlines $750M Florida Expansion.” Becker’s Hospital Review | Healthcare News & Analysis, April 14, 2025. https://www.beckershospitalreview.com/capital/orlando-health-outlines-750m-florida-expansion/.

[58] Mario Pedersen, Joe. “Shuttered Rockledge Hospital Leaves Community without Its Emergency Department.” Central Florida Public Media, April 23, 2025, sec. Health. https://www.cfpublic.org/health/2025-04-23/shuttered-rockledge-hospital.

[59] Berman, Dave. “Rockledge Hospital Closing to Affect 940 Employees.” Florida Today, February 26, 2025. https://www.floridatoday.com/story/money/business/2025/02/26/rockledge-hospital-cloin940-employees-to-be-affected-by-orlando-health-closing-of-rockledge-hospital/80089485007/.

[60] Berman, Dave. “Disappointed, Saddened Community Marks Death of Rockledge Hospital at Age 84.” Florida Today, April 20, 2025. https://www.floridatoday.com/story/news/local/2025/04/20/staff-community-mark-last-days-of-rockledge-hospital-with-sadness/83099233007/.

[61] Tkacik, Maureen. “Scenes From the Bat Cave.” The American Prospect, February 27, 2024. https://prospect.org/api/content/7b227dd8-d50a-11ee-b7cd-12163087a831/.

[62] Evans, Melanie, and Jonathan Weil. “A Bat Infestation, Postponed Surgeries and Unpaid Bills: A Hospital Chain in Crisis.” WSJ, March 20, 2024, sec. Health. https://www.wsj.com/health/healthcare/hospital-chain-financial-crisis-steward-mpt-45be8bfb.

[63] Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[64] Vogel, Susanna. “Steward Health Care Auction: What Assets Sold, Closed and Are Still up for Grabs | Healthcare Dive.” HealthcareDive, March 18, 2025. https://www.healthcaredive.com/news/steward-health-care-auction-what-assets-sold-closed-and-are-still-up-for/725230/.

[65] “Michael Sarian.” Accessed April 25, 2025. https://www.amhealthsystems.com/home/our-corporate-leadership-team/michael-sarian/.

[66] See Tkacik, Maureen. “Who’ll Stop the Raid?” The American Prospect, August 28, 2023. https://prospect.org/health/2023-08-28-wholl-stop-the-raid-medical-properties-trust/ and Tkacik, Maureen. “Quackonomics.” The American Prospect, May 23, 2023. https://prospect.org/health/2023-05-23-quackonomics-medical-properties-trust/.

[67] See Tkacik, Maureen. “Who’ll Stop the Raid?” The American Prospect, August 28, 2023. https://prospect.org/health/2023-08-28-wholl-stop-the-raid-medical-properties-trust/ and Tkacik, Maureen. “Quackonomics.” The American Prospect, May 23, 2023. https://prospect.org/health/2023-05-23-quackonomics-medical-properties-trust/.

[68] Biswas, Soma. “A Company Taking Over Steward Hospitals Has Struggled With Its Own Portfolio – WSJ.” WSJ Pro Bankruptcy, October 7, 2024. https://www.wsj.com/articles/a-company-taking-over-steward-hospitals-has-struggled-with-its-own-portfolio-0d1bb8ca.

[69] Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[70] Gaunter, Mike. “WARN Letters List 944 Jobs Lost with Closure of Trumbull Regional, Hillside Rehabilitation Hospital.” 21 WFMJ, August 23, 2024. https://www.wfmj.com/story/51268150/warn-letters-list-944-jobs-lost-with-closure-of-trumbull-regional-hillside-rehabilitation-hospital.

[71] Tkacik, Maureen. “The Ambulance Chasers of Totaled Hospitals.” The American Prospect, December 9, 2024. https://prospect.org/health/2024-12-09-ambulance-chasers-totaled-hospitals/.

[72] Tkacik, Maureen. “The Ambulance Chasers of Totaled Hospitals.” The American Prospect, December 9, 2024. https://prospect.org/health/2024-12-09-ambulance-chasers-totaled-hospitals/.

