As merger and acquisition (M&A) activity accelerates in the post‑pandemic era, the U.S. healthcare landscape is undergoing one of the most significant restructuring periods in recent history. Large health systems are rapidly expanding their footprints, creating regional powerhouses and national networks that are reshaping how hospitals operate, compete and hire.
For healthcare employers, especially hospitals and health systems, this consolidation wave has a direct impact on staffing. As systems grow, so do their needs for qualified nurses. At the same time, they’re expected to meet higher quality standards, unify electronic health record (EHR) platforms, and expand service lines across multiple states. This has led many hospital systems to turn more aggressively to international nurse recruitment.
At VisaMadeEZ, an immigration law firm that specializes in helping healthcare organizations hire international nurses, we closely track hospital mergers, acquisitions and affiliations because they often signal upcoming demand for foreign-educated RNs. Below is an overview of 30 major health system deals and expansions that are shaping the market and what they may mean for international nurse hiring and healthcare immigration strategy.
Why Hospital Mergers Matter for International Nurse Recruitment
Before diving into specific transactions, it’s important to understand why M&A activity is so closely tied to healthcare immigration and nurse staffing:
- Larger systems = larger staffing gaps
When a system acquires multiple hospitals, it assumes responsibility for existing vacancies plus newly planned service expansions.
- Standardization of EHR and clinical protocols
Many deals include major investments in EHR transitions (e.g., Epic), quality initiatives and new service lines that require additional nursing staff.
- Expansion into new states or markets
Health systems entering new regions often face localized nursing shortages and turn to international nurses to stabilize staffing quickly and cost‑effectively.
- Increased competition for domestic nurses
As large systems grow, they compete aggressively for the same U.S. nursing talent, making international recruitment and sponsorship a strategic necessity.
Hospitals that plan ahead on immigration including EB‑3 immigrant visas, H‑1B (in limited specialty roles), TN (for eligible Canadian/Mexican nurses), and other healthcare immigration options are better positioned to staff consistently through periods of rapid growth.
1. WVU Health System’s Expansion into Pennsylvania
Morgantown, W.Va.-based WVU Health System plans to acquire Independence Health System in Greensburg, Pa., which operates five hospitals. The transaction, expected to close in fall 2026, will expand WVU Health’s footprint to 30 hospitals.
Recent acquisitions by WVU Health include:
- Weirton Medical Center (Weirton, W.Va.)
- Grant Memorial Hospital (Petersburg, W.Va.)
- Thomas Memorial Hospital (South Charleston, W.Va.)
Staffing & immigration angle:
A system growing to 30 hospitals across West Virginia and Pennsylvania will likely need a sustained pipeline of nurses, especially in rural or underserved regions. For HR and talent acquisition teams, building a structured international nurse recruitment and visa sponsorship program now can support WVU’s long‑term growth.
2. UCHealth’s Growth in Colorado
Aurora, Colo.-based UCHealth is expected to acquire *Estes Park Health, a critical access hospital, on Dec. 1. Once complete, UCHealth will become a 15‑hospital system. The Park Hospital District signed a letter of intent with UCHealth in October 2024.
Critical access hospitals in mountain and rural regions often experience severe nursing shortages. Merging with a larger system gives them new tools and often the financial capacity to invest in international nurse hiring with proper immigration support.
3. Samaritan Health and MultiCare Merger
Corvallis, Ore.-based Samaritan Health Services plans to merge with Tacoma, Wash.-based MultiCare Health System, forming an 18‑hospital system with more than 33,000 employees by mid‑2026.
This merger will bring Samaritan under the MultiCare umbrella and create a multistate network across the Pacific Northwest.
Immigration insight:
Large, multi-site employers can leverage centralized immigration policies for international nurses. VisaMadeEZ frequently works with systems like this to design unified sponsorship strategies (EB‑3, consular processing, adjustment of status where eligible) that comply with federal regulations and local state board requirements.
4. Deaconess Health System’s Growth in Kentucky
Evansville, Ind.-based Deaconess Health System acquired Jennie Stuart Health in Hopkinsville, Ky. on Oct. 1, adding its 19th hospital. Deaconess committed to invest at least $95 million, including a transition to Deaconess’ Epic EHR.
EHR transitions and new capital investments often signal upcoming service expansion and with it, nurse hiring needs. International nurses experienced in Epic or other major EHRs can be particularly valuable in these environments.
