St. Elizabeth's Medical Center (Boston)

St. Elizabeth's Medical Center (abbreviated SEMC, also known locally as St. E's) is a mid-size non-profit teaching hospital located in the Brighton neighborhood of Boston, Massachusetts.[1] St. Elizabeth's is a part of Boston Medical Center Health System, a non-profit health care system which took over the hospital in 2024 from Steward Health Care, its previous operator, which was forced to sell its Massachusetts hospitals following its bankruptcy.[2]

St. Elizabeth's Medical Center
BMC Health System
St. Elizabeth's Medical Center
Map
Geography
LocationBrighton, Boston, Massachusetts, United States
Coordinates42°20′57″N 71°08′55″W / 42.3491°N 71.1486°W / 42.3491; -71.1486
Organization
Care systemPrivate
FundingNon-profit hospital
TypeTeaching
Affiliated universityBoston University School of Medicine
Services
StandardsJoint Commission
Emergency departmentLevel II trauma center
Beds326[1]
Public transit accessMBTA
History
Former name(s)St. Elizabeth's Hospital for Women
Opened1868
Links
Websitewww.bmchealthsystem.org/patients/st-elizabeths-medical-center
ListsHospitals in Massachusetts

History

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Originally named St. Elizabeth's Hospital for Women, the hospital was founded in 1868[3][4] by five laywomen of the Third Order of Saint Francis[5] at its original site in the South End neighborhood of Boston.[3]

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."[3] 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.[3] The Sisters' tenure would last until 1965[3] and would see the hospital's 1914 move to its current location in Brighton,[6] its expansion into several varied specialties, and the beginning of its development as a teaching hospital.[4]

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.[7] 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.[13]

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 offered $4.5 million to Apollo Global Management, the owner of the property, as their estimate of fair market value.[18] Apollo rejected this offer in a letter to the state, citing property records assessing it at a value of more than $200 million. Apollo's letter stated in part, "There are a number of highly valuable changed uses to the property that would be similarly valuable for the community and for which a developer or educational institution would likely obtain permits."[19] On September 27, 2024, the Commonwealth of Massachusetts formally seized control of the hospital, intending to transition operation of the hospital to the non-profit Boston Medical Center. After control was seized, Apollo announced that it intended to challenge the use of eminent domain, saying that the property was taken "for a fraction of the assessed value" and was taken unconstitutionally.[20]

On October 1, 2024, BMC Health System officially took over the hospital from Steward.[2]

Operations

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Today, St. Elizabeth's Medical Center is a teaching hospital affiliated with the Boston University Chobanian & Avedisian School of Medicine since 2021,[21] previously affiliated with Tufts University School of Medicine.[22]

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,[1] 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.[23]

References

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  1. ^ a b c "Steward St. Elizabeth's Medical Center" (PDF). Massachusetts Center for Health Information and Analysis. 2022. Archived from the original (PDF) on March 11, 2024. Retrieved March 11, 2024.
  2. ^ a b Fortin, Matt (October 1, 2024). "Healey says hospitals are 'freed from Steward's greed' as new operators step in". NBC Boston. Retrieved October 1, 2024.
  3. ^ a b c d e "St. Elizabeth's Hospital Centennial Celebration". The New England Journal of Medicine. November 13, 1969. doi:10.1056/NEJM196911132812014. Archived from the original on March 11, 2024. Retrieved March 11, 2024.
  4. ^ a b "St. Elizabeth's Medical Center". Boston University Chobanian & Avedisian School of Medicine. Archived from the original on December 10, 2023. Retrieved March 11, 2024.
  5. ^ "About Us". St. Elizabeth's Medical Center. Archived from the original on March 6, 2024. Retrieved March 11, 2024.
  6. ^ "St. Elizabeth's Medical Center Celebrates 100th Anniversary in Brighton". St. Elizabeth's Medical Center. September 24, 2014. Archived from the original on May 13, 2021. Retrieved March 11, 2024.
  7. ^ McCluskey, Priyanka (July 24, 2016). "Steward Health Care posts first-ever profit in 2015". The Boston Globe. Archived from the original on November 21, 2023. Retrieved February 8, 2024.
  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. doi:10.1108/S1474-823120210000020007. PMID 34779183.
  9. ^ "Steward Receives $1.25 Billion Investment from Medical Properties Trust, Setting Stage for National Growth" (Press release). Boston: Steward Health Care. PR Newswire. September 26, 2016. Archived from the original on January 20, 2024. Retrieved March 11, 2024.
  10. ^ "Unpacking Massachusetts' Steward health system crisis". Harvard T.H. Chan School of Public Health. March 6, 2024. Archived from the original on March 8, 2024. Retrieved March 11, 2024.
  11. ^ Buteau, Michelle (December 18, 2023). "Boston hospital sued by DOJ over alleged violation of federal law, submitting false claims to Medicare". WCVB. Archived from the original on December 20, 2023. Retrieved March 11, 2024.
  12. ^ "USA v. Steward Health Care System - United States' Complaint-in-Intervention" (PDF). December 16, 2023. Archived from the original (PDF) on February 28, 2024. Retrieved March 11, 2024.
  13. ^ a b Bartlett, Jessica (January 25, 2024). "Steward's medical devices were repossessed. Weeks later, a new mother died". The Boston Globe. Archived from the original on March 8, 2024. Retrieved March 11, 2024.
  14. ^ "Steward wants to sell four Mass. hospitals soon, congressman says". The Patriot Ledger. January 28, 2024. Archived from the original on February 21, 2024. Retrieved March 11, 2024.
  15. ^ "Steward Health Care to File for Bankruptcy as Soon as Sunday". The Wall Street Journal. May 5, 2024. Retrieved May 5, 2024.
  16. ^ Weisman, Robert; Bartlett, Jessica (May 6, 2024). "Steward files for bankruptcy, leaving its eight Massachusetts hospitals in limbo". The Boston Globe. Archived from the original on May 6, 2024. Retrieved May 6, 2024.
  17. ^ Schooly, Matt; Kaplan, Michael (May 6, 2024). "Steward Health Care files for Chapter 11 bankruptcy". CBS News. Archived from the original on May 6, 2024. Retrieved May 6, 2024.
  18. ^ Weisman, Robert; Laughlin, Jason (August 16, 2024). "'Good riddance and goodbye.' Healey announces deal to move six Steward hospitals to new owners". The Boston Globe. Archived from the original on August 16, 2024. Retrieved August 16, 2024.
  19. ^ Ryan, Aidan; Weisman, Robert (August 21, 2024). "Steward landlord rejects state's offer for St. Elizabeth's, setting up legal showdown". The Boston Globe. Retrieved August 21, 2024.
  20. ^ Sesselman, Jamy Pombo (27 September 2024). "St. Elizabeth's Medical Center seized by eminent domain to keep hospital open". WCVB. Retrieved 28 September 2024.
  21. ^ "St. Elizabeth's Medical Center Becomes a Boston University Teaching Hospital" (Press release). Boston: Steward Health Care. PR Newswire. Archived from the original on March 3, 2024. Retrieved March 11, 2024.
  22. ^ Bartlett, Jessica (May 3, 2021). "St. Elizabeth's switches affiliation to BU from Tufts". Boston Business Journal. Archived from the original on June 7, 2023. Retrieved March 11, 2024.
  23. ^ McCluskey, Priyanka Dayal (February 26, 2024). "Steward Health Care has kept financial information secret for years. Now, it faces a demand". WBUR Local Coverage. Archived from the original on February 27, 2024. Retrieved March 11, 2024.
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