The collapse of Steward Health left not just the hospital operator but its private equity landlord ensnared in turmoil — and caught the attention of legislators and criminal investigators.
Steward Health, the largest privately owned hospital system in the U.S., filed for bankruptcy in May, putting a chunk of its 32 hospitals in eight states at risk of closing. It was the main tenant of Medical Properties Trust, the country’s largest healthcare landlord, and the two companies had an entangled relationship. MPT, which loaned Steward money to stave off bankruptcy, went on to put up millions in debtor-in-possession financing to keep Steward’s facilities operational through the proceedings.
MPT has been dealing with its own financial strain, including taking more than $1B in writedowns through the year related to Steward’s unpaid rents and loans.
Steward blamed high costs and “insufficient reimbursement” from the government for its bankruptcy, but others pointed the finger at MPT and the private equity model in healthcare for charging unfairly high rents. Other MPT tenants ran into similar issues after doing sale-leasebacks with the REIT and were likewise loaned money by the firm when they ran into financial difficulties. The end result was often hospital closures.
U.S. senators, led by Elizabeth Warren, have called MPT a Ponzi scheme and asked the IRS to increase its scrutiny on healthcare REITs, accusing them of “meddling in the operations of their tenants.” Along the same lines, Steward filed a lawsuit against MPT, claiming that it obstructed Steward from doing deals.
Meanwhile, Steward execs have been accused of mismanagement, embezzlement, fraud and corruption, and a federal criminal probe is ongoing. Its CEO, Ralph de la Torre, was summoned before a Senate panel in September about Steward’s management practices and executive compensation but failed to appear and announced his resignation the same day. The Senate asked the DOJ to pursue criminal contempt charges against him, the first time it pursued such charges since 1971.
Steward is still working through its bankruptcy. It has sold or handed over operations of some hospitals while closing others and said its remaining portfolio will likely face a similar split.