The addition of 70-plus hospitals gave the investor-owned company a tally of 206 across 29 states, making it bigger for the first time, at least by hospital count, than its up-the-road rival HCA Holdings.
And CEO Wayne Smith vowed to put the company's efficient management to work to turn around the HMA facilities whose doctors had fled and where operations were neglected as HMA management unsuccessfully fought to hold onto power against activist investor Glenview Capital Management.
The reverse has happened. Those HMA hospitals, still struggling and yet to be fully integrated, have plunged CHS into crisis.
Last week, the company confirmed that it has retained Wall Street advisers to perform a strategic review that could lead to the chain's sale or it selling off its 159 hospitals in big blocks.
Private equity group Apollo Capital Partners is rumored to be interested in some or all of CHS. The group entered the hospital business last year by purchasing RegionalCare Hospital Partners, which grew to 18 hospitals through the merger this year with Capella Healthcare to create RCCH HealthCare Partners.
CHS, which is based in the Nashville suburb of Franklin, doesn't have much choice but to consider breaking up its assets, said Larry Prybil, a University of Kentucky professor who has authored books on healthcare governance. “They're stuck,” Prybil said flatly.