{
  "schemaVersion": 4,
  "entityId": "530025",
  "canonicalName": "IVINSON MEMORIAL HOSPITAL",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "IVINSON MEMORIAL HOSPITAL has a completed Wyoming 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": 8,
    "ownership_source_count": 13,
    "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"
  },
  "identifiers": {
    "ccn": "530025",
    "npi": "1336289552",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "IVINSON MEMORIAL HOSPITAL",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "IVINSON MEMORIAL HOSPITAL",
        "alias_type": "cms_care_compare_name",
        "source_id": "source-cms-care-compare"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-reportedowner-530025",
      "from_entity_id": "reported owner",
      "to_entity_id": "530025",
      "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."
    },
    {
      "relationship_id": "rel-cms-owner-530025",
      "from_entity_id": "governmentdistrictorauthority",
      "to_entity_id": "530025",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2024",
      "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-530025",
      "from_entity_id": "governmentdistrictorauthority",
      "to_entity_id": "530025",
      "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-530025",
      "from_entity_id": "governmentdistrictorauthority",
      "to_entity_id": "530025",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2024",
      "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-530025",
      "from_entity_id": "governmentdistrictorauthority",
      "to_entity_id": "530025",
      "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-530025",
      "from_entity_id": "governmentdistrictorauthority",
      "to_entity_id": "530025",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2024",
      "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": [
    {
      "date": "01/01/2018",
      "title": "CMS before/after ownership event",
      "detail": "ALBANY COUNTY HOSPITAL DISTRICT -> IVINSON MEMORIAL HOSPITAL.",
      "sourceIds": [
        "source-cms-hospital-chow"
      ]
    }
  ],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "530025-net_patient_revenue-06-30-2024",
      "entity_id": "530025",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "136123745",
      "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": "530025-net_patient_revenue-06-30-2023",
      "entity_id": "530025",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "128541496",
      "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": "530025-net_patient_revenue-06-30-2022",
      "entity_id": "530025",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "112610887",
      "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": "530025-net_patient_revenue-06-30-2021",
      "entity_id": "530025",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "103833512",
      "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": "530025-operating_expense-06-30-2024",
      "entity_id": "530025",
      "metric_name": "operating_expense",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "122444694",
      "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": "530025-operating_expense-06-30-2023",
      "entity_id": "530025",
      "metric_name": "operating_expense",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "116998627",
      "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": "530025-operating_expense-06-30-2022",
      "entity_id": "530025",
      "metric_name": "operating_expense",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "104213161",
      "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": "530025-operating_expense-06-30-2021",
      "entity_id": "530025",
      "metric_name": "operating_expense",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "94774244",
      "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": "530025-net_income-06-30-2024",
      "entity_id": "530025",
      "metric_name": "net_income",
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      "value": "44242332",
      "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": "530025-net_income-06-30-2023",
      "entity_id": "530025",
      "metric_name": "net_income",
      "period_start": "07/01/2022",
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      "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": "530025-net_income-06-30-2022",
      "entity_id": "530025",
      "metric_name": "net_income",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "-3270474",
      "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": "530025-net_income-06-30-2021",
      "entity_id": "530025",
      "metric_name": "net_income",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
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      "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": "530025-total_assets-06-30-2024",
      "entity_id": "530025",
      "metric_name": "total_assets",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "388880207",
      "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": "530025-total_assets-06-30-2023",
      "entity_id": "530025",
      "metric_name": "total_assets",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "343755759",
      "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": "530025-total_assets-06-30-2022",
      "entity_id": "530025",
      "metric_name": "total_assets",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "309989248",
      "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": "530025-total_assets-06-30-2021",
      "entity_id": "530025",
      "metric_name": "total_assets",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "314484631",
      "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": "530025-total_liabilities-06-30-2024",
      "entity_id": "530025",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "24818893",
      "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": "530025-total_liabilities-06-30-2023",
      "entity_id": "530025",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "22758603",
      "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": "530025-total_liabilities-06-30-2022",
      "entity_id": "530025",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "21428073",
      "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": "530025-total_liabilities-06-30-2021",
      "entity_id": "530025",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "21469138",
      "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": "530025-contract_labor_direct_patient_care-06-30-2024",
      "entity_id": "530025",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "3158878",
      "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": "530025-contract_labor_direct_patient_care-06-30-2023",
      "entity_id": "530025",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "5066332",
      "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": "530025-contract_labor_direct_patient_care-06-30-2022",