5–6. UPMC’s Strategic Moves in Ohio and Pennsylvania
UPMC (Pittsburgh) has been especially active:
- UPMC is in talks to acquire Trinity Health System in Steubenville, Ohio, a three‑hospital system currently owned by CommonSpirit. This would mark UPMC’s entry into the Ohio hospital market.
- In June 2024, Washington Health (two hospitals) joined UPMC, with UPMC committing at least $300 million over a decade. The hospitals have been rebranded as *UPMC Washington and UPMC Greene.
As UPMC continues its expansion, the system will likely need more nurses with specialized skills in oncology, cardiology, and surgical services. For large academic and teaching systems, healthcare immigration strategies often focus on long‑term retention of international nurses and clear pathways to permanent residency.
7. UnityPoint Health Adds Another Iowa Hospital
West Des Moines, Iowa-based UnityPoint Health acquired MercyOne Siouxland Medical Center in Sioux City, Iowa, on Sept. 1. Now called UnityPoint Health – St. Luke’s Downtown, this facility brings UnityPoint’s network to 37 hospitals.
Systems spanning multiple Midwestern states frequently report chronic nurse shortages. International nurses can help stabilize staffing in smaller markets where domestic recruitment has been challenging.
8. Baptist Memorial Health Care Expands in Mississippi
Memphis-based Baptist Memorial Health Care signed a definitive agreement to acquire OCH Regional Medical Center in Starkville, Miss. The transaction will increase its portfolio to 26 hospitals across Tennessee, Arkansas, and Mississippi.
For multi-state nonprofit systems like Baptist, setting up standardized immigration processes including coordination with multiple state licensing boards is key to scaling international nurse hiring efficiently.
9–10. Advocate Health, St. Luke’s and Continued Expansion in the East
- Atrium Health Wake Forest Baptist, part of Charlotte-based Advocate Health, acquired Hugh Chatham Health* in Elkin, N.C., expanding one of the country’s largest nonprofit systems.
- St. Luke’s University Health Network in Bethlehem, Pa., acquired Grand View Health in Sellersville, Pa., adding its 16th campus and strengthening its network of 21,000 employees.
Larger nonprofit health systems often view international nurse recruitment as a strategic, mission-aligned solution to care for growing communities, especially in aging populations.
11. Northwell Health and Nuvance Health Combine
In one of the year’s largest mergers, Northwell Health (New Hyde Park, N.Y.) and Nuvance Health (Danbury, Conn.) merged into a 28‑hospital system with:
- Over 1,050 ambulatory care sites
- 104,000 employees
- Approximately $23 billion in annual revenue
This scale puts the new organization among the nation’s largest healthcare employers. Such systems are ideal candidates for customized immigration frameworks to sponsor hundreds of international nurses annually while maintaining compliance and consistency.
12. Prime Healthcare’s Multi-State Expansion
Ontario, Calif.-based Prime Healthcare acquired eight Illinois hospitals from Ascension, boosting its portfolio to 51 hospitals nationwide. Prime also plans to acquire Central Maine Healthcare (three hospitals and a cancer center) by the end of 2025.
Multi-state, for-profit systems often look to international nurse recruitment as a way to remain competitive on cost while maintaining high standards of care in smaller or rural markets.
13. HCA Healthcare’s Acquisitions in New Hampshire and Florida
Nashville-based HCA Healthcare, one of the largest for-profit health systems in the U.S. with 187 hospitals, made several key moves:
- Acquired Catholic Medical Center in Manchester, N.H. (330 beds), bringing its New Hampshire hospital count to four.
- Acquired Lehigh Regional Medical Center in Florida (now HCA Florida Lehigh Hospital).
- Received approval in Indiana for a certificate of public advantage tied to a merger between Union Hospital in Terre Haute and HCA’s Terre Haute Regional Hospital.
HCA’s scale and frequent acquisitions underscore the need for structured immigration programs. Many of its hospitals rely on international nurses under EB‑3 sponsorship to maintain adequate staffing levels.
14. AdventHealth’s Florida Acquisitions
Altamonte Springs, Fla.-based AdventHealth acquired ShorePoint Health - Port Charlotte and certain assets of ShorePoint Health - Punta Gorda for $260 million.
Florida continues to be one of the most active states for international nurse deployment due to rapid population growth, heavy retiree demand and ongoing domestic nurse shortages.
