Are some community hospitals failing? Doctors must transfer dying patient as hospital supplies are repossessed.
Key Takeaways
A woman delivered a baby at St. Elizabeth's Medical Center in Boston, MA. Soon after, she suffered a severe liver bleed. However, when hospital staff rushed her for emergency surgery to control the bleeding, surgeons found themselves without an embolization coil.
In the preceding weeks, numerous supplies and equipment at the hospital had been repossessed due to nonpayment by its parent company, Steward Health Care.
This incident and similar occurrences have sparked concerns regarding the risk posed to community hospitals and their local residents by for-profit entities.
A Massachusetts woman, 39-year-old Sungida Rashid, gave birth to a daughter at St. Elizabeth's Medical Center in Boston, MA, last October. Shortly after, Rashid experienced several complications, including cardiac arrest and uterine bleeding. Staff subsequently discovered a deep bleed in Rashid’s liver. Hospital staff rushed her into emergency surgery to stop the bleeding. However, they found they didn’t have what they needed: an embolization coil, a small catheter placed inside the blood vessels to stop bleeding.[] [][]
Rashid had to be transferred to another hospital, where she died.[] In the weeks prior to Rashid’s death, many of the hospital’s devices had been repossessed, according to hospital staff. CBS News reports that staff at St. Elizabeth's said the manufacturer of the embolization coils had come to retrieve them weeks earlier because the hospital’s parent company, Dallas-based Steward Health Care, hadn't paid its bills.[][]
To make matters worse, not all hospital staff members were briefed on the repossessions. When Rashid was rushed into the operating room for emergency surgery, for example, this news came as a surprise.[]
Are shortages happening in your hospital?
Kenneth Perry, MD, an emergency medicine physician in Charleston, SC, says that supply shortages have been an issue in medicine, especially in the wake of the COVID-19 pandemic. “Shortages within the healthcare system can happen at many different levels. Sometimes, it is within the actual facility that is making certain medications. Other times, it is the inability for certain devices to be obtained,” Dr. Perry says.
“For some products, the issue is the lack of adequate production for the demand from our healthcare system. In the wake of the pandemic, supply chains seem to be stressed beyond normal capacity," he continues.
“For many of the supplies that are less prevalent at this time, there are obvious equivalent options, whether this means an alternative medication regimen or a different type of material for certain procedures. [This] has made providers be very nimble while taking care of patients,” Dr. Perry says. However, there are also supplies or medications that simply have no alternatives, Dr. Perry says.
How did this happen?
Rashid’s death sounded the alarm around the risks of private equity–backed companies like Steward buying up community hospitals.
St. Elizabeth's Medical Center was acquired by Steward in 2010, joining 32 other Steward-operated hospitals across several states. As of this January, there are at least six active lawsuits against Steward, alleging that the company has not paid vendors for supplies and services.[][]
Private equity firm Cerberus Capital Management financially backed and owned Steward from 2010 until May 2020, when Cerberus transferred 90% of its interest to a number of Steward physicians and 10% to its landlord, Medical Properties Trust (MPT).[][] MPT says it is owed $50 million by Steward, according to CBS News. According to a January 4, 2024, MPT news release, “Steward is pursuing several strategic transactions, including the potential sale or re-tenanting of certain hospital operations as well as the divestiture of non-core operations. Further, Steward has committed to seeking a third-party capital partner for its managed care business, net proceeds from which will be used in part to repay all outstanding obligations to MPT.”
In February, US Senators Elizabeth Warren and Edward J. Markey, along with Massachusetts’ nine congressional delegation members, sent a letter to Cerberus demanding that it explain its role in “creating the current financial challenges at Steward hospitals, which threaten access to medical care for thousands of people in eastern Massachusetts.”[]
The letter states, “We are particularly concerned about the extent to which Cerberus and its affiliates literally stripped out and sold the property from underneath these hospitals, creating hundreds of millions of dollars in profits for private equity executives, while leaving the facilities with long-term liabilities that are magnifying – if not creating – the current crisis.”[]
The Boston Globe reports that many of St. Elizabeth’s workers also raised concerns in a memo about the “precarious position management has placed both patients and caregivers [in].” Written by 1199SEIU United Healthcare Workers East, the memo was sent to the union’s 5,000 members working at Steward’s nine Massachusetts facilities.[]
Steward isn’t unique in its situation. CBS News has spent the last year and a half looking into how private equity investors have stripped funds from several community hospitals, leaving patients in potentially dire situations. In 2021, private equity firms made healthcare deals totaling over $151 billion.[][]
For example, Delaware County Memorial Hospital in Drexel Hill, PA, served its 85,000 residents with 168 beds until 2022, when its for-profit parent company, Prospect Medical Holdings, began making cuts. Patients arrived at the hospital’s emergency room only to discover it had shut down.[]
Beyond the impacts felt by individual patients, whole communities are affected when hospitals make cuts.
According to GBH, St. Elizabeth’s Medical Center had long been a pillar of funding for community groups. Under Steward, however, things changed.[]
“[T]he hospital has quietly backed away from more than $600,000 in community giving — including for the vouchers program — and still owes money that it signed agreements to provide,” GBH reports, saying there has also been a “near-complete retraction of community support from the hospital, particularly after the onset of the COVID-19 pandemic.”