“It shouldn’t be looked at as something where we foresee it’s going to happen,” Murphy said. “It’s in place if something like that happens. We can’t predict where medicine will go.”

In most cases, Steward must make a $25 million donation to a charity of the archbishop’s choosing that is publicly recognized by the state attorney general if the contract is terminated. Also, if Steward transfers ownership of one hospital or part of the assets, they would pay one-sixth of $25 million to a charity.

Termination would also result in the elimination of Catholic names, imagery, and facilities from the hospital.

However, Murphy said, Steward would not have to pay a penalty if the agreement is terminated because a change in the law requires hospitals to provide services that violate the bishops’ directives.

About three years ago, the Caritas network and the archdiocese began to explore ways to address the hospitals’ financial struggles. Talks with Ascension Health, a national Catholic health care system, broke down in June 2007. In November 2007, Caritas’ corporate team released results of a consulting firm’s report in a letter published in the Nov. 5, 2007 edition of The Pilot that suggested options such as governance changes, affiliating with a national Catholic health care system, merging with a local non-Catholic hospital, or a sale to a for-profit corporation.

In July 2009, Caritas withdrew from a proposed partnership with a St. Louis-based insurance company over concerns that the alliance would have forged a state health insurance plan that provides procedures like abortion and sterilization, which violate Catholic social teaching.

Earlier this year, Caritas announced that Cerberus will provide $830 million to fund operations and capital projects, assume pension obligations for current and former employees, and pay down Caritas’ debt.

Established in 1985, Caritas Christi is the second largest healthcare system in New England. Included in the system’s network are Caritas St. Elizabeth’s Medical Center of Boston, Caritas Carney Hospital in Dorchester, Caritas Good Samaritan Medical Center in Brockton, Caritas Holy Family Hospital and Medical Center in Methuen, Caritas Norwood Hospital and Saint Anne’s Hospital in Fall River.

“We’re very pleased that the acquiring enterprise has committed so forcefully to the continued Catholic identity of these hospitals,” Lovely said.