15. Sanford Health and Marshfield Clinic Merge
Sanford Health (Sioux Falls, S.D.) and Marshfield Clinic Health System (Wisconsin) merged into a 56‑hospital system with around 56,000 employees and two health plans, effective Jan. 1, 2025. Sanford also completed its acquisition of Prairie Lakes Healthcare System in Watertown, S.D.
Upper Midwest systems often rely heavily on foreign-educated nurses to staff rural hospitals and regional medical centers. Immigration planning is crucial to ensure continuity of care across large geographic regions.
16. OhioHealth’s Steady Growth
Columbus-based OhioHealth plans to acquire Fairfield Medical Center in Lancaster, Ohio, which will be its 17th acute-care hospital. In January, it acquired Morrow County Hospital, and over the past three years, it has:
- Acquired Van Wert Hospital
- Acquired Southeastern Medical Center (Cambridge, Ohio)
- Opened Pickerington Methodist Hospital
OhioHealth’s gradual but steady expansion shows how regional systems can quietly become major employers. Targeted international nurse recruitment can help fill persistent gaps in smaller communities.
17. Prisma Health Steps into Tennessee
Greenville, S.C.-based Prisma Health acquired Blount Memorial Hospital in Maryville, Tenn., a 304‑bed nonprofit hospital. This is Prisma’s only hospital outside South Carolina.
Operating in multiple states triggers new licensing and regulatory considerations for internationally trained nurses. A knowledgeable immigration law firm can help HR teams align visa processes with new state requirements.
18. Risant Health’s National Ambitions
Risant Health, a nonprofit created by Kaiser Permanente, acquired Geisinger (Danville, Pa.) and Cone Health (Greensboro, N.C.). Risant plans to acquire three to four more health systems, aiming for up to $35 billion in annual revenue within five years.
A national platform like Risant offers unique opportunities for system-wide international nurse intake programs, centralized credentialing and standardized immigration compliance.
19. UAB Health Expands with Ascension St. Vincent’s
The University of Alabama System acquired Ascension St. Vincent’s Health System (five hospitals) for $450 million. This brings the number of hospitals in the UAB Health network to 17.
Teaching and academic health systems are particularly attractive for many international nurses seeking training, specialty exposure and long-term career growth in the U.S.
20. Christus Health Adds Wadley Regional Medical Center
Irving, Texas-based Christus Health, which has more than 60 hospitals, acquired Wadley Regional Medical Center in Texarkana, Texas.
Texas remains one of the most active states in international nurse recruitment, with many systems regularly sponsoring foreign-educated nurses to keep pace with rapid population growth.
21. OSF HealthCare’s Acquisition in Illinois
Peoria, Ill.-based OSF HealthCare acquired Katherine Shaw Bethea Hospital, an 80‑bed facility in Dixon, Ill., in September 2024.
For smaller community hospitals joining larger systems, access to the parent system’s recruitment and immigration infrastructure can make it easier to bring in international RNs to stabilize staffing.
22. Orlando Health’s Major Expansion in Alabama and Florida
Orlando-based Orlando Health made several large moves:
- Acquired Tenet’s 70% majority interest in Brookwood Baptist Health in Alabama for about $910 million, adding:
- Brookwood Baptist Medical Center (Birmingham)
- Princeton Baptist Medical Center (Birmingham)
- Walker Baptist Medical Center (Jasper)
- Shelby Baptist Medical Center (Alabaster)
- Citizens Baptist Medical Center (Talladega)
- Acquired three Steward Health Care hospitals in Florida in a $439 million deal:
- Rockledge Regional Medical Center
- Melbourne Regional Medical Center
- Sebastian River Medical Center
- Plus certain Steward Medical Group practices
This rapid multi-state expansion is precisely the kind of environment where proactive international nurse recruitment supported by a specialized immigration law firm can prevent major staffing disruptions.
23. Mercy Adds Kansas Hospital from Ascension
St. Louis-based Mercy acquired Ascension Via Christi Hospital in Pittsburg, Kan., and now operates three hospitals in Kansas as part of its 50-hospital system.
Midwestern systems like Mercy often benefit from sponsoring international nurses for EB‑3 green cards to ensure long-term, stable staffing.
24. Jefferson Health and Lehigh Valley Health Network Merge
Jefferson Health (Philadelphia) and Lehigh Valley Health Network (Allentown, Pa.) merged in August 2024, creating a 32‑hospital system with 700+ care sites. The combined entity is now among the 15 largest nonprofit health systems in the U.S.
