{ "schemaVersion": 4, "entityId": "450128", "canonicalName": "KNAPP MEDICAL CENTER", "status": "corporate_chain", "statusLabel": "Prime Healthcare Foundation nonprofit system", "summary": "Knapp Medical Center is not independent and is not documented as PE-owned. It is a nonprofit hospital in the Prime Healthcare Foundation system. A Texas insurer facility-based disclosure for 2024 claims identifies Small Hospital Innovations for emergency medicine. Florida corporate records and a current business profile identify physician leadership; reviewed sources did not identify a PE sponsor. Knapp switched its emergency-department contract to EmCare in December 2011, when EmCare parent EMSC was owned by Clayton, Dubilier & Rice. Current 2024 claims-based disclosure instead identifies Small Hospital Innovations, so the EmCare/CD&R link is historical, not current.", "lastReviewed": "2026-07-12", "review": { "reviewer": "Codex targeted Rio Grande Valley ownership and clinical-staffing verification pass", "evidence_grade": "government-corroborated", "confidence": "high", "source_count": 10, "ownership_source_count": 3, "identity_match_method": "Matched by CMS CCN 450128, facility name, city, and address.", "publication_decision": "Publish major nonprofit-system control separately from current and historical clinical staffing relationships." }, "firstGlance": { "taxOwnershipType": "Nonprofit", "operator": "Prime Healthcare Foundation", "operatorType": "Major nonprofit health system", "operatorName": "Prime Healthcare Foundation", "parentSystem": "Prime Healthcare Foundation", "affiliatedSystem": "Prime Healthcare", "directPeOwnership": "No documented PE ownership in reviewed sources", "peRelationship": "No current PE-backed staffing relationship found; historical EmCare/CD&R emergency contract documented in 2011.", "currentClinicalStaffing": "Small Hospital Innovations — emergency medicine facility-based group", "confidence": "High for ownership/system control; high for the disclosed 2024 emergency-medicine group; no claim about undisclosed contracts.", "evidenceAsOf": "2026-07-12", "bottomLine": "Knapp Medical Center should be shown as Prime Healthcare Foundation system-controlled, not independent and not PE-owned." }, "identifiers": { "ccn": "450128", "enrollmentId": "O20050701000029", "npi": "1861488579", "legalOrganization": "KNAPP MEDICAL CENTER", "address": "1401 EAST EIGHTH STREET", "city": "WESLACO", "state": "TX", "zip": "78596", "county": "HIDALGO", "latitude": 26.15322840016, "longitude": -97.9776193699499, "aliases": [ { "alias": "KNAPP MEDICAL CENTER", "alias_type": "cms_enrollment_dba", "source_id": "source-cms-hospital-enrollments" } ] }, "ownershipHistory": [ { "relationship_id": "prime-foundation-control-450128", "relationship_type": "controls", "effective_date": "2013", "end_date": "", "status": "confirmed", "source_ids": "source-cms-hospital-all-owners|source-prime-community-benefit-2023|source-knapp-chna", "plain_english_summary": "Prime Healthcare Foundation owns/controls Knapp Medical Center within its nonprofit hospital system." }, { "relationship_id": "current-emergency-staffing-450128", "relationship_type": "contracts", "effective_date": "2024 claims year; disclosure current May 2025", "end_date": "", "status": "confirmed_facility_based_group", "source_ids": "source-ambetter-2025-facility-groups|source-florida-sos-small-hospital-innovations|source-ventra-small-hospital-innovations", "plain_english_summary": "A Texas insurer facility-based disclosure for 2024 claims identifies Small Hospital Innovations for emergency medicine. Florida corporate records and a current business profile identify physician leadership; reviewed sources did not identify a PE sponsor." }, { "relationship_id": "current-pe-check-450128", "relationship_type": "searched_for_current_pe_ownership_or_contract", "effective_date": "2026-07-12", "end_date": "", "status": "searched_not_found", "source_ids": "source-pesp-hospital-tracker|source-cms-hospital-all-owners|source-ambetter-2025-facility-groups|source-florida-sos-small-hospital-innovations|source-ventra-small-hospital-innovations", "plain_english_summary": "Reviewed