[73] Tkacik, Maureen. “The Ambulance Chasers of Totaled Hospitals.” The American Prospect, December 9, 2024. https://prospect.org/health/2024-12-09-ambulance-chasers-totaled-hospitals/.

[74] Ashley, Madeline. “Closures, Bids, Layoffs: Where Steward’s 31 Hospitals Stand | Becker’s.” Becker’s Hospital Review | Healthcare News & Analysis, January 31, 2025. https://www.beckershospitalreview.com/finance/closures-bids-layoffs-where-stewards-31-hospitals-stand/.

[75] Tkacik, Maureen. “The Ambulance Chasers of Totaled Hospitals.” The American Prospect, December 9, 2024. https://prospect.org/health/2024-12-09-ambulance-chasers-totaled-hospitals/.

[76] Boney, Stan. “Insight Health Systems, New Owner of Trumbull Regional Medical Center and Hillside Hospitals, Lays off Employees, Warren, Ohio,” October 24, 2024. https://www.wkbn.com/news/local-news/warren-news/new-owner-of-local-hospitals-lays-off-employees/.

[77] Stone, Laurel, Dave Sess, and Brandon Jaces. “Insight Trumbull and Hillside in Warren, Ohio Pauses All Operations, Including ER.” WKBN, March 27, 2025. https://www.wkbn.com/news/local-news/warren-news/local-hospital-pauses-all-operations-including-er/.

[78] Gaunter, Mike, and Leslie Huff. “Senator Moreno Demands Answers about Insight Hospital Closures in Trumbull County.” Wfmj.Com, April 7, 2025. https://www.wfmj.com/story/52672104/senator-moreno-demands-answers-about-insight-hospital-closures-in-trumbull-county.

[79] Norris, Kelcey. “143 Employees at Trumbull County Hospital out of Work. | Mahoning Matters,” April 4, 2025. https://www.mahoningmatters.com/news/local/article303414141.html.

[80] Gaunter, Mike, and Leslee Huff. “Senator Moreno Demands Answers about Insight Hospital Closures in Trumbull County.” wfmj.com, April 7, 2025. https://www.wfmj.com/story/52672104/senator-moreno-demands-answers-about-insight-hospital-closures-in-trumbull-county.

[81] Gaunter, Mike, and Leslee Huff. “Senator Moreno Demands Answers about Insight Hospital Closures in Trumbull County.” wfmj.com, April 7, 2025. https://www.wfmj.com/story/52672104/senator-moreno-demands-answers-about-insight-hospital-closures-in-trumbull-county.

[82] The website as of April 25, 2025 shows a popup that reads “Due to additional abrupt developments in Steward Health Care’s bankruptcy proceedings and the mounting lack of transferred dollars owed for healthcare services delivered to patients at Trumbull and Hillside hospitals, all inpatient, outpatient, and ER services are on diversion as of 3:00 p.m. March 27th, 2025. Future appointments are cancelled in the interest of patient safety. While the plan remains in place to redesign the hospitals’ operations fully independent of Steward, we apologize for the confusion this transition has caused the community and for the undue burden it has placed on patients and employees. Patient medical records are available by calling

(810) 895-4039 or by email at [email protected].” See: Insight Trumbull. “Insight Hospital & Medical Center Trumbull | Homepage.” Accessed April 25, 2025. https://trumbullregional.org/.

[83] Schlosser, Tyler. “WARN Notice for Insight Shows 143 Workers Furloughed as Insight Seeking Funding.” 21 WFMJ, March 31, 2025. https://www.wfmj.com/story/52648903/warn-notice-for-insight-shows-143-workers-furloughed-as-insight-seeking-funding; Ashley, Madeline. “Ohio Hospital Halts More Services, Furloughs Employees.” Becker’s Hospital Review | Healthcare News & Analysis, March 24, 2025. https://www.beckershospitalreview.com/finance/ohio-hospital-halts-more-services-furloughs-employees/.

[84] Mosca, Zach, and Kaitlyn McCarthy. “Warren Mayor Calls on Criminal Investigation of Steward Health for Alleged Medicare Fraud,” April 3, 2025. https://www.wfmj.com/story/52664938/warren-mayor-calls-on-criminal-investigation-of-steward-health-for-alleged-medicare-fraud.

