WARREN — Insight Hospital and Medical Center Trumbull is stopping patient admissions, effective immediately, because its president claims Steward Health Care is no longer honoring a transition services agreement (TSA) developed during Steward’s bankruptcy proceedings.

The TSA supported functions at the former Trumbull Regional Medical Center and Hillside Rehabilitation Hospital, according to a letter sent Tuesday from Dr. Gary Goncz, president, chief restructuring officer and chief medical officer at the Warren facility, to employees and medical staff at Insight’s facilities.

The letter states the TSA was set up to keep the hospitals’ doors open to patients during what normally would be a planned conversion over multiple months.

“Through Steward’s control of softwares, systems and accounts, Steward has already imposed millions in overhead costs and prevented millions more in revenues from reaching the local hospitals,” Goncz’s letter states. “Following a bankruptcy court order, Steward is now selling their management functions to another third-party with even greater costs to cover their debts without Insight’s consent. Despite repeated attempts to resolve the issues, no agreement was reached. We have exhausted all options of resolution.

“For our local hospitals, these burdens are untenable and contradict the hospitals’ purpose of providing affordable and accessible medical care to the Warren community. New systems will need to be rapidly installed which will require restructuring Trumbull and Hillside hospitals’ operations and services,” the letter continues.

It also states that effective immediately, Insight Hospital and Medical Center Trumbull will stop all patient admissions. The emergency room will remain open 24 / 7 to stabilize, treat and transfer patients if needed.

All locations, including the Insight Hospital and Medical Center Trumbull, Insight Rehabilitation Hospital Hillside, and outpatient centers in Austintown and Cortland, will remain open to provide outpatient services, including outpatient surgeries, cardiac cath procedures, lab, imaging, rehabilitation and any other outpatient procedures.

“Insight remains fully dedicated to the community’s well being despite these difficult circumstances,” Goncz’s letter ends.

The Insight hiring events scheduled Tuesday at OhioMeansJobs Trumbull County were canceled, according to a social media post.

STEWARD BANKRUPTCY

Dallas-based Steward Health Care filed for Chapter 11 bankruptcy protection May 6 in a Houston U.S. bankruptcy court, citing billions in debt.

Within days, the company announced its intention to sell its more than 30 hospitals, including Trumbull Regional Medical Center in Warren and Hillside Rehabilitation Hospital in Howland — institutions key to the health and welfare of residents in Trumbull and Mahoning counties.

In August — after canceling an auction for the local hospitals after reporting to the court it had not received qualified bids for the facilities the month prior — Steward Health announced it planned to close the hospitals in Warren and Howland as well as multiple satellite facilities Sept. 20.

The announcement sent shockwaves through the community, which rallied to keep the facilities open.

A local coalition of community, business and elected officials accelerated plans to keep the hospitals open. The group formed months prior because it was aware of Steward Health’s precarious financial condition. Trumbull County commissioners and Warren City Council approved conditional letters of support to contribute up to $3 million apiece to keep the facilities open, and the United Way of Trumbull County opened a portal to accept donations from the community.

The decision to close, however, was paused with the announcement Aug. 31 of settlement talks and broad outlines of a global settlement agreement in the bankruptcy.

The court approved an interim plan Sept. 11 that transferred control of Trumbull Regional, Hillside and 13 other Steward Health facilities to its landlord, Medical Properties Trust, based in Alabama, using interim managers.

At the time, Michigan-based Insight Health System was named interim operator for the local sites. The final settlement was approved Sept. 18.

Insight was named permanent operator and acquired the facilities. The bill of sale was completed Oct. 30. A sale price was not disclosed.

In early December, Dr. Jawad Shah, founder and CEO of Insight Health, addressed the news media at an event also attended by local elected, community and business leaders as well as physicians, nurses and staff from the hospital.

He said what was immediately evident during the first visit by Insight Health officials to the hospital was the community investment in it and their desire for it to remain open. Also, there were strong external forces that made a lasting imprint.

Internally, many of the pillars Insight Health was founded upon — from clinical safety to regulatory and legal compliance to financial stability to community presence to operational efficiency — already were in place.

“We were so surprised at how many of these pillars actually existed,” Shah said. “It was a matter of discovering that as opposed to doing something to change the reality on the ground.”

At the time, Shah said Insight Health was still working through revenue cycle management to ensure financial fitness, but volumes have increased as have emergency visits, charges and surgeries.