Steward's Chapter 11 case, 2024–2026

analysisOn May 6, 2024 Steward Health Care System LLC and affiliated entities filed voluntary petitions under chapter 11 of the Bankruptcy Code in the United States Bankruptcy Court for the Southern District of Texas (Houston Division). The cases are jointly administered under Steward Health Care System LLC's case, No. 24-90213 (CML), before Judge Christopher M. Lopez. On a consolidated basis the petition estimated assets and liabilities each at $1,000,000,001 to $10 billion and more than 100,000 creditors. John R. Castellano signed the petition as Chief Restructuring Officer and, the same day, signed the debtor's declaration under penalty of perjury covering, among other documents, its Consolidated Corporate Ownership Statement and List of Equity Holders. ^{1 2 3}

analysisSchedule A of the May 5, 2024 written consent authorizing the filings lists 166 companies. The debtors listed with the petition included Steward Health Care Holdings LLC and Steward Health Care System LLC; Steward Hospital Holdings LLC, Steward Medical Holdings LLC, Steward Operations Holdings LLC, Steward Florida Holdings LLC, Steward Ohio Holdings LLC, Steward Pennsylvania Holdings LLC, Steward Texas Hospital Holdings LLC, Steward ASC Holdings LLC and Brevard SHC Holdings LLC; IASIS Healthcare Corporation, IASIS Healthcare LLC, IASIS Healthcare Holdings, Inc. and Davis Hospital Holdings, Inc.; Steward Medical Group, Inc., Steward Health Care Network, Inc., Stewardship Health, Inc., Steward Emergency Physicians, Inc. and Steward Physician Contracting, Inc.; and Steward Health Care International LLC, Steward Health Care OZ Fund, Inc., TRACO Investment Management LLC, Arizona Diagnostic & Surgical Center, Inc., Beaumont Hospital Holdings, Inc., Blackstone Medical Center, Inc. and Blackstone Rehabilitation Hospital, Inc. Hospital companies among the debtors included Steward Carney Hospital, Inc., Steward Norwood Hospital, Inc., Steward Holy Family Hospital, Inc., Steward Good Samaritan Medical Center, Inc., Steward St. Anne's Hospital Corporation, Steward St. Elizabeth's Medical Center of Boston, Inc. and Steward St. Elizabeth's Realty Corp.; Morton Hospital, Nashoba Valley Medical Center, Quincy Medical Center and New England Sinai Hospital (each “A Steward Family Hospital, Inc.”); Steward Melbourne Hospital, Steward Rockledge Hospital, Steward Sebastian River Medical Center, Steward Sharon Regional Health System, Steward Trumbull Memorial Hospital, Steward Hillside Rehabilitation Hospital and Steward Easton Hospital (each Inc.); and The Medical Center of Southeast Texas, LP, SJ Medical Center, LLC, Mountain Vista Medical Center, LP, Mesa General Hospital, LP, St. Luke's Medical Center, LP, St. Luke's Behavioral Hospital, LP, Odessa Regional Hospital, LP, IASIS Glenwood Regional Medical Center, LP, Jordan Valley Medical Center, LP, Davis Hospital & Medical Center, LP, Salt Lake Regional Medical Center, LP and Southwest General Hospital, LP. Steward CGH, Inc., Steward FMC, Inc., Steward HH, Inc., Steward NSMC, Inc. and Steward PGH, Inc. were also debtors. ¹

analysisBy the omnibus action by written consent dated May 5, 2024, the governing bodies of the companies on its Schedule A authorized each company to file a voluntary chapter 11 petition in the Bankruptcy Court for the Southern District of Texas. For Steward Health Care System LLC the consent was signed by its managing member and member, Steward Health Care Holdings LLC, through Treasurer Mark Rich; subsidiary board signature pages bear the names of directors including Michael Callum, M.D. and Ralph de la Torre, M.D. The consent recites that the board of Steward Health Care Holdings LLC established a Transformation Committee of two board members and one independent member on December 19, 2023, adopted an amended and restated committee charter on or about February 21, 2024 delegating powers that included a potential restructuring of the group's indebtedness, and that on May 5, 2024 the committee recommended the chapter 11 filing, which the board authorized; Castellano's first-day declaration describes the committee as comprising himself, William Transier and Alan Carr. The consent designated John R. Castellano as Chief Restructuring Officer of each company, with the roles described in the engagement letter between AlixPartners and Steward Health Care Holdings LLC as amended by Addendum 1 on May 1, 2024 and Addendum 2 on May 5, 2024. In his first-day declaration Castellano stated that he was Chief Restructuring Officer of each debtor and had advised the company since October 2023 as a Managing Director at AlixPartners, LLP. ^{1 2}

