In November 2023, the FTC and the California AG challenged John Muir Health’s proposed acquisition of San Ramon Regional Medical Center from Tenet Healthcare. Both John Muir and San Ramon Medical operate in the San Francisco Bay Area. John Muir Health is a nonprofit system that already operates two hospitals and also holds a 49 percent non-operating ownership of San Ramon Medical. The proposed transaction would give John Muir the remaining 51 percent interest in San Ramon Medical, currently owned and operated by Tenet Healthcare, a for-profit health system based in Texas. The FTC administrative complaint alleges the deal would give John Muir more than 50% of the market for inpatient general acute care (GAC) services in the region and drive up healthcare costs.

On December 15, 2023, John Muir announced it would terminate its proposed deal to acquire Tenet’s remaining interest in San Ramon Medical Center. Following this development, the FTC and California moved to dismiss their federal court case and the FTC dismissed its administrative challenge on December 18, 2023.