{
  "schemaVersion": 3,
  "entityId": "050784",
  "canonicalName": "ADVENTIST HEALTH TULARE",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "ADVENTIST HEALTH TULARE appears in the source tracker as a venture-backed investment signal. This dossier does not classify that signal as completed private-equity ownership.",
  "lastReviewed": "2026-06-22",
  "review": {
    "reviewer": "Automated CMS/PESP reconciliation with editorial publication gate",
    "evidence_grade": "government-corroborated",
    "confidence": "medium",
    "source_count": 6,
    "ownership_source_count": 2,
    "identity_match_method": "CCN exact match",
    "publication_decision": "Meets the Phase 3 publication standard for its displayed status"
  },
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    "npi": "1801366711",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "ADVENTIST HEALTH TULARE",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
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      "relationship_id": "rel-reportedowner-050784",
      "from_entity_id": "reported owner",
      "to_entity_id": "050784",
      "relationship_type": "venture_backing",
      "effective_date": "",
      "end_date": "",
      "announcement_date": "",
      "status": "signal",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners|source-pesp-hospital-tracker",
      "plain_english_summary": "undefined is reported as an investment backer; this is not treated as a completed ownership claim.",
      "review_notes": "CMS corroborates the current enrolled ownership chain; the sponsor attribution comes from the research tracker."
    }
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  "acquisitionEvents": [],
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      "unit": "USD",
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      "better_when": "context_dependent",
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      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "BRADFORD NEWTON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "08/16/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROBERT CHERRY",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/05/2017",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "LARRY INNOCENT",
      "role": "CORPORATE DIRECTOR",
      "association_date": "09/19/2011",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ADVENTIST HEALTH SYSTEM/WEST",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "03/15/2019",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [],
  "actions": [],
  "contradictions": [],
  "limitations": [
    "CMS corroborates an enrolled ownership chain, but its owner names do not independently reproduce every sponsor or portfolio-company name from the tracker.",
    "The investment signal does not establish completed private-equity ownership or a pending sale."
  ],
  "unavailableFields": [
    "Precise acquisition date",
    "Official facility URL"
  ],
  "sources": [
    {
      "source_id": "source-hifld-hospitals",
      "title": "Hospitals RAPT",
      "publisher": "Homeland Infrastructure Foundation-Level Data",
      "publication_date": "current public layer",
      "retrieved_at": "2026-06-22",
      "url": "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
      "reliability_tier": "government",
      "research_note": "Used for facility location and basic identity context; it does not establish private-equity ownership.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-pesp-hospital-tracker",
      "title": "Private Equity Hospital Tracker",
      "publisher": "Private Equity Stakeholder Project",
      "publication_date": "2026-04-03 snapshot",
      "retrieved_at": "2026-06-22",
      "url": "https://pestakeholder.org/private-equity-hospital-tracker/",
      "reliability_tier": "research",
      "research_note": "Discovery and ownership-chain baseline. A red public status also requires independent corroboration in this dossier.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-enrollments",
      "title": "Hospital Enrollments",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026-05-01",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "reliability_tier": "government",
      "research_note": "Used to corroborate current enrollment identity, legal name, DBA, CCN, NPI, and location.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-all-owners",
      "title": "Hospital All Owners",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026-05-01",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "reliability_tier": "government",
      "research_note": "Used to corroborate direct or indirect ownership, control, holding-company, investment-firm, and security-interest records.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hcris",
      "title": "Hospital Provider Cost Reports",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2015–2024",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
      "reliability_tier": "government",
      "research_note": "Financial, staffing, and utilization values. These descriptive measures do not establish causation.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-care-compare",
      "title": "Hospital General Information",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "reliability_tier": "government",
      "research_note": "Used for current facility identity, hospital type, ownership category, and overall rating when available.",
      "source_type": "public_record"
    }
  ],
  "ownershipChain": {
    "model": "Sponsor, operator, CMS legal-owner/control records, and facility are shown as separate evidence layers.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "facility:050784",
        "label": "ADVENTIST HEALTH TULARE",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:adventist-health-system-west",
        "label": "ADVENTIST HEALTH SYSTEM/WEST",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:jason-wells:0",
        "label": "JASON WELLS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:jason-wells:1",
        "label": "JASON WELLS",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:kerry-heinrich:2",
        "label": "KERRY HEINRICH",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:john-cress:3",
        "label": "JOHN CRESS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:meredith-jobe:4",
        "label": "MEREDITH JOBE",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:eric-stevens:5",
        "label": "ERIC STEVENS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:heidar-thordarson:6",
        "label": "HEIDAR THORDARSON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:richard-reiner:7",
        "label": "RICHARD REINER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:joy-fehr:8",
        "label": "JOY FEHR",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:jonathan-daggett:9",
        "label": "JONATHAN DAGGETT",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:andrew-davis:10",
        "label": "ANDREW DAVIS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:ann-beckett:11",
        "label": "ANN BECKETT",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:marc-woodson:12",
        "label": "MARC WOODSON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:john-freedman:13",
        "label": "JOHN FREEDMAN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:jack-wagner:14",
        "label": "JACK WAGNER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:kenneth-jutzy:15",
        "label": "KENNETH JUTZY",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      }
    ],
    "edges": [
      {
        "id": "organization:adventist-health-system-west->facility:050784",
        "from": "organization:adventist-health-system-west",
        "to": "facility:050784",
        "relationship": "reported ownership or operating chain",
        "confidence": "medium",
        "sourceIds": [
          "source-cms-hospital-all-owners",
          "source-pesp-hospital-tracker"
        ],
        "note": "The platform attribution comes from the research tracker and is displayed separately from CMS legal-owner rows."