analysisAccording to the debtors' first-day declaration, the company engaged AlixPartners in October 2023 for liquidity management advisory services, vendor relationships and management support, and engaged Lazard in November 2023 to advise on strategic and financing alternatives. The May 5, 2024 consent ratified, under engagement letters with Steward Health Care Holdings LLC or Steward Health Care System LLC, the retention of a law firm as attorneys in the chapter 11 cases, AP Services, LLC (AlixPartners) as financial advisor, Lazard Frères & Co. LLC as investment banker, Leerink Partners LLC and Cain Brothers as healthcare and hospital investment bankers, a second law firm as special corporate and regulatory counsel, and a claims and noticing agent. According to the first-day declaration filed on May 6, 2024 (Docket No. 38), the board of Steward Health Care Holdings LLC then comprised Ralph de la Torre, M.D. (Director, Chairman of the Board and CEO), Mark Rich (Director and President), Rubén José King-Shaw, Jr. (Director and Chief Strategy Officer), Michael G. Callum, M.D. (Director and EVP for Physician Services), John Boehner, Sister Vimala Vadakumpadan, Carlos M. Hernandez and James J. Karam (Directors), and William Transier and Alan Carr (Directors and Transformation Committee members). ^{2 1}

analysisThe debtors' agenda filed on May 6, 2024 (Docket No. 59) set an emergency first-day hearing for May 7, 2024 at 10:00 a.m. (Central Time) before Judge Lopez. Matters going forward included motions to obtain junior lien postpetition financing – debtor-in-possession (DIP) financing, lent to a company operating under bankruptcy protection and ranking behind existing liens – and to use cash collateral (Docket No. 46), to pay prepetition wages and employee benefits (Docket No. 15), to continue the existing cash management system and intercompany transactions (Docket No. 5) and to pay critical vendor, lien and 503(b)(9) claims (Docket No. 13), the last being claims for goods received shortly before the filing. ⁴

analysisAccording to a declaration by Chief Restructuring Officer John R. Castellano filed on September 10, 2024 (Docket No. 2419), Medical Properties Trust's potential claims against the debtors' estates totaled up to about $7.5 billion: about $83.4 million under a junior lien debtor-in-possession credit agreement dated May 28, 2024 with Steward Health Care System LLC as borrower; about $448.1 million under prepetition secured loans (a June 30, 2023 note, a January 2, 2024 Stewardship note and a bridge facility; about $367.8 million excluding minimum-return multiples); about $403.4 million under SHC Holdings' guaranty of a February 3, 2022 secured note made by Steward Investors; and about $6.6 billion in future rent and other obligations under Master Leases I and II through October 31, 2041. On August 19, 2024 the debtors had commenced an adversary proceeding against MPT (Steward Health Care System LLC v. Medical Properties Trust, Inc. et al., No. 4:24-ap-03168) seeking a declaratory judgment allocating value between the debtors' hospital operations and MPT's real estate, and they had moved to reject their master leases with MPT; Castellano described the disagreement over value allocation as a major impediment to the sale of certain hospitals. As his declaration summarized its position, the official committee of unsecured creditors had investigated MPT and believed the estates had colorable claims to recharacterize the master leases as “disguised financings”, avoid certain liens and preferential payments made to MPT before the petition date, and equitably subordinate (rank below other creditors) MPT's claims arising from prepetition conduct. No court ruled on these potential claims: the global settlement approved by the bankruptcy court from September 11, 2024 resolved the dispute, and MPT reported that the order gave it a full release of claims from all parties. ^{1 2 3}

