Insight presents phased plan to reopen Trumbull Hospital, seeks billing records from Steward

Insight, the health‑care operator that took operational control of Trumbull Hospital, told Trumbull County elected officials and union representatives at a special meeting that it plans to reopen emergency and core inpatient services on a phased schedule and is seeking access to billing records currently controlled by Steward Health Care to reconcile millions of dollars in lost revenue.

The presentation and ensuing discussion centered on three near‑term actions Insight outlined: (1) restore an emergency department with laboratory, radiology and pharmacy services and basic inpatient care; (2) recruit and recall clinical staff in coordination with unions and medical staff; and (3) obtain visibility into historical billing and collections that Insight says Steward retained under a transitional services agreement. "We have to have visibility when it comes to reconcile my identity patients," Dr. Shah, representing Insight, said. "If we bill and it goes into their accounts and we have 0 visibility, that's gonna be an issue."

Why it matters: county officials and union leaders said the hospital is critical to local health care and jobs; union leaders pressed Insight for transparency on recalled staff, unpaid vacation pay and the timeline for nurses to return. Insight said it has changed ownership with CMS for the Trumbull facility and that the operator has been converted to a nonprofit 501(c)(3), steps it said will improve access to federal grants and other funding streams.

What Insight said it will do now

Dr. Shah described Insight's clinical and operational approach, saying the operator will start by reopening the emergency room, laboratory, radiology and pharmacy and then expand to behavioral health, operating rooms and a cath lab as volumes and staffing permit. He said the operator already has installed its own electronic health record and billing software and that the hospital’s diagnostic equipment (MRI, CT and lab analyzers) remains on site. "We're super excited about it installed, and we wanna continue from there to behavioral health," Dr. Shah said.

On timing, Insight repeatedly described the start as weeks rather than months but declined to give a specific opening date while work continues on regulatory and staffing steps. "We're thinking weeks," Dr. Shah said, adding later he did not want to mislead the public with a date until some minor tasks are completed.

Billing, back office and Steward Health Care

A central theme in the presentation and questions was the transitional services agreement (TSA) and back‑office billing that Steward Health Care performed while Insight operated clinical services. Insight officials said Steward limited Insight’s access to billing systems and at times stopped billing, causing a steep drop in collections and large write‑offs.

Dr. Shah provided financial figures he said reflect that period: billed charges rose from about $48 million to $52 million monthly during Insight’s period of operation, but cash collections lagged expectations (Insight presented expected monthly collections of roughly $9.7 million versus realized cash receipts near $7 million in the months shown). He said collection rates on billed charges fell from an expected historical rate near 22 percent to about 11 percent under Steward’s handling. He estimated the operator had absorbed more than $30 million in losses during the transition. He described efforts to recover accounts that Steward controls under its tax ID and urged government assistance to gain reconciliation and visibility.

Unions, unpaid wages and recall

Nurse and union leaders pressed Insight for transparency and concrete recall plans. Tom Connolly, who identified himself as representing registered nurses at Trumbull Hospital, said nurses need firm recall notices and more than a week’s notice to return because many have taken other jobs. Anne Mueller of the Ohio Nurses Association and a SEIU representative (Chrissy) said employees remain owed vacation pay and formal layoff notices from the March closure and asked Insight to resolve those outstanding labor issues before large‑scale recalls. "We need transparency," Connolly said. "We need to know what your intentions are, what goals you want to achieve so that we can match them up with ours and negotiate effectively."

Insight said it is negotiating with unions and plans to bring staff back in phases based on who is available and which specialties are staffed. "We have to be careful about that so that we don't make mistake or misstep where a patient gets hurt," Dr. Shah said.

Property and ownership path

Insight said it operates the hospital while a separate property‑holding entity (referred to in the meeting as MBT/MPT) retains ownership of the real estate. Insight officials said they are working with that property owner to create a pathway for the operating entity to acquire the real estate in the future, which Insight said would eliminate rent expense and better secure the hospital’s long‑term financial position.

Regulatory and accreditation steps

Insight said it received a change‑of‑ownership determination from the Centers for Medicare & Medicaid Services (CMS) for the Trumbull facility and is working with accrediting bodies including The Joint Commission on surveys and approvals needed before wider reopening. Hillside Rehabilitation Hospital, a separate facility discussed at the meeting, had not yet completed its change‑of‑ownership with CMS and remained dependent on that federal step.

What officials said

Trumbull County commissioners and local elected officials voiced support for reopening and urged cooperation with unions and federal and state partners. Commissioner Nanny Malloy said the commissioners "would like nothing more than to see both in, Hillside and Trumbull open," and Commissioner Rick Hernandez urged transparency and frequent updates so the community can plan. Several local officials — including representatives from congressional and state offices — attended and expressed willingness to help secure approvals.

Outstanding issues and next steps

Insight requested access to billing and patient accounting data to reconcile accounts that were processed under Steward’s billing arrangements; union leaders requested written recall timelines and resolution of unpaid compensation and vacation pay. Insight reiterated that clinical expansion beyond the emergency department will be dictated by observed ER volumes and available specialists, and said it will schedule medical‑staff and union meetings in the coming weeks to begin formal recall and staffing planning.

The county meeting closed without formal votes on hospital business. Officials said they will hold follow‑up meetings with Insight, union representatives and regulatory partners to resolve outstanding labor, billing and property issues and to set specific reopening milestones.

Ending note

County and community leaders repeatedly framed the hospital as essential to local health care and employment. Commissioner Hernandez said he would "trust you again" and urged Insight to maintain transparency; union leaders said they will condition cooperation on clear written plans and resolution of outstanding pay and recall language. Insight said it will continue work on staffing, regulatory approvals and reconciling accounts and will provide updates to local officials.