ownership and current staffing sources do not support a current PE-owned hospital label or current PE-backed staffing label." }, { "relationship_id": "knapp-emcare-historical-contract-2011", "relationship_type": "historical_contract", "effective_date": "2011-12", "end_date": "ended before the 2024 current-provider disclosure", "status": "historical_confirmed", "source_ids": "source-knapp-emcare-2011|source-sec-cdr-emsc-2011", "plain_english_summary": "Knapp contracted its emergency department to EmCare in 2011 while EmCare parent EMSC was owned by Clayton, Dubilier & Rice. Current disclosure names a different group." } ], "acquisitionEvents": [ { "date": "2013", "title": "Prime Healthcare Foundation acquisition/control began", "detail": "Knapp Medical Center entered the Prime Healthcare Foundation nonprofit hospital system.", "sourceIds": [ "source-cms-hospital-all-owners", "source-prime-community-benefit-2023", "source-knapp-chna" ] }, { "date": "2011-12", "title": "Historical PE-backed emergency staffing contract", "detail": "Knapp switched its ER contract to EmCare after CD&R had acquired EmCare parent EMSC; this is historical and is not the current disclosed staffing group.", "sourceIds": [ "source-knapp-emcare-2011", "source-sec-cdr-emsc-2011" ] } ], "financialAndUtilizationSeries": [], "descriptiveTrends": [], "cmsOwnerRecords": [ { "organization": "PRIME HEALTHCARE SERVICES, INC", "role": "OPERATIONAL/MANAGERIAL CONTROL", "percentage": "0", "associationDate": "01/01/2013", "forProfit": "Y", "nonprofit": "N", "privateEquityCompany": "", "source_id": "source-cms-hospital-all-owners" }, { "organization": "PRIME HEALTHCARE FOUNDATION INC", "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST", "percentage": "100", "associationDate": "01/01/2013", "forProfit": "N", "nonprofit": "Y", "privateEquityCompany": "", "source_id": "source-cms-hospital-all-owners" }, { "organization": "PRIME HEALTHCARE FOUNDATION INC", "role": "OPERATIONAL/MANAGERIAL CONTROL", "percentage": "100", "associationDate": "01/01/2013", "forProfit": "N", "nonprofit": "Y", "privateEquityCompany": "", "source_id": "source-cms-hospital-all-owners" } ], "ownershipChain": { "model": "Nonprofit hospital ownership/control, Prime Healthcare system affiliation, and clinical-staffing contracts are separate layers.", "confidence": "high", "nodes": [ { "id": "system:prime-healthcare-foundation", "label": "Prime Healthcare Foundation", "kind": "nonprofit_owner_and_health_system", "evidence": "CMS owner records and official system/hospital documents" }, { "id": "affiliate:prime-healthcare", "label": "Prime Healthcare", "kind": "integrated_health_system_affiliation", "evidence": "Official Prime Healthcare and hospital documents" }, { "id": "staffing:small-hospital-innovations", "label": "Small Hospital Innovations", "kind": "current_emergency_medicine_group", "evidence": "Texas HMO facility-based physician-group disclosure" }, { "id": "facility:450128", "label": "Knapp Medical Center", "kind": "hospital", "evidence": "CMS CCN 450128" }, { "id": "historical-staffing:emcare-cdr", "label": "EmCare / Clayton, Dubilier & Rice", "kind": "historical_pe_backed_staffing", "evidence": "2011 contract reporting and SEC transaction filing" } ], "edges": [ { "id": "system:prime-healthcare-foundation->facility:450128", "from": "system:prime-healthcare-foundation", "to": "facility:450128", "relationship": "owns and controls within nonprofit system", "confidence": "high", "sourceIds": [ "source-cms-hospital-all-owners", "source-prime-community-benefit-2023", "source-knapp-chna" ], "note": "Major-system control, not private-equity ownership." }, { "id": "staffing:small-hospital-innovations->facility:450128", "from": "staffing:small-hospital-innovations", "to": "facility:450128", "relationship": "current disclosed emergency-medicine