This story has been updated.

After nearly 40 years of operation on San Antonio’s South Side, Texas Vista Medical Center will close on May 1.

The hospital’s for-profit owner, Steward Health Care, said Wednesday that financial pressures were driving the closure and that it had “put forth” a proposal to University Health System, the county’s public hospital system, and Bexar County to “take control” of the hospital. 

But officials from the county said they had a single meeting in January with Texas Vista President Jon Turton, who sought a multimillion-dollar bailout.

“Since this conversation took place, Steward Health has not attempted to communicate with Bexar County, and staff has not been asked to vet any formal proposal to assume control of TVMC,” the county stated Wednesday.

The hospital’s closure will mark a significant blow to health care access in the South Side, said Councilwoman Adriana Rocha Garcia (D4), whose district includes the hospital.

“It is disheartening to hear about the closure of a local health care facility, and equally concerning is the devastating impact this will have on our residents living in Southwest San Antonio,” Rocha Garcia said in an email. “More than a quarter of District 4 residents are uninsured and struggle to receive the health care they need, so this closure will only exacerbate prevalent health disparities.”

She also expressed concern about the loss of more than 800 jobs and the economic impact of the closure.

Rocha Garcia, who chairs the council’s Community Health, Environment and Culture Committee, said she will work with council colleagues to identify ways to fill in the health care and employment gap the hospital’s closure will tear into the South Side.

Losing an acute care hospital will mean that only 100 hospital beds, at Mission Trail Baptist Hospital, remain on the South Side, which is home to half a million people, said Dr. Lyssa Ochoa, a surgeon and founder of the San Antonio Vascular and Endovascular Clinic. 

Ochoa, who also who serves on Texas Vista’s board, said news of the impending closure is “still a little bit of a shock.” 

The hospital’s physicians knew that “Steward was likely going to let go of ownership of that hospital,” but they weren’t expecting the closure announcement. Hospital administrators, she said, were “working hard to try to find a solution to keep it open.”

Ochoa fretted about the loss to the South Side. “There’s a few standalone urgent care centers, but not much, and certainly not enough to handle the volume” of demand for surgeries, maternity services and psychiatric care. 

Physicians and health-care providers must strategize on ways to fill the gaps, Ochoa said. “This is the time where we know there’s a need, and we all need to come together and come up with solutions.”

Texas Vista also hosted a residency program for graduate students from University of the Incarnate Word’s School of Osteopathic Medicine. Those students will also need to find a new program, Ochoa said. 

Hopefully, they’ll stay in Bexar County, because typically doctors work close to where they’ve trained, she said. “Preserving these [residency] spots for San Antonio, really is vital for addressing our health-care inequities and our health care needs.”

Fomerly known as Southwest General Hospital, Texas Vista was purchased by Dallas-based Steward Health Care from IASIS Healthcare Inc. in 2017. Steward is one of the largest for-profit, physician-owned hospital systems in the United States with 38 hospitals across nine states, excluding Texas Vista.

When Steward renamed the hospital in 2021, it launched an effort to provide preventive health screenings and promote healthy lifestyles in the historically underserved South Side, where residents experience higher rates of diabetes and obesity and have a much shorter life expectancy than those living on the North Side.

“I have reached out to University Health leadership and other community health partners to assist in coordinating the redirection of more than 175 patients who will be directly affected by the closure, as well as the 842 employees who work there,” Bexar County Judge Peter Sakai said in a news release Wednesday.

Due to existing staffing shortages, most hospitals in the area are hiring and can likely absorb many of the workers departing Texas Vista, Ochoa said. “Everyone is looking for experienced quality health care workers, from nursing assistants to nurses, to ultrasound techs, to the radiology and [operating room] staff.” 

University Health plans to build a 140-bed hospital near Texas A&M University-San Antonio that is scheduled to open in 2027. The health system has no plans to purchase or shore up Texas Vista, University Health officials said in its own news release Wednesday. 

“The building is more than 40 years old and would require significant renovation and IT upgrades to bring it up to University Health standards,” it states. “It has also become increasingly clear that our mission and values are not aligned with Medical Properties Trust, the real estate investment trust (REIT) that owns the assets of Texas Vista Medical Center and collects lease payments from Steward Health, which operates the hospital.”

In its own news release, Steward cited long-term financial challenges, the coronavirus pandemic and a lack of support from Bexar County and its University Health System for the closing.

“Steward was able and willing to assume financial losses and risks during that extraordinary public health crisis; it is not sustainable to do so any longer,” the company stated. “Nearly one quarter of the hospital’s patients cannot and do not pay for the services the hospital provides.”

The company said the 327-bed hospital “was choked out by the well-heeled ‘public’ hospital competitor across town,” referring to University Health. Steward said it sent a proposal for the county to take over control of the hospital, but it was not accepted.

Bexar County officials challenged that version of events, noting that county staff met with Texas Vista officials in January to discuss the hospital’s financial challenges. At that meeting, Turton said the hospital “would need a bail out of approximately $5 million to $10 million of taxpayer dollars” to sustain the company.

University Health said it was “disappointed that these two for-profit companies made the decision to identify University Health and Bexar County as somehow being responsible for their inability to successfully operate Texas Vista, and to imply that local taxpayers should bail them out.” 

According to the county, Turton indicated that Steward was “facing challenges and he had been instructed to limit his communications with local entities pending some resolution to these challenges.”

In June last year, Steward agreed to resolve a whistleblower case that alleged its hospital in Boston “paid physicians and physician practices for services not performed” in a payment-for-patient-referral scheme, according to the U.S. Attorney’s Office in Massachusetts. The hospital violated federal law, including the False Claims Act, and agreed to pay $4.7 million.

In December, the hospital system extended an asset-based loan with its lenders through 2023.

“The COVID pandemic, and its aftermath, exposed serious fault lines in the traditional approach to health care,” Steward Chairman and CEO Dr. Ralph de la Torre stated at the time. “Steward used lessons from the pandemic to refocus its nationally acclaimed value-based model. The extension of our [loan] coupled with our reengineered structure position us extraordinarily well for the coming year.”

Other health care providers on the South Side and beyond are likely bracing for increased patient traffic after the closure, Ochoa said.

“All of us are working together to find a solution [so] that [ South Side residents] will not be left alone, they will not be forgotten. And we will work relentlessly to make sure we address their needs.”

Correction: Dr. Lyssa Ochoa said hospital physicians knew that “Steward was likely going to let go of ownership of that hospital.” An earlier version of this story incorrectly credited Texas Vista’s board with having that knowledge.

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Iris Dimmick

Senior Reporter Iris Dimmick covers public policy pertaining to social issues, ranging from affordable housing and economic disparity to policing reform and mental health. Contact her at