Providence St. Joseph Health, which runs 14 hospitals in Southern California, is in talks to merge with Ascension Health to create the nation’s largest hospital chain, according to the Wall Street Journal.

The news outlet reported Sunday that talks between the Providence, based in Renton, Wash., and Ascension, headquartered in St. Louis, Mo., have been going on for months – but that a merger is far from assured. Financial terms of the potential deal were unclear, it said.

A marriage between the two Roman Catholic hospital chains would create a coast-to-coast nonprofit entity of 191 hospitals in 27 states with combined annual revenue of $44.8 billion, the Journal reported.

If successful, the merged entity would unseat HCA Healthcare Inc. – which owns 177 hospitals and reported revenue of $41.5 billion last year – as the nation’s largest hospital operator.

A spokeswoman for Providence St. Joseph Health did not immediately respond to a request for comment.

Providence St. Joseph Health, which is the result of a merger between Providence Health & Services and St. Joseph Health, now operates 50 hospitals in seven western states.

Ascension Health, now the nation’s largest Catholic system, operates in 22 states and the District of Columbia.

On Thursday, San Francisco-based Dignity Health, which operates six hospitals in Southern California, announced a merger agreement with Catholic Health Initiatives, based in Colorado. The combined entity would include 139 hospitals and total revenue of $28.4 billion.

This past fall, Providence St. Joseph Health consolidated operations in Southern California, with 14 hospitals across the region run by leadership based in Los Angeles.

Health business reporter Dana Bartholomew can be reached at [email protected]. Follow him on Twitter @_DanaBart.