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For-profit hospital M&As: 9 deals involving HCA, CHS and Tenet

Three for-profit health systems entered into several transactions this year as part of strategic plans to strengthen their hospital portfolios, offload certain facilities or explore ways to expand their reach.

Below is a breakdown of the transactions that HCA Healthcare, Community Health Systems and Tenet Healthcare have entered into or completed since January:

HCA Healthcare (Nashville, Tenn.)

1. HCA sold three Louisiana hospitals for $150 million to New orleans-based LCMC Health in January. The Federal Trade Commission had ordered LCMC to halt the acquisition while it conducted a review, but the Louisiana legislature and state attorney general had authorized the deal to go through. A federal judge ruled in favor of LCMC in September, stating that the system sought the correct state approvals for the purchase of the three Tulane University hospitals.

2. Manchester, N.H.-based Catholic Medical Center signed a letter of intent in September to explore a merger with HCA. The two organizations will begin exclusive discussions to consider a potential agreement.

3. Dallas-based Medical City Healthcare, a division of HCA, is in talks to acquire Wise Health System, a three-hospital system based in Decatur, Texas. The board unanimously supports affiliating with Medical City. Wise Health System's hospital serves five counties and includes more than 450 providers.

4. Terre Haute, Ind.-based Union Health plans to acquire HCA's Terre Haute Regional Hospital as well as its related businesses, physician clinic operations and outpatient services. The hospital will continue operations with no interruption through the transition. Union Health's human resources department will work with Terre Haute Regional to extend job offers and answer employee questions.

Community Health Systems (Franklin, Tenn.) 

5. In February, CHS signed a definitive agreement to sell two hospitals to Winston-Salem, N.C.-based Novant Health. Subsidiaries of CHS will sell Lake Norman Regional Medical Center in Mooresville, N.C., and Davis Regional Medical Center in Statesville, N.C., to Novant for cash consideration of about $320 million. The sale comes as Davis Regional transitions from a general acute care hospital to an inpatient behavioral health hospital. The deal is expected to close by the end of this year, pending regulatory approvals.

6. CHS completed the $92 million sale of Oak Hill, W.Va.-based Plateau Medical Center to Charleston, W.Va.-based Vandalia Health on April 1. Vandalia signed an agreement to acquire the 25-bed hospital in January. 

7. El Dorado-based South Arkansas Regional Hospital signed a definitive agreement in April to acquire El Dorado-based Medical Center of South Arkansas from CHS. The Medical Center of South Arkansas is a 166-bed hospital that had more than 95,000 patient encounters in 2022. 

8. CHS subsidiaries in July inked a definitive agreement to sell three Florida hospitals — Bravera Health Brooksville, Bravera Health Seven Rivers in Crystal River and Bravera Health Spring Hill — to Tampa General Hospital. The deal, which is subject to regulatory approvals, is expected to be completed for a total cash consideration of about $290 million.

Tenet Healthcare (Dallas) 

9. In January, John Muir Health entered into a definitive agreement with Tenet to acquire sole ownership of San Ramon (Calif.) Regional Medical Center. Under the agreement, Walnut Creek, Calif.-based John Muir will acquire the remaining 51 percent interest in the hospital from Tenet for about $142.5 million. The transaction is subject to FTC review and various closing conditions.

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