{
  "schemaVersion": 3,
  "entityId": "400048",
  "canonicalName": "HOSPITAL MENONITA GUAYAMA",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "HOSPITAL MENONITA GUAYAMA 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": "400048",
    "npi": "1639696289",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "HOSPITAL MENONITA GUAYAMA INC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "HOSPITAL MENONITA DE GUAYAMA",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
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    {
      "relationship_id": "rel-reportedowner-400048",
      "from_entity_id": "reported owner",
      "to_entity_id": "400048",
      "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": [],
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      "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:400048",
        "label": "HOSPITAL MENONITA GUAYAMA",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "cms-owner:lymari-colon-colon:0",
        "label": "LYMARI COLON COLON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:lymari-colon-colon:1",
        "label": "LYMARI COLON COLON",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:jose-veguilla-cartagena:2",
        "label": "JOSE VEGUILLA CARTAGENA",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:lissette-vasquez-rivera:3",
        "label": "LISSETTE VASQUEZ RIVERA",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:lissette-vasquez-rivera:4",
        "label": "LISSETTE VASQUEZ RIVERA",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:jose-solivan-rivera:5",
        "label": "JOSE SOLIVAN RIVERA",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:jose-solivan-rivera:6",
        "label": "JOSE SOLIVAN RIVERA",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:ricardo-hernandez-rivera:7",
        "label": "RICARDO HERNANDEZ RIVERA",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:ricardo-hernandez-rivera:8",
        "label": "RICARDO HERNANDEZ RIVERA",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:ricardo-hernandez-rivera:9",
        "label": "RICARDO HERNANDEZ RIVERA",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:gerson-jimenez-catanon:10",
        "label": "GERSON JIMENEZ CATANON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:robert-miller-eimen:11",
        "label": "ROBERT MILLER EIMEN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:larry-bonilla-sauder:12",
        "label": "LARRY BONILLA SAUDER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:rogelio-garcia-diaz:13",
        "label": "ROGELIO GARCIA DIAZ",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:rogelio-garcia-diaz:14",
        "label": "ROGELIO GARCIA DIAZ",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      }
    ],
    "edges": [
      {
        "id": "cms-owner:lymari-colon-colon:0->facility:400048",
        "from": "cms-owner:lymari-colon-colon:0",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 100% reported ownership · associated 11/01/2019"
      },
      {
        "id": "cms-owner:lymari-colon-colon:1->facility:400048",
        "from": "cms-owner:lymari-colon-colon:1",
        "to": "facility:400048",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 100% reported ownership · associated 11/01/2019"
      },
      {
        "id": "cms-owner:jose-veguilla-cartagena:2->facility:400048",
        "from": "cms-owner:jose-veguilla-cartagena:2",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 09/13/2017"
      },
      {
        "id": "cms-owner:lissette-vasquez-rivera:3->facility:400048",
        "from": "cms-owner:lissette-vasquez-rivera:3",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 100% reported ownership · associated 09/13/2017"
      },
      {
        "id": "cms-owner:lissette-vasquez-rivera:4->facility:400048",
        "from": "cms-owner:lissette-vasquez-rivera:4",
        "to": "facility:400048",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 100% reported ownership · associated 09/13/2017"
      },
      {
        "id": "cms-owner:jose-solivan-rivera:5->facility:400048",
        "from": "cms-owner:jose-solivan-rivera:5",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 100% reported ownership · associated 09/13/2017"
      },
      {
        "id": "cms-owner:jose-solivan-rivera:6->facility:400048",
        "from": "cms-owner:jose-solivan-rivera:6",
        "to": "facility:400048",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 100% reported ownership · associated 09/13/2017"
      },
      {
        "id": "cms-owner:ricardo-hernandez-rivera:7->facility:400048",
        "from": "cms-owner:ricardo-hernandez-rivera:7",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 09/13/2017"
      },
      {
        "id": "cms-owner:ricardo-hernandez-rivera:8->facility:400048",
        "from": "cms-owner:ricardo-hernandez-rivera:8",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 100% reported ownership · associated 11/01/2019"
      },
      {
        "id": "cms-owner:ricardo-hernandez-rivera:9->facility:400048",
        "from": "cms-owner:ricardo-hernandez-rivera:9",
        "to": "facility:400048",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 100% reported ownership · associated 11/01/2019"
      },
      {
        "id": "cms-owner:gerson-jimenez-catanon:10->facility:400048",
        "from": "cms-owner:gerson-jimenez-catanon:10",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 09/13/2017"
      },
      {
        "id": "cms-owner:robert-miller-eimen:11->facility:400048",
        "from": "cms-owner:robert-miller-eimen:11",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 09/13/2017"
      },
      {
        "id": "cms-owner:larry-bonilla-sauder:12->facility:400048",
        "from": "cms-owner:larry-bonilla-sauder:12",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 09/13/2017"
      },
      {
        "id": "cms-owner:rogelio-garcia-diaz:13->facility:400048",
        "from": "cms-owner:rogelio-garcia-diaz:13",
        "to": "facility:400048",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 09/13/2017"
      },
      {
        "id": "cms-owner:rogelio-garcia-diaz:14->facility:400048",
        "from": "cms-owner:rogelio-garcia-diaz:14",
        "to": "facility:400048",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 09/13/2017"
      }
    ],
    "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": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 64495815,
      "latestValue": 74577237,
      "absoluteChange": 10081422,
      "percentChange": 15.631125833513385,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 52057181,
      "latestValue": 66191958,
      "absoluteChange": 14134777,
      "percentChange": 27.152405736299855,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 33269719,
      "latestValue": 31290640,
      "absoluteChange": -1979079,
      "percentChange": -5.9485894665957355,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 149444618,
      "latestValue": 214169338,
      "absoluteChange": 64724720,
      "percentChange": 43.310171263578056,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 33205218,
      "latestValue": 38105533,
      "absoluteChange": 4900315,
      "percentChange": 14.757665497031219,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 313285,
      "latestValue": 358564,
      "absoluteChange": 45279,
      "percentChange": 14.452974128987982,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 404,
      "latestValue": 432.11,
      "absoluteChange": 28.110000000000014,
      "percentChange": 6.957920792079212,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 133,
      "latestValue": 140,
      "absoluteChange": 7,
      "percentChange": 5.263157894736842,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 27479,
      "latestValue": 34864,
      "absoluteChange": 7385,
      "percentChange": 26.875068233924086,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 6293,
      "latestValue": 7067,
      "absoluteChange": 774,
      "percentChange": 12.299380263785158,
      "unit": "discharges"
    }
  ]
}
