Healthcare Facility Ownership and PE Sponsor Map

Description

Who owns every Medicare-certified hospital, skilled nursing facility, home health agency and hospice in the US, and which financial sponsor, if any, sits behind it. Built from the ownership filings each facility makes with CMS (the All Owners and Enrollments files), resolved to the facility's CMS Certification Number (CCN), with every owner classified: financial sponsor, investment firm, listed operator, REIT, nonprofit system, holding company, chain home office, other organization or individual.

Three files:

1. pe_facility_ownership: one row per facility. Is it sponsor-backed, which sponsor families and fund entities, its largest organizational owner and that owner's facility count, the listed operator where one is mapped, an independent flag, and beds, revenue and net income from the latest cost report.
2. pe_facility_owners: one row per facility x owner x ownership role. The raw cap-table view behind the summary, with each owner's class and the basis for it.
3. pe_sponsor_portfolios: one row per sponsor family. Facilities by type, states, fund entities, first and latest association dates, facilities added in the last 12 months, and the family it overlaps most with.

Built for deal teams: sourcing, add-on screening, market maps, sponsor portfolio reviews and ownership diligence. The companion Change-of-Ownership Deal Feed gives the dated transactions, and the Independent Operator Target Universe is the independent = true slice of pe_facility_ownership.

How a "financial sponsor" is identified (read this before filtering)

CMS asks each owner to tick a "private equity company" box. The box is self-reported and mostly left blank: in the 2026-09-29 SNF file 195 owner rows say Y, about 99,000 say N and about 201,000 are blank. Relying on it alone would miss most sponsor ownership. So an owner is classed financial_sponsor when either:

Overrides, in order:

• An owner the operator crosswalk resolves to a listed operator, REIT or nonprofit system is classed as that, even if the PE box was ticked (filers sometimes tick it for these).
• The CMS investment-firm flag on its own (index funds, insurers and asset managers holding listed operators' shares) is its own class, investment_firm, not a sponsor.
• Only ownership roles count: 5% or greater direct or indirect ownership interest, direct or indirect ownership interest, and general or limited partnership interest. Management companies, officers and accounting firms filed with "operational/managerial control" are not owners and are not in these files.

sponsor_family is a grouping aid, not entity resolution. Sponsor entity names are cut at the first fund, vehicle or holdco token ("BAIN CAPITAL FUND XI LP" becomes BAIN CAPITAL; "COMPASSUS PARENT LLC" becomes COMPASSUS). One platform therefore often appears as several families: its holdco, its sponsor and the sponsor's aggregator vehicle. overlap_family and overlap_share in pe_sponsor_portfolios exist to show those layers; COMPASSUS, TOWERBROOK and TI V COMPASSUS INVESTMENT AGGREGATOR share 99 to 100% of their facilities.

• Source: 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); CMS Care Compare for facility names and locations; CMS HCRIS hospital cost reports and the SNF and hospice cost reports for beds, revenue and net income; the Healthparse operator crosswalk for the listed-operator mapping.
• Refresh cadence: monthly. Ownership loads on the 2nd, ahead of the monthly marketplace export on the 3rd.
• Row count: 40,753 facilities in pe_facility_ownership, 138,096 facility x owner rows in pe_facility_owners, 338 sponsor families in pe_sponsor_portfolios (2026-10-24 export of the 2026-09-29 snapshot).
• Vintage: 2026-09-29 (the CMS ownership snapshot date).
• Coverage: 9,138 hospitals, 14,404 SNFs, 11,522 home health agencies and 5,689 hospices. 2,196 facilities are sponsor-backed: 220 hospitals, 379 SNFs, 859 home health agencies, 738 hospices. 1,595 of those rest on the CMS flag, 601 on the name pattern alone.
• History: the current ownership snapshot. Monthly CMS snapshots back to 2022 can be loaded as a backfill on request. Dated ownership changes back to 2016 are in the Deal Feed.

Owner rows by class (pe_facility_owners):

Table: pe_facility_ownership

One row per facility (CCN). 40,753 rows.

Table: pe_facility_owners

One row per facility x owner x ownership role. 138,096 rows over 34,753 facilities and 35,750 distinct owners.

Table: pe_sponsor_portfolios

One row per sponsor family. 338 rows.

Example queries (SQL)

-- 1. Sponsor-backed hospices in Texas with the sponsor and the latest financials.
SELECT ccn, facility_name, city, sponsor_families, sponsor_basis,
       first_sponsor_association, revenue, net_income, financials_fy
FROM pe_facility_ownership
WHERE facility_type = 'hospice' AND state = 'TX' AND sponsor_backed
ORDER BY revenue DESC NULLS LAST;

-- 2. A sponsor's portfolio, facility by facility, with the entities on file.
SELECT f.ccn, f.facility_type, f.facility_name, f.state,
       o.owner_name, o.role_text, o.ownership_pct, o.association_date
FROM pe_facility_owners o
JOIN pe_facility_ownership f USING (ccn)
WHERE o.sponsor_family = 'TOWERBROOK'
ORDER BY f.state, f.facility_name;

-- 3. Most active sponsor families in the last 12 months. Read overlap_family
--    alongside: rows near overlap_share = 1.0 are layers of one platform.
SELECT sponsor_family, facilities, facilities_added_12m, states,
       overlap_family, overlap_share
FROM pe_sponsor_portfolios
ORDER BY facilities_added_12m DESC
LIMIT 25;

-- 4. Strict view: only sponsor attributions backed by the CMS flag.
SELECT * FROM pe_facility_ownership
WHERE sponsor_backed AND sponsor_basis = 'cms_flag';

Known limits

• The CMS PE flag is self-reported and mostly blank. cms_flag attributions rest on at least one filer ticking the box; name_pattern attributions rest on the owner's name alone. Filter on sponsor_basis to pick the evidence you trust. Sponsors that own through vehicles with plain operating-company names (no FUND, PARTNERS IV and so on) and never tick the box are missed.
• The CMS flag sweeps in some non-sponsors. Because one tick propagates to every facility an owner holds, a lender, insurer or family office that a filer marked as PE is classed as a sponsor (PACIFIC LIFE INSURANCE COMPANY appears as a family). Check fund_entity_names before quoting a family.
• sponsor_family is name-based. Expect one platform to appear as its sponsor, its holdco and its aggregator vehicles (COMPASSUS, TOWERBROOK, FC COMPASSUS, TI V COMPASSUS INVESTMENT AGGREGATOR). Use overlap_family and overlap_share to collapse them; do not add family facility counts together.
• Sponsor-backed and operator-mapped can both be true. 471 sponsor-backed facilities also map to a listed operator (for example a listed company with a sponsor as a 5%+ holder). The operator mapping comes from the crosswalk's name registry and inherits its limits.
• Ownership roles only. Management agreements, leases and operational control are not ownership and are not here; a facility run under a management contract by a sponsor-backed platform is not sponsor_backed unless the platform holds an ownership role.
• Indirect percentages are not multiplied through. A fund holding 60% of a holdco that holds 100% of a facility files as an indirect owner at whatever percentage it reported.
• Home health revenue is null. No HHA cost reports are loaded.
• SNF financials are FY2021 or earlier for now. Beds, revenue and net income for SNFs come from the latest cost report through FY2021; the FY2022 and FY2023 SNF reports are being reloaded. Hospital and hospice figures use the latest year filed.
• About 3,250 hospital CCNs have no state. They are mostly units and sub-providers that file ownership but appear in neither Care Compare nor HCRIS.
• Current snapshot only. Use the Deal Feed for what changed and when.