{
  "schemaVersion": 4,
  "entityId": "200031",
  "canonicalName": "CARY MEDICAL CENTER",
  "status": "verified_independent",
  "statusLabel": "No documented PE link",
  "summary": "CARY MEDICAL CENTER has a completed Maine state-template dossier baseline with official identity, CMS enrollment/owner context when matched, CMS Care Compare point-in-time context when matched, HCRIS financial/utilization context when matched, and explicit limitations for missing fields. Unsupported ownership, compensation, labor, quality-trend, or causation claims are not inferred.",
  "lastReviewed": "2026-07-02",
  "review": {
    "reviewer": "Five-state state-template completion batch",
    "evidence_grade": "completed state-template official-source baseline",
    "confidence": "medium",
    "source_count": 6,
    "ownership_source_count": 11,
    "identity_match_method": "CMS enrollment match used where available",
    "publication_decision": "Publish state-template completion fields while preserving explicit unavailable/searched-not-found limitations.",
    "batch_id": "state-template-complete-2026-07-02-001"
  },
  "firstGlance": {
    "taxOwnershipType": "Government / public",
    "operator": "Government - Local",
    "directPeOwnership": "Not documented as direct PE ownership in this state-template pass",
    "peRelationship": "No documented PE link in current baseline sources",
    "careLevel": "Acute Care Hospitals",
    "currentCeo": "Needs source-backed local leader research",
    "bottomLine": "CARY MEDICAL CENTER is shown with official-source baseline context for Maine. Missing fields remain visible instead of being inferred."
  },
  "communityImpact": {
    "populationServedEstimate": 0,
    "populationServedLabel": "Needs system/facility catchment estimate",
    "estimateMethod": "Not estimated in this state-template completion pass",
    "catchmentDescription": "CARIBOU, AROOSTOOK, Maine. Service role should be refined in manual follow-up.",
    "traumaCareLevel": "Acute Care Hospitals",
    "publicFacingCaveat": "Community role is sourced from facility type and location until a deeper local-service review is completed."
  },
  "qualityAndLaborContext": {
    "sourceId": "source-cms-care-compare",
    "cmsOverallRating": "1",
    "emergencyServices": "Yes",
    "hospitalType": "Acute Care Hospitals",
    "careCompareOwnership": "Government - Local",
    "note": "CMS Care Compare point-in-time identity/rating context captured for the state template. This is not a quality trend or ownership-causation claim.",
    "noCausationClaim": true
  },
  "identifiers": {
    "ccn": "200031",
    "npi": "1780615492",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "CITY OF CARIBOU",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "CARY MEDICAL CENTER",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "CARY MEDICAL CENTER",
        "alias_type": "cms_care_compare_name",
        "source_id": "source-cms-care-compare"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-cms-owner-200031",
      "from_entity_id": "governmentlocal",
      "to_entity_id": "200031",
      "relationship_type": "cms_owner_context",
      "effective_date": "01/01/2016",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners",
      "plain_english_summary": "CMS Hospital All Owners rows are attached as current owner/control context. They do not by themselves prove private-equity sponsorship unless the row says so or another cited source supports it.",
      "review_notes": ""
    },
    {
      "relationship_id": "rel-state-template-operator-200031",
      "from_entity_id": "governmentlocal",
      "to_entity_id": "200031",
      "relationship_type": "operates",
      "effective_date": "",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-pehw-state-template-completion-2026-07-02|source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-cms-care-compare",
      "plain_english_summary": "State-template baseline operator/owner context assembled from current hospital fields and matched official sources where available. This is not a new PE ownership claim.",
      "review_notes": "Used to keep the public dossier graph explicit while preserving limitations for unmatched source families."