      },
      {
        "id": "cms-owner:jason-wells:0->facility:050784",
        "from": "cms-owner:jason-wells:0",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/01/2024"
      },
      {
        "id": "cms-owner:jason-wells:1->facility:050784",
        "from": "cms-owner:jason-wells:1",
        "to": "facility:050784",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 01/01/2024"
      },
      {
        "id": "cms-owner:kerry-heinrich:2->facility:050784",
        "from": "cms-owner:kerry-heinrich:2",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 0% reported ownership · associated 12/15/2014"
      },
      {
        "id": "cms-owner:john-cress:3->facility:050784",
        "from": "cms-owner:john-cress:3",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2024"
      },
      {
        "id": "cms-owner:meredith-jobe:4->facility:050784",
        "from": "cms-owner:meredith-jobe:4",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 0% reported ownership · associated 03/31/2014"
      },
      {
        "id": "cms-owner:eric-stevens:5->facility:050784",
        "from": "cms-owner:eric-stevens:5",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 03/05/2025"
      },
      {
        "id": "cms-owner:heidar-thordarson:6->facility:050784",
        "from": "cms-owner:heidar-thordarson:6",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/06/2025"
      },
      {
        "id": "cms-owner:richard-reiner:7->facility:050784",
        "from": "cms-owner:richard-reiner:7",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 0% reported ownership · associated 01/16/2017"
      },
      {
        "id": "cms-owner:joy-fehr:8->facility:050784",
        "from": "cms-owner:joy-fehr:8",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2020"
      },
      {
        "id": "cms-owner:jonathan-daggett:9->facility:050784",
        "from": "cms-owner:jonathan-daggett:9",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      },
      {
        "id": "cms-owner:andrew-davis:10->facility:050784",
        "from": "cms-owner:andrew-davis:10",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/05/2017"
      },
      {
        "id": "cms-owner:ann-beckett:11->facility:050784",
        "from": "cms-owner:ann-beckett:11",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      },
      {
        "id": "cms-owner:marc-woodson:12->facility:050784",
        "from": "cms-owner:marc-woodson:12",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 0% reported ownership · associated 01/01/2019"
      },
      {
        "id": "cms-owner:john-freedman:13->facility:050784",
        "from": "cms-owner:john-freedman:13",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 0% reported ownership · associated 09/26/2016"
      },
      {
        "id": "cms-owner:jack-wagner:14->facility:050784",
        "from": "cms-owner:jack-wagner:14",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 12/01/2022"
      },
      {
        "id": "cms-owner:kenneth-jutzy:15->facility:050784",
        "from": "cms-owner:kenneth-jutzy:15",
        "to": "facility:050784",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      }
    ],
    "caveats": [
      "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor."
    ]
  },
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 33863588,
      "latestValue": 59163519,
      "absoluteChange": 25299931,
      "percentChange": 74.71131233937763,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 81878368,
      "latestValue": 92350430,
      "absoluteChange": 10472062,
      "percentChange": 12.789778614053471,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": -46515232,
      "latestValue": -25376100,
      "absoluteChange": 21139132,
      "percentChange": 45.445612310393294,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2832970,
      "latestValue": 9752130,
      "absoluteChange": 6919160,
      "percentChange": 244.236966858103,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 59120373,
      "latestValue": 130782439,
      "absoluteChange": 71662066,
      "percentChange": 121.21382590059098,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 444801,
      "latestValue": 1239820,
      "absoluteChange": 795019,
      "percentChange": 178.73588413695114,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 224,
      "latestValue": 286.8,
      "absoluteChange": 62.80000000000001,
      "percentChange": 28.035714285714292,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 73,
      "latestValue": 73,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 9231,
      "latestValue": 7580,
      "absoluteChange": -1651,
      "percentChange": -17.885386198678365,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2348,
      "latestValue": 1876,
      "absoluteChange": -472,
      "percentChange": -20.10221465076661,
      "unit": "discharges"
    }
  ]
}