group", "confidence": "high", "sourceIds": [ "source-ambetter-2025-facility-groups", "source-florida-sos-small-hospital-innovations", "source-ventra-small-hospital-innovations" ], "note": "Clinical staffing relationship, not hospital ownership." }, { "id": "historical-staffing:emcare-cdr->facility:450128", "from": "historical-staffing:emcare-cdr", "to": "facility:450128", "relationship": "historical emergency-department contract", "confidence": "high", "sourceIds": [ "source-knapp-emcare-2011", "source-sec-cdr-emsc-2011" ], "note": "Historical 2011 exposure; not current." } ], "caveats": [ "Prime Healthcare Foundation nonprofit control is not private-equity ownership.", "Prime Healthcare Services is a separate for-profit entity; CMS reports operational/managerial control at Knapp but only an OTHER association at Mission.", "The insurer disclosure identifies facility-based physician groups for 2024 claims and does not expose every hospital vendor or contract term.", "EmCare/CD&R is historical; current disclosure identifies Small Hospital Innovations." ] }, "ownershipConnections": [ { "entityName": "Prime Healthcare Foundation", "entityKind": "Nonprofit hospital owner and system", "relationship": "owner/controller", "classification": "Major nonprofit system-control layer", "evidenceSourceIds": [ "source-cms-hospital-all-owners", "source-prime-community-benefit-2023", "source-knapp-chna" ], "note": "Reason the hospital is no longer shown as independent." }, { "entityName": "Small Hospital Innovations", "entityKind": "Emergency-medicine physician group", "relationship": "current facility-based clinical group", "classification": "Current PE link searched but not found", "evidenceSourceIds": [ "source-ambetter-2025-facility-groups", "source-florida-sos-small-hospital-innovations", "source-ventra-small-hospital-innovations" ], "note": "This is a staffing relationship, not hospital ownership." } ], "directConnections": [ "Knapp Medical Center -> Prime Healthcare Foundation: nonprofit owner/system control confirmed.", "Knapp Medical Center -> Prime Healthcare: integrated health-system affiliation confirmed.", "Knapp Medical Center -> Small Hospital Innovations: current emergency-medicine facility-based group identified.", "Knapp -> EmCare / Clayton, Dubilier & Rice: historical 2011 ER contract; not current." ], "actions": [ "Show as Prime Healthcare Foundation nonprofit system-controlled, not independent.", "Do not label as PE-owned.", "Show Small Hospital Innovations as the current disclosed emergency-medicine group, with no current PE link found.", "Preserve the 2011 EmCare/CD&R contract as historical PE-backed staffing exposure only." ], "importantLinks": [ { "label": "CMS Hospital Enrollments", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments", "sourceId": "source-cms-hospital-enrollments", "note": "Confirms the nonprofit enrollments, legal organizations, facility names, locations, NPIs, and CCNs for Knapp and Mission Regional." }, { "label": "CMS Hospital All Owners", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners", "sourceId": "source-cms-hospital-all-owners", "note": "For Knapp, reports Prime Healthcare Foundation Inc. as 100% direct owner and operational/managerial controller and Prime Healthcare Services Inc. as a separate for-profit operational/managerial controller. For Mission, reports Prime Healthcare Foundation - Mission LLC as 100% direct owner, Prime Healthcare Foundation Inc. as an indirect owner, and Prime Healthcare Services Inc. only with role OTHER. CMS does not flag these organizations as private-equity companies." }, { "label": "Prime Healthcare 2023 Community Benefit Report", "url": "https://www.primehealthcare.com/wp-content/uploads/2024/03/PHS_2023-Community-Benefit-Report-3.6.24.pdf", "sourceId": "source-prime-community-benefit-2023", "note": "Prime Healthcare identifies Knapp and Mission Regional in its Prime Healthcare Foundation hospital growth timeline." }, { "label": "Knapp Medical Center