    },
    {
      "relationship_id": "rel-cms-owner-200031",
      "from_entity_id": "governmentlocal",
      "to_entity_id": "200031",
      "relationship_type": "cms_owner_context",
      "effective_date": "01/01/2016",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners",
      "plain_english_summary": "CMS Hospital All Owners rows are attached as current owner/control context. They do not by themselves prove private-equity sponsorship unless the row says so or another cited source supports it.",
      "review_notes": ""
    },
    {
      "relationship_id": "rel-state-template-operator-200031",
      "from_entity_id": "governmentlocal",
      "to_entity_id": "200031",
      "relationship_type": "operates",
      "effective_date": "",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-pehw-state-template-completion-2026-07-02|source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-cms-care-compare",
      "plain_english_summary": "State-template baseline operator/owner context assembled from current hospital fields and matched official sources where available. This is not a new PE ownership claim.",
      "review_notes": "Used to keep the public dossier graph explicit while preserving limitations for unmatched source families."
    },
    {
      "relationship_id": "rel-cms-owner-200031",
      "from_entity_id": "governmentlocal",
      "to_entity_id": "200031",
      "relationship_type": "cms_owner_context",
      "effective_date": "01/01/2016",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners",
      "plain_english_summary": "CMS Hospital All Owners rows are attached as current owner/control context. They do not by themselves prove private-equity sponsorship unless the row says so or another cited source supports it.",
      "review_notes": ""
    }
  ],
  "acquisitionEvents": [],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "200031-net_patient_revenue-12-31-2023",
      "entity_id": "200031",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "65587271",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-net_patient_revenue-12-31-2022",
      "entity_id": "200031",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "59468088",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-net_patient_revenue-12-31-2021",
      "entity_id": "200031",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "51764083",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-net_patient_revenue-12-31-2020",
      "entity_id": "200031",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "48143891",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-operating_expense-12-31-2023",
      "entity_id": "200031",
      "metric_name": "operating_expense",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "69377686",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-operating_expense-12-31-2022",
      "entity_id": "200031",
      "metric_name": "operating_expense",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "66169661",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-operating_expense-12-31-2021",
      "entity_id": "200031",
      "metric_name": "operating_expense",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "63589501",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-operating_expense-12-31-2020",
      "entity_id": "200031",
      "metric_name": "operating_expense",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "59266310",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-net_income-12-31-2023",
      "entity_id": "200031",
      "metric_name": "net_income",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "348681",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-net_income-12-31-2022",
      "entity_id": "200031",
      "metric_name": "net_income",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "122481",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-net_income-12-31-2021",
      "entity_id": "200031",
      "metric_name": "net_income",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "3140092",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-net_income-12-31-2020",
      "entity_id": "200031",
      "metric_name": "net_income",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "905360",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_assets-12-31-2023",
      "entity_id": "200031",
      "metric_name": "total_assets",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "39070079",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_assets-12-31-2022",
      "entity_id": "200031",
      "metric_name": "total_assets",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "39105234",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_assets-12-31-2021",
      "entity_id": "200031",
      "metric_name": "total_assets",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "37602559",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_assets-12-31-2020",
      "entity_id": "200031",
      "metric_name": "total_assets",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "32953798",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_liabilities-12-31-2023",
      "entity_id": "200031",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "13087261",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_liabilities-12-31-2022",
      "entity_id": "200031",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "13521542",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_liabilities-12-31-2021",
      "entity_id": "200031",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "12112271",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-total_liabilities-12-31-2020",
      "entity_id": "200031",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "10611182",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-contract_labor_direct_patient_care-12-31-2023",
      "entity_id": "200031",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "4549601",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-contract_labor_direct_patient_care-12-31-2022",
      "entity_id": "200031",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "4778216",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-contract_labor_direct_patient_care-12-31-2021",
      "entity_id": "200031",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "498245",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-contract_labor_direct_patient_care-12-31-2020",
      "entity_id": "200031",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "2053796",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-fte_employees-12-31-2023",
      "entity_id": "200031",
      "metric_name": "fte_employees",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "352.03",
