September 21, 2010Attorney General Martha CoakleyOffice of the Attorney General100 Cambridge StreetBoston, MA 02114-2509RE: Caritas Christi/Cerberus Proposed TransactionDear Attorney General Coakley:We are writing to express our serious concerns with the rapidly moving processfor government approval regarding the proposed purchase of the non-profitCaritas Christi Health Care System (Caritas) by Steward Healthcare System LLC(Steward), a subsidiary of the Wall Street private equity firm Cerberus CapitalManagement (Cerberus). While we understand the desire of the proponents tomove this sale forward quickly, we urge you to conduct this review in adeliberate, transparent, and inclusive manner.As you are aware, this proposed conversion is unprecedented in theCommonwealth. This complex transaction involves the state’s second largesthospital chain and tenth leading employer. The sale could impact access to vitalservices in many communities and has far-reaching implications for the future of the state’s healthcare system. News reports detail Cerberus’ interest inpurchasing as many as six additional hospitals to add to their network.Given the stakes for the Commonwealth and its citizens, we are concerned aboutthe rush to approve such a complicated transaction. Community-based groupshave articulated a set of issues and concerns that they would like addressed toprotect and enhance the health care services that these community hospitalsprovide. Other transactions involving the sale and conversion of single non-profitto for-profit hospitals, both in Massachusetts and in other states, have beenevaluated and approved on a much more extended timeframe.We urge you to make sure this approval process provides all stakeholders withthe time and opportunity to have a dialogue with the proponents of the deal andgovernment officials about the deal’s impacts.We also ask you to make public for review the information, data, and analysisthat your office and hired consultants have compiled over the past three months;to require Steward to provide a detailed business plan and how it will spend itsproposed $400+ million of capital investment for public comment and analysis;and, to provide the public a forum to provide feedback with this new information.