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Fonteum Data GlossaryRegulatory

What is a nursing-home change of ownership?

A change of ownership (CHOW) is a transaction in which a Medicare-enrolled provider is purchased, leased, merged, or otherwise changes ownership or control. Under specified conditions, the provider agreement can be assigned to the new owner; the transaction itself does not describe care quality or a regulatory finding.

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Full name: Medicare Provider Change of Ownership (CHOW)

Short explanation

In Medicare enrollment, a change of ownership (CHOW) is a transaction that changes the ownership or control of a participating provider, such as a purchase, lease, acquisition, or consolidation. The relevant rules determine when a provider agreement is assigned to a new owner and what reporting follows. CMS publishes SNF ownership and transaction data so that ownership relationships can be examined with their source date and stated limitations. A CHOW record is not, by itself, a judgment about a facility's care or compliance.

Related data: SNF ownership data

Last updated: 2026-07-11Reviewed by: Dr. Jennifer Montecillo, MDGullas College of Medicine, 2019. Non-practicing medical reviewer.

How it’s used

  • CMS SNF Change of Ownership data: transaction and ownership context can be used to distinguish a reported ownership change from a facility-quality measure or enforcement record.
  • Fonteum ownership data: ownership facts are shown with their public source, date, and limitations so a transaction can be evaluated in context.

Frequently asked questions

What is a CHOW in Medicare?
CHOW means change of ownership. It describes a transaction that changes the ownership or control of a Medicare-enrolled provider and may affect assignment of its provider agreement.
Does a CHOW change a nursing home's CCN?
CMS rules determine how the provider agreement and identifying records are handled in a particular transaction. A CHOW record should be read with the source's stated transaction and reporting details.
Does a change of ownership show a quality problem?
No. An ownership transaction is not itself a measure of care quality, a survey finding, or an enforcement action.

Explore in Fonteum

How Fonteum sources, resolves, and publishes data tied to this term.

What’s on file, by the numbers

Platform snapshot · 2026-08-30

13.4Mproviders & companiesProviders, organizations, owners, and facilities on file
26.2Msource-linked factsSource-linked field facts in the dated platform snapshot
90sources with dataDistinct snapshot source IDs with at least one positive record count
16fresh sourcesDistinct source IDs whose latest positive-data snapshot falls within the preceding 45 days
111sources integratedActive registry rows; integration does not establish a load
13state Medicaid jurisdictionsDistinct states represented in the state-exclusions serving table

Integrated, with-data, and fresh-observation counts are separate. No platform-wide source-completeness count is published. Completeness is source-specific and must be evaluated against the named source's expected scope. State coverage is a separate jurisdiction measure.

Source authority is record-specific

Use the issuer named on the record.

Fonteum spans federal, state, and global public publishers. A source page or returned record identifies its issuer and dataset where that metadata is available. A platform registry count does not assign every page to one authority or establish loaded, fresh, or complete coverage.

Browse source records and their stated limitations →

Reproducible by design

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Source and date

Research pages expose the named public file and observation date where those fields are available. Source-file SHA-256 coverage is separate; facts do not currently link deterministically to signatures.

Available derivation

Studies with a retained release and committed derivation link the SQL or method used. Other studies state the evidence and reproduction limits they actually have.

Daily observations

Dated table row-count observations can detect local drift. They do not imply that an upstream publisher released or Fonteum ingested new data that day.

Named medical review

Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

Read the full provenance and attestation methodology →

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