Ardent Health, a Tennessee-based hospital operator, announced Thursday it has reached an agreement to acquire Boone Health for $47 million in cash. It plans to spend $200 million running Boone Health over the next ten years.
The deal includes the 392-bed Boone Hospital Center, Boone Health Medical Group, 19 other sites of care, ancillary services and associated real estate. The transaction is expected to close in the first quarter of 2027.
A publicly traded company controlled by a private investment firm
Ardent is a publicly traded, for-profit hospital operator whose shares trade on the New York Stock Exchange under the symbol ARDT.
But Equity Group Investments, a private investment firm founded by the late Chicago businessman Sam Zell (once known as “the grave dancer” for his propensity to buy distressed companies and cut staff), controls about 54% of the company, according to Ardent's 2025 annual report. Zell is perhaps best known for his tumultuous acquisition of the Tribune Company and its media holdings, such as the Chicago Tribune, Los Angeles Times, and Orlando Sentinel (the latter of which where Zell profanely chastised a photographer for a question about how his ownership might change the newspaper’s coverage).
Ardent is not itself a private equity firm but it is a private equity-affiliated health system because of its ownership structure.
When asked by KBIA about concerns surrounding private investment ownership of hospitals, Ardent Chief Medical Officer F.J. Campbell said Ardent does not plan to cut services or staff at Boone Health.
“The benefit, in some ways, of working with a private equity company is that we have access to more resources and capital,” Campbell said. “The way Boone takes care of patients will not change. And the way Boone is paid for the care it provides isn't going to change either. The reimbursement experience doesn't change because you work for a private equity company.”
Built through acquisitions and partnerships
The company has since grown through acquisitions and partnerships. It now operates 30 acute-care hospitals and more than 280 sites of care across six states employing around 2000 employees. Eighteen of its hospitals operate through joint ventures with other organizations. However, the partnership structure between Boone Health and Ardent Health is unknown at this point.
Financial scrutiny and an investor lawsuit
Ardent reported $1.62 billion in revenue during the second quarter of 2026.
The company is also facing a class-action lawsuit from one of its investors following financial disclosures made in late 2025.
Ardent announced a $43 million reduction in third-quarter revenue after reassessing how much money it expected to collect from insurers. It also increased its professional liability reserves by $54 million.
Ardent investor Dhruv Postiwala alleges Ardent and some executives made misleading statements about the company’s finances, insurance reserves, revenue collection and quality of care.
Plaintiffs also allege the company failed to disclose safety and quality problems at some hospitals that they say resulted in patient injuries and deaths.
The allegations have not been established in court. The case is an investor lawsuit, not a malpractice case filed by patients or their families. Ardent denies wrongdoing and is seeking dismissal of the case.
Quality of care
Ardent's 2025 annual report said 88% of its graded hospitals received an A or B from Leapfrog's Hospital Safety Grade program, a free, public rating system that assigns an A-F letter grade to general U.S. hospitals. Nationally, 58% receive an A or a B. Nine Ardent hospitals also received Leapfrog's Top Hospital designation.
The Lown Institute, a health care research organization, included Ardent in a 2024 comparison of seven hospital systems with current or recent private equity ownership.
Ardent received a B in overall social responsibility, equity and patient outcomes, and a C for value of care. The comparison was not a comprehensive ranking of all private equity-affiliated hospital systems, and system-level grades can mask differences among individual hospitals.
Boone Health announced that Ardent will continue Boone’s existing charity care policy. Ardent's 2025 community impact information shows its facilities provided $214.3 million in uncompensated care, including charity care, uninsured discounts, other uncompensated care and charitable contributions.
Ardent and Boone Health will continue to operate separately until the transaction closes. The organizations’ leaders said there will be no immediate changes to patient care, employee roles or day-to-day operations.
