St. Elizabeth's Medical Center (Boston) Explained

St. Elizabeth's Medical Center
Org/Group:Steward Health Care
Location:Brighton
Region:Boston
State:Massachusetts
Country:United States
Healthcare:Private
Funding:For-profit
Type:Teaching
Standards:Joint Commission
Emergency:II
Affiliation:Boston University School of Medicine
Beds:326
Publictransit:MBTA
Former-Names:St. Elizabeth's Hospital for Women
Opened:1868
Website:https://www.semc.org

St. Elizabeth's Medical Center (abbreviated SEMC, also known locally as St. E's) is a mid-size for-profit teaching hospital located in the Brighton neighborhood of Boston, Massachusetts.[1] St. Elizabeth's is a part of Dallas-based Steward Health Care System,[2] a private, for-profit health care system which took over the hospital in 2010 as part of its acquisition of the non-profit Caritas Christi Health Care system from the Archdiocese of Boston.[3]

History

Originally named St. Elizabeth's Hospital for Women, the hospital was founded in 1868[4] [5] by five laywomen of the Third Order of Saint Francis[6] at its original site in the South End neighborhood of Boston.

Established to primarily attend to medical needs specific to the poor and elderly women of Boston, the hospital was an early pioneer in the field of gynecology. The new hospital saw plenty of use, with its approximately thirty beds "always filled." In 1882, the hospital's charter was amended to allow for the care of men.

In 1884, Boston Archbishop John Joseph Williams invited the Franciscan Sisters of Allegany to take over operations at the hospital. The Sisters's tenure would last until 1965 and would see the hospital's 1914 move to its current location in Brighton,[7] its expansion into several varied specialties, and the beginning of its development as a teaching hospital.

In 2010, St. Elizabeth's was converted into a for-profit hospital when its parent organization, Caritas Christi Health Care, was purchased from the Archdiocese of Boston by private equity firm Cerberus Capital Management, becoming one of the original members and the flagship hospital of the newly created Steward Health Care System. Steward sold much of their hospitals' real estate, including that of St. Elizabeth's, to real estate investment trust Medical Properties Trust in 2016 in a sale-leaseback deal, providing the hospital system with $1.25 billion used both to pay hundreds of millions of dollars in dividends to investors[8] and to fund a nationwide expansion of the healthcare system.[9] This deal, which imposed large lease payments on the affected hospitals, would largely be blamed for St. Elizabeth's - and the whole system's - financial crisis in the 2020s.[10]

The 2020s saw escalating difficulties in hospital operations and finances. In December 2023, St. Elizabeth's was sued by the Department of Justice for violations of the False Claims Act and Stark Law in regards to allegations of improper referrals and Medicare billings from its cardiac surgery program.[11] [12] In 2023 and 2024, financial difficulties across the Steward Health Care System led to reports of unpaid vendors, missed rent payments, and inadequate supplies, including at St. Elizabeth's, where several lawsuits related to unpaid bills were filed in those years. Staff at the hospital reported vendors refusing to continue supplying the hospital with various supplies due to unpaid invoices, and contracted staff departing after months working without pay.[13] One significant event took place in December 2023, when a new mother admitted to St. Elizabeth's following delivery died of a liver bleed. According to reports, when doctors tried to treat her by using an embolism coil, they discovered that the devices needed had been reposessed several weeks earlier. The manufacturer later explained to staff that the repossession was due to outstanding invoices which had gone unpaid by Steward.

Amid these financial difficulties, Steward Health Care in January 2024 informed state lawmakers of its intention to sell at lease four of its Massachusetts hospitals to other operators, including St. Elizabeth's.[14]

On May 5, 2024, The Wall Street Journal reported that Steward Health Care was expected to file for Chapter 11 bankruptcy protection within the coming days, blaming rising costs, insufficient revenue and cash crunches as part of the decision. Steward's bankruptcy is set to be one of the largest hospital bankruptcies in U.S. history, and the largest one in decades.[15] The next day, Steward announced that it had indeed filed voluntarily for Chapter 11 bankruptcy protection. The company stressed that its hospitals and medical offices would remain open during the proceedings. In its press release, Steward stated it was finalizing terms of a $75 million in new debtor-in-possession financing from MPT, with the possibility for $225 million more if it meets certain unspecified conditions set by MPT. The company's filing papers list that more than 30 of its creditors owe about $500 million, and the U.S. government is owed $32 million to the federal government in "reimbursements for insurance overpayments".[16] [17]