      "unit": "FTE",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-fte_employees-12-31-2022",
      "entity_id": "200031",
      "metric_name": "fte_employees",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "346.59",
      "unit": "FTE",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-fte_employees-12-31-2021",
      "entity_id": "200031",
      "metric_name": "fte_employees",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "354.13",
      "unit": "FTE",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-fte_employees-12-31-2020",
      "entity_id": "200031",
      "metric_name": "fte_employees",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "344.99",
      "unit": "FTE",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-beds-12-31-2023",
      "entity_id": "200031",
      "metric_name": "beds",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "49",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-beds-12-31-2022",
      "entity_id": "200031",
      "metric_name": "beds",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "49",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-beds-12-31-2021",
      "entity_id": "200031",
      "metric_name": "beds",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "49",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-beds-12-31-2020",
      "entity_id": "200031",
      "metric_name": "beds",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "49",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-patient_days-12-31-2023",
      "entity_id": "200031",
      "metric_name": "patient_days",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "9022",
      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-patient_days-12-31-2022",
      "entity_id": "200031",
      "metric_name": "patient_days",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "8796",
      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-patient_days-12-31-2021",
      "entity_id": "200031",
      "metric_name": "patient_days",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "7674",
      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-patient_days-12-31-2020",
      "entity_id": "200031",
      "metric_name": "patient_days",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "7840",
      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-discharges-12-31-2023",
      "entity_id": "200031",
      "metric_name": "discharges",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "1266",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-discharges-12-31-2022",
      "entity_id": "200031",
      "metric_name": "discharges",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "1061",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-discharges-12-31-2021",
      "entity_id": "200031",
      "metric_name": "discharges",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "1159",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "200031-discharges-12-31-2020",
      "entity_id": "200031",
      "metric_name": "discharges",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "1313",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    }
  ],
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 48143891,
      "latestValue": 65587271,
      "absoluteChange": 17443380,
      "percentChange": 36.231761990321885,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 59266310,
      "latestValue": 69377686,
      "absoluteChange": 10111376,
      "percentChange": 17.060917070760777,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 905360,
      "latestValue": 348681,
      "absoluteChange": -556679,
      "percentChange": -61.48703278253954,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 32953798,
      "latestValue": 39070079,
      "absoluteChange": 6116281,
      "percentChange": 18.560170211639946,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 10611182,
      "latestValue": 13087261,
      "absoluteChange": 2476079,
      "percentChange": 23.334620026308098,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2053796,
      "latestValue": 4549601,
      "absoluteChange": 2495805,
      "percentChange": 121.52156299846723,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 344.99,
      "latestValue": 352.03,
      "absoluteChange": 7.039999999999964,
      "percentChange": 2.0406388590973545,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 49,
      "latestValue": 49,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 7840,
      "latestValue": 9022,
      "absoluteChange": 1182,
      "percentChange": 15.076530612244898,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "12/31/2020",
      "latestPeriod": "12/31/2023",
      "earliestValue": 1313,
      "latestValue": 1266,
      "absoluteChange": -47,
      "percentChange": -3.57958872810358,
      "unit": "discharges"
    }
  ],
  "cmsOwnerRecords": [
    {
      "organization": "SHAWN LAFERRIERE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2016",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "LUKE DYER",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CLARA COLLINS",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "NEAL GRIFFETH",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2019",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MICHAEL GAHAGAN",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHELSEA DESROSIERS",
      "role": "CORPORATE OFFICER",
      "association_date": "01/02/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHRISTOPHER BELL",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2016",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CITY OF CARIBOU",
      "role": "OTHER",
      "association_date": "11/05/2013",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PENNY THOMPSON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/18/2021",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "IRENE DJUANDA",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JANE WHITE-MCCALL",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MEAGAN THOMPSON",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KRIS DOODY",
      "role": "CONTRACTED MANAGING EMPLOYEE",
      "association_date": "11/27/2007",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KRIS DOODY",
      "role": "CORPORATE OFFICER",
      "association_date": "11/27/2007",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KEVIN BARNES",
      "role": "CORPORATE DIRECTOR",
      "association_date": "12/31/2014",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [
    "Operator/owner context: Government - Local.",
    "CMS Care Compare ownership category: Government - Local."
