Steward Health Care has announced it has structured a recapitalization transaction with Cerberus Capital Management. The transaction transfers controlling interest of Steward Health Care to a management group of its physicians led by Steward Health Care CEO and Founder Dr. Ralph de la Torre.

The company announced that the transaction makes Steward Health Care the largest physician-owned and operated U.S. healthcare system.

Steward Health Care is comprised of 35 community hospitals across nine states and the country of Malta. Its network also includes more than 25 urgent care facilities and 42 preferred skilled nursing facilities.

Cerberus, based in New York, is an alternative investing firm with a reported $42 billion-plus in assets across private equity, complementary credit, and real estate strategies. Founded in 1992, the firm invested in Steward Health Care in 2010 to acquire the original six hospitals of the Caritas Christi system in Massachusetts.

Following the transaction, the management group of Steward Health Care physicians will control 90% of the company and Medical Properties Trust will maintain its 10% stake.