Hospital Tracker Methodology and Data Dictionary
Methodology
Our list is based on Center for Medicare and Medicaid Services’ (CMS) list of all Medicare-enrolled hospitals, including acute care hospitals and specialty hospitals (long-term acute care, rehabilitation, children’s, psychiatric, and religious hospitals).[1]
We identified hospitals that are private-equity-owned through a combination news searches and the data provider Pitchbook, which tracks private equity firms and deals. We also consulted the CMS database “Hospital All Owners Information,” which provides ownership information self-reported by facilities.[2] This data was in most cases insufficient on its own to trace private equity ownership but provided helpful clues.
It is likely that there are hospitals that we failed to identify – private equity firms are generally not required to disclose acquisitions, so many deals are not publicly disclosed. Our list provides an approximation based on the best available data.
What counts as Private Equity?
We include traditional private equity buyouts as well as growth/expansion capital.
We do not include venture capital (VC) investments in our count of private equity-owned facilities, but we have indicated where we have seen VC investments in our list.
Rural vs Urban
As a basis for data on rurality, we used data from the Cecil G. Sheps Center for Health Services Research on rural hospitals in the US.[3]
We calculated rurality based the following factors:
- Rural status based on the definition used by the Federal Office of Rural Health Policy (FORHP) and the hospitals’ payment designation with CMS (provided by the Sheps Center).
- CMS rural payment designations: sole community hospital (SCH), Medicare-dependent hospital (MDH), rural referral center (RRC), and critical access hospital (CAH).
Sale-leaseback
We identified facilities that have executed sale-leaseback transactions through news searches, press releases, and SEC filings for the major REITs that acquire hospital real estate. Our data on sale-leasebacks is preliminary, and we intend to build out this data in the coming months.
Data Dictionary
| Heading | Description |
| Name | Facility name as reported by CMS Hospital General Information file. |
| Facility ID (CCN) | CMS Certification Number (CCN) – unique six-digit identification for certified Medicare providers. |
| Parent System/Company | Affiliated health system or parent company. |
| PE Firm | Private equity owner/investor. |
| Currently PE? | Indication of private equity ownership or backing. VC indicates venture capital backing. |
| State | Facility state as reported by CMS Hospital General Information file. |
| Address | Facility address as reported by CMS Hospital General Information file. |
| City | Facility city as reported by CMS Hospital General Information file. |
| Zip | Facility zip code as reported by CMS Hospital General Information file. |
| County | County name as reported by CMS Hospital General Information file. |
| Hospital Ownership | Facility ownership type as reported by CMS Hospital General Information file.
Government – Federal, Government – Hospital District or Authority, Government – Local, Government – State, Physician, Proprietary, Tribal, Voluntary non-profit – Church, Voluntary non-profit – Other, Voluntary non-profit – Private |
| TYPE | Facility specialty type from CMS Hospital General Information file and/or Provider Specific File. |
| Region | Facility location US region. |
| Payment Designation | CMS rural payment designations: Sole community hospital (SCH), Medicare-dependent hospital (MDH), rural referral center (RRC), critical access hospital (CAH), None = Prospective Payment System (PPS) or no special payment designation. |
| Hospital overall rating | Overall rating of hospital – star rating based on a 1-5 scale provided by CMS Hospital General Information. |
| Rural? | Rural status designated by PESP based on either the definition used by the Federal Office of Rural Health Policy (FORHP) or rural payment designation with CMS. |
| RUCA | Rural-urban commuting area (RUCA) codes classify U.S. census tracts using measures of population density, urbanization, and daily commuting. |
| FORHP Rural/Urban | Rural status based on the definition used by the Federal Office of Rural Health Policy (FORHP). FORHP defines an area as rural if it is a) located outside a metropolitan Core Based Statistical Area OR b) has a 2010 RUCA code of 4 or greater or c) is located in one of the census tracts with RUCA codes 2 or 3 that are at least 400 square miles in area with a population density of no more than 35 people per square mile or d) is located in an outlying metro county without a UA. https://www.hrsa.gov/rural-health/about-us/definition/index.html |
| CBSA Rural/Urban | Rural/Urban status based on U.S. Census Core Based Statistical Area. |
| FIPS | Federal Information Processing Standard (FIPS) codes are numbers which uniquely identify geographic areas. The number of digits in FIPS codes vary depending on the level of geography. State-level FIPS codes have two digits, county-level FIPS codes have five digits of which the first two are the FIPS code of the state to which the county belongs. FIPS codes are from geocoding addresses using the ESRI StreetMap data package. |
| Sale-leaseback | Indication of whether a facility’s real estate is owned by a third party (e.g., a REIT) through a sale-leaseback transaction. |
| Transaction date | Date of sale-leaseback transaction if applicable. |
| HCRIS Acute | CMS acute bed count as reported by the Health Care Cost and Information Reporting System (HCRIS / Medicare cost reports) |
| HCRIS Beds | CMS inpatient bed count as reported by the Health Care Cost and Information Reporting System (HCRIS / Medicare cost reports) |
| PHONE | Hospital phone number as reported by CMS Hospital General Information file. |
| POS Certified Beds | CMS certified inpatient count as reported by the CMS Provider of Services file. |
| POS Total Beds | CMS total inpatient bed count as reported by the CMS Provider of Services file. |
| PSF Beds | Number of inpatient beds as reported in the CMS Provider Specific file. |
| Emergency Services | Facility provision of emergency services as reported by CMS Hospital General Information file. |
For questions and comments please contact Eileen O’Grady, PESP’s Healthcare Research Director: eileen.ogrady@pestakeholder.org.
[1] See the CMS Hospital General Information dataset (accessed November 2022). https://data.cms.gov/provider-data/dataset/xubh-q36u.
[2] Centers for Medicare and Medicaid Services, “Hospital All Owners Information,” CMS database, accessed February 2023. https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners.
[3] UNC Sheps Center List of Hospitals in the U.S. (2021 dataset). https://www.shepscenter.unc.edu/programs-projects/rural-health/list-of-hospitals-in-the-u-s/.