Community Health Needs Assessment", "url": "https://knappmed.org/wp-content/uploads/2022/09/KMC-CHNA-2014-2016.pdf", "sourceId": "source-knapp-chna", "note": "Hospital document says nonprofit Prime Healthcare Foundation obtained a controlling interest and Knapp continued as a nonprofit facility." }, { "label": "Private Equity Hospital Tracker", "url": "https://pestakeholder.org/private-equity-hospital-tracker/", "sourceId": "source-pesp-hospital-tracker", "note": "The repo-local imported tracker rows for CCNs 450128 and 450176 report Currently PE? = N and no PE firm." }, { "label": "Texas HMO facility-based physician-group disclosure", "url": "https://www.ambetterhealth.com/content/dam/centene/Superior/Ambetter/PDFs/Annual-OON-HBP-Superior-HMO.pdf", "sourceId": "source-ambetter-2025-facility-groups", "note": "For claims from January through December 2024, identifies Small Hospital Innovations as Knapp emergency medicine provider and Rio Grande Valley Emergency Physicians as Mission Regional emergency medicine provider. This supports a facility-based clinical relationship, not hospital ownership." }, { "label": "Small Hospital Innovations LLC entity record", "url": "https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?aggregateId=flal-l13000098383-292ab51e-c4b3-43f9-9b36-d80e1e76c9f0&directionType=CurrentList&inquirytype=EntityName&listNameOrder=SMALLHILL+L120001298060&searchNameOrder=SMALLHOSPITALINNOVATIONS+L130000983830&searchTerm=SMALL+HILL%2C+LLC.", "sourceId": "source-florida-sos-small-hospital-innovations", "note": "Current active LLC record names physician Ruddy A. Valdes as president and managing member. It does not identify a PE sponsor." }, { "label": "Small Hospital Innovations business profile", "url": "https://ventrahealth.com/success-story/small-hospital-innovations/", "sourceId": "source-ventra-small-hospital-innovations", "note": "Describes Small Hospital Innovations as founded by two emergency physicians and providing emergency medicine and other staffing services. It does not independently prove the Knapp contract or absence of undisclosed investors." }, { "label": "Knapp gets new ER doctors; city mulls weighing in on hospital sale", "url": "https://www.hmpgloballearningnetwork.com/site/emsworld/news/10576720/knapp-gets-new-er-doctors-city-mulls-weighing-hospital-sale", "sourceId": "source-knapp-emcare-2011", "note": "Contemporaneous report documents Knapp switching its emergency-room contract to EmCare in December 2011. It does not establish that the contract continued after the period reported." }, { "label": "EMSC transaction filing", "url": "https://www.sec.gov/Archives/edgar/data/1344154/000104746911008231/a2204534zs-4.htm", "sourceId": "source-sec-cdr-emsc-2011", "note": "Documents that Clayton, Dubilier & Rice funds owned EMSC after the May 25, 2011 merger and that EmCare was EMSC's outsourced physician-services business." } ], "sources": [ { "source_id": "source-cms-hospital-enrollments", "title": "CMS Hospital Enrollments", "publisher": "Centers for Medicare & Medicaid Services", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments", "reliability_tier": "government", "research_note": "Confirms the nonprofit enrollments, legal organizations, facility names, locations, NPIs, and CCNs for Knapp and Mission Regional.", "source_type": "government", "what_this_source_proves": "Confirms the nonprofit enrollments, legal organizations, facility names, locations, NPIs, and CCNs for Knapp and Mission Regional.