      "entity_id": "530025",
      "metric_name": "contract_labor_direct_patient_care",
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      "period_end": "06/30/2022",
      "value": "2386732",
      "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": "530025-contract_labor_direct_patient_care-06-30-2021",
      "entity_id": "530025",
      "metric_name": "contract_labor_direct_patient_care",
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      "value": "370077",
      "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": "530025-fte_employees-06-30-2024",
      "entity_id": "530025",
      "metric_name": "fte_employees",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "488.71",
      "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": "530025-fte_employees-06-30-2023",
      "entity_id": "530025",
      "metric_name": "fte_employees",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "457.51",
      "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": "530025-fte_employees-06-30-2022",
      "entity_id": "530025",
      "metric_name": "fte_employees",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "445.5",
      "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": "530025-fte_employees-06-30-2021",
      "entity_id": "530025",
      "metric_name": "fte_employees",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "441.32",
      "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": "530025-beds-06-30-2024",
      "entity_id": "530025",
      "metric_name": "beds",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "76",
      "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": "530025-beds-06-30-2023",
      "entity_id": "530025",
      "metric_name": "beds",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "76",
      "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": "530025-beds-06-30-2022",
      "entity_id": "530025",
      "metric_name": "beds",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "76",
      "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": "530025-beds-06-30-2021",
      "entity_id": "530025",
      "metric_name": "beds",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "76",
      "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": "530025-patient_days-06-30-2024",
      "entity_id": "530025",
      "metric_name": "patient_days",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "6107",
      "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": "530025-patient_days-06-30-2023",
      "entity_id": "530025",
      "metric_name": "patient_days",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "4819",
      "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": "530025-patient_days-06-30-2022",
      "entity_id": "530025",
      "metric_name": "patient_days",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "4965",
      "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": "530025-patient_days-06-30-2021",
      "entity_id": "530025",
      "metric_name": "patient_days",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "4323",
      "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": "530025-discharges-06-30-2024",
      "entity_id": "530025",
      "metric_name": "discharges",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "1512",
      "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": "530025-discharges-06-30-2023",
      "entity_id": "530025",
      "metric_name": "discharges",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "1330",
      "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": "530025-discharges-06-30-2022",
      "entity_id": "530025",
      "metric_name": "discharges",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "1250",
      "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": "530025-discharges-06-30-2021",
      "entity_id": "530025",
      "metric_name": "discharges",
      "period_start": "07/01/2020",
      "period_end": "06/30/2021",
      "value": "840",
      "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": "CATIE BALLARD",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2024",
      "percentage_ownership": "10",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JAMES BANDS",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2018",
      "percentage_ownership": "15",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JAMES BANDS",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "01/01/2018",
      "percentage_ownership": "20",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "BRAD JACKSON",
      "role": "CORPORATE OFFICER",
      "association_date": "03/25/2019",
      "percentage_ownership": "10",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ANDREA LEWIS",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "01/01/2018",
      "percentage_ownership": "5",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DOUG FAUS",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2018",
      "percentage_ownership": "20",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "GARY CRUM",
      "role": "CORPORATE OFFICER",
      "association_date": "03/24/2019",
      "percentage_ownership": "10",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JOSEPH STEINER",
      "role": "CORPORATE OFFICER",
      "association_date": "03/25/2019",
      "percentage_ownership": "10",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "IVINSON MEMORIAL HOSPITAL",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "01/01/2018",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "RICK MELONE",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2024",
      "percentage_ownership": "10",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PAMELA DUNNUCK",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "10",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [
    "Operator/owner context: Government - Hospital District or Authority.",
    "CMS Care Compare ownership category: Government - Hospital District or Authority."
  ],
  "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.",
    "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": [
    "Precise acquisition date",
    "Official facility URL",
    "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-pesp-hospital-tracker",
      "title": "Private Equity Hospital Tracker",
      "publisher": "Private Equity Stakeholder Project",
      "publication_date": "2026-04-03 snapshot",
      "retrieved_at": "2026-07-02",
      "url": "https://pestakeholder.org/private-equity-hospital-tracker/",
      "reliability_tier": "research",
      "research_note": "Discovery source for PE, contract, and transaction-signal follow-up; not enough by itself for direct control claims.",
      "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-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-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-hospital-chow",
      "title": "Hospital Change of Ownership",
