Massachusetts has many regulatory agencies tasked with overseeing health care – the Executive Office of Health and Human Services, the Attorney General, and the Health Policy Commission. Yet Steward still fell through the cracks. Finding out how and why will be important — not to blame well-meaning government officials, but to understand what went wrong and how to avoid it happening again.
As the Globe Spotlight team noted, the responsibility does not fall on a single administration. In October 2010, then-Attorney General Martha Coakley approved Steward’s acquisition of several hospitals in Massachusetts with conditions that Steward would not comply with.
In the years that followed, the company lived a charmed life with its regulators.
In 2015, Healey, then the attorney general, said Steward met his obligations. But an editorial writer of one government report who backed up that finding told the Spotlight team that Healey played down the author’s concerns about Steward’s financial insecurity. (Healey’s office says the 2015 report “was clear about Steward’s financial problems.”)
The Spotlight investigation suggests John Polanowicz, health secretary under Gov. Charlie Baker, rewrote a state rule to help Steward expand. (He says the rule change was not made “to favor any hospital or system.”)
A health care official working in Baker’s administration was allegedly told by a superior to remove data about patient injuries at Steward facilities from a public presentation. (The official did not respond to requests for comment from the Spotlight team.)
The Baker administration allegedly ignored serious problems at Steward hospitals: the closing of intensive care units without proper notification and a 38-hour power outage, both early in the COVID-19 pandemic. (Through a spokesman, Baker denied that his administration went easy on Steward.)
Healey’s administration was informed in the summer of 2023 of Steward’s financial instability but failed to act. (The governor has said that “our administration is working night and day to protect jobs, protect patients and pick up the pieces of the situation that Ralph de la Torre has put us in.”)
According to the Globe story: “From almost the moment of Steward’s founding in 2010, Massachusetts officials failed to discipline the Boston-born hospital chain for regulatory violations, check its aggressive expansion plans and relentless cost-cutting, or respond forcefully to dire warnings that it was spiraling toward financial collapse, The Spotlight Team has discovered. Critical reports were softened, troubling economics went unnoticed, and broken Steward’s promises went unpunished.”
One of the most damning incidents of Healey’s governorship shows the human cost of Steward’s problems. In September 2023, Jennifer Knight, 37, was waiting in the hospital registration line and thought she was having a heart attack. Holly Zachos, an overwhelmed triage nurse, sent Knight to wait without evaluating her. Minutes later, Knight collapsed and died. Zachos was fired.
Health and Human Services Minister Kate Walsh then called de la Torre and asked him to reinstate Zachos. Holly Zachos’ husband, George Zachos, is executive director of the Massachusetts Board of Registration in Medicine, and sources told the Globe they perceived the call as a political favor. Holly Zachos was rehired.
Healey’s office said it believed Zacho’s firing was unfair. That may be the case, and Zacho’s union had protested her termination. But that’s exactly why companies like Steward have processes for unions and employees to dispute discipline, and any resolution should have gone through established processes.
The Massachusetts Legislature is considering bills to strengthen the Health Policy Commission’s authority over for-profit health care companies, and this board have approved increase the power of state regulatory authorities. But all the rules in the world will not be effective if the tools and political will to enforce them are lacking. For example, one nurse said she routinely called a department of public health hotline to report dangerous conditions at Good Samaritan Medical Center — but gave up after there was no answer.
The Spotlight reports suggest that the will to enforce the laws simply wasn’t there in the case of Steward, whose politically connected officials also happened to be generous donors to Beacon Hill. Patients who relied on Steward for care deserve to know who failed on the job and what needs to change.
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.
