{
  "schemaVersion": 1,
  "generatedAt": "2026-07-02T17:31:14.077Z",
  "state": "WY",
  "stateName": "Wyoming",
  "slug": "wyoming",
  "files": {
    "json": "/data/states/wyoming-impact-summary.json",
    "csv": "/data/states/wyoming-hospital-impact-2026-07-02.csv",
    "workbook": "/data/states/wyoming-state-impact-2026-07-02.xlsx"
  },
  "methodology": {
    "baseline": "Acquisition-anchored before/after where a documented acquisition date and compatible pre/post HCRIS periods exist; otherwise earliest-to-latest context is labeled as non-causal.",
    "quality": "Quality trend fields are reserved for CMS HAI, mortality, readmission, and related measure series. Missing fields are shown as not_available rather than inferred.",
    "debt": "Documented debt events are separated from HCRIS financial-stress signals. Financial stress is not labeled asset stripping unless filings document a debt, dividend, leaseback, asset-sale, bankruptcy, or bond event.",
    "causation": "These are descriptive before/after signals, not proof that ownership caused the change."
  },
  "counts": {
    "hospitals": 37,
    "currentPeCount": 3,
    "formerPeCount": 0,
    "peBefore2010Count": 0,
    "closuresAfterPeCount": 0,
    "worseningQualityCount": 0,
    "worseningFinancialCount": 24,
    "unresolvedCount": 3,
    "documentedDebtEventCount": 0,
    "ceoCompensationStructuredCount": 0
  },
  "statusCounts": {
    "verified_independent": 26,
    "confirmed_pe": 3,
    "corporate_chain": 5,
    "signal": 2,
    "unknown": 1
  },
  "tierDefinitions": [
    {
      "tier": "Tier 1",
      "definition": "Confirmed PE ownership/control or closed after documented PE acquisition."
    },
    {
      "tier": "Tier 2",
      "definition": "PE-backed contract, former PE ownership, documented debt/bankruptcy/asset-sale concern, or transaction warning."
    },
    {
      "tier": "Tier 3",
      "definition": "Corporate-chain or major-system exposure without PE proof."
    },
    {
      "tier": "Independent/Unresolved",
      "definition": "No documented PE exposure, verified independent, unknown, or evidence incomplete."
    }
  ],
  "topFinancialDeclines": [
    {
      "hospitalId": "531316",
      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
      "city": "RAWLINS",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -885.8975348244174,
      "display": "Net income -885.9%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 753.5731753121648,
      "display": "Direct-care contract labor +753.6%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530034",
      "hospital": "SUMMIT MEDICAL CENTER LLC",
      "city": "CASPER",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 627.2168792102699,
      "display": "Direct-care contract labor +627.2%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530012",
      "hospital": "WYOMING MEDICAL CENTER",
      "city": "CASPER",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 467.02129862336596,
      "display": "Direct-care contract labor +467.0%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 467.02129862336596,
      "display": "Direct-care contract labor +467.0%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
      "city": "RIVERTON",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -290.1362362620126,
      "display": "Net income -290.1%",
      "baselineType": "earliest_latest_no_pre_acquisition_period",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "status": "Critical",
      "leadMetric": "Total liabilities",
      "percentChange": 269.5270141542886,
      "display": "Total liabilities +269.5%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
      "city": "GILLETTE",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -248.082428508448,
      "display": "Net income -248.1%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    }
  ],
  "hospitalRows": [
    {
      "hospitalId": "0196784473",
      "ccn": "",
      "hospital": "90TH MEDICAL GROUP",
      "city": "F.E. WARREN AFB",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0196784473.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "53004F",
      "ccn": "53004F",
      "hospital": "CHEYENNE VA MEDICAL CENTER",
      "city": "CHEYENNE",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "U.S. Department of Veterans Affairs",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 5",
      "qualityLeadDisplay": "CMS overall rating 5",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 3,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-care-compare",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/53004F.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531313",
      "ccn": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Total liabilities",
      "financialLeadPercentChange": 269.5270141542886,
      "financialLeadDisplay": "Total liabilities +269.5%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531313.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0004282410",
      "ccn": "",
      "hospital": "SOUTH BIG HORN COUNTY CRITICAL ACCESS HOSPITAL",
      "city": "BASIN",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0004282410.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531308",
      "ccn": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -114.71710123037735,
      "financialLeadDisplay": "Net income -114.7%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531308.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531312",
      "ccn": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Declining",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 3",
      "qualityLeadDisplay": "CMS overall rating 3",
      "financialTrendStatus": "Declining",
