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After growing rapidly across the United States this year, Boston-based Steward Health Care System is going international.

Steward said this week that it has reached a deal that involves three hospitals in the European island nation of Malta. The agreement includes one new hospital and the renovation of two others, Steward said in a statement this week.

The company would not provide details, but it apparently will operate all three facilities. In addition, Steward said it will run campus facilities for Barts and the London School of Medicine and Dentistry.

In each case, Steward will continue the work that began under a Malta company, Vitals Global Healthcare.


“Steward Health Care . . . has signed an agreement with Vitals Global Healthcare to deliver world-class, free health care in the country of Malta,” Steward said in a statement. Financial terms were not released.

In Massachusetts, Steward owns nine hospitals, including St. Elizabeth’s Medical Center in Boston. It was founded in 2010 by New York private equity firm Cerberus Capital Management to take over the struggling former Caritas Christi hospitals.

This year, Steward launched a major national expansion. It now includes three dozen hospitals across 10 states. In addition, the company — headquartered in Boston’s Back Bay — has considered moving some top executives to Dallas, the Globe reported last month.

While Steward has not publicly discussed overseas plans, other US health care providers have. Boston-based Partners HealthCare, parent company of Massachusetts General and Brigham and Women’s hospitals, has an international business arm that has done work in China and Saudi Arabia, among other countries.

Partners has also set its sights on Malta, a small nation off the coast of Italy with a population of about 440,000. Two years ago Partners announced an agreement to help improve health care in Malta by advising on clinical quality and patient safety standards, among other areas.


The Partners agreement was with Vitals Global Healthcare, the subsidiary of a Singapore-based investment firm. It’s unclear how Partners will be affected now that Vitals is apparently transferring its health care work in Malta to Steward.

“We expect to better understand the details of the agreement in the coming weeks,” Partners spokesman Rich Copp said.

Officials in Malta touted Steward’s involvement in the country.

“The Government of Malta believes that the involvement of this US-based health care leader is a very important vote of confidence in the country,” they said in a statement. “This will lead to the further upgrading of Malta’s free universal healthcare system, thereby improving the health of our citizens and benefiting the local economy.”

In the United States, Steward has marketed its model of community-based health care. But the privately held company closely guards information about its business dealings. Steward repeatedly has refused to file required financial statements with Massachusetts officials, saying it has no obligation to submit sensitive and proprietary information.

Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.