{
  "schemaVersion": 3,
  "entityId": "361326",
  "canonicalName": "ADAMS COUNTY REGIONAL MEDICAL CENTER",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "ADAMS COUNTY REGIONAL MEDICAL CENTER 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"
  },
  "identifiers": {
    "ccn": "361326",
    "npi": "1851946909",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "ADAMS COUNTY REGIONAL MEDICAL CENTER",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-reportedowner-361326",
      "from_entity_id": "reported owner",
      "to_entity_id": "361326",
      "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."
    }
  ],
  "acquisitionEvents": [],
  "financialAndUtilizationSeries": [
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      "metric_id": "361326-net_patient_revenue-12-31-2023",
      "entity_id": "361326",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "36600457",
      "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": "361326-net_patient_revenue-12-31-2022",
      "entity_id": "361326",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "36044736",
      "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": "361326-net_patient_revenue-12-31-2021",
      "entity_id": "361326",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "33156260",
      "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": "361326-operating_expense-12-31-2023",
      "entity_id": "361326",
      "metric_name": "operating_expense",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "39134206",
      "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": "361326-operating_expense-12-31-2022",
      "entity_id": "361326",
      "metric_name": "operating_expense",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "37224703",
      "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": "361326-operating_expense-12-31-2021",
      "entity_id": "361326",
      "metric_name": "operating_expense",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "32801235",
      "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": "361326-net_income-12-31-2023",
      "entity_id": "361326",
      "metric_name": "net_income",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "608218",
      "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": "361326-net_income-12-31-2022",
      "entity_id": "361326",
      "metric_name": "net_income",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "1502086",
      "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": "361326-net_income-12-31-2021",
      "entity_id": "361326",
      "metric_name": "net_income",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "5422263",
      "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": "361326-total_assets-12-31-2023",
      "entity_id": "361326",
      "metric_name": "total_assets",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "48537590",
      "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": "361326-total_assets-12-31-2022",
      "entity_id": "361326",
      "metric_name": "total_assets",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "49284196",
      "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": "361326-total_assets-12-31-2021",
      "entity_id": "361326",
      "metric_name": "total_assets",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "47366697",
      "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": "361326-total_liabilities-12-31-2023",
      "entity_id": "361326",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "29459935",
      "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": "361326-total_liabilities-12-31-2022",
      "entity_id": "361326",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "33234287",
      "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": "361326-total_liabilities-12-31-2021",
      "entity_id": "361326",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "32806594",
      "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": "361326-fte_employees-12-31-2023",
      "entity_id": "361326",
      "metric_name": "fte_employees",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "217.96",
      "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": "361326-fte_employees-12-31-2022",
      "entity_id": "361326",
      "metric_name": "fte_employees",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "204.98",
      "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": "361326-fte_employees-12-31-2021",
      "entity_id": "361326",
      "metric_name": "fte_employees",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "197.61",
      "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": "361326-beds-12-31-2023",
      "entity_id": "361326",
      "metric_name": "beds",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "25",
      "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": "361326-beds-12-31-2022",
      "entity_id": "361326",
      "metric_name": "beds",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "25",
      "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": "361326-beds-12-31-2021",
      "entity_id": "361326",
      "metric_name": "beds",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "25",
      "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": "361326-patient_days-12-31-2023",
      "entity_id": "361326",
      "metric_name": "patient_days",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "3231",
      "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": "361326-patient_days-12-31-2022",
      "entity_id": "361326",
      "metric_name": "patient_days",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "3561",
      "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": "361326-patient_days-12-31-2021",
      "entity_id": "361326",
      "metric_name": "patient_days",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "3988",
      "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": "361326-discharges-12-31-2023",
      "entity_id": "361326",
      "metric_name": "discharges",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "493",
      "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": "361326-discharges-12-31-2022",
      "entity_id": "361326",
      "metric_name": "discharges",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "552",
      "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": "361326-discharges-12-31-2021",
      "entity_id": "361326",
      "metric_name": "discharges",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "614",
      "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"
    }
  ],
  "cmsOwnerRecords": [
    {
