PESP Private Equity Hospital Tracker

PESP has created the Private Equity Hospital Tracker (April 2025)

A current list of all private equity-owned hospitals in the U.S.

Key Points

• Approximately 488 US hospitals are owned by private equity firms. That represents:
  • 8.5% of all private hospitals 
  • 22.6% of all proprietary for-profit hospitals
• At least 27.7% of private equity-owned hospitals serve rural populations.
• A handful of private equity firms dominate the list of private equity-owned hospitals: Apollo Global Management (Lifepoint Health, ScionHealth), Equity Group Investments (Ardent Health Services), One Equity Partners (Ernest Health), GoldenTree Asset Management and Davidson Kempner (Quorum Health), Surgery Partners (Bain Capital), and Webster Equity Partners (Oceans Healthcare).
• Texas has the most private equity-owned hospitals (108).
• New Mexico has the highest proportion of private equity-owned hospitals (36.2%).
• Nearly a quarter (22.6%) of private equity-owned facilities are psychiatric hospitals.
• This tracker was updated in April 2025. For notes on this update, see here.
• Jump to the PESP Private Equity Hospital Tracker
• Jump to the interactive map of PE-owned hospitals in the U.S.

Introduction

Private equity ownership of hospitals has drawn scrutiny in recent years as some private equity hospital acquisitions have produced troubling impacts for patients and workers across the country. We have seen private equity firms aggressively loot safety net hospitals, strip out valuable real estate, cut critical but less profitable services, and exploit government funding programs designed to support and stabilize healthcare access.

The consequences have been borne by healthcare workers and the communities they serve. Private equity’s hospital profiteering has resulted in dangerous conditions, closures and reduced access to services, declining quality, and fraud.

2024 saw the historic bankruptcy of Steward Health Care, a multistate hospital system previously owned by Cerberus Capital Management. Steward’s bankruptcy was one of the largest hospital bankruptcies in decades.^[1] Less than a year later, Prospect Medical Holdings, the parent company of Crozer Health, filed for bankruptcy.^[2]

Already in 2025, there have been announced or completed closures of at least six private equity or formerly private equity-backed hospitals including Sharon Regional Hospital in Pennsylvania and Rockledge Hospital in Florida (both formerly owned by Steward Health Care/Cerberus Capital Management), Johnstown Heights Behavioral Health hospital in Colorado (Patient Square Capital) and three ScionHealth hospitals (Apollo Global Management) across Illinois and Florida (Kindred Sycamore, Kindred Hospital Lakeshore, and Kindred Hospital Tampa).[3]

Despite the threat they pose to critical healthcare services, private equity firms are largely able to operate in the shadows. Limited regulation of hospital ownership, particularly of the predatory financial practices sometimes employed by private equity investors, makes accurate and up-to-date data on private equity in hospitals difficult to generate and maintain.

In recent years researchers have conducted a handful of essential studies analyzing both the extent of private equity hospital ownership and its impacts (see for example: Anaeze C. Offodile II et al., “Private Equity Investments in Health Care: An Overview of Hospital and Health System Leveraged Buyouts, 2003–17,” and Sneha Kannan et al., “Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition”). Overall, though, there is a dearth of research in the space. Particularly challenging is the ever-changing investment landscape; private equity firms typically own healthcare companies for just four to seven years, buying and selling frequently enough that existing research loses relevance quickly.

In creating the Private Equity Hospital Tracker, we aim to provide an accurate, up-to-date, and accessible tool to pierce the veil of private equity hospital ownership.

See the hospital tracker here

Why Private Equity?

Private equity has invested over $1 trillion in the US healthcare sector over the last decade, and touches virtually every corner of the industry, including hospitals, physician specialties such as gastroenterology and anesthesiology, emergency medicine, dentistry, travel nursing, durable medical equipment, behavioral health, disability services, and healthcare services for people in prisons and jails.

The growing presence of private equity in healthcare is concerning. The private equity business model, which is characterized by the pursuit of outsized profits over short periods of time and a reliance on high levels of debt, is in many ways incompatible with providing quality affordable healthcare.

Hospitals are some of the largest institutions impacting patients, communities, and workers that have been targeted by private equity. For example, Bain Capital’s $33 billion takeover of HCA Healthcare in 2006 was at the time the largest leveraged buyout in private equity history.[4] Today, some of the biggest hospital chains in the country are private equity-owned, including Lifepoint Health (Apollo Global Management) and Ardent Health Services (Equity Group Investments).[5]

Private equity firms often seek to double or triple their investment over four to seven years. The pursuit of these outsized return expectations over relatively short time horizons can lead to cost-cutting that hurts care. In addition, use of high levels of debt can divert cash from operations to interest payments and dividends paid out to private equity owners.

