At California-based Prime Healthcare, Mike Sarian was in charge of scouting nationwide for hospitals in or near bankruptcy to buy and revive. When he started in 2012, he oversaw 12 hospitals. By the time he left in 2020, his portfolio had grown to 46. He started his own company, American Healthcare Systems, and set out to replicate the Prime playbook. Sarian’s first move was buying Asheboro’s only hospital, Randolph Health, which was bankrupt.