Sometimes it seems that patient investors, rather than hospital patients, are the main thing keeping Health Management Associates ( HMA) off the critical list. Just take a look at the company's stock chart. After a stellar performance throughout most of the 1990s, the shares have bumped along and wound up essentially unchanged around the $20 mark over the past five years. Certainly, the stock has fared better than industry laggard Tenet ( THC) and the much larger HCA ( HCA). However, after a series of high-priced acquisitions in a tough industry environment, the company hardly ranks as the standout investment that it once did. Sheryl Skolnick, senior vice president of CRT Capital Group, cannot fathom why investors continue to hang on. "We view HMA as a classic consolidation play that hit a brick wall and can no longer acquire its way out of its problems," Skolnick wrote last month, when reiterating her sell recommendation on HMA after a profit warning from the company. "In our more than 18 years of research experience, we have seen this sad story often enough. But never have we seen such a loyal investor base clinging to its belief in the quality of HMA's assets and the legend of what HMA once was." For years, HMA managed to thrive -- and post industry-leading margins -- by gobbling up distressed hospitals that monopolize rural markets and turning the facilities around. More recently, however, the company has started paying higher and higher prices for hospitals in real cities such as Orlando, Fla., Jackson, Miss., and its home base of Naples, Fla. Indeed, Skolnick estimates, the company paid a whopping $1.5 million per bed -- nearly three times more than it did for its second-most expensive acquisition -- for its latest hospital and the 400 doctors who came with it.