Below are some financial tactics characteristic of private equity investment:

• High leverage: Private equity firms often utilize significant amounts of debt then buying companies. Firms typically buy companies through leveraged buyouts, whereby a private equity firm finances a substantial portion of an acquisition by taking out a loan secured by the company it is buying. High leverage can divert cash away from operations to paying interest on debt and leave companies more at risk for restructuring or bankruptcy. PESP found that seven of the eight largest healthcare bankruptcies last year (companies with more than $500 million in liabilities) were by private-equity-backed healthcare providers.
• Sale-leaseback of real estate: Private equity firms that own hospitals sometimes conduct sale-leaseback transactions, where the firm will sell the hospital’s real estate to a third party and lease it back. While these transactions provide a quick way to monetize real estate and generate cash, they can leave hospitals with fewer assets and higher monthly lease payments.[6]
• Debt-Funded Dividends: Some private equity firms siphon money out of companies they own through dividend recapitalizations, where a private equity firm directs its portfolio company to take on new debt and use the proceeds to pay the private equity owner a cash payout. These transactions can unnecessarily load healthcare providers with debt. While the private equity firm in these situations makes money, the healthcare provider often does not receive proceeds from the loan and still must pay it back, leaving it more vulnerable to market conditions and with fewer resources to support operations as it pays its monthly debt service payments.[7]
• Roll-ups: Private equity companies often conduct “roll-ups” by buying up multiple companies in the same industry segment and merging them under the same corporate umbrella. These transactions can allow firms to take advantage of economies of scale. However, a wide body of research has shown that provider consolidation leads to higher healthcare prices for private insurance and public healthcare programs like Medicare.[8]
• Fees: Private equity firms often charge management or advisory fees to the companies they own, which can cost companies millions of dollars each year. Fees are typically stipulated in a Management Services Agreement between the private equity firm and a company that it controls. In some cases, companies must pay fees to the private equity firm even for services never rendered (“accelerated monitoring fees”). These fees can further drain a company’s cash away from hospital operations into the pockets of investors.[9]

Key Findings

We tracked 488 hospitals owned or operated by private equity firms as of March 2025. That represents approximately 8.5% of all private (non-government-owned or operated) hospitals (5,618 facilities total).

For context, most community hospitals (58%) in the US are non-profits.[10] Of the country’s proprietary for-profit hospitals, private equity-owned facilities represent approximately 22.6% of hospitals (of 1,933 facilities total).

Hospital Systems and Private Equity Firms

We identified dozens of different private equity firms that own or operate hospitals; however, a small number of firms own most of them.

By far the largest private equity owner and operator of hospitals is Apollo Global Management. We tracked at least 235 locations through Apollo’s two health systems Lifepoint Health and ScionHealth.

The two companies are the result of a series of hospital acquisitions by Apollo, which in 2018 bought Lifepoint and merged it with another hospital chain, RegionalCare Hospital Partners.[11] Then in December 2021 Lifepoint acquired large acute care hospital chain Kindred Healthcare. As part of the transaction, Lifepoint shifted some of the acquired facilities and some of its existing hospitals into a new company called ScionHealth, which is also controlled by Apollo.[12]

See our report on Lifepoint Health:  “Apollo’s Stranglehold on Hospitals Harms Patients and Healthcare Workers” (January 2024)

One Equity Partners owns Ernest Health, which operates at 34 acute rehab and long-term acute care facilities in 11 states: Arizona, California, Colorado, Idaho, Indiana, Montana, New Mexico, Ohio, South Carolina, Texas, Utah, Wisconsin, and Wyoming.[13]

Equity Group Investments (EGI) owns 32 hospitals throughout Texas, Oklahoma, Idaho, Kansas, New Mexico, and New Jersey through its hospital system Ardent Health Services.[14] EGI took Ardent public through an IPO in 2024 but remains the controlling stockholder in the company and has four board seats.[15]

Read more about Ardent Health Services in our report on rural healthcare: “Private Equity Descends on Rural Healthcare” (February 2023)

GoldenTree Asset Management and Davidson Kempner together own Quorum Health, which they acquired after it filed for bankruptcy in 2020.[16] As of September 30, 2022, Quorum operated 21 hospitals in rural and mid-sized markets in 13 states. Due to its lender credit agreement related to the bankruptcy, Quorum is actively selling hospitals to generate cash to meet its financial obligations.[17] As of March 2025, Quorum operates 12 hospitals in nine states.[18]