analysisIn his September 10, 2024 declaration Castellano stated that the global settlement with MPT followed about 12 weeks of mediation sessions overseen by Judge Isgur and would give the estates $395 million in proceeds from the sale of the Space Coast hospitals, secure funding for operating and transferring the specified Master Lease I hospitals to designated operators, and provide for the waiver and release of all MPT claims, which he understood totaled up to about $7.5 billion. A condition to closing the Space Coast sale was agreement among the debtors, Orlando Health and MPT on the value allocation dispute. Castellano stated that the debtors lacked the liquidity to keep funding the specified hospitals and had only about $21 million of cash on hand as of the week ending September 6, 2024. Under the settlement, interim managers were to fund those hospitals; to the extent they did not, MPT agreed to pay accrued payroll as of September 11, 2024 (about $27 million) and to fund a $5 million account for hospital-level expenses. ¹

analysisIn a September 11, 2024 press release, MPT announced a global settlement with Steward, its secured lenders and the unsecured creditors committee that restored MPT's control over its real estate and covered 23 hospitals remaining after the planned Space Coast sale. MPT said it had definitive agreements with four tenants to lease and operate 15 hospitals – Healthcare Systems of America (five in Southeast Florida, two in East Texas, one in Louisiana), HonorHealth (three in Arizona), Quorum Health (two in West Texas) and Insight Health (two in Ohio) – which from September 11, 2024 would manage them for Steward on an interim basis until purchase agreements were finalized. Under the terms MPT described, it consented to the sale of the three Space Coast hospitals in Florida to Orlando Health with a substantial portion of the proceeds going to Steward; Steward and its other stakeholders gave up rights to further value from transactions involving the other hospitals remaining in the portfolio as of September 11, 2024; and once the transitions were complete the parties would mutually dismiss claims and exchange broad general releases, including for MPT's loans and deferred rent. MPT also referred to its construction projects in Norwood, Massachusetts and Texarkana, Texas, and put the aggregate lease base of four hospitals closed well before the bankruptcy and two that recently closed or became uncertain at about $300 million. A hearing on a final order was set for September 17. ⁴

analysisIn Exhibit 99.1 to a Form 8-K filed with the SEC, describing developments through January 2025, MPT stated that on September 11, 2024 the bankruptcy court entered an interim order, later made final, approving a global settlement among Steward, its lenders, the unsecured creditors committee and MPT. The order terminated MPT's master lease with Steward, released claims against 23 MPT properties and gave MPT a full release from all parties; MPT consented to the sale of three Space Coast facilities (real estate net book value about $180 million) with a substantial part of the proceeds going to Steward, and released its claims, including past-due rent and interest, loans and its equity investment. A hospital-industry news tracker reported that at a final hearing on September 17, 2024 Judge Christopher Lopez gave final approval to make the interim management of 15 Steward hospitals permanent; the final order itself is not in the reviewed record, and the former CEO's website likewise states that final approval of the agreement with MPT was obtained on September 17, 2024. MPT reported that, after the release of claims on the 23 properties, it reached definitive agreements with six operators (Healthcare Systems of America, Honor Health, Insight Health, Quorum Health, College Health and Tenor Health) to lease 18 of the facilities, had provided less than $100 million in short-term working capital loans to them, and that certain operators were receiving transitional services from Steward. After September 30, 2024 the Space Coast sale was completed for about $440 million, of which MPT received about $47 million. ^{3 5 6}

analysisA hospital-industry news tracker reported that at a September 4, 2024 hearing Judge Lopez approved Boston Medical Center taking over Good Samaritan Medical Center and St. Elizabeth's Medical Center as part of a $140 million deal, Lawrence General Hospital purchasing the Holy Family hospitals in Haverhill and Methuen as part of a $28 million deal, and Lifespan purchasing Morton Hospital and St. Anne's Hospital as part of a $175 million deal, each buyer taking over operations on October 1, 2024. These deal values are as reported by the publication; of the agreements only the Lifespan asset purchase agreement ($175 million) is in the reviewed court record. The Massachusetts Department of Public Health states that these five hospitals received qualified bids and transitioned to new operators: St. Elizabeth's Medical Center (Brighton) and Good Samaritan Medical Center (Brockton) to Boston Medical Center; Saint Anne's Hospital (Fall River) and Morton Hospital (Taunton) to Brown University Health (previously Lifespan); and Holy Family Hospital (Methuen and Haverhill campuses) to Lawrence General Hospital. A state press release of October 1, 2024 marked Steward's exit from Massachusetts. ^{1 2 3}

