The Ledger

Select Medical told Massachusetts about its take-private 106 days after it closed, and the state’s review of the $3.9 billion deal is still open. The Massachusetts Health Policy Commission (HPC) posted Select Medical Holdings’ notice of material change, dated October 15. The form says the transaction occurred July 1, 2026, when the operator of more than 140 specialty hospitals and about 1,900 outpatient therapy sites became a private company wholly owned by Stallion Intermediate Corporation, an entity affiliated with a buyer consortium that includes Select executives Robert Ortenzio and Martin Jackson. The HPC’s own form instructions require notice no fewer than 60 days before closing. Select says its federal Hart-Scott-Rodino antitrust filing was approved on or about April 27, so federal review finished more than two months before the state was told. The $3.9 billion price, the involvement of Welsh, Carson, Anderson & Stowe (WCAS), and the account that the HPC reached out after a private equity watchdog’s August inquiry come from HIT Consultant’s reporting, not from the filing. We found no published HPC determination. The so-what for deal teams: a closed federal clearance does not settle a state notice, and a late filing invites a Cost and Market Impact Review, which the HPC can start within 30 days of a complete notice. Confidence: High on dates and structure (primary filing), Med on price and what prompted the filing (trade press).

Private equity now owns 561 U.S. hospitals, 11.9% of all private hospitals and 33.6% of for-profit ones, and two firms hold roughly 325 of them. The Private Equity Stakeholder Project (PESP), an advocacy group, published its fall 2026 hospital tracker October 28, with counts as of June 2026. Apollo Global Management holds about 200 hospitals through Lifepoint Health and ScionHealth, and WCAS holds 124 through Select Medical (115 hospitals in 30 states per PESP) and Emerus Hospital Partners. One Equity Partners has 35, Equity Group Investments 28, Webster Equity Partners 28 and Bain Capital 19, through Surgery Partners. Texas has the most PE-owned hospitals (99), New Mexico the highest share (42.1%), and at least 116 serve rural populations. Rehabilitation hospitals are the largest category at 193. The tracker is advocacy-lens research, so Confidence: Med until independently counted.

At least 144 PE-owned hospitals sit on real estate owned by REITs, and at least 129 operate through joint ventures with nonprofits or other companies. The same PESP tracker identifies 223 hospitals whose property is owned by real estate investment trusts (REITs), 144 of them PE-owned. Medical Properties Trust is the largest landlord, with 105 hospitals. About 23% of PE-owned hospitals (at least 129) run as joint ventures, 67 of them at Lifepoint Health. The so-what for operators and lenders: lease obligations and joint-venture governance, not the headline owner, determine who can sell, close or restructure a hospital. State transaction-review laws that cover outright acquisitions can miss joint ventures. Confidence: Med (advocacy tracker; we did not audit the hospital list).

Davion Healthcare, a Dublin health monitoring technology developer, agreed to pay $13.5 million for Philadelphia home care provider Healthcare Stat Homecare. Per the company release announced October 29, the agreement is dated October 27 and pays $8 million in cash plus $5.5 million in Davion shares valued at $13 each (about 423,000 shares by our math). The target reported about $11.6 million in gross receipts and about $1.9 million in ordinary business income for 2025, unaudited. Completion is expected on or before December 31. Why it matters: a small technology company is buying delivery capacity rather than building it, at roughly 1.2 times the target’s gross receipts. Confidence: High on terms (company release, via GlobeNewswire syndication), Low on target financials (unaudited, company-supplied).

THE DEAL SHEET

No new transactions spotted in the last 24 hours (October 31 to November 1; weekend window). Recent items, dated, listed for the record:

Target	Acquirer/Investor	Vertical	Value	Source
Select Medical Holdings	Stallion Intermediate Corporation (consortium including WCAS), closed July 1; state notice filed October 15	Specialty hospitals, outpatient rehabilitation	$3.9 billion (per HIT Consultant)	HPC notice of material change
Healthcare Stat Homecare	Davion Healthcare	Home health	$13.5 million, announced October 29	Davion release

Scan covered SEC filings, company releases, rating agency coverage and trade press for October 30 to November 1. No new health system bankruptcy, rating action, or FTC or DOJ healthcare merger action dated in the window could be confirmed from a primary source. Frontier scan this run: non-emergency medical transportation (NEMT) brokers; no fresh 2026 deal found, and the stack note records the state-by-state broker reshuffle to verify against state Medicaid announcements.