Bain Capital is the largest owner of Surgery Partners, which operates 161[19] surgical facilities in 31 states. Although Surgery Partners is currently publicly traded, Bain Capital continued to be the largest investor with a 40% stake as of December 31, 2024.  In a December 2024 filing with the SEC, Surgery Partners noted that “Although we are no longer ‘controlled company’ within the meaning of the corporate governance standards of Nasdaq, affiliates of Bain Capital continue to be able to significantly influence our decisions.”[20] Bain may soon own the remainder of Surgery Partners; in January 2025, the firm submitted a proposal to buy all outstanding shares of Surgery Partners and take the company fully private. The proposal is non-binding and will require approval from a special committee of Surgery Partners’ independent directors.[21]

The top owner of psychiatric hospitals is Webster Equity Partners, which owns hospital chain Oceans Healthcare.[22] Under Webster’s ownership Oceans has grown significantly; in early 2025 Oceans announced that it had acquired competitor Haven Behavioral Healthcare. The transaction brought Oceans’ total footprint to 48 combined inpatient and outpatient locations in in nine states, 29 of which are behavioral health hospitals.[23] Previously Haven Behavioral was owned by private equity firms Thoma Bravo and Brentwood Capital Advisors.[24]

Top PE Hospitals Owners in 2025

* This number includes Surgery Partners’ hospital locations. It differs greatly from the total number of Surgical Partners facilities (approximately 200) because our tracker does not include ambulatory surgery centers or other outpatient locations.

Note: The numbers reflected in our tracker are an approximation. In many cases they differ from what hospital systems or private equity firms report. These differences may be the result of recent transactions, inaccuracies in CMS source data, and/or limited publicly available information on facility ownership. In addition, some facilities appear in the list twice. These duplicate listings occur when a hospital has multiple unique CMS identifiers for the same physical location, which usually signifies[25] that there is separately registered inpatient or rehabilitation unit within a facility. Because CMS recognizes these as separate entities, PESP will as well.

Mapping Private Equity Hospital Ownership

The state with the most PE-owned hospitals is Texas, with 108 facilities. This represents 19.6% of the state’s private hospitals.

While New Mexico has fewer private equity-owned hospitals (17 facilities), the state has the highest proportion of private equity-backed hospitals compared to all private non-government hospitals at 36.2%.

Top States with PE Hospital Ownership

In Wyoming, three of the state’s nine private hospitals are private equity-owned, representing 33.3% of private hospitals. However, 24 of Wyoming’s 34 hospitals are government-owned.

At least 121 (27.7%) of the private equity-owned facilities serve rural populations. Private equity firms have a growing presence in rural healthcare services.[26]

See our report on private equity’s growing influence in rural healthcare: “Private Equity Descends on Rural Healthcare” (February 2022)

Types of Hospitals

Non-specialty acute care hospitals were the most common type of private equity-owned hospital at 159 (32.6%) facilities. The second most common were rehabilitation hospitals, at 142 (29.2%) facilities, followed closely by psychiatric facilities at 110 (22.6%) facilities. Long term acute care facilities (LTACH) were the least common, at 76 facilities (15.6%).

The high volume of psychiatric hospitals reflects private equity’s broader interest in behavioral health, which has been a top investment target for private equity investment.

See our reports on private equity investments in behavioral health:

“The Kids Are Not Alright: How Private Equity Profits Off of Behavioral Health Services for Vulnerable and At-Risk Youth” (February 2022)

“Understaffed, Unlicensed, and Untrained: Behavioral Health Under Private Equity” (September 2020)

Quality Ratings

CMS assigns an overall star rating between 1 and 5 for hospitals that summarizes quality information collected by CMS, including mortality, safety, readmission, patient experience, and timely and effective care. According to CMS, “The overall rating shows how well each hospital performed on an identified set of quality measures compared to other hospitals in the U.S. The more stars, the better a hospital performed on the available quality measures.”[27]

Just 92 (19%) of the 488 private equity-owned hospitals we tracked had CMS star ratings available, which we believe to be an insufficient amount of data to glean trends in private equity ownership compared to non-private-equity ownership. However, the distribution of ratings is shown below for reference alongside the national average.[28]

Of the 92 facilities with star ratings available, private equity-backed facilities lagged behind national averages with a greater proportion of 1-, 2-, and 3-star facilities and a lower proportion of 4- and 5-star than the national average. For example, 2-star facilities represented 29.4% of private equity-backed facilities compared to the 20.9% national average and 1- star facilities represented 25.0% of PE-backed facilities compared to the 9.7% national average. Meanwhile, 5 star-facilities represented just 5.4% for private equity compared to the 13.4% national average.[29] The average star rating for all private equity-owned facilities was 2.5 stars.

