Top state officials who have been monitoring the financial turmoil at Steward Health Care say they are preparing for a number of potential outcomes, including changes in services and the potential closure of hospitals.
Dr. Robbie Goldstein, the state's public health commissioner, said the uncertainty around the situation is "unsettling and unnerving to us all."
"Speculation about hospital closures among Steward facilities has been widely reported by the media. It's discussed among those in health care. it's being examined by those in the State House and city halls and town councils," Goldstein said. "The bottom line is, at this time, we do not know what the future of Steward hospitals will be. 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."
Goldstein and Gov. Maura Healey briefed the Public Health Council Wednesday on state government's response to the financial crisis within the Steward hospital system and its potential ramifications for patients, workers and the state's health care network as a whole.
Steward, a Dallas-based for-profit company that employs around 16,000 health care workers in Massachusetts, has hospitals in Boston's Brighton and Dorchester neighborhoods, Brockton, Haverhill, Methuen, Taunton, Ayer, Norwood and Fall River. Another Steward facility, New England Sinai Hospital in Stoughton, is set to close in April.
The system's severe money troubles sparked fears of additional closures. Earlier this month, in announcing a plan for bridge financing to help stabilize the system's operations, Steward leaders said they had no current plans to close other Massachusetts hospitals.
Since the end of January, Department of Public Health officials have been conducting daily monitoring visits at some Steward hospitals. Goldstein said that monitoring — which looks at staffing, supplies and patient care — expanded this week to cover a total of six Steward hospitals. By next week, DPH staff will be present at all Steward hospitals, he said.
He said state officials are talking with leaders of other hospitals, labor unions, health insurers, community health centers and local organizations to prepare for whatever comes next in a health care system that’s already under strain.
"You've heard and you've read about emergency departments operating far above their capacity,” Goldstein said. “There are staffing shortages that are challenging our acute care hospitals and long-term care facilities. Primary care providers are experiencing extraordinary backlogs, and community health centers are maintaining unprecedented waitlists. Behavioral health services are severely limited in both ambulatory and inpatient settings."
Healey described herself as "frustrated with where we are right now as a state and what Steward has done." She said her team is "relentlessly focused" on the health and safety of Steward patients, many of whom are "among the most vulnerable in the state."
"We know that in many instances, these hospitals are leading employers," Healey said. "They provide an important social safety net and a touchstone, of course, of local identity."
Top Democrats in the state House of Representatives have ruled out a monetary bailout for Steward. Beacon Hill lawmakers could opt for policy changes, though, like putting more teeth into financial reporting requirements for hospitals or beefing up the state's authority in the hospital closure process.
Public Health Council member Dr. Edward Bernstein, a professor of emergency medicine at Boston University's medical school, asked about the possibility of putting Steward hospitals under state receivership or other accountability measures. He said he sees the situation as "approaching a public health crisis."
Goldstein replied that officials are "doing the appropriate due diligence" to understand the powers that could be available under a public health emergency or crisis declaration. He said they are "thinking through very thoughtfully with people across state government what resources we may need, what various legal authorities we may need in the various permutations of what could happen here."
Dr. Eduardo Haddad, another council member and the chief of medical affairs at Lawrence General Hospital, said people across the region are worried about what will happen with Steward's Holy Family hospitals in Methuen and Haverhill.
"It goes without saying that we are going to increase our capacity to the utmost, and we are indeed sharing medical staff that goes to both hospitals already," Haddad said. "So the issue will become space in the physical plant. There is no lack of will on our part to take care of all of these patients."
