Today, Steward Health Care responded via letter to Massachusetts Governor Maura Healey, outlining the comprehensive financial documentation it has provided to various state agencies and regulatory bodies to date.

The health care system also re-affirmed its commitment to working with the Commonwealth to ensure the continuity of safe, high-quality, and compassionate care for all patients.

The full letter from Steward Health Care follows:

Dear Governor Healey:

We have reviewed your letter of February 20. Let me first make crystal clear that Steward is committed to continuing to work with you and your Administration to ensure continuity of access to high-quality medical care in the communities we serve. For fourteen years, our hospitals have helped anchor the health-care system, and the local economy, in places like Dorchester, Fall River, Haverhill, Brockton, and other underserved communities in easter Massachusetts. Our commitment, and our accomplishments, are steadfast and ongoing: Steward hospitals and providers see approximately 1,500 patients every day. Our hospitals and related practices in the Commonwealth employ approximately 15,000 people, and we are humbled every day by their hard work and dedication to providing high-quality patient care.

You ask us in your letter to partner with your administration on three topics, which I will address in turn.

First, you ask that we “ensure safe staffing and appropriate supply levels” at each facility. As your administration knows, we have cooperatively engaged with Department of Public Health (DPH) and Centers for Medicare & Medicaid Services (CMS) surveyors and met routinely, at some locations daily, with DPH monitors. We are addressing each and every concern raised by a DPH or CMS official at every hospital in Massachusetts. Our hospital presidents, chief medical officers, and other staff have had an open line of communication with DPH and will continue to do so. We continue to provide high-quality care at all of the hospitals, and we have no plan to abandon our communities or our employees. Every one of our employees should be honored for the work they perform, and the service they provide, every day.

You next ask that we “[a]llow for increased monitoring” by DPH. We welcome this. We’ve repeatedly affirmed our commitment not only to host monitors but to work in lockstep with them to ensure and promote the highest safety standards: our track record proves this. Our hospital administrators are actively working with the monitors currently in place and we will guarantee the same open dialogue with any additional DPH employees you choose to deploy. Any suggestion that patient care is not the first priority of every employee and administrator in a Steward hospital is not correct.

Finally, you ask that we “[i]mmediately disclose financial documents,” and you assert that we have been neither “forthcoming” nor “transparent” to date in doing so. You state we have kept the “hospitals’ financial condition in a black box” and kept your administration “in the dark.”

In fact, at their request, we have provided the Attorney General (AGO) and Executive Office of Health and Human Services (EOHHS) 613 megabytes – running across tens of thousands of pages – of financial and operating materials over the last two months, including consolidated financials for the years ending in 2017, 2018, 2019, 2020, 2021, and 2022. Our financials for 2023 are not yet available, but will be provided in due time.

Here is a snapshot of some of the materials we have provided to the AGO and to EOHHS:

Financial Information:

• Hospital Consolidated financials 2021 – November 2023
• Hospital A/R Aging June 2022 – November 2023
• SMG A/R Aging Summary 2022 and 2023
• AP Aging September 2022 – December 2023
• Weekly receipts FY23
• Balance sheet by hospital – December 2022

Staffing and Payroll Information:

• 2022 and 2023 YTD payroll on a monthly basis (employee, title, department, hours, gross pay, overtime, taxes, net pay)
• Salary by employee by department and facility/service
• Employee benefit plan/fringe information
• Collective bargaining agreements

In addition, the AGO has received:

• Capital investment statements by hospital
• P&L by hospital

In addition, Steward has provided the AGO and EOHHS thousands of pages of materials related to its hospital leases and other financial documents. We have played with our cards face up on these data requests, using teams of professionals to interact with multiple state officials and to gather and produce data into the night and over weekends. To this day we continue to provide data. Further, we have had multiple calls with the AGO and EOHHS concerning and explaining the data provided. We remain committed to continuing an open process with you and your administration, and will continue to share as much as possible given various regulatory and contractual constraints we are obligated to honor.

More, we have been in daily communication with state and local leaders, repeatedly briefing them on the quality of care in the system and hosting multiple on-site visits to the hospitals. This ongoing dialogue has included:

• More than a dozen conversations with members of the AGO’s staff, including an in-person meeting with the Attorney General;
• Five joint meetings with EOHHS and DPH between September 2023 and January 2024 with over 50 other communications with EOHHS leadership;
• Several communications with your staff including a meeting with you on January 10, 2024;
• In-person and virtual meetings with approximately 36 state legislators and their staff including committee and chamber leadership, totaling approximately 100 communications (regarding Steward’s specific and community hospital writ large distress);
• Routine communication with nearly all Steward’s city/town leadership (mayors and city councils);
• Multiple individual briefings and one delegation-wide briefing with federal House and Senate members or their staff beginning in January 2024.

Rather than parry on that issue, however, I will address what is the key point in your letter. You state that it is time for Steward to “execut[e] a safe, orderly transition of [its] seven licensed facilities in Massachusetts to new operators as soon as possible.” As a reminder, we approached your Administration through EOHHS in October last year suggesting the same.

Nonetheless, we accept your offer to partner with your administration to “build a path forward” and “work together to resolve this effectively.” We would welcome the opportunity to meet with you personally concerning the orderly departure of Steward from Massachusetts. We guarantee that it is our priority to orchestrate a transition that emphasizes the continuity of first-class medical care in the communities we serve. We look forward to continuing a productive dialogue with your Administration to effectuate this plan in short order.

Sincerely yours,

Michael Callum, M.D.,

Executive Vice President for Physician Services and Interim President, NE Region

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