Healthcare Change-of-Ownership Deal Feed

Description

A dated feed of ownership changes at Medicare-certified hospitals, skilled nursing facilities, home health agencies and hospices: who bought which facility, when, from whom, and whether a financial sponsor sits behind the buyer. One row per deal record, from two sources stacked in one table and told apart by deal_source:

Sponsor attribution uses the same classifier as the Facility Ownership and PE Sponsor Map: an owner is a financial sponsor when CMS's private-equity flag is Y on any filing by that owner, or its name reads as a fund vehicle. Read that dictionary's "How a financial sponsor is identified" section before relying on sponsor_buyer.

Built for deal teams: comps and precedent transactions by segment and state, sponsor activity tracking, add-on cadence of a platform, and seller identification in diligence.

• Source: CMS Change of Ownership files for hospitals and SNFs (data.cms.gov); CMS All Owners and Enrollments files for hospitals, SNFs, home health agencies and hospices (data.cms.gov; monthly for hospitals and SNFs, quarterly for home health and hospice); Care Compare for facility names and locations; the Healthparse operator crosswalk for the current operator.
• Refresh cadence: monthly. Ownership loads on the 2nd, ahead of the monthly marketplace export on the 3rd.
• Row count: 15,322 deal rows: 6,329 CHOW records and 8,993 new-ownership filings (2026-10-24 export of the 2026-09-29 snapshot).
• Vintage: 2026-09-29 (the CMS ownership snapshot date).
• Coverage: CHOW 801 hospital and 5,528 SNF records; filings 1,440 hospital, 3,436 SNF, 2,598 home health and 1,519 hospice. 1,207 rows have a sponsor-backed buyer (168 CHOW, 1,039 filings).
• History: CHOW back to January 2016. New-ownership filings cover association dates from 2023-09-29; earlier filings can be derived from monthly CMS snapshots back to 2022 as a backfill on request.

Rows by year of deal_date:

The jump in sponsor-buyer rows from 2023 is the filings source starting, not a change in deal activity. Compare years within one deal_source.

Table: pe_ownership_deals

Example queries (SQL)

-- 1. Sponsor-backed acquisitions of hospices and home health agencies in the
--    last 12 months, newest first.
SELECT deal_date, facility_type, facility_name, state, buyer_sponsor_families, new_owners
FROM pe_ownership_deals
WHERE sponsor_buyer AND facility_type IN ('hospice', 'hha')
  AND deal_date >= DATE '2025-09-29'
ORDER BY deal_date DESC;

-- 2. SNF precedent transactions in one state, with buyer and seller.
SELECT deal_date, facility_name, city, deal_type, buyer, seller
FROM pe_ownership_deals
WHERE deal_source = 'cms_chow' AND facility_type = 'snf' AND state = 'OH'
ORDER BY deal_date DESC;

-- 3. A platform's add-on cadence: facilities joining per quarter.
SELECT date_trunc('quarter', deal_date) AS qtr, count(DISTINCT ccn) AS facilities
FROM pe_ownership_deals
WHERE buyer_sponsor_families LIKE '%LINDEN CAPITAL PARTNERS%'
GROUP BY 1 ORDER BY 1;

-- 4. Deal rows with the facility's current size, for comps.
SELECT d.deal_date, d.facility_name, d.state, d.buyer_sponsor_families,
       f.beds, f.revenue, f.financials_fy
FROM pe_ownership_deals d
JOIN pe_facility_ownership f USING (ccn)
WHERE d.facility_type = 'hospital' AND d.sponsor_buyer;

Known limits

• Two sources, two meanings of "deal". A CHOW row is a change of ownership CMS processed. A filing row is a date on which new owners were associated with a facility; it captures acquisitions but also recapitalizations, holdco reorganizations and corrected filings. Filter on deal_source and do not add the two together as a deal count.
• One transaction, many rows. A platform acquisition of 40 facilities appears as 40 rows (one per facility), and a CHOW can appear alongside a filing for the same facility and date. Group by deal_date and buyer_sponsor_families to see transactions rather than facilities.
• No CHOW file for home health or hospice. Those types are covered by filings only, so they have no seller and no history before 2023-09-29.
• CHOW lags. CMS publishes CHOW records after processing; 2026 holds 62 CHOW rows through June. Recent months fill in on later refreshes.
• Sponsor attribution is current, not as of the deal. sponsor_buyer and buyer_sponsor_families come from today's ownership filings. A buyer that was sponsor-backed at the deal and has since been sold to a strategic shows its present owners.
• No price. CMS records no deal value. Use the facility's beds and revenue from the ownership map or HCRIS as a size proxy.
• The sponsor classifier's limits apply. The CMS PE flag is self-reported and mostly blank; see the ownership map dictionary.