CHOWatch: Healthcare Facility M&A / Change-of-Ownership Deal Feed

CHOWatch tracks 5,896 completed hospital and skilled-nursing change-of-ownership deals from CMS PECOS, current through 2026-07-03.

Records
5,896 completed CHOW deals (755 hospital, 5,141 SNF), rolled up into 4,836 acquirer profiles
Sources
6 free, keyless CMS public APIs (PECOS CHOW filings, Care Compare reference data)
History depth
2016–2025, by deal effective date
Update cadence
Rebuilt each time CMS posts new PECOS CHOW filings
Delivery format
CSV, JSON, and Excel exports; SQLite database on request
License
Commercial license after signed agreement; underlying CMS data is public domain
Sample availability
Gated preview below; full sample by request
Preview-only page. It shows the structure and capability of this dataset using a limited, representative sample. The buyer / acquirer identity on each deal, the buyer NPI and CCN enrollment keys, and the serial-acquirer and PE-linked flags (the sellable columns) are withheld, and the full dataset is not downloadable here. It is provided separately after licensing.

Coverage & headline figures

Built 2026-07-03 from six free, keyless CMS public APIs (PECOS CHOW transaction files plus Care Compare reference data) and derived into one exportable deal feed. Deterministic and rule-based: no LLM in the pipeline.

5,896
Completed CHOW deals
755 hospital · 5,141 SNF
4,836
Distinct acquirers
the derived league table
246
Trigger leads, trailing 18 months
across 39 states
2016–2025
Deal coverage
by effective date
110
Serial acquirers
3+ arms-length deals
84
PE-linked buyers
investment-firm or holding-co owner on file

Deal mix: 5,765 arms-length · 131 related-party transfers flagged. 5,461 deals (92.6%) carry Care Compare facility context (name, city, star rating, ownership type, beds), joined on seller CCN. 73,028 CHOW owner-information rows back the PE and roll-up flags. Mean deal quality score 0.9999 (0–1 weighted completeness; 100% of deals at 0.80 or higher).

Sources (all free, keyless, public CMS APIs; verified live 2026-07-03)

  • CMS PECOS Hospital Change of Ownership (data.cms.gov data-api) → 755 of 755 hospital CHOW transactions.
  • CMS PECOS SNF Change of Ownership (data.cms.gov data-api) → 5,141 of 5,141 skilled-nursing CHOW transactions.
  • Hospital CHOW Owner Information (data.cms.gov data-api) → 23,028 of 23,028 owner rows.
  • SNF CHOW Owner Information (data.cms.gov data-api) → 50,000 of 116,973 owner rows (fixed API order, sample logged for reproducibility).
  • Care Compare: Hospital General Information (data.cms.gov provider-data) → 5,432 hospital reference records.
  • Care Compare: Nursing Home Provider Information (data.cms.gov provider-data) → 14,695 SNF reference records.

What buyers screenshot

Two aggregate views computed directly from the exported deals table. No buyer / acquirer identity or PE-linked flag is shown here beyond the aggregate totals already in the KPI row above.

Completed change-of-ownership deals more than tripled from 304 in 2016 to a peak of 956 in 2023

02505007501,000 3042016 4052017 4892018 7002019 4882020 6832021 7692022 9562023 8092024 2932025* Completed CHOW deals by effective-date year (n = 5,896)
Source: CMS PECOS Hospital and SNF Change of Ownership, deals.effective_date grouped by year across all 5,896 deals, extracted 2026-07-03. *2025 is partial: CMS PECOS filings lag their effective date.

51% of change-of-ownership targets carry a CMS rating of 1 or 2 stars

0%10%20%30% 26%1 star 25%2 stars 20%3 stars 17%4 stars 12%5 stars CMS overall star rating of facility sold (n = 5,295 rated deals)
Source: CMS Care Compare joined to PECOS Change of Ownership on seller CCN, deals.facility_rating across 5,295 of 5,896 deals with a rating on file, extracted 2026-07-03.

What’s in it: schema

Four cross-linked tables. deals is the headline deliverable: one row per completed change of ownership, de-duplicated on buyer enrollment, seller enrollment, effective date, and CHOW type. acquirers is the derived league table that rolls the deals up by buyer.