In August 2024, Massachusetts Governor Maura Healey announced that, following stalled negotiations for Boston Medical Center to purchase the hospital, the state would seize the hospital through eminent domain to facilitate the transfer of ownership. The state was expected to offer $4.5 million to Apollo Global Management, the owner of the property, as fair market value.[18]

Operations

Today, St. Elizabeth's Medical Center is a teaching hospital affiliated with the Boston University Chobanian & Avedisian School of Medicine since 2021,[19] previously affiliated with Tufts University School of Medicine.[20]

It is a designated Level 2 Adult trauma center, and discharged more than 12,000 patients in 2022, accounting for 1.7% of discharges in Massachusetts that year. As of 2022, St. Elizabeth's had 326 licensed beds, and operated with total revenue of $445.7 million. The hospital is designated by the Commonwealth of Massachusetts as a "high public payer" hospital, measured by the ratio of revenues from "public pay" patients (i.e. those covered by Medicare or Medicaid) versus those covered by commercial health insurance. Many details of St. Elizabeth's financial situation are unknown publicly, a result of Steward Health Care's pattern of resistance to providing data to the state, provision of which is legally mandated by the Commonwealth of Massachusetts in order to monitor the stability of the state's healthcare system.[21]

External links

Notes and References

  1. Web site: Steward St. Elizabeth's Medical Center . Massachusetts Center for Health Information and Analysis . 2022 . March 11, 2024 . https://web.archive.org/web/20240311170747/https://www.chiamass.gov/assets/docs/r/hospital-profiles/2022/st-eliz.pdf . March 11, 2024.
  2. News: Steward Health Care posts first-ever profit in 2015 . McCluskey . Priyanka . July 24, 2016 . The Boston Globe . February 8, 2024 . https://web.archive.org/web/20231121074401/https://www.bostonglobe.com/business/2016/07/24/steward-health-care-stops-bleeding-money/JYKmRaPxdA4ZFhE9sM3fJI/story.html . November 21, 2023.
  3. News: Steward Health Care posts first-ever profit in 2015 . McCluskey . Priyanka . July 24, 2016 . The Boston Globe . February 8, 2024 . https://web.archive.org/web/20231121074401/https://www.bostonglobe.com/business/2016/07/24/steward-health-care-stops-bleeding-money/JYKmRaPxdA4ZFhE9sM3fJI/story.html . November 21, 2023.
  4. St. Elizabeth's Hospital Centennial Celebration . November 13, 1969 . The New England Journal of Medicine . 10.1056/NEJM196911132812014 . March 11, 2024 . https://web.archive.org/web/20240311172736/https://www.nejm.org/doi/full/10.1056/NEJM196911132812014 . March 11, 2024.
  5. Web site: St. Elizabeth's Medical Center . Boston University Chobanian & Avedisian School of Medicine . March 11, 2024 . https://web.archive.org/web/20231210050223/https://www.bumc.bu.edu/camed/education/medical-education/affiliated-sites/st-elizabeths-medical-center/ . December 10, 2023.
  6. Web site: About Us . St. Elizabeth's Medical Center . March 11, 2024 . https://web.archive.org/web/20240306050600/https://www.semc.org/about-us . March 6, 2024.
  7. Web site: St. Elizabeth's Medical Center Celebrates 100th Anniversary in Brighton . September 24, 2014 . St. Elizabeth's Medical Center . March 11, 2024 . https://web.archive.org/web/20210513013949/https://www.semc.org/article/St-Elizabeths-Medical-Center-celebrates-its-100th-anniversary-in-Brighton . May 13, 2021.
  8. La France . Aimee . Batt . Rosemary . Appelbaum . Eileen . December 6, 2021 . Hospital Ownership and Financial Stability: A Matched Case Comparison of a Nonprofit Health System and a Private Equity-Owned Health System . Advances in Health Care Management . 10.1108/S1474-823120210000020007 . 34779183.