Comparisons to star ratings from our 2024 Hospital Tracker update

The average star rating for private equity-owned hospitals is largely unchanged from last year (from 2.6 stars in 2024 to 2.5 stars in 2025).  However, there were significant decreases in star ratings for individual facilities: 30 facilities saw their star ratings decrease, compared with just 17 facilities that saw their ratings increase. Ratings for 44 facilities remained unchanged.[30]

The number of private equity-owned hospitals with a 1-star rating more than doubled, from ten to 23 facilities.

Several facilities had their star ratings decline by multiple points since the last update. For example, three facilities had their star ratings plummet from 3 stars to 1 star: Central Carolina Hospital and Frye Regional Medical Center in North Carolina (both Lifepoint Health), and Mountain View Hospital (Surgery Partners) in Idaho. Logan Regional Medical Center in West Virginia (ScionHealth) and Southern Tennessee Regional Health System Pulaski (Lifepoint) both fell from 4 stars to 2 stars.[31]

Lifepoint’s hospitals in North Carolina stand out in particular. Over the last year, three of its North Carolina hospitals have had their star rating reduced.^[32] One (Wilson Medical Center) has remained unchanged from a rating of 1 star, the lowest possible rating. None of the ratings for Lifepoint’s North Carolina hospitals have improved as of March 2025.[33]

PESP delved into the decline of Lifepoint’s North Carolina hospitals in this case study, which also examines CMS data on a number of other indicators including hospital acquired infections, heart failures, and ER wait times.

Recent Policy Developments

Policy and regulation have not kept pace with private equity’s growing ownership of healthcare companies. However, following the high-profile bankruptcy of Steward Health Care in 2024, as well as increased federal scrutiny of private equity in healthcare under the Biden administration, 2024 saw multiple state legislatures and members of Congress introduce and debate legislation that would curtail some of the harmful business practices of private equity firms in healthcare and bring greater oversight of healthcare transactions involving private equity. Two states – Indiana and Massachusetts – ultimately passed legislation that increased oversight over healthcare deals, including private equity dealmaking.[34]

Already in 2025, policymakers in at least nineteen states have introduced bills to regulate private equity in healthcare directly, bring greater oversight and transparency to healthcare transactions, or update the corporate practice of medicine laws, including in California, Colorado, Connecticut, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Texas, Vermont, Washington, and Wisconsin.

In January 2025, the US Senate Budget Committee released the findings of a year-long investigation of private equity ownership of hospitals. The bipartisan effort, which focused on Prospect Medical Holdings and Lifepoint Health, documented a harrowing pattern of private equity firms prioritizing profits at the expense of patient care and calls for greater oversight to address those harms.

In late 2024 PESP published a comprehensive report detailing the legislative and regulatory actions taken across the US in response to the growing evidence of private equity’s detrimental impact on healthcare systems. You can see the report here:

“Recent policy and regulatory initiatives to address private equity’s negative impacts in healthcare” (December 2024)

Research Methods

Our list is based on Center for Medicare and Medicaid Services’ (CMS) lists of all Medicare-enrolled hospitals, including acute care hospitals and specialty hospitals (long-term acute care, rehabilitation, children’s, psychiatric, and religious hospitals).[35]

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.[36] 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 investments. We also include hospitals that are operated by PE firms through more complex ownership structures, such as joint ventures with non-profits or academic health systems.

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.[37]

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), rural emergency hospital (REH), and critical access hospital (CAH).

Notes on the April 2025 Update

This page was last updated in April 2025. The update is based on CMS data accessed in December 2024. Here is a summary of the most significant changes:

• A handful of hospitals were removed as PE-owned due to sales, including several facilities previously owned by Quorum Health.
• Newly added PE-owned hospitals include a combination of acquisitions and new builds that have registered with CMS since the 2024 Hospital Tracker update. In addition, corrections were made to facilities that were previously incorrectly labeled.
• Acquisitions include several Lifepoint Health facilities and new joint ventures, ZT Corporate’s acquisition of STAT Specialty Hospital, Quorum Health’s acquisition of two hospitals formerly owned by Steward Health Care, and Oceans Healthcare’s buyout of Haven Behavioral Healthcare.
• Newly registered hospitals include six Clearsky Rehabilitation facilities, three Lifepoint Health and four ScionHealth rehabilitation or specialty hospitals.