[85] 21 WFMJ. “Job Losses Jump to 468 at Northside Regional Medical Center – WFMJ.Com,” August 17, 2018. https://www.wfmj.com/story/38909561/job-losses-jump-to-468-at-northside-regional-medical-center.

[86]WKBN News. “Northside Regional Medical Center in Youngstown Closing.” August 15, 2018. https://www.wkbn.com/news/local-news/northside-regional-medical-center-in-youngstown-closing/.

[87] See O’Connor, Kyra, William Pitts, and Chase Golightly. “St. Luke’s License Revoked by State Department of Health | 12news.Com,” August 13, 2024. https://www.12news.com/article/news/local/valley/employees-have-been-bringing-in-our-own-supplies-shortages-reported-no-ac-at-st-lukes-behavioral-health/75-3e3cba4d-bb78-48aa-979b-188ab865bc96 and Marshall, Micaela. “St. Luke’s Behavioral Health Center Reopens under New Ownership after Months in Limbo.” AZ Family, December 8, 2024, sec. News. https://www.azfamily.com/2024/12/08/st-lukes-behavioral-health-center-reopens-under-new-ownership-after-months-limbo/.

[88] Marshall, Micaela. “St. Luke’s Behavioral Health Center Reopens under New Ownership after Months in Limbo.” AZ Family, December 8, 2024, sec. News. https://www.azfamily.com/2024/12/08/st-lukes-behavioral-health-center-reopens-under-new-ownership-after-months-limbo/.

[89] Boney, Stan, and Shianna Gibbons. “Sharon Regional Medical Center Closes, No Longer Accepting ER Patients.” WKBN.Com (blog), January 5, 2025. https://www.wkbn.com/news/local-news/sharon-news/sharon-regional-medical-center-closes-no-longer-accepting-er-patients/.

[90] Mamula, Kris. “Mercer County Hospital Closes: ‘Just an Awful Time for Us,’ Surgeon Says | Pittsburgh Post-Gazette.” Pittsburgh Post-Gazette, January 6, 2025. https://www.post-gazette.com/business/healthcare-business/2025/01/06/sharon-regional-medical-center-bankruptcy-steward-health-system/stories/202501060048.

[91] McCarthy, Kaitlyn. “One Month since Sharon Regional Reopened Its Doors,” April 23, 2025. https://www.wfmj.com/story/52716102/one-month-since-sharon-regional-reopened-its-doors.

[92] Simonek, Erin. “Sharon Regional Medical Center Re-Opens – WFMJ.Com,” March 18, 2025. https://www.wfmj.com/story/52574399/sharon-regional-medical-center-reopens.

[93] Moody’s Investors Service. “Moody’s Ratings Appends Limited Default (LD) to Quorum Health’s PDR Following Missed Interest Payment | Announcement,” August 12, 2024. https://www.moodys.com/research/Moodys-Ratings-appends-limited-default-LD-to-Quorum-Healths-PDR-Announcement–PR_494260.

[94] Ashley, Madeline. “Judge OKs Sale of 2 Steward Texas Hospitals to Quorum Health.” Becker’s Hospital Review, October 11, 2024. https://www.beckershospitalreview.com/hospital-transactions-and-valuation/judge-oks-sale-of-2-steward-texas-hospitals-to-quorum-health.html.

[95] Moody’s Investors Service. “Moody’s Ratings Announces Completion of a Periodic Review of Ratings of Quorum Health Corporation,” October 4, 2024. https://www.moodys.com/research/Moodys-Ratings-announces-completion-of-a-periodic-review-of-ratings-Announcement-of-Periodic-Review–PR_496701; Moody’s Investors Service. “Moody’s Ratings Appends Limited Default (LD) to Quorum Health’s PDR Following Missed Interest Payment | Announcement,” August 12, 2024. https://www.moodys.com/research/Moodys-Ratings-appends-limited-default-LD-to-Quorum-Healths-PDR-Announcement–PR_494260.

[96] Medical Properties Trust. “Medical Properties Trust Takes Control of Its Real Estate From Steward Health Care,” September 11, 2024. https://www.medicalpropertiestrust.com/press-release?page=https://medicalpropertiestrust.gcs-web.com/news-releases/news-release-details/medical-properties-trust-takes-control-its-real-estate-steward.