      "organization": "PETE DAGENBACH",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MATTHEW ARMSTRONG",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ALAN BIRD",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2019",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ALAN BIRD",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DANE CLARK",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PEGGY CHALKER",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JACK MCCOY",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "UMB BANK NA",
      "role": "5% OR GREATER MORTGAGE INTEREST",
      "association_date": "10/01/2019",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "UMB BANK NA",
      "role": "5% OR GREATER SECURITY INTEREST",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "SHERRI SPENCER",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHAD WILSON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROY GUSTIN",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "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"
  ],
  "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:361326",
        "label": "ADAMS COUNTY REGIONAL MEDICAL CENTER",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:adams-county-regional-medical-center",
        "label": "ADAMS COUNTY REGIONAL MEDICAL CENTER",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:pete-dagenbach:0",
        "label": "PETE DAGENBACH",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:matthew-armstrong:1",
        "label": "MATTHEW ARMSTRONG",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:alan-bird:2",
        "label": "ALAN BIRD",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:alan-bird:3",
        "label": "ALAN BIRD",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:dane-clark:4",
        "label": "DANE CLARK",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:peggy-chalker:5",
        "label": "PEGGY CHALKER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:jack-mccoy:6",
        "label": "JACK MCCOY",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:umb-bank-na:7",
        "label": "UMB BANK NA",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER MORTGAGE INTEREST"
      },
      {
        "id": "cms-owner:umb-bank-na:8",
        "label": "UMB BANK NA",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER SECURITY INTEREST"
      },
      {
        "id": "cms-owner:sherri-spencer:9",
        "label": "SHERRI SPENCER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:chad-wilson:10",
        "label": "CHAD WILSON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:roy-gustin:11",
        "label": "ROY GUSTIN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      }
    ],
    "edges": [
      {
        "id": "organization:adams-county-regional-medical-center->facility:361326",
        "from": "organization:adams-county-regional-medical-center",
        "to": "facility:361326",
        "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:pete-dagenbach:0->facility:361326",
        "from": "cms-owner:pete-dagenbach:0",
        "to": "facility:361326",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 10/01/2019"
      },
      {
        "id": "cms-owner:matthew-armstrong:1->facility:361326",
        "from": "cms-owner:matthew-armstrong:1",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      },
      {
        "id": "cms-owner:alan-bird:2->facility:361326",
        "from": "cms-owner:alan-bird:2",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 100% reported ownership · associated 10/01/2019"
      },
      {
        "id": "cms-owner:alan-bird:3->facility:361326",
        "from": "cms-owner:alan-bird:3",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      },
      {
        "id": "cms-owner:dane-clark:4->facility:361326",
        "from": "cms-owner:dane-clark:4",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      },
      {
        "id": "cms-owner:peggy-chalker:5->facility:361326",
        "from": "cms-owner:peggy-chalker:5",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      },
      {
        "id": "cms-owner:jack-mccoy:6->facility:361326",
        "from": "cms-owner:jack-mccoy:6",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      },
      {
        "id": "cms-owner:umb-bank-na:7->facility:361326",
        "from": "cms-owner:umb-bank-na:7",
        "to": "facility:361326",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER MORTGAGE INTEREST · 100% reported ownership · associated 10/01/2019"
      },
      {
        "id": "cms-owner:umb-bank-na:8->facility:361326",
        "from": "cms-owner:umb-bank-na:8",
        "to": "facility:361326",
        "relationship": "holds a security interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER SECURITY INTEREST · associated 10/01/2019"
      },
      {
        "id": "cms-owner:sherri-spencer:9->facility:361326",
        "from": "cms-owner:sherri-spencer:9",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      },
      {
        "id": "cms-owner:chad-wilson:10->facility:361326",
        "from": "cms-owner:chad-wilson:10",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      },
      {
        "id": "cms-owner:roy-gustin:11->facility:361326",
        "from": "cms-owner:roy-gustin:11",
        "to": "facility:361326",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 10/01/2019"
      }
    ],
    "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": 33156260,
      "latestValue": 36600457,
      "absoluteChange": 3444197,
      "percentChange": 10.38777292734464,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 32801235,
      "latestValue": 39134206,
      "absoluteChange": 6332971,
      "percentChange": 19.307111454797358,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 5422263,
      "latestValue": 608218,
      "absoluteChange": -4814045,
      "percentChange": -88.78294911183761,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 47366697,
      "latestValue": 48537590,
      "absoluteChange": 1170893,
      "percentChange": 2.471975193879362,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 32806594,
      "latestValue": 29459935,
      "absoluteChange": -3346659,
      "percentChange": -10.201177848575197,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 197.61,
      "latestValue": 217.96,
      "absoluteChange": 20.349999999999994,
      "percentChange": 10.298061838975757,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 25,
      "latestValue": 25,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 3988,
      "latestValue": 3231,
      "absoluteChange": -757,
      "percentChange": -18.981945837512537,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 614,
      "latestValue": 493,
      "absoluteChange": -121,
      "percentChange": -19.706840390879478,
      "unit": "discharges"
    }
  ]
}
