Private equity firms own about 561 U.S. hospitals, according to the Private Equity Stakeholder Project’s latest hospital tracker, published Oct. 28. That is 11.9% of the nation’s 4,714 private, nongovernment hospitals and 33.6% of its 1,668 for-profit hospitals.
The watchdog group’s update, based on CMS data, Pitchbook and news reports, adds two new lenses for the first time: hospitals held through joint ventures with nonprofit health systems, and hospitals whose real estate is owned by real estate investment trusts.
10 things to know
- A handful of firms own most of the hospitals. Apollo Global Management is the largest owner by far, with about 200 facilities through Lifepoint Health and ScionHealth. Welsh, Carson, Anderson & Stowe follows with 124 through Select Medical Holdings and Emerus Hospital Partners. One Equity Partners (Ernest Health, 35), Equity Group Investments (Ardent Health, 28) and Webster Equity Partners (Oceans Healthcare, 28) round out the top five.
- Texas leads in volume. The state has 99 private equity-owned hospitals, 21.9% of its private hospitals. Ohio (37), Louisiana (27), California (26) and Florida (26) follow.
- New Mexico leads in share. Sixteen of New Mexico’s 38 private hospitals, or 42.1%, are private equity-owned, the highest proportion of any state. In Wyoming, three of eight private hospitals are private equity-owned, though most of the state’s hospitals are government-run.
- Rehabilitation hospitals are the largest category. Rehab facilities make up 34.4% (193) of private equity-owned hospitals, followed by acute care hospitals at 28.9% (162), long-term acute care hospitals at 27.3% (153) and psychiatric hospitals at 19.4% (109).
- Nearly 1 in 4 runs through a nonprofit partnership. At least 129 private equity-owned hospitals, or 23%, are held through joint ventures with nonprofit health systems and other healthcare companies. Four companies account for 94.5% of them: Lifepoint, Select Medical, Ardent and Emerus.
- Duke Lifepoint is the largest joint venture. The partnership between Duke Health and Lifepoint includes 16 hospitals across North Carolina, Virginia, Pennsylvania and Michigan. Lifepoint’s other top partners include Mercy Health (eight) and Ascension (six). All nine Emerus hospitals and 62% of Ardent’s are joint ventures.
- REITs own the real estate under 1 in 4 private equity hospitals. At least 144 private equity-owned hospitals, or 25.6%, have their real estate owned by REITs. That compares with at least 11.9% of all for-profit hospitals and 4.7% of all private hospitals. Medical Properties Trust is the largest REIT landlord among the 223 REIT-owned hospitals tracked, with 105.
- Ernest Health is the most REIT-reliant. At least 82.9% of Ernest Health’s hospitals sit on REIT-owned real estate, nearly all held by Medical Properties Trust. ScionHealth follows at 46.2%, largely through Ventas.
- Rated hospitals trail national quality averages. Only 96 private equity-owned hospitals, 17% of the total, had CMS star ratings, which PESP said was too few to draw firm conclusions. Among those, the average was 2.6 stars, up from 2.5 in 2025. Just 3.1% earned five stars, compared with 10.1% nationally, while 15.6% earned one star, compared with 7.9% nationally.
- About 1 in 5 serves rural communities, and states are watching. At least 116 private equity-owned hospitals, or 20.7%, serve rural populations. Following the Steward Health Care and Prospect Medical Holdings bankruptcies, 11 state legislatures have passed laws expanding oversight of healthcare transactions over the past two years: California, Connecticut, Delaware, Illinois, Indiana, Maine, Massachusetts, New Mexico, Oregon, Vermont and Washington.
What the count leaves out
PESP calls its figures an approximation. Private equity firms generally are not required to disclose acquisitions, and the group said some hospitals likely went unidentified.
The tracker also excludes nonprofit and public hospitals managed by private equity-owned companies. One example is Ovation Healthcare, owned by Grant Avenue Capital, which reports more than 375 hospital management clients in 47 states. Ambulatory surgery centers and other outpatient sites are excluded too, which is why Surgery Partners appears with 19 hospitals despite operating about 200 facilities.
This year’s update also changed how hospitals are counted: facilities at the same location with the same owner now count once, even when CMS assigns them separate identifiers. That lowered the tracker’s national hospital count from 7,218 in 2025 to 6,062, closer to figures from the American Hospital Association and KFF, so year-over-year comparisons should be read with care.
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