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-cms-hospital-all-owners", "title": "CMS Hospital All Owners", "publisher": "Centers for Medicare & Medicaid Services", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners", "reliability_tier": "government", "research_note": "For Knapp, reports Prime Healthcare Foundation Inc. as 100% direct owner and operational/managerial controller and Prime Healthcare Services Inc. as a separate for-profit operational/managerial controller. For Mission, reports Prime Healthcare Foundation - Mission LLC as 100% direct owner, Prime Healthcare Foundation Inc. as an indirect owner, and Prime Healthcare Services Inc. only with role OTHER. CMS does not flag these organizations as private-equity companies.", "source_type": "government", "what_this_source_proves": "For Knapp, reports Prime Healthcare Foundation Inc. as 100% direct owner and operational/managerial controller and Prime Healthcare Services Inc. as a separate for-profit operational/managerial controller. For Mission, reports Prime Healthcare Foundation - Mission LLC as 100% direct owner, Prime Healthcare Foundation Inc. as an indirect owner, and Prime Healthcare Services Inc. only with role OTHER. CMS does not flag these organizations as private-equity companies.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-prime-community-benefit-2023", "title": "Prime Healthcare 2023 Community Benefit Report", "publisher": "Prime Healthcare", "publication_date": "2024-03", "retrieved_at": "2026-07-12", "url": "https://www.primehealthcare.com/wp-content/uploads/2024/03/PHS_2023-Community-Benefit-Report-3.6.24.pdf", "reliability_tier": "primary", "research_note": "Prime Healthcare identifies Knapp and Mission Regional in its Prime Healthcare Foundation hospital growth timeline.", "source_type": "primary", "what_this_source_proves": "Prime Healthcare identifies Knapp and Mission Regional in its Prime Healthcare Foundation hospital growth timeline.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-knapp-chna", "title": "Knapp Medical Center Community Health Needs Assessment", "publisher": "Knapp Medical Center", "publication_date": "2013", "retrieved_at": "2026-07-12", "url": "https://knappmed.org/wp-content/uploads/2022/09/KMC-CHNA-2014-2016.pdf", "reliability_tier": "primary", "research_note": "Hospital document says nonprofit Prime Healthcare Foundation obtained a controlling interest and Knapp continued as a nonprofit facility.", "source_type": "primary", "what_this_source_proves": "Hospital document says nonprofit Prime Healthcare Foundation obtained a controlling interest and Knapp continued as a nonprofit facility.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-pesp-hospital-tracker", "title": "Private Equity Hospital Tracker", "publisher": "Private Equity Stakeholder Project", "publication_date": "2026-04-03 snapshot", "retrieved_at": "2026-07-12", "url": "https://pestakeholder.org/private-equity-hospital-tracker/", "reliability_tier": "research", "research_note": "The repo-local imported tracker rows for CCNs 450128 and 450176 report Currently PE? = N and no PE firm.", "source_type": "research", "what_this_source_proves": "The repo-local imported tracker rows for CCNs 450128 and 450176 report Currently PE? = N and no PE firm.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-ambetter-2025-facility-groups", "title": "Texas HMO facility-based physician-group disclosure", "publisher": "Superior HealthPlan / Ambetter", "publication_date": "2025-05", "retrieved_at": "2026-07-12", "url": "https://www.ambetterhealth.com/content/dam/centene/Superior/Ambetter/PDFs/Annual-OON-HBP-Superior-HMO.pdf", "reliability_tier": "regulated-plan-disclosure", "research_note": "For claims from January through December 2024, identifies Small Hospital Innovations as Knapp emergency medicine provider and Rio Grande Valley Emergency Physicians as Mission Regional emergency medicine provider. This supports a facility-based clinical relationship, not hospital ownership.", "source_type": "regulated-plan-disclosure", "what_this_source_proves": "For claims from January through December 2024, identifies Small Hospital Innovations as Knapp emergency medicine provider and Rio Grande Valley Emergency Physicians as Mission Regional emergency medicine provider. This supports a facility-based clinical relationship, not hospital ownership.