 Related Research

A 2021 study published in Health Affairs looked at private equity acquisitions of short-term acute care hospitals between 2003–17. The study identified a total of 42 private equity acquisitions involving 282 unique hospitals for the period. [38]

The Health Affairs study had one notable outlier: 57% of the total hospital acquisitions (161 hospitals) were the result of Bain Capital and KKR’s 2006 acquisition of HCA,[39] one of the largest hospital buyouts in history. HCA went public in 2010, so those hospitals are not included in our tracker.[40]

Another 2021 study published in the Annals of Internal Medicine identified 130 hospitals under private equity control in 2018. Most hospitals identified in the study were in the South, considered rural and in zip codes with a lower median household income. The study also found fewer full-time–equivalent employees per occupied bed and lower average patient experience scores among private equity-owned hospitals, though the researchers note that these measures “do not fully capture quality of care” and that “additional research is necessary to identify and characterize the mechanisms underlying these differences.”[41]

In December 2023, a study published in the Journal of the American Medical Association (JAMA) found that rates of hospital-acquired complications for patients increased by 25% at hospitals after they were purchased by private equity firms. The increase was driven by a 27% increase in falls, which tend to happen on the general floors of the hospital; a 38% increase in central line infections, which are associated with ICU care; and a doubling of the rates of surgical site infections. The study drew from Medicare Part A claims data for hospital stays between 2009 and 2019 at 51 private equity-acquired hospitals compared against 259 matched control hospitals (non-PE-owned).[42]

Next Steps

Hospital Management Companies

Some non-profit or publicly owned hospitals are operated by private-equity-owned management companies. Many of these management relationships are not publicly disclosed, so it is difficult to know the extent to which private equity firms manage public and non-profit facilities.

One such company is Ovation Health (formerly QHR Health), owned by private equity firm Grant Avenue Capital since 2021, which focuses on independent and rural hospitals.[43] On its website, Ovation calls itself the “The premier provider of shared services to independent hospitals, health systems, and their leadership across the nation.” It currently has over 375 hospital management clients across 47 states.[44]

Hospitals that are managed by private equity-owned companies like Ovation are not yet captured in our tracker, but we intend to include these facilities when more data becomes available.

Hospital Joint Ventures

Private equity firms are increasingly using joint ventures (JVs) with nonprofit health systems as a growth strategy that can provide them with trusted brands and access to geographic markets they might otherwise not readily access. Joint venture partnerships may also help both parties evade antitrust scrutiny versus if they were engaging in traditional merger and acquisition growth strategies.[45] Nonprofit health system joint ventures with for-profit entities remains a relatively under-scrutinized and under-regulated area in the health policy landscape.

Lifepoint Health, which is owned by Apollo Global Management, uses joint ventures and other forms of partnerships to grow its business.[46] As of November 2024, at least 78 of Lifepoint hospitals[47] involving at least 26 health systems were covered by joint venture arrangements. Its largest joint venture is with Duke Health (“Duke Lifepoint”) and consists of 14 hospitals across North Carolina, Virginia, and Pennsylvania.[48] Many of Lifepoint’s most recent joint ventures involve the construction of new rehabilitation and behavioral health hospitals in partnership with local healthcare providers.[49]

PESP is beginning to examine the prevalence of joint ventures and their impacts on hospital management. We hope to add data on joint ventures to future updates of the Hospital Tracker.

See Our Other Work on PE-Owned Hospitals

The Pillaging of Steward Health Care (June 2024)

Apollo’s Stranglehold on Hospitals Harms Patients and Healthcare Workers (January 2024)

How private equity raided safety net hospitals: Pipeline Health (July 2023)

Private Equity Descends on Rural Healthcare (February 2023)

How Private Equity Raided Safety Net Hospitals and Left Communities Holding the Bag (November 2022)

Steward Health Care Reaches $4.7 Million Settlement to Resolve Allegations of False Claims Act Violations (June 2022)

Apollo Global Management Completes Merger of Kindred Healthcare and LifePoint Health, Shifts Some Hospitals to New Company (January 2022)

Private Equity Firms Reap Payouts After Hospital Chain Received $1.6 Billion in CARES Act Support (September 2021)

[1] Evans, Melanie, and Andrew Scurria. “One of the Biggest Hospital Failures in Decades Raises Concerns for Patient Care.” WSJ, May 6, 2024, sec. Business. https://www.wsj.com/health/healthcare/one-of-the-biggest-hospital-failures-in-decades-raises-concerns-for-patient-care-e9ac2422.

^[2] Vogel, Susanna. “Prospect Medical Holdings Files for Bankruptcy.” Healthcare Dive, January 13, 2025. https://www.healthcaredive.com/news/prospect-medical-holdings-files-bankruptcy/737138/.

[3] February 2025 WARN Act Notices for Illinois and Florida. Employee totals are 83 for Kindred Hospital Sycamore; 74 for Kindred Hospital Lakeshore; and 143 for Kindred Hospital Bay Area – Tampa. 

