Uncertainty swirling around Steward, state ramps up monitoring

State officials will ramp up monitoring of the safety-net hospitals owned by troubled Steward Health Care, which was revealed last month to be in grave financial distress with the fate of its many facilities in limbo.

“The bottom line is, at this time, we do not know what the future of Steward hospitals will be,” said Robbie Goldstein, the state’s public health commissioner, at a Public Health Council meeting on Wednesday morning. “That said, it’s likely that there will need to be some reorganization, reconfiguration, transition, and potential closures for Steward hospitals and the health care they deliver,” he said. The Department of Public Health “is responsible for overseeing the health and well-being of all residents by supporting and preserving access to safe and high quality health care. We take this responsibility, this covenant, seriously.”

Public health officials have been monitoring four Steward hospitals – St. Elizabeth’s Medical Center in Brighton, Good Samaritan Medical Center in Brockton, Holy Family Hospital in Haverhill, and Holy Family Hospital in Methuen – daily for the past several weeks, Goldstein said. They expanded monitoring to Carney Hospital in Dorchester and Morton Hospital in Taunton this week, and will be present in all Steward hospitals by next week.

Goldstein said DPH is investigating any specific quality or safety concern that arises, in partnership with federal regulatory agencies as appropriate. Beacon Hill has been openly enraged by the situation, though neither lawmakers nor Gov. Maura Healey have shown any interest in bailing out the for-profit health care system. 

Steward’s financial crisis will impact emergency departments, inpatient facilities, and ambulatory clinics across the state, Goldstein and council members emphasized. 

The Holy Family hospitals in the Merrimack Valley are “serving a very vulnerable population,” said Eduardo Haddad, president of the Lawrence General Hospital medical staff. “And these folks would be left without a place to go if they were to close.” 

Lawrence General will “increase our capacity to the utmost,” Haddad said, “and we are indeed sharing medical staff that goes to both hospitals already.” He said the limitation will be capacity limits at Lawrence General. “There is no lack of will, on our part, to take care of all of these patients,” Haddad said.

Underscoring the severity of the situation was the appearance at the meeting of Healey, who assured the council that the crisis is “top of mind” for the administration. 

“I am frustrated with where we are right now as a state and what Steward has done,” the governor said, pointing to her efforts as attorney general to seek greater transparency and disclosure from the health group.

The hospitals are also major employers, she noted. 

“They provide an important social safety net and a touchstone, of course, of local identity,” Healey said. “We’re mindful about any potential impacts on other hospitals, and on the health care sector generally, which we know is already under considerable stress.”

Edward Bernstein, a Gov. Deval Patrick appointee to the Public Health Council, said in his decade on the board, “this is the first time that the governor has come to speak to us, and the sort of monitoring that’s taking place, I haven’t seen in that history.” 

The Steward issue is unfolding against “a backdrop of a health care system already confronting unprecedented capacity constraints,” Goldstein said. He emphasized ongoing staffing shortages challenging the state’s acute care hospitals and long-term care facilities, primary care providers backlogs, “unprecedented waitlists” at community health centers, and severely limited behavioral health services.

“This is a situation that is enormously challenging and unsustainable,” he said, requiring a  “multifaceted, long-term approach that involves collaboration with all segments of the health care infrastructure, all of government, and all of our community partners to move us through this increasingly challenging time.”

Bernstein said the situation is “approaching a public health crisis or an emergency,” and he asked Goldstein if there are any powers to put Steward into receivership or force some sort of accountability.

Goldstein said the administration is doing “due diligence” to find out if there are any applicable emergency powers or other legal resources that could be brought to bear on the Steward situation. For now, he said, they are focused on the “downstream issues” of ensuring patient care and confidence, as well as assuring the nearly 16,000 Steward employees in Massachusetts that they will be paid for their work and have safe workplaces. But “upstream solutions” may need to be put in place in the future, he said.

Administration officials said they are committed to transparent processes if and when Steward makes any closure decisions, as in the case of New England Sinai Hospital in Stoughton.

“We’ve listened to the issues they’re facing, and we’ve offered support, advice, and our perspective,” Goldstein said. “But Steward itself must address its significant financial challenges. It must develop a reasonable plan and relay that plan and a timeline to us, and then work with us to move the process forward. Right now, we don’t know what Steward will do, or what the pathway to a resolution looks like.”