Medical Personnel, a nurse, Pushing Stretcher in Hospital Corridor
(Photo via Canva)

FOR THE SECOND time in two years, Massachusetts is considering whether it needs to seize hospital land by force just to get a community its health care back. In February, state legislators held a hearing on taking the Norwood Hospital property by eminent domain, the same tool the state used at St. Elizabeth’s Medical Center in Brighton at a cost of $66 million to taxpayers. For Norwood, six years into a flood-related closure that never had to happen, it remains the only option available.

That fact alone should tell us something is broken. Not because eminent domain is the wrong call for Norwood, but because a state that regulates its utilities, its transit systems, and its energy grid with layers of intermediate oversight has no equivalent tools for hospital infrastructure. When a community loses its hospital, the state can wait or it can seize. There is nothing in between. And that is the problem, because eminent domain is not a health care policy. It is what a state resorts to when it has no other tools left.

There’s a way to fill that gap. A bill before the Legislature would create receivership authority for hospitals, modeled on what Massachusetts already uses when a utility fails its customers, and would give the state a middle option between waiting and seizing.

Before the floodwaters rushed in, Norwood Hospital was a profitable community hospital serving roughly 126,000 patients a year, generating $25 million in profit, and running at 81 percent bed occupancy, well above the statewide average.

Its emergency department handled nearly 40,000 visits a year, funneling patients to a catheterization lab that anchored cardiac care for the surrounding region. Its psychiatric unit was the only inpatient behavioral health facility in the area, treating patients from more than a dozen communities with nowhere else to be admitted.

Norwood Hospital did not fail. It was failed.

In 2016, Steward Health Care sold the real estate beneath nine Massachusetts hospitals to Medical Properties Trust, a Birmingham-based real estate investment trust, for $1.25 billion, and overnight, those hospitals began paying over $100 million a year in rent on buildings they used to own. Because the deal was structured as a real estate sale, it fell entirely outside the state’s Determination of Need process that oversees significant health care capital expenditures or changes in services.

Regulators had the power to review changes to a hospital’s license, not the sale of its bricks and mortar, and no one in state government had to approve or even examine a deal that would ultimately determine whether these hospitals survived.

We now know how dangerous that blind spot was. A study published in The BMJ last December found that REIT-acquired hospitals are 5.7 times more likely to close or go bankrupt than comparable hospitals, with one in four failing outright. The REIT model did not cause Norwood’s flood, but it stripped away the financial resilience that would have let a profitable, essential hospital recover from one, and that is the difference between a crisis and a permanent loss.

The community that depended on Norwood Hospital has spent nearly six years living with that difference. Emergency transport times to hospitals were suddenly three to four times what they had been, and the catheterization lab that once anchored cardiac care for the region is gone, with the nearest one now roughly 40 minutes away.

Research published in Circulation found that when drive time to emergency care increases by 30 minutes or more, heart attack mortality rises by 30 percent. All of this in a region that is not shrinking but growing, with thousands of new housing units built or approved, and no hospital to serve them.

In 2025, Gov. Healey signed a law that was a genuine step forward. It made Massachusetts the first state in the country to bar the licensing of hospitals whose campuses are leased from REITs, and it expanded state authority over private equity transactions that had previously fallen through the cracks. But the law applies prospectively. Existing REIT arrangements in effect before April 1, 2024, are explicitly grandfathered, so the law that was written to prevent exactly this situation cannot touch it.

For Norwood Hospital, that leaves a single option: seize the property and pay for it, or at least threaten to do so. When the state seized St. Elizabeth’s, it paid $66 million for a working hospital on land assessed at roughly $56 million. At Norwood, the math is inverted: the land is worth $5 to $6 million, but Medical Properties Trust has stated publicly that it has invested over $220 million in an unfinished shell, which means the cost of using this tool is not holding steady but climbing every time the state reaches for it.

That trajectory should make the case for building something better. When a utility company in Massachusetts fails to provide adequate service, the state has tools between doing nothing and seizing property: receivership authority, intermediate penalties, enforceable obligations to maintain service. For a REIT that sits on a half-built hospital while a quarter of a million people go without care, the state has none of that. The hospital receivership bill that has been before the Legislature since last year would give the state exactly the kind of intermediate authority it is missing.

Massachusetts has shown it knows how to prevent the next Norwood-like crisis. The question is whether it will build the tools to help the communities already living through one. Because eminent domain is not a health care policy. It is the absence of one.

Meredith McGee has a master’s degree in public health from the Yale School of Public Health and is a junior research fellow at Parabola Center for Law and Policy. K. Massi, a master’s degree student in community health sciences at Boston University School of Public Health, contributed to the research and development of this piece.