In early August, Flint, Mich.-based Insight Health System shared plans to reopen two of its Warren, Ohio, hospitals, Insight Hospital and Medical Center Trumbull and Hillside Rehabilitation Hospital, which have been temporarily closed since late March.

The two facilities halted operations due to ongoing bankruptcy and financial challenges stemming from its former owner, Dallas-based Steward Health Care, which sought Chapter 11 bankruptcy protection in May 2024.

Jawad Shad, MD, CEO of Insight, recently connected with the Becker’s Healthcare Podcast to share more behind the division to reopen the two hospitals and plans for their future.

Editor’s note: Responses have been lightly edited for clarity and length.

Question: What led to the decision to move forward with reopening Insight Hospital and Medical Center Trumbull and Hillside Rehabilitation Hospital, and can you share any updates on progress so far?

Dr. Jawad Shah: This was not a new decision in August. We had intended to reopen the hospitals from the time that we had to downsize and shut them down. [The] assessment of our organization [was] that the hospitals are very important for the community. They are needed, and there’s a history related to them. There’s a need for medical care and beds for taking care of the community. Being … responsible for the hospital, we didn’t feel that this is something that the community could not do without. We always felt that this is something that has to exist. The circumstances leading to this closure surprised us, but we’ve always felt that this is something that we are committed to establishing, and allowing [the hospitals] to really do great work in the community.

[We] don’t have a specific date, to date. Internally, we are very close to reopening. At this point, the final touches are being done in the ED, a little bit of paint and that story of stuff, but we’re very close. There’s just a few minor elements of coming up with an exact date and then making that public announcement. But we’re very close to making that.

Q: What is your long-term vision for the Trumbull and Hillside hospitals, and how do you see them evolving under Insight’s leadership?

JS: The long-term vision for both Trumbull and Hillside is that they’re fully functional hospitals. The case of Trumbull is a general hospital, of course, which takes care of all patients for acute illnesses, and we would continue to grow that, grow it clinically. We would add … the graduate medical education and residencies, and then continue to expand on service lines, particularly those that we find to be deficient within the community, and to grow them. The idea to make it a full-fledged hospital, fully functioning, flourishing, would be the idea.

Hillside … is a rehab hospital, and [it] is working very much in conjunction with the Trumbull Hospital, where our rehab needs are served there. We find there’s really an excellent path forward to establishing it and growing it, both clinically and financially. So we’re very much wanting to see both hospitals flourish in the time to come.

Q: The hospitals were previously under Dallas-based Steward Health Care’s ownership prior to Insight purchasing them. Can you share some lessons learned following the hospital transition? How has this shaped your leadership approach moving forward?

JS: It’s interesting, to be honest. For me, it’s been a learning experience working with the previous leadership and everything that’s happened with them, but it’s been an experience that hasn’t been a pleasant one.

[The] hospitals were shut down, and the bankruptcy, and so on that [Steward was] going through, for whatever reasons as a for-profit entity, led to the jeopardy of the asset now for the community. So we were in discussions for helping and coming in. It wasn’t until Sept. 8, 2024, where we said, ‘OK, we will jump in,’ because, there … was no one to really help.

At that point, we were in discussions with a variety of different groups, but in particular, [Medical Properties Trust], and so we said, ‘You know what? We’ll do this. We’ll bite the bullet, we’ll jump in, and we’ll do it,’ but not with very clean and proper terms. [One] of the things I really try and assess is how aligned everybody is with the vision. The government and various layers of the government were very much wanting to see the hospital succeed. The public was very aligned. MPT was aligned. I was assuming that Steward was aligned as well, in the sense that the hospitals now won’t help them much, but given the history, they would be wanting to see them succeed under a new leadership.

I was surprised [to see that the] back end of the elements of a hospital that really are very critical, revenue cycle, some of the back end work that needs to be done for patient access and security and all those other elements were still under [Steward’s] control, and that’s because there were 33 hospitals, so there’s a cross collateralization of some of these activities. We were expecting that we would be dealt with favorably, and there would be no issues just because everyone’s aligned. We weren’t forensic in terms of trying to figure out exactly what everybody does.