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-florida-sos-small-hospital-innovations", "title": "Small Hospital Innovations LLC entity record", "publisher": "Florida Department of State, Division of Corporations", "publication_date": "2026-04-25", "retrieved_at": "2026-07-12", "url": "https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?aggregateId=flal-l13000098383-292ab51e-c4b3-43f9-9b36-d80e1e76c9f0&directionType=CurrentList&inquirytype=EntityName&listNameOrder=SMALLHILL+L120001298060&searchNameOrder=SMALLHOSPITALINNOVATIONS+L130000983830&searchTerm=SMALL+HILL%2C+LLC.", "reliability_tier": "government", "research_note": "Current active LLC record names physician Ruddy A. Valdes as president and managing member. It does not identify a PE sponsor.", "source_type": "government", "what_this_source_proves": "Current active LLC record names physician Ruddy A. Valdes as president and managing member. It does not identify a PE sponsor.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-ventra-small-hospital-innovations", "title": "Small Hospital Innovations business profile", "publisher": "Ventra Health", "publication_date": "2025-06-23", "retrieved_at": "2026-07-12", "url": "https://ventrahealth.com/success-story/small-hospital-innovations/", "reliability_tier": "business-primary-context", "research_note": "Describes Small Hospital Innovations as founded by two emergency physicians and providing emergency medicine and other staffing services. It does not independently prove the Knapp contract or absence of undisclosed investors.", "source_type": "business-primary-context", "what_this_source_proves": "Describes Small Hospital Innovations as founded by two emergency physicians and providing emergency medicine and other staffing services. It does not independently prove the Knapp contract or absence of undisclosed investors.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-knapp-emcare-2011", "title": "Knapp gets new ER doctors; city mulls weighing in on hospital sale", "publisher": "The Monitor via EMS World", "publication_date": "2011-12-23", "retrieved_at": "2026-07-12", "url": "https://www.hmpgloballearningnetwork.com/site/emsworld/news/10576720/knapp-gets-new-er-doctors-city-mulls-weighing-hospital-sale", "reliability_tier": "reputable-reporting", "research_note": "Contemporaneous report documents Knapp switching its emergency-room contract to EmCare in December 2011. It does not establish that the contract continued after the period reported.", "source_type": "reputable-reporting", "what_this_source_proves": "Contemporaneous report documents Knapp switching its emergency-room contract to EmCare in December 2011. It does not establish that the contract continued after the period reported.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." }, { "source_id": "source-sec-cdr-emsc-2011", "title": "EMSC transaction filing", "publisher": "U.S. Securities and Exchange Commission", "publication_date": "2011", "retrieved_at": "2026-07-12", "url": "https://www.sec.gov/Archives/edgar/data/1344154/000104746911008231/a2204534zs-4.htm", "reliability_tier": "government-filing", "research_note": "Documents that Clayton, Dubilier & Rice funds owned EMSC after the May 25, 2011 merger and that EmCare was EMSC's outsourced physician-services business.", "source_type": "government-filing", "what_this_source_proves": "Documents that Clayton, Dubilier & Rice funds owned EMSC after the May 25, 2011 merger and that EmCare was EMSC's outsourced physician-services business.", "what_this_source_does_not_prove": "No single source proves every vendor relationship, every contract term, or the absence of undisclosed investment." } ], "limitations": [ "Current clinical-staffing conclusions are limited to publicly identified facility-based groups; private contract documents were not available.", "A searched-not-found PE result is not proof that no undisclosed investor or vendor relationship exists.", "The end date of the historical EmCare contract was not located; current 2024 data identifies a different group." ], "trackerContext": { "currentlyPe": "N", "peFirm": "" } }