Tenet
Dallas-based Tenet saw the biggest change among the three for-profit systems in 2024. As of Dec. 31, Tenet operated 49 hospitals, down from 61 on the same date in 2023, according to a Feb. 18 regulatory filing. The system netted $4.8 billion through the sale of three hospitals in South Carolina, six in California and its 70% ownership interest in Birmingham, Ala.-based Brookwood Baptist Health.
“All of the sales that we have executed on have been at high multiples to reflect the operational improvements that we have made to each of these facilities over the last several years,” CEO Saum Sutaria, MD, said during the company’s Oct. 29 earnings call. “As a result of these sales, our current hospital portfolio has an enhanced return profile, more attractive geographies for us and our business model, and higher expected returns … should result.”
Conifer Health Solutions, Tenet’s revenue cycle management subsidiary, retained or expanded its relationship with the acquirers of these hospitals.
CHS
Franklin, Tenn.-based CHS operated 76 hospitals as of Dec. 31, down from 78 on the same date in 2023, according to a Feb. 19 regulatory filing. In February 2024, the system announced a $1 billion divestiture plan.
In 2024, CHS completed the sale of Tennova Healthcare — Cleveland (Tenn.) to Dalton, Ga.-based Hamilton Health Care System for $160 million. The system also completed the sale of Davis Regional Psychiatric Hospital and Davis Regional Medical Center in Statesville, N.C., to Iredell Health System. The health systems did not disclose the price of the transaction.
That divestiture work is continuing into 2025. The system expects to offload two North Carolina hospitals and two Florida hospitals in the first quarter for about $540 million in gross proceeds, executives said during the company’s fourth-quarter earnings call on Feb. 19.
“These transactions reflect attractive double digit multiples, on trailing EBITDA, leading to further de-leveraging,” CFO Kevin Hammons said. “In addition to these previously announced transactions, we continue to advance discussions on additional divesters that we expect to announce in the near future, also at very attractive multiples.”
Effective Jan. 31, CHS also divested its 50% interest in Merit Health Biloxi (Miss.) to Gulfport, Miss.-based Memorial Health System. The terms of the transaction were not disclosed.
HCA
Nashville, Tenn.-based HCA operated 190 hospitals as of Dec. 31, up from 186 on the same date in 2023, according to a Feb. 14 regulatory filing. HCA’s M&A work in 2024 included the acquisition of Trinity Regional Hospital Sachse (Texas) from Sunland Medical Foundation. The bond-financed hospital, located in a northeastern suburb of Dallas, opened in 2021 and filed for Chapter 11 bankruptcy protection in 2023, when it also began its search for a buyer.
On Jan. 31, HCA completed its acquisition of Manchester, N.H.-based Catholic Medical Center in a $110 million deal. HCA CEO Sam Hazen said on the company’s Jan. 26 earnings call that the acquisition of the 330-bed hospital would “round out our New Hampshire network and give us a fairly broader and more productive Southern New Hampshire network.”
“We’re excited about that, but most of our investments [in 2025] are going to go toward organic system development,” he said. “We’ll have to wait and see if the market starts to shift and more inorganic growth opportunities develop, but at this point, we are not anticipating anything material.”