We were rather surprised that once we came into the contract, I believe that alignment completely vanished. [There] was no special concern for our accounts. The transfer of cash was something which we disputed repeatedly, and the back end processes that were being done were not adequate and not sufficient. So we did not feel we were actually manning the hospital on that back end.

On the front end, which was the patient volumes, the inpatient volumes, the operating rooms, the graduate medical education, the expansion of services, that’s what we had control over, and that was really going spectacularly well. We were very proud of some of the work that we did as we expanded. [We] not only maintained clinical service lines, but expanded that. But of course, we were crippled because of those other elements. [With Steward] being in Chapter 11, we are left with very little options as to how to extract the right behaviors.

Over the course of the next several months, we were unable to really get any of the corrections that I wanted right, and it further crippled us, hurt us, until a decision had to be made that we cannot continue with this type of disjointed leadership. Therefore, we made the decision that we are going to extricate ourselves from them. That’s where we are today, we really are independently working, independent of Steward and, whatever they have to offer, we just have reached a point that we’re really not … trusting that anything that they have to offer will be in our favor. So we made that bold decision. That’s, unfortunately, what I believe we had to do, and I’m very comfortable that we had no choice.

Q: Now that you’re about to move forward with the reopening of both hospitals, how does that feel for you as Insight’s CEO?

JS: I feel very elated in the sense that we can now start working with the chains off, where it’s our own systems, our own softwares and no back-end support. We’re doing everything on our own [by] establishing all the contracts and relationships.

We’ve been very open with the public and with the government to tell them that this is where we are, and then getting a lot of support. It’s not that we are a massive healthcare system. We are a medium to small size system, and we can only tolerate so much in terms of inefficiencies.

We’ve made that clear, and we’ve seen that we’ve gotten a lot of support, where people are really jumping in and helping. We’re particularly indebted to different layers of the government that helped us expedite certain things, in terms of regulatory issues and licensing. That’s all helped us get to where we want to at the end.

At the end, this a 501, c3, it isn’t owned by Dr Shah. It’s a community-owned project. We felt that it was extremely important to transition from a for-profit entity to a not-for-profit. In our assessment, that would allow it to breathe and live with further supports it would get.

Now we’re asking everyone to jump in to help do what we started to do … I’m excited to say that with all that energy, we have a fully licensed hospital, a facility that’s ready to go, equipment ready, ready to go, and now we’re opening up, and we’re just trying to build it right back up to where it was and beyond.

Q: How do these hospital reopenings align with your broader mission for Insight, and what does sustainable, impactful growth look like to you?

JS: The broader mission of Insight really revolves around the idea of delivering healthcare to communities that really need it. That’s our primary motive. It’s not that we’re looking for financial opportunities.

We’re looking for places that really need medical care, and then [we] bring all of our expertise and energy into ensuring that happens in a financially solvent manner. It very much aligns with our overall vision of healthcare. At the same time, I’d point out that our definition of healthcare is a little broader than simply end-of-life issues, someone coming to the emergency department and being resuscitated. Our definition of healthcare goes beyond the idea of preventative care or personalized medicine.

I think that our definition goes deep into the communities and assessing the social determinants of health. I believe that’s the hospital of the future. It’s not enough simply to take care of patients that come through your doors and provide the medicines and all the different things that they’re required in those medically difficult circumstances, end of life circumstances. We should really be looking at the factors that lead to health within our communities, recognizing that the hospital is perhaps one of the most important institutions any community has.

Looking deep into the social determinants of health and what leads to a position where a young person or a family doesn’t have the equipment necessary to get the proper healthcare, financial and economic and so on … assessing all of that, addressing all of that and giving people an opportunity to potentially overcome those barriers, enter into the economy, kids getting the right education, these are all elements to me, of healthcare that I believe we should really be paying attention to as a community, as a medical community. If we can address those issues with our voice, with the access we have to the government and the public, I think that’s really what’s going to transform communities. The idea that Insight is in the middle of that, and we want to see that succeed even at that level, deep into the communities and the preventative care that will come from that. I think that’s part of our mission. We see what we’re doing in Trumbull, we feel that this is a big part of that.

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