      "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-change-of-ownership",
      "reliability_tier": "government",
      "research_note": "Used for before/after ownership and enrollment transfer events when a matching CHOW row exists.",
      "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": "Sponsor, operator, CMS legal-owner/control records, and facility are shown as separate evidence layers.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "facility:530025",
        "label": "IVINSON MEMORIAL HOSPITAL",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "cms-owner:catie-ballard:0",
        "label": "CATIE BALLARD",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:james-bands:1",
        "label": "JAMES BANDS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:james-bands:2",
        "label": "JAMES BANDS",
        "kind": "cms_owner_or_controller",
        "evidence": "OPERATIONAL/MANAGERIAL CONTROL"
      },
      {
        "id": "cms-owner:brad-jackson:3",
        "label": "BRAD JACKSON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:andrea-lewis:4",
        "label": "ANDREA LEWIS",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:doug-faus:5",
        "label": "DOUG FAUS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:gary-crum:6",
        "label": "GARY CRUM",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:joseph-steiner:7",
        "label": "JOSEPH STEINER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:ivinson-memorial-hospital:8",
        "label": "IVINSON MEMORIAL HOSPITAL",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:rick-melone:9",
        "label": "RICK MELONE",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:pamela-dunnuck:10",
        "label": "PAMELA DUNNUCK",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      }
    ],
    "edges": [
      {
        "id": "cms-owner:catie-ballard:0->facility:530025",
        "from": "cms-owner:catie-ballard:0",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 10% reported ownership · associated 10/01/2024"
      },
      {
        "id": "cms-owner:james-bands:1->facility:530025",
        "from": "cms-owner:james-bands:1",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 15% reported ownership · associated 01/01/2018"
      },
      {
        "id": "cms-owner:james-bands:2->facility:530025",
        "from": "cms-owner:james-bands:2",
        "to": "facility:530025",
        "relationship": "controls or manages",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "OPERATIONAL/MANAGERIAL CONTROL · 20% reported ownership · associated 01/01/2018"
      },
      {
        "id": "cms-owner:brad-jackson:3->facility:530025",
        "from": "cms-owner:brad-jackson:3",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 10% reported ownership · associated 03/25/2019"
      },
      {
        "id": "cms-owner:andrea-lewis:4->facility:530025",
        "from": "cms-owner:andrea-lewis:4",
        "to": "facility:530025",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 5% reported ownership · associated 01/01/2018"
      },
      {
        "id": "cms-owner:doug-faus:5->facility:530025",
        "from": "cms-owner:doug-faus:5",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 20% reported ownership · associated 01/01/2018"
      },
      {
        "id": "cms-owner:gary-crum:6->facility:530025",
        "from": "cms-owner:gary-crum:6",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 10% reported ownership · associated 03/24/2019"
      },
      {
        "id": "cms-owner:joseph-steiner:7->facility:530025",
        "from": "cms-owner:joseph-steiner:7",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 10% reported ownership · associated 03/25/2019"
      },
      {
        "id": "cms-owner:ivinson-memorial-hospital:8->facility:530025",
        "from": "cms-owner:ivinson-memorial-hospital:8",
        "to": "facility:530025",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 01/01/2018"
      },
      {
        "id": "cms-owner:rick-melone:9->facility:530025",
        "from": "cms-owner:rick-melone:9",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 10% reported ownership · associated 10/01/2024"
      },
      {
        "id": "cms-owner:pamela-dunnuck:10->facility:530025",
        "from": "cms-owner:pamela-dunnuck:10",
        "to": "facility:530025",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 10% reported ownership · associated 01/01/2024"
      }
    ],
    "caveats": [
      "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor."
    ]
  },
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 103833512,
      "latestValue": 136123745,
      "absoluteChange": 32290233,
      "percentChange": 31.098084210038085,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 94774244,
      "latestValue": 122444694,
      "absoluteChange": 27670450,
      "percentChange": 29.196170638934348,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 51607510,
      "latestValue": 44242332,
      "absoluteChange": -7365178,
      "percentChange": -14.271523660025451,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 314484631,
      "latestValue": 388880207,
      "absoluteChange": 74395576,
      "percentChange": 23.65634713640426,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 21469138,
      "latestValue": 24818893,
      "absoluteChange": 3349755,
      "percentChange": 15.602652514507104,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 370077,
      "latestValue": 3158878,
      "absoluteChange": 2788801,
      "percentChange": 753.5731753121648,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 441.32,
      "latestValue": 488.71,
      "absoluteChange": 47.389999999999986,
      "percentChange": 10.738239825976613,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 76,
      "latestValue": 76,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 4323,
      "latestValue": 6107,
      "absoluteChange": 1784,
      "percentChange": 41.2676382142031,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "06/30/2021",
      "latestPeriod": "06/30/2024",
      "earliestValue": 840,
      "latestValue": 1512,
      "absoluteChange": 672,
      "percentChange": 80,
      "unit": "discharges"
    }
  ],
  "firstGlance": {
    "taxOwnershipType": "Government / public",
    "operator": "Government - Hospital District or Authority",
    "directPeOwnership": "Not documented as direct PE ownership in this state-template pass",
    "peRelationship": "Watchlist signal",
    "careLevel": "Acute Care Hospitals",
    "currentCeo": "Needs source-backed local leader research",
    "bottomLine": "IVINSON MEMORIAL HOSPITAL is shown with official-source baseline context for Wyoming. 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": "LARAMIE, ALBANY, Wyoming. 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": "3",
    "emergencyServices": "Yes",
    "hospitalType": "Acute Care Hospitals",
    "careCompareOwnership": "Government - Hospital District or Authority",
    "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
  }
}