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Nursing Home Change of Ownership in Texas
CMS has recorded 700 nursing home changes of ownership in Texas since 2016. Each one is a building that changed hands — a new operator, often a new staffing model, and a new set of vendor relationships.
| Year | Ownership changes |
|---|---|
| 2016 | 2 |
| 2017 | 84 |
| 2018 | 30 |
| 2019 | 65 |
| 2020 | 47 |
| 2021 | 76 |
| 2022 | 127 |
| 2023 | 101 |
| 2024 | 121 |
| 2025 | 47 |
The CMS change-of-ownership file lags. The most recent quarters are incomplete and fill in over the following months, so treat the last two years as a floor rather than a count.
Most Recent Texas Transactions
| Buyer | Seller | Effective |
|---|---|---|
| MAVERICK COUNTY HOSPITAL DISTRICT | APOLLO HEALTHCARE AT BAY AREA LP | 2025-11-19 |
| SOUTH LIMESTONE HOSPITAL DISTRICT | CITY OF WEST | 2025-10-01 |
| 821 US HIGHWAY 81 W OPCO LLC | SLP NEW BRAUNFELS LLC | 2025-10-01 |
| MEADOWS OF CORSICANA LLC | COUNTRY MEADOWS HEALTH AND REHABILITATION LLC | 2025-10-01 |
| 214 JONES RD OPCO LLC | LOH ELKHART LLC | 2025-10-01 |
Who Is Buying
| Most acquisitive buyers since 2020 | Facilities acquired |
|---|---|
| WEST WHARTON COUNTY HOSPITAL DISTRICT | 90 |
| WINNIE-STOWELL HOSPITAL DISTRICT | 50 |
| HAMILTON COUNTY HOSPITAL DISTRICT | 46 |
| FANNIN COUNTY HOSPITAL AUTHORITY | 32 |
| FRIO HOSPITAL DISTRICT | 18 |
What a Medicare Change of Ownership Actually Is
A CHOW is the formal Medicare process when a certified provider changes hands. The buyer either accepts assignment of the existing provider agreement — inheriting its compliance history and its liabilities — or the agreement terminates and the buyer enrolls fresh. The choice matters enormously to the buyer, and it is visible in the filing.
Every Texas Ownership Change on Record
| facility | ccn | care_setting | owner_org | relationship | ownership_pct | association_date | corporate_family | confidence |
|---|---|---|---|---|---|---|---|---|
| ••••% | ||||||||
| ••••% | ||||||||
| ••••% |
Plus every recorded change of ownership with parties and dates. See a worked example of the file · full field list.
Common Questions
What Is a CHOW in Medicare?
A change of ownership: the formal process when a Medicare-certified provider is sold. The buyer either assumes the existing provider agreement along with its compliance history, or lets it terminate and enrolls as a new provider.
How Many Nursing Homes Changed Hands in Texas?
700 recorded changes of ownership since 2016, per CMS.