analysisA proposed order filed in the case on September 4, 2024, the day of the sale hearing (Docket No. 2324-3; the reviewed copy has a blank signature line), would authorize the sale of Saint Anne's Hospital and Morton Hospital free and clear of liens, claims, encumbrances and interests to Lifespan of Massachusetts, Inc., with Lifespan Corporation as buyer guarantor, under an asset purchase agreement dated August 29, 2024 with sellers Steward St. Anne's Hospital Corporation and Morton Hospital, A Steward Family Hospital, Inc. The hospitals' real property was to be sold to the buyer by ACREFI CS U, LLC as “Real Property Seller” under a separate agreement of the same date, which also covered equipment owned by MPT of Methuen-Steward, LLC or the Real Property Seller. Under section 1.6 of the asset purchase agreement the purchase price was $175,000,000, payable as $75,000,000 in cash and a $100,000,000 promissory note or other payment obligation in favor of MPT, an MPT successor or MPT's existing lender; it was adjusted for purchased working capital and reduced by the amount payable under the MPT Real Property Purchase Agreement, fixed at $166,845,188.19 (the note plus $66,845,188.19 in cash at closing), and the buyer was not required to pay more than the cash purchase price in cash. The buyer had to place a $17,500,000 good faith deposit in a segregated account maintained by Acquiom Clearinghouse LLC, closing was conditional on the MPT Real Property Purchase Agreement being consummated concurrently, and the sellers could terminate after August 31, 2024 if they did not have third-party funding to continue operating the business. ³

analysisThe definitions of the August 29, 2024 Lifespan asset purchase agreement refer to a Clean Room Black Box Agreement dated April 1, 2024 between Steward Health Care Holdings, LLC and Lifespan Corporation, and designate the Stewardship Agreement of April 30, 2010 among Steward Health Care System LLC, Steward Hospital Holdings LLC and the Roman Catholic Archbishop of Boston as an excluded contract. Its form of Transition Services Agreement names Steward St. Anne's Hospital Corporation and Morton Hospital as providers of service bundles, including IT and revenue cycle services, to Lifespan of Massachusetts, Inc.; Steward Health Care System, LLC appears as a provider in brackets, with a drafting note that the buyer expected Steward to be a party because services were provided at the Steward level. The proposed Lifespan sale order recites that, under an order authorizing rejection of the Master Lease II agreements in connection with the planned transition and sale of the Massachusetts hospitals to new operators (Docket No. 1782), the existing MPT lease had been rejected, and that on closing it would be severed and terminated as to the purchased properties without further liability to the buyer. It also provides that, on closing of the six Massachusetts hospital sales, the Master Lease II landlord parties, including MPT of Brockton-Steward, LLC, MPT of Fall River-Steward, LLC, MPT of Methuen-Steward, LLC, MPT of Ayer-Steward, LLC and MPT of Dorchester-Steward, LLC, release the debtors from claims arising from the existing MPT lease; that on the earlier of that closing and final approval of a global settlement on Master Lease I, the debtors and the creditors' committee release MPT and its related parties, and MPT releases the debtors, from such claims; and that MPT's rights under Master Lease I, other leases and its loans, including the prepetition bridge obligations, TRS note and Stewardship note, are preserved. ³

analysisA hospital-industry news tracker reported that Massachusetts Gov. Maura Healey seized control of St. Elizabeth's Medical Center through eminent domain (the government's power to take private property for public use) on September 27, 2024 to transfer its operations to Boston Medical Center, which officially took over operations on October 1, 2024; the taking itself is not documented in the reviewed record. According to a timeline compiled by a research institute, Apollo Management, from which the property was to be taken, had rejected the governor's $4.5 million eminent-domain offer on August 20, 2024, contending that the property was worth $200 million, and about a year later agreed to sell the hospital to the Commonwealth for $66 million, with the money coming from the state. The former CEO's website states that the state allocated about 500 new hospital beds to Harvard teaching hospitals while St. Elizabeth's got none, making it less attractive to buyers and a market-priced sale unachievable. ^{4 5 2 1}

