YOUNGSTOWN, Ohio – We wish we could report all is well, that the new owner of Sharon Regional Medical Center is well-equipped and well-financed to return the hospital to good health and sustain its operations. We cannot. California-based Tenor Health Partners does not have a track record that inspires confidence.

The first and only other attempt by Tenor to resuscitate a hospital died four months after it took ownership, leading to the September closure of Thomasville Regional Medical Center in Alabama. From the start, Sheldon Day, the mayor of Thomasville, questioned the expertise of Tenor’s CEO in operating a hospital.

So here we are.

The situation seemingly is more stable with Insight Health System, the new operator of bankrupt Steward Health Care’s former hospitals in Warren and Howland. Insight, which took ownership in mid-December, is hiring health care workers, promising competitive pay and no mandatory overtime. That’s encouraging.

Readers of this space will recall the shame – not that we thought it would matter – that we heaped on Steward’s former CEO and its venture capital partners for their greed and self-dealings that nearly closed 31 hospitals. We still await criminal charges and civil penalties that could drain their ill-gotten gains. And we await legislators in Ohio and Pennsylvania to act and close the regulatory gaps that Steward and its landlord, Medical Properties Trust, exploited.

According to a January 2025 report by the Center for Healthcare Quality & Payment Reform, nearly 200 rural hospitals have closed in the past two decades and 35 hospitals have eliminated inpatient services since the beginning of 2023.

The report goes on to say more than a third – 700 rural hospitals in the country – are at risk because of financial problems. More than 300 are described as at “serious risk.”

The primary reason for the financial problems, the report states, is private health insurance companies pay less than the actual cost to deliver the services. Others blame public health care – Medicare and Medicaid – for not paying enough to cover costs, leaving private insurance providers to make up (or not) the difference.

So who’s going to do what? Where do they start?