[97] See pgs. 11 and 28 of Bugbee, Mary. “The Pillaging of Steward Health Care: How a Privat Equity Firm and Hospital Landlord Contributed to Steward’s Bankruptcy.” Private Equity Stakeholder Project, June 26, 2024. https://pestakeholder.org/wp-content/uploads/2024/07/PESP_report_Steward-Bankruptcy_2024.pdf.

[98] Pifer, Rebecca. “Troubled Quorum Health Mulls Going Private with PE Firm KKR.” Healthcare Dive, December 3, 2019. https://www.healthcaredive.com/news/troubled-quorum-health-mulls-going-private-with-pe-firm-kkr/568332/.

[99] Mensik, Hailey. “Quorum Completes Bankruptcy Process, Taps New CEO.” Healthcare Dive, June 30, 2020. https://www.healthcaredive.com/news/quorum-bankruptcy-approval-emerging-in-july/580805/.

[100] Lombaerde, Geert De. “Quorum Pencils in Final Post-Bankruptcy Director.” Nashville Post, June 8, 2020. https://www.nashvillepost.com/quorum-pencils-in-final-post-bankruptcy-director/article_34fd960c-8133-5da9-9dc2-4e58c738d2f7.html.

[101] Hill, Jeremy. “Quorum Health Topples Mudrick, Clearing Path to Bankruptcy Exit.” Bloomberg Law, June 29, 2020. https://news.bloomberglaw.com/bankruptcy-law/quorum-health-topples-mudrick-clearing-path-to-bankruptcy-exit; Case M.9845 – DAVIDSON KEMPNER CAPITAL MANAGEMENT / GOLDEN TREE ASSET MANAGEMENT / QUORUM HEALTH CORPORATION, No. 32020M9845 (European Commission, Directorate-General for Competition May 28, 2020). https://ec.europa.eu/competition/mergers/cases/decisions/m9845_112_3.pdf

[102] Moody’s Investors Service. “Moody’s Ratings Appends Limited Default (LD) to Quorum Health’s PDR Following Missed Interest Payment | Announcement,” August 12, 2024. https://www.moodys.com/research/Moodys-Ratings-appends-limited-default-LD-to-Quorum-Healths-PDR-Announcement–PR_494260.

[103] Moody’s Investors Service. “Moody’s Ratings Appends Limited Default (LD) to Quorum Health’s PDR Following Missed Interest Payment | Announcement,” August 12, 2024. https://www.moodys.com/research/Moodys-Ratings-appends-limited-default-LD-to-Quorum-Healths-PDR-Announcement–PR_494260.

[104] QHR Health. “QHR Health Becomes Independent Company Through Acquisition by Grant Avenue Capital,” June 1, 2021. https://qhr.com/news/qhr/qhr-health-becomes-independent-company-through-acquisition-by-grant-avenue-capital/.

[105] Bugbee, Mary. “Ovation Healthcare Finds Profit in Nonprofit Rural Health Providers.” Private Equity Stakeholder Project (blog), April 27, 2023. https://pestakeholder.org/news/ovation-healthcare-finds-profit-in-nonprofit-rural-health-providers/.

[106]ABC11 Raleigh-Durham. “Hospital in Rural North Carolina Area, with a Declining Population Shuts down in Martin County.” August 4, 2023, sec. health. https://abc11.com/nc-hospital-closes-bankruptcy-martin-general-rural-health-care/13599605/.

[107] Schwartz, Noah. “Shuttered North Carolina Hospital Failed to Submit Compliance Reports for 5 Years.” Becker’s Hospital Review, October 18, 2023. https://www.beckershospitalreview.com/legal-regulatory-issues/shuttered-north-carolina-hospital-failed-to-submit-compliance-reports-for-5-years.html.