analysisOn July 26, 2024 Steward announced it would close Carney Hospital in Dorchester and Nashoba Valley Medical Center in Ayer, saying in a statement that despite an extensive sale process involving close coordination with lenders and regulators there were no qualified bids for the two hospitals; according to a news report that day, the governor's office reported that in June an average of 13 of Carney's 83 beds and 11 of Nashoba Valley's 46 beds were filled. Gov. Maura Healey said in a July 2024 statement, as quoted in a news report, that “Ralph de la Torre and Steward's greed and mismanagement” were resulting in the closures, and called on Steward and its real estate partners to put the communities they serve over “their own selfish greed” – a political statement, not a finding by a court or regulator. The former CEO's website, answering the claim that he is to blame for the Massachusetts closures, states that the state “has had the opportunity to fix its failed healthcare system”, that Carney and Nashoba averaged only 25 medical and surgical in-patients combined on any given day, and that the state “refused to offer support to the debtors regarding the bids that were in fact received for Carney and Nashoba.” A healthcare trade publication reported on August 5, 2024 that Judge Lopez had approved the closures over the Massachusetts Nurses Association's urging that the hospitals be kept open, and that under a WARN notice (an advance notice of mass layoffs required by federal law) Steward would lay off 753 employees at Carney and 490 at Nashoba Valley at the end of the month; the closure order and the notice are not in the reviewed record. A Steward spokesperson said the system was working to find roles for some of the affected employees, noting “more than a thousand jobs open at other Steward hospitals”, and Steward said the hospitals were losing money and had low patient volumes. According to the Massachusetts Department of Public Health, Carney and Nashoba Valley, two of the eight hospitals Steward operated in the state, have been closed since August 31, 2024; as required in the closure process, Steward submitted closure plans to the department. ^{1 6 4 7}

analysisNorwood Hospital, closed in 2020 because of flood damage, was not included in the Massachusetts sale process, a July 26, 2024 news report said. A news tracker reported that Steward filed an October 7 notice of closure for the already nonoperational hospital and four satellite facilities and received bankruptcy court approval on November 5 to close the affiliated facilities; the notice and the court approval are not in the reviewed record. MPT's September 11, 2024 release listed its ongoing Norwood, Massachusetts construction project as still under discussion. A July 30, 2026 newspaper report said a bill pending in the Massachusetts Legislature could clear the way for the state to seize the closed hospital through eminent domain. ^{8 6 2 9}

analysisA hospital-industry news tracker reported that Orlando Health received bankruptcy court approval on September 10, 2024 to buy Melbourne Regional Medical Center, Rockledge Regional Medical Center and Sebastian River Medical Center in Florida for $439.42 million and acquired the hospitals on October 24, 2024. The sale order is not in the reviewed record; MPT's SEC disclosure states that the sale of the three Space Coast properties closed after September 30, 2024 for about $440 million. According to a timeline compiled by a research institute, Orlando Health shut down Rockledge Hospital on April 22, 2025, a few months after acquiring it, saying its architects and engineers had concluded the facility was in such disrepair that repairing it would be more expensive than building a hospital; nearly 1,000 employees were laid off. ^{1 2 3}

analysisHealthcare Systems of America said in a press release, as reported by a Texas television station, that on Wednesday, September 11 it would assume daily operations of eight Steward facilities: Glenwood Regional Medical Center (West Monroe, Louisiana), St. Joseph Medical Center (Houston), Medical Center SE Texas (Port Arthur) and, in Florida, Coral Gables Hospital, Florida Medical Center, Hialeah Hospital, North Shore Medical Center and Palmetto General Hospital; MPT's September 11, 2024 release lists Healthcare Systems of America as interim operator of eight hospitals. A news tracker later reported that the bankruptcy court approved its purchase of the five Florida hospitals and the Port Arthur and Houston hospitals at an October 25 hearing, and that Healthcare Systems of America Glenwood was named interim manager of Glenwood Regional Medical Center; the court's sale orders are not in the reviewed record. According to a timeline compiled by a research institute, in January and February 2025 Healthcare Systems of America contended that Steward was overcharging for its management services while temporarily helping the facilities during the transition, and in February told the bankruptcy court that Steward was failing to adhere to the sale agreement. ^{4 1 2 5}