With this scale, building a coordinated immigration and international nurse hiring strategy can significantly impact clinical quality, cost control, and workforce stability.
25. UCSF Health Acquires Two San Francisco Hospitals
UCSF Health acquired Saint Francis Memorial Hospital and St. Mary’s Medical Center from Dignity Health in August 2024. The $100 million acquisition included:
- Rebranding to UCSF Health Saint Francis and UCSF Health St. Mary’s
- Shedding religious affiliation
- UCSF’s commitment to invest another $100 million over two years for integration
San Francisco faces some of the highest costs of living and intense competition for nurses. International recruitment is often a necessary piece of a broader workforce strategy.
26. Henry Ford Health and Ascension Michigan Joint Venture
Detroit-based Henry Ford Health and Ascension Michigan created a joint venture that essentially brought Ascension’s southeast Michigan sites under the Henry Ford Health brand. The JV includes:
- ~50,000 employees
- 550+ care sites
- Ten major hospitals, including former Ascension facilities like:
- Ascension St. John Hospital
- Ascension Genesys Hospital
- Ascension Macomb-Oakland Hospital (Warren, Madison Heights)
- Ascension Providence Hospital (Novi, Southfield)
- Ascension Providence Rochester Hospital
- Ascension River District Hospital
Integrating these sites under one brand will likely bring systemwide staffing initiatives. Structured international nurse sponsorship could help the joint venture standardize staffing and reduce reliance on contract labor.
27. MyMichigan Health Acquires Three Ascension Hospitals
MyMichigan Health acquired three Michigan hospitals and related Ascension assets in August:
- Ascension St. Mary’s (Saginaw)
- Ascension St. Mary’s (Standish)
- Ascension St. Joseph (Tawas City)
MyMichigan also acquired associated Ascension Medical Group practices. For regional systems like MyMichigan, international nurses can be vital in maintaining services in smaller communities where recruitment is difficult.
28. UCI Health’s $975 Million Deal with Tenet
Orange, Calif.-based UCI Health acquired four hospitals from Tenet’s Pacific Coast Network for $975 million:
- Fountain Valley Regional Hospital
- Lakewood Regional Medical Center
- Los Alamitos Medical Center
- Placentia-Linda Hospital
These acquisitions dramatically expand UCI Health’s presence in Southern California, an area with intense nurse demand and a high cost of living a combination that makes international nurse recruitment especially important.
29. Adventist Health Adds Two California Hospitals
Roseville, Calif.-based Adventist Health spent about $550 million to acquire:
- Sierra Vista Regional Medical Center (San Luis Obispo)
- Twin Cities Community Hospital (Templeton)
The hospitals were rebranded as Adventist Health Sierra Vista and Adventist Health Twin Cities. As Adventist expands along the California coast, staffing these facilities will require creative recruitment including foreign-educated nurses.
30. Novant Health’s $2.4 Billion Acquisition from Tenet
Winston-Salem, N.C.-based Novant Health spent $2.4 billion to acquire three hospitals from Tenet in early 2024:
- East Cooper Medical Center (Mount Pleasant, S.C.)
- Hilton Head Hospital (Hilton Head Island, S.C.)
- Coastal Carolina Hospital (Hardeeville, S.C.)
South Carolina’s growing coastal communities are popular retirement and tourism destinations, driving increased healthcare demand. International nurses can help meet this demand while maintaining quality and continuity of care.
What These Deals Mean for Healthcare Employers and International Nurses
Across these 30 transactions, several themes emerge:
- Consolidation is accelerating, with nonprofit, academic and for-profit systems all expanding.
- Staffing needs are growing faster than the domestic nurse supply, especially in rural and high-growth regions.
- International nurses are a critical part of the solution, particularly through EB‑3 immigrant visas and related healthcare immigration pathways.
- Health systems that plan their immigration strategy early before or during integration are better positioned to keep units fully staffed and avoid costly burnout.
Turn Today’s Hospital Mergers into a Strategic International Nurse Pipeline
If your health system is growing through mergers and acquisitions, now is the time to build a reliable, compliant international nurse recruitment strategy.
VisaMadeEZ is an immigration law firm dedicated to helping hospitals and healthcare organizations hire and sponsor international nurses efficiently and with confidence.
Schedule a Free Strategy Call with a Healthcare Immigration Attorney
We’ll review your current growth plans, staffing needs, and walk you through EB‑3 and other visa options tailored to multi-hospital systems.
Contact Us to Get Started
