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Brockton, other lower-income communities on edge as hospital chain faces financial crisis

Good Samaritan is the lone remaining active hospital in the Brockton area.Danielle Parhizkaran/Globe Staff

Lena Svizzero has relied on Good Samaritan Medical Center since 1978. The 85-year-old lives 20 minutes away in Bridgewater, but Good Samaritan is the only remaining active hospital in the area, and the only nearby hospital where she can use her Steward Group Insurance.

But now, an extreme financial crisis facing Good Samaritan’s owner, Steward Health Care, has Svizzero and other patients terrified that the hospital they have relied on for years could be forced to close.

“I don’t know where else I would go,” Svizzero said while heading into the hospital for an ultrasound appointment Thursday afternoon.

Good Samaritan is one of nine Massachusetts hospitals owned by Steward Health Care, a for-profit system in such grave financial condition that Massachusetts officials are feverishly working to prevent a collapse, including possibly putting the endangered facilities into receivership. The hospitals’ landlord recently disclosed Steward hasn’t paid its full rent for months, and other vendors say they haven’t been paid, while some employees disclosed they’ve been hoarding supplies amid shortages.

In addition to Good Samaritan in Brockton, Steward also runs St. Elizabeth’s Medical Center in Brighton, Saint Anne’s Hospital in Fall River, Carney Hospital in Dorchester, Holy Family Hospital in Haverhill and Methuen, Morton Hospital in Taunton, Nashoba Valley Medical Center in Ayer, New England Sinai Hospital in Stoughton, and Norwood Hospital in Norwood

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Seventy percent of Steward patients are covered by Medicare and Medicaid, and several of its Massachusetts locations are in underserved cities, raising fears that any closures could make access to care harder for the most vulnerable patients.

“There are dramatic health inequities that are based on geography, that are based on race, that are based on income,” said Carlene Pavlos, executive director of the Massachusetts Public Health Association. “The slightest tip in the health care landscape is going to always impact people who are already experiencing the worst health outcomes.”

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Brockton is already short on health care options in the wake of a fire that damaged Brockton Hospital in February 2023. A hospital closure in a city where the median household income is $20,000 below the state’s as a whole could seriously restrict people’s access to life saving medical care.

“Wealthier people are more readily able to find alternative options to get health care,” said Jose Figueroa, an assistant professor of Health Policy and Management at the Harvard T.H. Chan School of Public Health. “Lower-income populations with less education are more likely to have issues accessing the health care system at baseline. Even in their local area, they are going to be left behind.”

Loss of a nearby hospital can make ambulance rides longer and lead doctors groups to close their practices or move. Nearby dialysis and radiology clinics, too, may close after a nearby hospital shutters.

In under-resourced communities, health experts said, people also tend to rely on emergency departments more for primary medical care, making Good Samaritan’s emergency room a critical resource for the Brockton area. Lack of transportation access and poorer health insurance coverage also play roles in limiting people’s ability to find alternatives when they lose a local health care provider.

“If something had happened to this hospital, maybe my husband wouldn’t be here today,” said Mary-Ellen Williams, 54, whose husband, Steve, suffered a heart attack a few months ago. “It’s scary for a lot of people.”

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Another Steward property, Carney Hospital, is the only hospital in Dorchester. State Representative Christopher Worrell, a Dorchester Democrat, said in a statement that Carney’s potential closure would be a sign of continued “mass disinvestment from Black and Brown communities.”

Steward facilities are also among the largest employers in their communities, employing about 16,000 doctors, nurses, and other health workers, and treating about 200,000 Massachusetts patients a year.

“It’s not an option, in our opinion, if Steward” shuts down, said Christopher Cooney, president of the Metro South Chamber of Commerce, which represents Brockton and the surrounding towns. “We need it.”

Hospitals that serve lower-income communities are themselves less financially stable because they rely so heavily on Medicaid payments, which are less generous than private insurance plans.

“If you have a hospital that’s predominantly taking care of Black and Hispanic patients, even if they take care of the same number of heart failures, the same numbers of pneumonias, they’re going to make less money,” Figueroa, of Harvard, said.

Such hospitals, also, are more at risk of purchase from private equity firms, which tend to look for struggling facilities where an injection of capital could yield profits.

“I think if there are hospitals that are struggling to take care of their patient population because of poor financial performance, then unfortunately they’re more at risk,” Figueroa said.

A private equity firm, Cerberus Capital Management, created Steward more than a decade ago when it bought the Caritas Christi Health Care network, six struggling Catholic hospitals that primarily cared for people in poorer communities. A recent story from STAT, the Boston Globe’s sister publication, noted private equity’s investment in health care tends to drive up costs and reduce quality.

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On Thursday at Good Samaritan, Svizzero and her daughter, Tammy Toppan, were distressed about the possibility of closures.

“She can’t change her insurance because it’s military insurance,” Toppan said of her mother. “Other than [Good Samaritan], I don’t know where she would be going.”

Paul Roan, another lifelong Brockton resident, was at the hospital for a follow-up CT exam of his lung, because doctors found a concerning spot four months ago and wanted to check if it has grown.

“This is the only [hospital] I come to,” he said. “I certainly hope it doesn’t close.”

Mike Lawrence gleefully exited Good Samaritan Thursday afternoon with his son, Dan, who just had a child at the facility two days ago. He said he has depended on the hospital for more than 40 years.

“I had a child born in here, a doctor saved my life here 37 years ago, and I just had my grandson born here,” Lawrence said. The milestones the hospital has seen him through keep Lawrence returning from his home in Kingston.

“It would be a travesty for this hospital to close down,” he said.


Alexa Coultoff can be reached at alexa.coultoff@globe.com. Follow her @alexacoultoff. Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him @jasmlaughlin. Diti Kohli can be reached at diti.kohli@globe.com. Follow her @ditikohli_.