[4] Kevin Dowd, “This Day in Buyout History: KKR, Bain Capital Complete the Biggest LBO Ever | PitchBook,” Pitchbook News, November 17, 2017, https://pitchbook.com/news/articles/this-day-in-buyout-history-kkr-bain-capital-complete-the-biggest-lbo-ever.

[5] Anna Falvey, “100 of the Largest Hospitals and Health Systems in America | 2023,” Becker’s Hospital Review, February 28, 2023, https://www.beckershospitalreview.com/lists/100-of-the-largest-hospitals-and-health-systems-in-america-2023.html.

[6] Brian Spegele, “How a Small Alabama Company Fueled Private Equity’s Push Into Hospitals,” Wall Street Journal, February 14, 2022, sec. Markets, https://www.wsj.com/articles/hospitals-private-equity-reit-mpt-steward-11644849598.

[7] Eileen O’Grady, “Dividend Recapitalizations in Health Care: How Private Equity Raids Critical Health Care Infrastructure for Short Term Profit” (Private Equity Stakeholder Project, October 2020), https://pestakeholder.org/reports/dividend-recapitalizations-in-health-care-how-private-equity-raids-critical-health-care-infrastructure-for-short-term-profit/.

[8] Karyn Schwartz et al., “What We Know About Provider Consolidation,” KFF (blog), September 2, 2020, https://www.kff.org/health-costs/issue-brief/what-we-know-about-provider-consolidation/.

[9] Eileen Appelbaum and Rosemary Batt, “Fees, Fees and More Fees: How Private Equity Abuses Its Limited Partners and U.S. Taxpayers” (Center for Economic and Policy Research), accessed March 24, 2023, https://www.cepr.net/report/private-equity-fees-2016-05/.

[10] “Fast Facts on U.S. Hospitals, 2025 | AHA,” American Hospital Association, accessed March 20, 2025, https://www.aha.org/statistics/fast-facts-us-hospitals.

[11]https://www.wsj.com/articles/lifepoint-health-agrees-to-apollo-buyout-1532347207?mod=article_inline

[12] “LifePoint Health Completes Kindred Healthcare Transaction,” December 23, 2021, https://lifepointhealth.net/news/2021/12/23/lifepoint-health-completes-kindred-healthcare-transaction.

[13] “Portfolio,” One Equity Partners, accessed March 17, 2025, https://www.oneequity.com/portfolio ; Ernest Health website, accessed March 2025. https://ernesthealth.com/our-hospitals/.

[14] “Ventas and Equity Group Investments Announce Completion of Ardent Transactions,” press release, Ventas and Equity Group Investments, August 4, 2015. https://ir.ventasreit.com/news/news-details/2015/Ventas-and-Equity-Group-Investments-Announce-Ardent-Hospital-Operating-Company-Transaction/default.aspx  ; Ardent Health Services website, accessed January 2024. https://ardenthealth.com/systems.

[15] Ardent Health Partners, Inc. Form 10-K filed with the US Securities and Exchange Commission for the fiscal year ended December 31, 2024. https://www.sec.gov/ix?doc=/Archives/edgar/data/0001756655/000162828025008727/ardt-20241231.htm pg. 57.

[16] Case M.9845 – DAVIDSON KEMPNER CAPITAL MANAGEMENT / GOLDEN TREE ASSET MANAGEMENT / QUORUM HEALTH CORPORATION, No. 32020M9845 (European Commission, Directorate-General for Competition May 28, 2020). https://ec.europa.eu/competition/mergers/cases/decisions/m9845_112_3.pdf

[17] “Moodys Downgrades Quorum Health Corporations CFR to Ca; Outlook Negative,” Moodys Investor Service, January 30, 2023, https://www.moodys.com/research/Moodys-downgrades-Quorum-Health-Corporations-CFR-to-Ca-outlook-negative–PR_473331#:~:text=The%20outlook%20is%20negative.,in%20the%20next%20few%20quarters.

[18] Quorum Health website, accessed March 17, 2025. https://quorumhealth.com/locations/

[19] While Surgical Partners operates 161 surgical locations, only a fraction of these appear in our hospital tracker. This is because the tracker only includes CMS-designated hospitals, and would not reflect ambulatory surgery centers, physicians’ practices, or other outpatient locations. For total location numbers, see Surgery Partners form 10-K filed with the US Securities and Exchange Commission for the year ended December 31, 2024. https://www.sec.gov/ix?doc=/Archives/edgar/data/0001638833/000163883325000053/sgry-20241231.htm. Pg. 1.