      "financialLeadMetric": "Patient days",
      "financialLeadPercentChange": -13.584827870542156,
      "financialLeadDisplay": "Patient days -13.6%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531312.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531302",
      "ccn": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
      "city": "DOUGLAS",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 4",
      "qualityLeadDisplay": "CMS overall rating 4",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -63.259512305223296,
      "financialLeadDisplay": "Net income -63.3%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531302.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0001983101",
      "ccn": "",
      "hospital": "SOUTH LINCOLN HOSPITAL DISTRICT DBA SOUTH LINCOLN MEDICAL CENTER",
      "city": "KEMMERER",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0001983101.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531309",
      "ccn": "531309",
      "hospital": "NORTH BIG HORN HOSPITAL DISTRICT",
      "city": "LOVELL",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 4",
      "qualityLeadDisplay": "CMS overall rating 4",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -69.85242972272859,
      "financialLeadDisplay": "Net income -69.9%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531309.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531314",
      "ccn": "531314",
      "hospital": "NIOBRARA COUNTY HOSPITAL DISTRICT",
      "city": "LUSK",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -42.991527080483976,
      "financialLeadDisplay": "Net income -43.0%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531314.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531303",
      "ccn": "531303",
      "hospital": "WESTON COUNTY HOSPITAL DISTRICT DBA WESTON COUNTY HEALTH SERVICES",
      "city": "NEWCASTLE",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -140.72704478237125,
      "financialLeadDisplay": "Net income -140.7%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531303.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531310",
      "ccn": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 4",
      "qualityLeadDisplay": "CMS overall rating 4",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -144.33779171379624,
      "financialLeadDisplay": "Net income -144.3%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531310.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531316",
      "ccn": "531316",
      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
      "city": "RAWLINS",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -885.8975348244174,
      "financialLeadDisplay": "Net income -885.9%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531316.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0002582729",
      "ccn": "",
      "hospital": "CROOK COUNTY MEDICAL SERVICES DISTRICT",
      "city": "SUNDANCE",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0002582729.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531304",
      "ccn": "531304",
      "hospital": "HOT SPRINGS COUNTY HOSPITAL DBA HOT SPRINGS COUNTY MEMORIAL HOSPITAL",
      "city": "THERMOPOLIS",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 3",
      "qualityLeadDisplay": "CMS overall rating 3",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -104.09839034085596,
      "financialLeadDisplay": "Net income -104.1%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531304.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531307",
      "ccn": "531307",
      "hospital": "COMMUNITY HOSPITAL",
      "city": "TORRINGTON",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 2",
      "qualityLeadDisplay": "CMS overall rating 2",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -107.97364161450862,
      "financialLeadDisplay": "Net income -108.0%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531307.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0002782201",
      "ccn": "",
      "hospital": "PLATTE COUNTY MEMORIAL HOSPITAL",
      "city": "WHEATLAND",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0002782201.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531306",
      "ccn": "531306",
      "hospital": "WASHAKIE MEDICAL CENTER",
      "city": "WORLAND",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Declining",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 4",
      "qualityLeadDisplay": "CMS overall rating 4",
      "financialTrendStatus": "Declining",
      "financialLeadMetric": "Patient days",
      "financialLeadPercentChange": -9.576968272620446,
      "financialLeadDisplay": "Patient days -9.6%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531306.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0003382609",
      "ccn": "533027",
      "hospital": "ELKHORN VALLEY REHABILITATION HOSPITAL LLC",
      "city": "CASPER",
      "state": "WY",
      "tier": "Tier 1",
      "overallStatus": "Declining",
      "publicStatus": "confirmed_pe",
      "publicStatusLabel": "Confirmed PE",
      "relationshipType": "ownership",
      "peFirm": "One Equity Partners",
      "parentSystem": "Ernest Health",
      "formerOperator": "",
      "acquisitionDate": "October 2018",
      "acquisitionYear": 2018,
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Declining",
      "financialLeadMetric": "Total liabilities",
      "financialLeadPercentChange": 42.3075813996096,
      "financialLeadDisplay": "Total liabilities +42.3%",
      "financialBaselineType": "earliest_latest_no_pre_acquisition_period",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://pestakeholder.org/private-equity-hospital-tracker/",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0003382609.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530034",
