Ralph de la Torre

When Cerberus Capital Management acquired the Archdiocese of Boston's Caritas Christi Health Care system in 2010, converting it from nonprofit to for-profit, Ralph de la Torre became CEO. Over the next fourteen years, Cerberus and de la Torre collectively extracted approximately $1.3 billion from Steward Health Care through a combination of management fees, dividend recapitalizations, and sale-leaseback transactions. The most consequential instrument was the sale-leaseback: Steward sold its hospital buildings to Medical Properties Trust, a real estate investment trust, and then rented them back — stripping the company of its tangible assets and locking it into $6.6 billion in long-term rent obligations. On May 6, 2024, Steward Health Care filed for Chapter 11 bankruptcy with approximately $9.2 billion in total liabilities. It was the largest hospital system bankruptcy in American history. The extraction left the company insolvent; the bills were left for workers, patients, and communities to absorb.

• —Cerberus Capital Management acquired Caritas Christi Health Care (Archdiocese of Boston nonprofit system) in 2010, converting it to for-profit Steward Health Care.
• —Steward grew to 33 hospitals across 8 states, employing approximately 33,000 workers.
• —Extraction mechanisms: management fees charged annually by Cerberus; dividend recapitalizations (borrowing against the company to pay shareholders); sale-leaseback of hospital real estate.
• —Sale-leaseback: Steward sold its buildings to Medical Properties Trust (REIT), then paid rent on its own facilities — stripping tangible assets and locking in $6.6 billion in long-term rent obligations.
• —Total extraction estimated at $1.3 billion by the Private Equity Stakeholder Project, based on public filings and the Senate HELP Committee investigation.
• —Steward filed Chapter 11 bankruptcy May 6, 2024 — $9.2 billion in total liabilities. Largest hospital system bankruptcy in American history.
• —The Private Equity Stakeholder Project report: "The Pillaging of Steward Health Care" (2024).
• —No individual executive was criminally charged in connection with the extraction.

The bankruptcy triggered the permanent closure of five Steward hospitals. Two closures defined the human cost. Carney Hospital in Dorchester, Massachusetts — located in Boston's lowest-income neighborhood — closed permanently in 2024. Nashoba Valley Medical Center in Ayer, Massachusetts closed the same year, eliminating emergency care for approximately 115,000 residents across 17 rural communities. Before the closure, Nashoba handled approximately 16,000 emergency room visits per year. After the closure, those patients faced 15 to 20-mile drives — a 40-minute journey — to the next available emergency room. The Massachusetts Nurses Association stated that "people could die if they have to travel farther and wait longer for care." Across Steward's bankrupt system, approximately 2,400 workers were laid off. A September 2025 peer-reviewed study published in the Annals of Internal Medicine found that private equity-owned hospitals generated seven additional deaths per 10,000 emergency room visits compared to matched non-PE hospitals — a 13% increase — driven directly by staffing cuts after acquisition.

• —Five Steward hospitals permanently closed during or after the 2024 bankruptcy.
• —Carney Hospital, Dorchester, MA: Boston's lowest-income neighborhood. Served populations with the fewest alternative care options.
• —Nashoba Valley Medical Center, Ayer, MA: 115,000 residents across 17 rural communities. 16,000 ER visits per year. Closure sent patients 15–20 miles to next ER.
• —Massachusetts Nurses Association: "People could die if they have to travel farther and wait longer for care."
• —Approximately 2,400 workers laid off across the bankrupt system.
• —Harvard Medical School / Annals of Internal Medicine study (September 2025): PE-owned hospitals showed +7 deaths per 10,000 ER visits post-acquisition — a 13% increase — linked directly to 18% cuts in ER staff salaries and 16% cuts in ICU staff salaries.
• —The study analyzed more than 1 million emergency department visits and 121,000 ICU hospitalizations across 49 PE-owned hospitals vs. 293 matched control hospitals using Medicare claims 2009–2019.
• —The academic record on PE hospital ownership and patient outcomes: a December 2023 JAMA study found 25% higher rates of adverse events at PE-owned hospitals versus non-PE hospitals.

As Steward's bankruptcy unfolded in summer 2024, the Senate Health, Education, Labor, and Pensions (HELP) Committee — chaired by Senator Bernie Sanders — issued a subpoena compelling Ralph de la Torre to testify about the collapse of his hospital system. It was the first subpoena the Senate HELP Committee had issued since 1981. De la Torre refused to appear. He sent a letter calling the hearing a "pseudo-criminal proceeding." The Senate HELP Committee voted 16–4 to recommend criminal and civil contempt charges. The full Senate then gave unanimous consent — a 20–0 vote — to refer both criminal and civil contempt charges to the Department of Justice. De la Torre subsequently resigned as CEO and filed a lawsuit against the Senate HELP Committee. The DOJ had not charged him as of May 2026.

• —Senate HELP Committee, chaired by Senator Bernie Sanders, issued a subpoena compelling de la Torre to testify about the Steward bankruptcy — July 2024.
• —This was the Senate HELP Committee's first subpoena since 1981 — over four decades.
• —De la Torre refused to appear. His letter to the Committee described the hearing as a "pseudo-criminal proceeding."
• —Senate HELP Committee voted 16–4 to refer criminal and civil contempt charges.
• —Full Senate gave unanimous consent to refer both criminal and civil contempt charges to the Department of Justice — a 20–0 vote.
• —At the hearing de la Torre refused to attend, Senator Bernie Sanders displayed a photograph of de la Torre's $40 million, 190-foot yacht.
• —De la Torre resigned as CEO of Steward Health Care following the contempt vote.
• —De la Torre filed a lawsuit against the Senate HELP Committee, arguing the subpoena was unconstitutional.
• —As of May 2026, the Department of Justice had not filed criminal charges against de la Torre.

As Steward Health Care deteriorated and hospitals moved toward closure, Ralph de la Torre accumulated personal assets that became the visual centerpiece of the congressional investigation. When Senator Bernie Sanders convened the Senate HELP Committee hearing that de la Torre refused to attend, Sanders displayed a photograph of de la Torre's yacht — a 190-foot, $40 million vessel — before the empty witness chair. De la Torre also owns a $15 million sportfishing boat and a mansion in Dallas. The source of this wealth was the management structure he oversaw: Steward paid him from the fee and extraction mechanisms that simultaneously drove the company toward bankruptcy. The personal assets survived the corporate collapse. The 2,400 workers who lost their jobs and the communities who lost their hospitals did not.

• —Ralph de la Torre's yacht: 190 feet in length, estimated value $40 million.
• —$15 million sportfishing boat: documented in CBS Boston reporting.
• —Dallas mansion: additional personal real estate.
• —Senator Sanders displayed a photograph of the yacht at the Senate HELP Committee hearing, before the empty chair where de la Torre should have been sitting.
• —De la Torre's personal assets were not at risk in the Steward Health Care bankruptcy — they were extracted through the management fee and compensation structure.
• —Steward's patients and workers had no comparable protection: approximately 2,400 workers were laid off; five hospitals closed.
• —Sources: CBS Boston; Wikipedia — Ralph de la Torre; Senate HELP Committee hearing, July/August 2024.