[20] Surgery Partners form 10-K filed with the US Securities and Exchange Commission for the year ended December 31, 2024. https://www.sec.gov/ix?doc=/Archives/edgar/data/0001638833/000163883325000053/sgry-20241231.htm. Pg. 25.

[21] Surgery Partners press release, “Surgery Partners, Inc. Confirms Receipt of Non-Binding Acquisition Proposal from Bain Capital,” January 28, 2025. https://ir.surgerypartners.com/news-releases/news-release-details/surgery-partners-inc-confirms-receipt-non-binding-acquisition

[22] “Oceans Healthcare Secures New Capital Partner, Eyes Accelerated Growth,” Oceans Healthcare (blog), February 1, 2022, https://oceanshealthcare.com/ohc-news/oceans-healthcare-secures-new-capital-partner/.

[23] Oceans Healthcare press release, “Oceans Healthcare Acquires Haven Behavioral Healthcare, Inc.,” PR Newswire, January 2, 2025. https://www.prnewswire.com/news-releases/oceans-healthcare-acquires-haven-behavioral-healthcare-inc-302341420.html

[24] Brentwood Capital Advisors, “Brentwood Capital Advisors Serves as Exclusive Financial Advisor to Haven Behavioral Healthcare, Inc.,” August 4, 2016. https://www.brentwoodcap.com/haven-behavioral-healthcare-inc-is-recapitalized-by-bbh-capital-partners/

[25] Healthcare facilities may be co-located but have separately registered CCNs, which has resulted in some duplicates in our database. This typically applies to inpatient, rehabilitation, or long-term care units operating within a hospital. In rarer circumstances, duplicate listings may be related to an error in CMS data.

[26] Rurality data was available for 437 of the PE-owned facilities. 121 of those facilities are rural, representing 27.7%. See “research methods” section of this report for more on how PESP determined rurality. 

[27] Centers for Medicare and Medicaid Services, “Overall star rating for hospitals,” accessed March 2025. https://www.medicare.gov/care-compare/resources/hospital/overall-star-rating

[28] “National distribution of the Overall Hospital Quality Star Rating,” Overall hospital quality star rating, Centers for Medicare and Medicaid Services. Based on July 2024 results. Accessed March 2025. https://data.cms.gov/provider-data/topics/hospitals/overall-hospital-quality-star-rating/

[29] National averages are drawn from CMS data as of July 2024. We subtracted hospitals for which there are no ratings available. Percentages are based on all rated hospitals.

[30] One facility that had a rating available in the 2025 Hospital Tracker update was not previously available for the 2024 update:  Baptist Neighborhood Hospital Thousand Oaks.

[31] Star ratings data comes from the Centers for Medicare and Medicaid Services’ “Hospital General Information” dataset. PESP has compared star ratings between our 2024 and 2025 Hospital Tracker updates. The data from the January 2024 hospital tracker update was released by CMS in November 2023 and accessed by PESP in January 2024. The data for the April 2025 update was released by CMS in October 2024 and accessed by PESP in December 2024. CMS does not maintain historical data on its website, but you can access the most current Hospital General Information dataset here: https://data.cms.gov/provider-data/dataset/xubh-q36u

^[32] CMS Care Compare Data, accessed January 2024 and February 20, 2025. https://www.medicare.gov/care-compare/

[33] Star ratings data comes from the Centers for Medicare and Medicaid Services’ “Hospital General Information” dataset. PESP has compared star ratings between our 2024 and 2025 Hospital Tracker updates. The data from the January 2024 hospital tracker update was released by CMS in November 2023 and accessed by PESP in January 2024. The data for the April 2025 update was released by CMS in October 2024 and accessed by PESP in December 2024. CMS does not maintain historical data on its website, but you can access the most current Hospital General Information dataset here: https://data.cms.gov/provider-data/dataset/xubh-q36u

[34] Mary Bugbee, Michael Fenne, and Chris Noble, “Recent Policy and Regulatory Initiatives to Address Private Equity’s Negative Impacts in Healthcare,” Private Equity Stakeholder Project, December 2024. https://pestakeholder.org/wp-content/uploads/2025/01/PESP_Report_Healthcare-Policy_2024-compressed.pdf

[35] See the CMS Hospital General Information dataset: https://data.cms.gov/provider-data/dataset/xubh-q36u.  See the CMS Long-Term Care Hospital – General Information: https://data.cms.gov/provider-data/dataset/azum-44iv . See CMS Inpatient Rehabilitation Facility – General Information: https://data.cms.gov/provider-data/dataset/7t8x-u3ir. All accessed December 2024.

