Garnet Health Medical Center

Garnet Health Medical Center

Garnet Health Medical Center operates as a three-campus community health system anchored in Middletown, New York, with additional hospital sites in Harris and Callicoon. Virginia Rizzo chairs the board, bringing prior experience as owner of the firm Eclat. The system is structured around its 707 East Main Street main campus, with clinical partnerships extending to NewYork-Presbyterian for cardiac surgery and ColumbiaDoctors for cardiothoracic specialty services. An academic affiliation with Touro College of Osteopathic Medicine supplies the system's residency pipeline. In October 2025, Garnet announced its intent to join Montefiore Health System, a transaction that would fold its operations into one of New York's largest integrated delivery networks. The retirement plan deploys capital through a buyout strategy focused on the system's own real assets. Confirmed holdings include the Physician Office Building in Middletown, the Spagnoli Family Cancer Center addition, and the Garnet Health Doctors practice site in Goshen. A land lease at The Knolls at Goshen extends the portfolio beyond clinical facilities. The plan's footprint covers Orange, Sullivan, and Delaware counties in New York's Hudson Valley and Catskills regions, with no indication of out-of-state investment activity. Team size and professional staff dedicated to the plan remain undisclosed. The 403(b) Retirement Savings Plan operates alongside two philanthropic foundations — Garnet Health Foundation and Garnet Health Foundation - Catskills — that support capital campaigns for the hospital system. The system is a member of the Healthcare Association of New York State and the Greater New York Hospital Association. In October 2025, the board signed a non-binding letter of intent for Garnet Health to join Montefiore Health System, a move that would reshape governance and investment oversight for the combined entity. The pension's structure is genuinely unusual: a self-directed 403(b) plan that invests directly in the physical assets of the sponsoring employer. This alignment — retirement savings deployed into the buildings where plan participants work — creates a tight feedback loop between capital allocation and operational expansion. The pending Montefiore integration introduces succession complexity, as Montefiore's own retirement structures and investment policies would likely subsume or restructure the existing buyout program.