analysisHonorHealth announced that effective September 11, 2024 it had assumed daily operations of Mountain Vista Medical Center (Mesa), St. Luke's Hospital (Tempe), the Steward Mesa Hospital emergency room and Florence Hospital, leasing the properties through Medical Properties Trust, with full operational ownership expected by October; a news tracker reported that the bankruptcy court approved HonorHealth's purchase of Florence Hospital, Mountain Vista Medical Center and Tempe St. Luke's Hospital at an October 3 hearing. The sale order is not in the reviewed record. St. Luke's Behavioral Health in Phoenix was not part of HonorHealth's takeover: the tracker reported that Arizona state officials ordered it to cease operations on August 14, 2024 after temperatures inside reached 99 degrees, that Steward filed an October 1 WARN notice to lay off 255 employees, and that College Health Enterprises received bankruptcy court approval at an October 22 hearing to become interim manager; the state order and the court approval are not in the reviewed record. A Steward spokesperson told a Phoenix television station on September 11, 2024 that it had no comment about the current status of St. Luke's. The tracker reported that in early December the hospital received permission from the Arizona Department of Health Services to reopen in a limited capacity; a timeline compiled by a research institute says it remained closed until December 2024, when it reopened under new ownership. The tracker also noted that Arizona Attorney General Kris Mayes had launched an investigation into Steward's bankruptcy on May 10, 2024; her own release of that date lists St. Luke's Behavioral Health Center in Phoenix among four affected Arizona hospitals, and the outcome of the investigation is not in the reviewed record. ^{6 2 7 1}

analysisA news tracker reported that Quorum Health received bankruptcy court approval on October 11 to buy Odessa Regional Medical Center and Scenic Mountain Medical Center (Big Spring) in Texas; that Christus Health Ark-La-Tex signed a binding asset purchase agreement for Wadley Regional Medical Center (Texarkana) on September 3, received approval on September 24 and completed the acquisition on November 1; and that Pafford Health Systems received approval on September 12 to buy Wadley Regional Medical Center at Hope, Arkansas for $200,000. These sales are as reported by the publication; the sale orders are not in the reviewed record. ²

analysisIn Ohio, a news tracker reported that Hillside Rehabilitation Hospital and Trumbull Regional Medical Center in Warren, which had been set to close around September 20 with 170 and 765 layoffs respectively, received bankruptcy court approval on October 16 for purchase by Insight Health Systems, which took them over on November 4; MPT's September 11, 2024 release had named Insight Health as the new tenant of two Ohio hospitals, and the sale order is not in the reviewed record. The tracker later reported that both hospitals had been temporarily closed since March 27, 2025 “due to ongoing Steward bankruptcy and financial disruptions”; a timeline compiled by a research institute says Insight alleged that Steward had stopped making payments required under the bankruptcy proceedings to support the transition of operations, and that Insight said in August that both hospitals were about to reopen. In Pennsylvania, according to the tracker as updated in 2025, the state agreed to pay Steward $4.5 million over three months to keep Sharon Regional Medical Center open; after Meadville Medical Center withdrew its proposed purchase, Steward filed a closure notice on December 16, the hospital closed on January 5, and Tenor Health Foundation received bankruptcy court approval to purchase it on January 10, 2025; it fully reopened in late May as Sharon Regional Health System. The closure notice and the sale order are not in the reviewed record. MPT's SEC disclosure lists Tenor Health among its six new operators of former Steward facilities. ^{2 1 5 3}