      "ccn": "530034",
      "hospital": "SUMMIT MEDICAL CENTER LLC",
      "city": "CASPER",
      "state": "WY",
      "tier": "Tier 3",
      "overallStatus": "Critical",
      "publicStatus": "corporate_chain",
      "publicStatusLabel": "Corporate chain",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Direct-care contract labor",
      "financialLeadPercentChange": 627.2168792102699,
      "financialLeadDisplay": "Direct-care contract labor +627.2%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530034.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530012",
      "ccn": "530012",
      "hospital": "WYOMING MEDICAL CENTER",
      "city": "CASPER",
      "state": "WY",
      "tier": "Tier 2",
      "overallStatus": "Critical",
      "publicStatus": "signal",
      "publicStatusLabel": "Watch signal",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 2",
      "qualityLeadDisplay": "CMS overall rating 2",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Direct-care contract labor",
      "financialLeadPercentChange": 467.02129862336596,
      "financialLeadDisplay": "Direct-care contract labor +467.0%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 8,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-hcris",
        "source-cms-care-compare",
        "source-cms-hospital-chow",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://pestakeholder.org/private-equity-hospital-tracker/",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-change-of-ownership",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530012.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530014",
      "ccn": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 3",
      "qualityLeadDisplay": "CMS overall rating 3",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -32.73406867309075,
      "financialLeadDisplay": "Net income -32.7%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530014.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "531319",
      "ccn": "531319",
      "hospital": "EVANSTON REGIONAL HOSPITAL",
      "city": "EVANSTON",
      "state": "WY",
      "tier": "Tier 1",
      "overallStatus": "Mixed",
      "publicStatus": "confirmed_pe",
      "publicStatusLabel": "Confirmed PE",
      "relationshipType": "ownership",
      "peFirm": "GoldenTree Asset Management, Davidson Kempner",
      "parentSystem": "Quorum Health Corporation",
      "formerOperator": "",
      "acquisitionDate": "May 2020",
      "acquisitionYear": 2020,
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://pestakeholder.org/private-equity-hospital-tracker/",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/531319.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530002",
      "ccn": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
      "city": "GILLETTE",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 3",
      "qualityLeadDisplay": "CMS overall rating 3",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -248.082428508448,
      "financialLeadDisplay": "Net income -248.1%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530002.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530015",
      "ccn": "530015",
      "hospital": "TETON COUNTY HOSPITAL DISTRICT - ST JOHN'S HEALTH - ST JOHN'S MEDICAL CENTER",
      "city": "JACKSON",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 5",
      "qualityLeadDisplay": "CMS overall rating 5",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -57.353608333496965,
      "financialLeadDisplay": "Net income -57.4%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530015.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530025",
      "ccn": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "state": "WY",
      "tier": "Tier 2",
      "overallStatus": "Critical",
      "publicStatus": "signal",
      "publicStatusLabel": "Watch signal",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 3",
      "qualityLeadDisplay": "CMS overall rating 3",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Direct-care contract labor",
      "financialLeadPercentChange": 753.5731753121648,
      "financialLeadDisplay": "Direct-care contract labor +753.6%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 8,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-hcris",
        "source-cms-care-compare",
        "source-cms-hospital-chow",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://pestakeholder.org/private-equity-hospital-tracker/",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-change-of-ownership",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530025.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530008",
      "ccn": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
      "city": "RIVERTON",
      "state": "WY",
      "tier": "Tier 1",
      "overallStatus": "Critical",
      "publicStatus": "confirmed_pe",
      "publicStatusLabel": "Confirmed PE",
      "relationshipType": "ownership",
      "peFirm": "Apollo Global Management",
      "parentSystem": "ScionHealth",
      "formerOperator": "",
      "acquisitionDate": "November 2018",
      "acquisitionYear": 2018,
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 2",
      "qualityLeadDisplay": "CMS overall rating 2",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Net income",
      "financialLeadPercentChange": -290.1362362620126,
      "financialLeadDisplay": "Net income -290.1%",
      "financialBaselineType": "earliest_latest_no_pre_acquisition_period",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 7,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-hcris",
