Who owns Texas’s freestanding emergency rooms?

The same address can outlast the company

St. David’s acquired six existing Austin Emergency Center locations from ZT Corporate’s Altus portfolio on February 1, 2026. The sites kept operating as emergency departments under new names, integrated with St. David’s hospitals. The acquisition expanded St. David’s Central Texas freestanding ER network to 13. HCA participates in the St. David’s partnership, alongside St. David’s Foundation and Georgetown Health Foundation. St. David’s acquisition announcement · Medical City Healthcare

Altus, a ZT Health company, advertised 27 ERs and microhospitals across its network. Seventeen of those addresses matched freestanding ERs with their own licenses, four matched ERs reporting under a hospital license and five matched hospital addresses. One hospital address was unresolved. Great Hill Partners acquired a majority stake in Intuitive Health from Altamont in 2024. Its announcement’s 33 facilities were a national network count. Altus location directory · Great Hill investment announcement

Comparing two state license files shows how easily a change of hands can look like a closure. Of 54 licenses from a July 2024 snapshot that were absent from the October 2026 directory, 33 addresses had another freestanding ER license. Eighteen still appeared as ERs under a hospital license, one as a hospital, and two could not be matched to a current state entry. The dates describe the snapshots. They give no date of closure for either unmatched address. Historical HHSC-derived location layer · HHSC license directory

A bankruptcy filing counts companies, not closed ERs

Adeptus’s 2017 Chapter 11 disclosure described 71 Texas sites across its independent operations and hospital partnerships. When the plan took effect that October, the old public equity was canceled and lenders and Deerfield interests received new equity. In 2019, Pipeline and Adeptus announced that 22 existing Dallas–Fort Worth addresses would become City Hospital Emergency Care outpatient departments. Adeptus later entered Chapter 7. Those court records track the company’s finances. To find out what happened to an ER, follow the address into the next license or hospital roster. Adeptus disclosure statement · Adeptus confirmation filing · Pipeline transaction announcement · Bankruptcy court calendar

What the listed charges show

For the facility component of a level-four emergency visit, the five sampled schedules range from $1,409 to $3,240. One freestanding ER’s posted charge is below Methodist Dallas’s gross charge. The other freestanding ER’s charge is above both hospital-campus schedules. All figures below are rounded to whole dollars. Full Spectrum schedule · Texas Health hospital charge files

A discounted cash schedule can change the order. For code 99284, Texas Health Dallas listed a cash charge of about $845 and Methodist Dallas about $775. The hospital with the higher gross charge had the lower cash price. The research could compare posted facility charges across settings. It could only compare verified cash prices at the two hospitals.

TDI reported roughly 811,000 mediation requests involving freestanding ERs, or 73% of the facility requests in its 2020 to October 7, 2025 figures. These are filings in billing disputes, which can involve multiple claims. If you receive an out-of-network emergency bill, check the plan’s explanation of benefits and the federal and Texas surprise-billing rules for your coverage. TDI dispute-resolution report · CMS surprise-billing guidance

How we got this

The location count uses the November 5, 2026 DSHS reporting list, matched to the October 21 HHSC license directory and hospital records. Neither list identifies every ultimate owner. Prices are selected posted charges, excluding clinician charges billed on their own. They are a sample of five schedules, with the Full Spectrum schedule covering two sites, and do not predict a patient’s bill.