analysisIn a June 27, 2025 declaration supporting plan confirmation (Docket No. 5220), independent manager Alan J. Carr stated that during the chapter 11 cases the debtors' operations were transitioned, including the transfer of the U.S. Family Health Plan to BMI and the sale of twenty-eight hospitals and Stewardship Health. The first-day declaration had described Stewardship Health administering the US Family Health Plan, a Tricare Prime option funded by the Department of Defense, through a management services arrangement with Brighton Marine, Inc. On July 25, 2025 Judge Christopher M. Lopez entered findings of fact, conclusions of law and an order (Docket No. 5774) approving the disclosure statement on a final basis and confirming the Joint Chapter 11 Plan of Liquidation of Steward Health Care System LLC and Its Affiliated Debtors, dated July 11, 2025 (Docket No. 5492). A notice of entry of the confirmation order dated July 28, 2025, filed by counsel for the Plan Administrator Committee of Steward Health Care System LLC and its debtor affiliates, set August 14, 2025 as the deadline to request payment of administrative expense claims arising between November 15, 2024 and July 25, 2025 and to file proofs of claim for certain specified claims. The notice concerned the confirmation order and did not announce an effective date (the date on which a confirmed plan takes effect); it gave the debtors' service address as 2811 McKinney Avenue, Suite 300, Dallas, Texas 75204. ^{1 2 3}

analysisThe case docket lists adversary proceedings – lawsuits brought within the bankruptcy case – including Brighton Marine, Inc. v. Steward Health Care System LLC et al. (No. 4:24-ap-03102, filed May 16, 2024), Steward Health Care System LLC v. Medical Properties Trust, Inc. et al. (No. 4:24-ap-03168, August 19, 2024), TRACO International Group S. De R.L. v. Steward Health Care System LLC (No. 4:24-ap-03261, December 6, 2024), Catholic Health Initiatives Colorado et al. v. Steward Health Care System, LLC et al. (No. 4:25-ap-03001, January 3, 2025), Steward Health Care System LLC et al. v. Commonwealth of Massachusetts (No. 4:25-ap-03053, February 14, 2025), a suit by a group of plaintiffs filed on March 3, 2025, and a series of suits by the debtors against companies and organizations filed on April 11, 2025, beginning with No. 4:25-ap-03125. ⁴

analysisSteward Operations Holdings LLC, one of the debtors, filed its own chapter 11 petition on May 6, 2024 (No. 4:24-bk-90369), and an order for its joint administration under case 24-90213 was signed the same day. Its docket, as reproduced by a commercial docket service, lists more than 100,000 creditors and estimated assets and liabilities of $1,000,000,001 to $10 billion; its monthly operating reports for periods from May 31, 2024 through August 26, 2025 each reported $0 disbursed, and those filed from September 2, 2025 were filed by the SHC Plan Administrator Trust. As of October 13, 2026 the court docket, as reproduced by a commercial docket service, showed the SHC Plan Administrator Trust acting in the jointly administered cases (the member cases are listed under each debtor's name together with the trust) and recorded service of the trust's thirty-second omnibus objection to proofs of claim (claims with insufficient documentation, duplicative, late-filed and overpayment claims). On October 6, 2026 the court signed a stipulation and agreed order among the Plan Trust, the SHC Creditor Litigation Trust and Stryker Corporation (with affiliates including Stryker Sales LLC, Howmedica Osteonics Corp., Mako Surgical Corp., Tornier Inc. and Wright Medical Technology Inc.) resolving avoidance claims (Docket No. 6781), following a Rule 9019 settlement motion for which the Litigation Trust filed a certificate of no objection; the Litigation Trust's trustee had sued Stryker Corporation and others in an adversary proceeding filed on May 5, 2026. ^{5 4}

analysisA hospital-industry publication reported on February 24, 2026 that the SHC Plan Administrator Trust had moved on February 2 to close 165 of the 166 subsidiary debtor cases, arguing that the remaining matters could be administered effectively in the main case without maintaining 165 separate claims registers and filing operating reports in each subsidiary case. According to the same report, U.S. Trustee Kevin Epstein objected on February 22 that the cases were not fully administered: the confirmation order was not final, appeals by several parties including the U.S. Trustee were pending in the District Court, the plan was not in effect, creditor distributions had not begun, plan-required property transfers had not been implemented, and the effective date was not expected before the second half of 2027. The motion and the objection themselves, and any ruling on the motion, are not in the reviewed record; the July 2025 notice of the confirmation order did not announce an effective date. ⁶