[36] Centers for Medicare and Medicaid Services, “Hospital All Owners Information,” CMS database, accessed January 2025. https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners. 

[37] UNC Sheps Center List of Hospitals in the U.S. (2024 dataset). https://www.shepscenter.unc.edu/programs-projects/rural-health/list-of-hospitals-in-the-u-s/.

[38] Anaeze C. Offodile II et al., “Private Equity Investments In Health Care: An Overview Of Hospital And Health System Leveraged Buyouts, 2003–17,” Health Affairs 40, no. 5 (May 1, 2021): 719–26, https://doi.org/10.1377/hlthaff.2020.01535.

[39] Anaeze C. Offodile II et al., “Private Equity Investments In Health Care: An Overview Of Hospital And Health System Leveraged Buyouts, 2003–17,” Health Affairs 40, no. 5 (May 1, 2021): 719–26, https://doi.org/10.1377/hlthaff.2020.01535.

[40] “KKR, Bain’s HCA Files for up to $4.6 Billion IPO,” Reuters, May 7, 2010, sec. Business News, https://www.reuters.com/article/uk-hca-idUKTRE6464I420100507.

[41] Joseph Bruch, Dan Zeltzer, and Zirui Song, “Characteristics of Private Equity–Owned Hospitals in 2018,” Annals of Internal Medicine 174, no. 2 (February 2021): 277–79, https://doi.org/10.7326/M20-1361.

[42] Kannan S, Bruch JD, Song Z. Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition. JAMA. 2023;330(24):2365–2375. doi:10.1001/jama.2023.23147. https://jamanetwork.com/journals/jama/article-abstract/2813379

[43] QHR Health Becomes Independent Company Through Acquisition by Grant Avenue Capital,” QHR Health, June 1, 2021, https://www.prnewswire.com/news-releases/qhr-health-becomes-independent-company-through-acquisition-by-grant-avenue-capital-301303045.html

[44] Ovation Healthcare website, https://ovationhc.com/why-ovation-healthcare/. Accessed March 2025.

[45] Browder, Brian, Bill Katz, and Alexander Dudley. “Avoiding Antitrust Enforcement in Health Care Joint Ventures.” Holland & Knight, June 13, 2023. https://www.hklaw.com/-/media/files/insights/publications/2023/06/avoiding-antitrust-enforcement-in-health-care-joint-ventures.pdf?la=en&rev=dbf428c005b24ac3b16322d2084e2f47; “Recent Trends & Developments in Health Care Joint Ventures: Nonprofit/For-Profit Joint Ventures | Insights | Ropes & Gray LLP.” Accessed December 3, 2024. https://www.ropesgray.com/en/insights/podcasts/2023/10/recent-trends-and-developments-in-health-care-joint-ventures-nonprofit-for-profit-joint-ventures.

[46] Lifepoint Health. “Types of Partnerships | Partnering with Lifepoint.” Accessed September 8, 2023. https://Lifepointhealth.net/types-of-partnerships.

[47] Pg. 448 of “Certificate of Need Application Hospital Projects – PeaceHealth Southwest, LLC.” Washington State Department of Health, August 9, 2024. https://doh.wa.gov/sites/default/files/2024-08/CN25-04.pdf.

[48] Lifepoint Health. “Duke Lifepoint Healthcare.” Accessed September 8, 2023. https://Lifepointhealth.net/duke-Lifepoint-healthcare-partnership.

[49] Lifepoint Health. “Northeast Georgia Health System and Lifepoint Rehabilitation Announce Plans to Build New Inpatient Rehabilitation Facility.” Accessed September 8, 2023. https://Lifepointhealth.net/news/northeast-georgia-health-system-and-Lifepoint-rehabilitation-announce-plans-to-build-new-inpatient-rehabilitation-facility?adcnt=9403867287-_-9403867288&platform=osm; Lifepoint Health. “Centra and Lifepoint Behavioral Health Announce Agreement to Build New Inpatient Behavioral Health Hospital.” Accessed September 8, 2023. https://Lifepointhealth.net/partnership-news/centra-and-Lifepoint-behavioral-health-announce-agreement-to-build-new-inpatient-behavioral-health-hospital; “PeaceHealth and Lifepoint Health Have Entered into a Joint Venture Partnership for a New Inpatient Rehabilitation Facility | Kaufman Hall.” Accessed September 8, 2023. https://www.kaufmanhall.com/news/peacehealth-and-Lifepoint-health-have-entered-joint-venture-partnership-new-inpatient; Byrd, Jeff. “Baptist Plans to Expand in Madison.” Madison County Journal, February 23, 2023. https://onlinemadison.com/stories/baptist-plans-to-expand-in-madison,37178.