Hartford Business Journal

8 HARTFORDBUSINESS.COM | DECEMBER 15, 2025 DE AL WATCH | BUYERS & SELLERS Hartford HealthCare's bid for Prospect Medical hospitals could further consolidate CT's ambulance industry By David Krechevsky davidk@hartfordbusiness.com H artford HealthCare's bid to acquire two Prospect Medical Holdings hospitals doesn't just involve beds and emergency rooms — it could also expand the health system's footprint in Connecticut's emergency medical transport network. If regulators approve HHC's bid to purchase Manchester Memorial and Rockville General hospitals, the deal would also give HHC full ownership of two additional ambulance providers, Aetna Ambulance Service Inc. and Ambu- lance Service of Manchester LLC (AMS). That would double the number of ground ambulance companies HHC controls and potentially give the system one-third of all privately owned or hospital-controlled ambulance services in the state. HHC and Prospect each currently own 50% stakes in both ambulance companies. Approval, according to the state, would transfer Prospect's shares to Hartford HealthCare, joining American Ambulance Service Inc. and Hunter's Ambulance Service in HHC's portfolio. (The system also owns the Life Star critical care helicopter service.) Of the 18 ground ambulance services licensed in Connecticut, 12 are owned by hospitals or held privately. If the Prospect hospital deal goes through, HHC would control one-third of those 12 ambulance providers — prompting at least one observer to question whether the state's second- largest health system could end up controlling too much of the market. Approval not required While the hospital purchase faces regulatory review and public scru- tiny, the ambulance consolidation is drawing far less attention. The Office of Health Strategy, which will rule on HHC's bid for the two hospitals, said ambulance ownership transfers are not subject to its review. Separately, the state Department of Public Health regulates ambu- lance licensing in Connecticut, but its approval isn't required for the Prospect deal because the license holders would remain the same. DPH reviews changes to the license itself, not changes in corporate ownership, according to an agency spokesperson. Hartford HealthCare declined to comment for this story, citing a nondis- closure agreement with Prospect and ongoing discussions with state regulators. Consolidation Bob Holdsworth, founder of EMS consulting firm The Holdsworth Group in Old Saybrook, said ambulance consol- idation has accelerated in recent years. Last month, Yale New Haven Health completed its acquisition of Nelson Ambulance and its affiliates — Access Ambulance Service, Connecticut Handivan and The Limo Group. Yale New Haven also owns ambulance services that cover Lawrence + Memo- rial Hospital in New London. That deal leaves just two inde- pendently owned private ambulance providers in Connecticut: Empress EMS of New York, which serves Litchfield County, and American Medical Response. Meantime, Hartford HealthCare Hartford HealthCare and Prospect Medical Holdings currently each own 50% stakes in Aetna Ambulance Service Inc. HBJ Photo | David Krechevsky acquired Hunter's in 2021 and American Ambulance Services in Norwich in 2023. "For years, the hospitals did not want any part of the ambulance business," Holdsworth said. "They wanted to be independent from it, because there were concerns about Medicare self-re- ferrals and those kinds of things." Now, hospitals want ambulances because "they need to move patients," he said. Limited staffed beds mean hospitals have to discharge patients to make room for new ones, but private ambulance oper- ators typically prioritize 911 calls. That can clog emergency departments when hospitals are unable to move patients to rehab or other facilities due to a shortage of available ambulances, he said. Owning ambulance services allows hospitals to control both 911 coverage and non-emergency transport, Hold- sworth said. He added that ambulances are not a "cash cow," because non-emer- gency trips are generally reimbursed at discounted Medicare and Medicaid rates. "I don't think any of the hospitals are looking at it as a significant revenue stream," Holdsworth said. Too big? Holdsworth noted that when ambu- lance services change ownership, state law requires the new owner to continue serving the same communities. Ambu- lances cover primary service areas (PSAs), where a provider is designated as a community's primary responder. But consolidation could eventually shrink choices if a new owner seeks to exit certain PSAs, he warned. "So the real risk with this for the municipalities going forward is lack of choice," he said. Another concern is a single provider controlling too large a region. That issue surfaced in the late 1990s, when the state sued American Medical Response after it grew significantly. In 1999, then-Attorney General Richard Blumenthal sued AMR, claiming it controlled too vast an area of the state. The case was ultimately settled, with AMR required to divest 30 ambu- lance licenses and sell 20 ambulances at fair market value to competitors. AMR also agreed not to oppose any ambulance licensing applications filed by competitors for three years and paid $100,000 in attorneys' fees and costs. State Attorney General William Tong's office did not respond to a request for comment on HHC potentially acquiring full shares of Aetna and AMS. Niagara Bottling leases Enfield warehouse to support Bloomfield plant 35 Manning Road, Enfield. Photo | CoStar WEST HARTFORD A developer is seeking approval to build six two-story buildings with 54 residential units on a vacant site in West Hartford. Avon-based Honeycomb Real Estate Partners has proposed a 54-unit "Madsen Acres" develop- ment at 230 Newington Road, with 38 one-bedroom and 16 two-bed- room units to be marketed for sale. Honeycomb submitted the application under the state's 8-30g affordable housing law, which allows developers to bypass local zoning in communities with less than 10% affordable housing, provided 30% of units remain affordable. BRISTOL An investor group recently paid $3 million for three mixed-use apartment buildings in downtown Bristol. A firm led by Ascher Berkowitz of Toms River, N.J., sold 411 and 425 North Main St. to Bristol Property Group LLC. The buyer's principals include Peter Sirois and Ronald Mairano of Simsbury; Alex Ilchenko of West Hartford; Jean Cho of Peekskill, N.Y.; Mohammed Shams of Union- ville; and Kershwin Singh of Avon. The 1913 brick buildings sit on nearly 1 acre, totaling 26,300 square feet, with 14 two-bedroom apartments, 12 one-bedroom units and six ground-floor retail spaces. They last sold in 2022 for $2.91 million. CHESHIRE A 25-lot residential subdivision has been proposed for the former site of a more than 250-year-old Cheshire fruit farm that closed earlier this year. The 42.3-acre property at the corner of Academy and Wiese roads was formerly the site of Norton Brothers Fruit Farm, which closed in May after 268 years of operation. The property owners — Norton Brothers Fruit Farm LLC and Norton Family Partnership — along with Birdsey Development LLC are seeking a permit to subdivide the land into 25 single-family home lots. C alifornia-based Niagara Bottling has leased 164,725 square feet of warehouse space in Enfield to support its Bloomfield bottling operation. The water bottler signed the short- term lease in November for space at 35 Manning Road, with occupancy beginning Jan. 1. The 235,880-square-foot facility will serve as an outside warehouse for the company's 432,000-square-foot Bloom- field plant, which opened in 2016 and employs about 120 people. Niagara Bottling, which operates bottling and distribution facilities across the U.S. and Mexico, produces bottled water and other beverages for major retailers under both its own and private- label brands. The company opened its Bloomfield plant to meet growing demand in the Northeast, investing more than $115 million in construction and three produc- tion lines for purified drinking water.

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