Tables in the dataset
Table Grain (one row =) Notable columns Rows
deals one completed CHOW transaction buyer_org_name, chow_type, effective_date, facility_rating, quality_score 5,896
owners one owner-of-record on a CHOW filing owner_type, investment-firm / holding-co flags 73,028
facilities one Care Compare facility (CCN reference) facility_name, city, star rating, ownership type, beds 20,127
acquirers one resolved buyer entity deal_count, states, provider_types, is_rollup, is_pe_linked 4,836

Source: CMS PECOS Change of Ownership and Care Compare, extracted 2026-07-03.

Columns in deals (the master transaction table)

deal_key Unique key: buyer + seller enrollment + date + type
provider_category hospital / snf
chow_type_text Acquisition/Merger, Change of Ownership, and similar
effective_date / quarter ISO deal effective date and fiscal quarter
seller_org_name / dba Selling entity, legal and doing-business-as
seller_state / npi / ccn Seller location and Medicare enrollment keys
facility_name / city Care Compare join on seller CCN
facility_rating / beds / ownership_type CMS star rating, certified beds, ownership class
first_seen Snapshot date (powers monthly new-deal diffs)
buyer_org_name / dba The acquirer (gated)
buyer_state / npi / ccn Buyer location and enrollment keys (gated)
related_party Arms-length vs. internal-transfer flag (gated)
quality_score 0–1 weighted completeness score (gated)

Columns in acquirers (the league table)

acquirer_name Normalized buyer entity (suffixes stripped)
deal_count / arms_length_count Completed deals attributed to this buyer
states / provider_types Footprint: states plus hospital/SNF mix
first_deal / last_deal Acquisition-pace window
is_rollup Serial acquirer, 3+ arms-length deals (gated)
is_pe_linked Investment-firm / holding-co owner on file (gated)

Sample preview gated

A representative slice of recent arms-length deals: the just-sold facilities the feed surfaces as trigger leads. Effective date, deal type, the facility that changed hands, location, and Care Compare context are shown. The buyer / acquirer identity and the PE-linked flag (the proprietary, sellable columns) are redacted. Eight of 5,896 deals shown; ordering does not reflect deal size or buyer rank.

deals: 8 sample rows (buyer identity and PE-linked flag withheld)
Effective Type Deal type Facility sold (seller side) Location CMS stars Beds Buyer / acquirer† PE-linked†
2025-12-01 Hospital Acquisition/Merger Southwestern Medical Center Lawton, OK 2 n/a withheld withheld
2025-11-01 SNF Change of Ownership Stonehenge of South Jordan South Jordan, UT 4 32 withheld withheld
2025-10-21 SNF Change of Ownership Ingraham Manor Rehab and Nursing Bristol, CT 2 128 withheld withheld
2025-10-01 SNF Change of Ownership Avir at New Braunfels New Braunfels, TX 1 154 withheld withheld
2025-09-30 SNF Change of Ownership Thermopolis Rehabilitation and Wellness Thermopolis, WY 3 60 withheld withheld
2025-09-01 Hospital Acquisition/Merger MercyOne Siouxland Medical Center Sioux City, IA 2 n/a withheld withheld
2025-05-01 Hospital Change of Ownership Merit Health Madison Canton, MS 3 n/a withheld withheld
2025-04-01 Hospital Change of Ownership Duke Health Lake Norman Hospital Mooresville, NC 1 n/a withheld withheld

Source: CMS PECOS Change of Ownership, extracted 2026-07-03. 8 of 5,896 deals shown; ordering does not reflect deal size or buyer rank.

† Buyer/acquirer identity and the PE-linked flag are withheld pending license.

Request the full live sample

Get a live, end-to-end sample of CHOWatch: the master deals table with buyer identities and enrollment keys, the acquirer league table with serial-acquirer and PE-linked flags, per-state trigger-lead lists, and the methodology.

Request the full live sample →

No full dataset is downloadable from this page. Public U.S. Government data (CMS PECOS & Care Compare); not affiliated with CMS. Deal prices are not part of the federal record and are not included.