  9. . September 26, 2016 . Steward Receives $1.25 Billion Investment from Medical Properties Trust, Setting Stage for National Growth . Boston . Steward Health Care . PR Newswire . March 11, 2024 . https://web.archive.org/web/20240120203020/https://www.prnewswire.com/news-releases/steward-receives-125-billion-investment-from-medical-properties-trust-setting-stage-for-national-growth-300334227.html . January 20, 2024.
  10. Web site: Unpacking Massachusetts’ Steward health system crisis . March 6, 2024 . Harvard T.H. Chan School of Public Health . March 11, 2024 . https://web.archive.org/web/20240308103757/https://www.hsph.harvard.edu/news/hsph-in-the-news/unpacking-massachusetts-steward-health-system-crisis/ . March 8, 2024.
  11. Web site: Boston hospital sued by DOJ over alleged violation of federal law, submitting false claims to Medicare . December 18, 2023 . Buteau . Michelle . WCVB . March 11, 2024 . https://web.archive.org/web/20231220014935/https://www.wcvb.com/article/steward-st-elizabeth-lawsuit-us-attorney-doj-boston/46168647 . December 20, 2023.
  12. Web site: USA v. Steward Health Care System - United States' Complaint-in-Intervention . December 16, 2023 . March 11, 2024 . https://web.archive.org/web/20240228014431/https://htv-prod-media.s3.amazonaws.com/files/usa-v-steward-health-complaint-in-intervention-6580c17078bba.pdf . February 28, 2024.
  13. Web site: Steward's medical devices were repossessed. Weeks later, a new mother died. . January 25, 2024 . Bartlett . Jessica . The Boston Globe . March 11, 2024 . https://web.archive.org/web/20240308143719/https://www.bostonglobe.com/2024/01/25/business/steward-health-care-mother-death/ . March 8, 2024.
  14. Web site: Steward wants to sell four Mass. hospitals soon, congressman says . January 28, 2024 . The Patriot Ledger . March 11, 2024 . https://web.archive.org/web/20240221122127/https://www.patriotledger.com/story/news/2024/01/28/steward-wants-to-leave-mass-health-care-market-lynch-says-norwood-hospitals-health-care/72387887007/ . February 21, 2024.
  15. Web site: Steward Health Care to File for Bankruptcy as Soon as Sunday. May 5, 2024. May 5, 2024. The Wall Street Journal. en.
  16. News: Weisman . Robert . Bartlett . Jessica . May 6, 2024 . Steward files for bankruptcy, leaving its eight Massachusetts hospitals in limbo . The Boston Globe . https://web.archive.org/web/20240506143916/https://www.bostonglobe.com/2024/05/06/business/steward-bankruptcy/ . May 6, 2024 . May 6, 2024.
  17. News: Schooly . Matt . Kaplan . Michael . May 6, 2024 . Steward Health Care files for Chapter 11 bankruptcy . CBS News . https://web.archive.org/web/20240506183708/https://www.cbsnews.com/boston/news/steward-health-care-bankruptcy/ . May 6, 2024 . May 6, 2024 . en.
  18. News: Weisman . Robert . Laughlin . Jason . August 16, 2024 . 'Good riddance and goodbye.' Healey announces deal to move six Steward hospitals to new owners. . https://web.archive.org/web/20240816204226/https://www.bostonglobe.com/2024/08/16/business/steward-hospitals-massachusetts-staying-open/ . August 16, 2024 . August 16, 2024 . The Boston Globe.
  19. St. Elizabeth's Medical Center Becomes a Boston University Teaching Hospital . Boston . Steward Health Care . PR Newswire . March 11, 2024 . https://web.archive.org/web/20240303023411/https://www.prnewswire.com/news-releases/st-elizabeths-medical-center-becomes-a-boston-university-teaching-hospital-301282118.html . March 3, 2024.
  20. Web site: St. Elizabeth's switches affiliation to BU from Tufts . May 3, 2021 . Bartlett . Jessica . Boston Business Journal . March 11, 2024 . https://web.archive.org/web/20230607213645/https://www.bizjournals.com/boston/news/2021/05/03/st-elizabeths-switches-affiliation-to-bu-from-tu.html . June 7, 2023.
  21. Web site: Steward Health Care has kept financial information secret for years. Now, it faces a demand . February 26, 2024 . McCluskey . Priyanka Dayal . WBUR Local Coverage . March 11, 2024 . https://web.archive.org/web/20240227033621/https://www.wbur.org/news/2024/02/23/steward-health-care-audited-financial-statements-healey-deadline . February 27, 2024.