  ],
  "actions": [],
  "contradictions": [],
  "limitations": [
    "This five-state template completion pass used official cached CMS/HIFLD/PESP/HCRIS sources and records missing items; it does not claim the entire internet was exhausted."
  ],
  "unavailableFields": [
    "source-backed local CEO/current leader",
    "official CEO image URL",
    "facility-level CEO compensation amount"
  ],
  "sources": [
    {
      "source_id": "source-hifld-hospitals",
      "title": "Hospitals RAPT",
      "publisher": "Homeland Infrastructure Foundation-Level Data",
      "publication_date": "current public layer",
      "retrieved_at": "2026-07-02",
      "url": "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
      "reliability_tier": "government",
      "research_note": "Facility location and identity source; does not establish ownership or control.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-enrollments",
      "title": "Hospital Enrollments",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "current cached official file",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "reliability_tier": "government",
      "research_note": "Used for legal name, DBA, CCN, NPI, enrollment identity, and location matching.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-all-owners",
      "title": "Hospital All Owners",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "current cached official file",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "reliability_tier": "government",
      "research_note": "Used for current CMS owner, officer, managerial, holding-company, investment-firm, and security-interest rows.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-care-compare",
      "title": "Hospital General Information",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "current cached official file",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "reliability_tier": "government",
      "research_note": "Facility type, ownership category, emergency services, and overall rating context.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hcris",
      "title": "Hospital Provider Cost Reports",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2015-2024 cached official files",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
      "reliability_tier": "government",
      "research_note": "Financial, staffing, and utilization values; descriptive only and not causal evidence.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-pehw-state-template-completion-2026-07-02",
      "title": "PE Healthcare Watch five-state template completion batch",
      "publisher": "PE Healthcare Watch",
      "publication_date": "2026-07-02",
      "retrieved_at": "2026-07-02",
      "url": "/data/releases/release-2026-07-02-state-template-complete-001.json",
      "reliability_tier": "research",
      "research_note": "Internal public release marker for the five-state template completion. It documents scope and limitations; it is not independent ownership evidence.",
      "source_type": "public_record"
    }
  ],
  "ownershipChain": {
    "model": "State-template baseline separates facility record, operator/owner context, CMS owner rows, and PE status evidence. Context nodes do not create new ownership claims.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "200031",
        "label": "CARY MEDICAL CENTER",
        "type": "hospital",
        "sourceIds": [
          "source-hifld-hospitals"
        ]
      },
      {
        "id": "governmentlocal",
        "label": "Government - Local",
        "type": "organization",
        "sourceIds": [
          "source-pehw-state-template-completion-2026-07-02",
          "source-cms-hospital-enrollments",
          "source-cms-hospital-all-owners",
          "source-cms-care-compare"
        ]
      }
    ],
    "edges": [
      {
        "id": "edge-state-template-operator-200031",
        "from": "governmentlocal",
        "to": "200031",
        "relationship": "operates",
        "confidence": "medium",
        "sourceIds": [
          "source-pehw-state-template-completion-2026-07-02",
          "source-cms-hospital-enrollments",
          "source-cms-hospital-all-owners",
          "source-cms-care-compare"
        ],
        "note": "Baseline operator/owner context for state-page completion; not an inferred PE ownership claim."
      }
    ],
    "caveats": [
      "CMS owner rows identify enrolled owner/control roles but may not name every ultimate financial sponsor.",
      "Missing local CEO, compensation, state-regulator, Form 990, or quality-trend fields remain explicit.",
      "This chain is a template baseline and should be superseded by deeper source-family research when available."
    ]
  }
}