[108] “Medical Properties Trust, Inc. (NYSE: MPW) – Medical Properties Trust, Inc. Reports Second Quarter Results,” July 29, 2021. https://medicalpropertiestrust.gcs-web.com/news-releases/news-release-details/medical-properties-trust-inc-reports-second-quarter-results-5; Fine, Howard. “Pipeline Health Finds Success With Safety Net 50 Model.” Los Angeles Business Journal, September 6, 2021. https://labusinessjournal.com/special-reports/pipeline-health-success-safety-net-hospitals/. “Medical Properties Trust 2021 Form 10-K.” United States Securities and Exchange Commission, December 21, 2021. https://www.sec.gov/Archives/edgar/data/1287865/000156459022008100/mpw-10k_20211231.htm.

[109] Fine, Howard. “Pipeline Health, Operator of Safety Net Hospitals, Files for Chapter 11 Bankruptcy Protection.” Los Angeles Business Journal, October 10, 2022. https://labusinessjournal.com/featured/pipeline-health-operator-of-safety-net-hospitals-files-for-chapter-11-bankruptcy-protection/.

[110] Pg. 4 of Bugbee, Mary. “The Pillaging of Steward Health Care: How a Private Equity Firm and Hospital Landlord Contributed to Steward’s Bankruptcy.” Private Equity Stakeholder Project, June 26, 2024. https://pestakeholder.org/reports/the-pillaging-of-steward-health-care/.

[111] “Hospital Locations | Prospect Medical Holdings, Inc.” Accessed January 12, 2025. https://www.pmh.com/locations/hospital-locations/.

[112] PE Hub Staff, “Leonard Green Buying Prospect Medical,” PE Hub (blog), August 16, 2010,  https://www.pehub.com/leonard-green-buying-prospect-medical/

[113] Eileen O’Grady, “UPDATE: Leonard Green-Led Ownership Collected $658 Million in Dividends and Fees from Prospect Medical Holdings despite Challenges, Commitment to Regulators to Forgo Dividends” (Private Equity Stakeholder Project, May 2020),  https://pestakeholder.org/wp-content/uploads/2020/05/UPDATE-Leonard-Green-Prospect-Medical-Dividends-PESP-051420.pdf

[114] “Profits Over Patients: The Harmful Effects of Private Equity on the U.S. Health Care System.” Senate Budget Committee Bipartisan Staff Report, January 2025, 118th Congress. Pg. iv.;  “Decision Re: Initial Application of Chamber Inc.; Ivy Holdings Inc.; Ivy Intermediate Holdings, Inc.; Prospect Medical Holdings, Inc.; Prospect East Holdings, Inc.; Prospect East Hospital Advisory Services, LLC; Prospect CharterCARE, LLC; Prospect CharterCARE SJHSRI, LLC; Prospect CharterCARE RWMC, LLC” (State of Rhode Island Office of the Attorney General, June 1, 2021), 37,  https://riag.ri.gov/sites/g/files/xkgbur496/files/documents/Prospect_Chamber_Ivy_AG_HCA_Decision.pdf

[115] “Prospect to Receive $1.55 Billion Investment from Medical Properties Trust, Inc.,” July 15, 2019. https://www.businesswire.com/news/home/20190715005786/en/Prospect-to-Receive-1.55-Billion-Investment-from-Medical-Properties-Trust-Inc.

[116] Vogel, Susanna. “‘I Lose Sleep over This Case’: Prospect Cleared to Close Crozer Health | Healthcare Dive.” Healthcare Dive, April 23, 2025. https://www.healthcaredive.com/news/prospect-medical-holdings-close-crozer-health/746117/; Dougherty, Tom, Kerri Corrado, Madeleine Wright, and Joe Holden. “Crozer Health Hospitals in Pennsylvania Are Closing, Prospect Medical Holdings Says – CBS Philadelphia.” CBS News, April 22, 2025. https://www.cbsnews.com/philadelphia/news/crozer-health-hospital-closing-news/.

[117] O’Connell, Chris. “Crozer Health Remains Open after Receiving $6 Million Donation in Short-Term Funding.” FOX 29 Philadelphia, April 10, 2025. https://www.fox29.com/news/crozer-health-remains-open-after-receiving-6-million-donation-short-term-funding.

[118] Southwick, Ron. “How Crozer Health’s Closure Will Impact a Pennsylvania County.” Chief Healthcare Executive, April 23, 2025. https://www.chiefhealthcareexecutive.com/view/how-crozer-health-s-closure-will-impact-a-pennsylvania-county.