        "source-cms-care-compare",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://pestakeholder.org/private-equity-hospital-tracker/",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530008.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0004182901",
      "ccn": "",
      "hospital": "ASPEN MOUNTAIN MEDICAL CENTER LLC",
      "city": "ROCK SPRINGS",
      "state": "WY",
      "tier": "Tier 3",
      "overallStatus": "Mixed",
      "publicStatus": "corporate_chain",
      "publicStatusLabel": "Corporate chain",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0004182901.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "530006",
      "ccn": "530006",
      "hospital": "MEMORIAL HOSPITAL OF SHERIDAN COUNTY DBA SHERIDAN MEMORIAL HOSPITAL",
      "city": "SHERIDAN",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Critical",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 3",
      "qualityLeadDisplay": "CMS overall rating 3",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Total liabilities",
      "financialLeadPercentChange": 29.12886361603398,
      "financialLeadDisplay": "Total liabilities +29.1%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/530006.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0000882902",
      "ccn": "",
      "hospital": "MEMORIAL HOSPITAL OF SWEETWATER COUNTY DBA COUNTY OF SWEETWATER",
      "city": "ROCK SPRINGS",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 5,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0000882902.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "534004",
      "ccn": "534004",
      "hospital": "UHS OF WYOMING INC DBA WYOMING BEHAVIORAL INSTITUTE",
      "city": "CASPER",
      "state": "WY",
      "tier": "Tier 3",
      "overallStatus": "Declining",
      "publicStatus": "corporate_chain",
      "publicStatusLabel": "Corporate chain",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "Universal Health Services",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating Not Available",
      "qualityLeadDisplay": "CMS overall rating Not Available",
      "financialTrendStatus": "Declining",
      "financialLeadMetric": "Discharges",
      "financialLeadPercentChange": -8.956014838367778,
      "financialLeadDisplay": "Discharges -9.0%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 6,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/534004.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0004382931",
      "ccn": "",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Declining",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Declining",
      "financialLeadMetric": "Discharges",
      "financialLeadPercentChange": -52.34375,
      "financialLeadDisplay": "Discharges -52.3%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 5,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0004382931.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0001182520",
      "ccn": "",
      "hospital": "SAGEWEST HEALTH CARE - LANDER",
      "city": "LANDER",
      "state": "WY",
      "tier": "Tier 3",
      "overallStatus": "Mixed",
      "publicStatus": "corporate_chain",
      "publicStatusLabel": "Corporate chain",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0001182520.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0017182801",
      "ccn": "",
      "hospital": "VA MEDICAL CENTER - SHERIDAN",
      "city": "SHERIDAN",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "U.S. Department of Veterans Affairs",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0017182801.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0003982240",
      "ccn": "",
      "hospital": "ST JOSEPH'S CHILDREN'S HOME",
      "city": "TORRINGTON",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Mixed",
      "publicStatus": "verified_independent",
      "publicStatusLabel": "Verified independent",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0003982240.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0002182601",
      "ccn": "",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "state": "WY",
      "tier": "Tier 3",
      "overallStatus": "Critical",
      "publicStatus": "corporate_chain",
      "publicStatusLabel": "Corporate chain",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Available",
      "qualityLeadMetric": "CMS overall rating 2",
      "qualityLeadDisplay": "CMS overall rating 2",
      "financialTrendStatus": "Critical",
      "financialLeadMetric": "Direct-care contract labor",
      "financialLeadPercentChange": 467.02129862336596,
      "financialLeadDisplay": "Direct-care contract labor +467.0%",
      "financialBaselineType": "earliest_latest_no_acquisition_date",
      "financialSourceIds": [
        "source-cms-hcris"
      ],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 7,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-cms-hospital-chow",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
        "https://data.cms.gov/provider-data/dataset/xubh-q36u",
        "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-change-of-ownership",
        "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0002182601.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    },
    {
      "hospitalId": "0196784976",
      "ccn": "",
      "hospital": "PLATTE VALLEY HEALTHCARE PROJECT",
      "city": "SARATOGA",
      "state": "WY",
      "tier": "Independent/Unresolved",
      "overallStatus": "Unknown",
      "publicStatus": "unknown",
      "publicStatusLabel": "Unknown",
      "relationshipType": "",
      "peFirm": "",
      "parentSystem": "",
      "formerOperator": "",
      "acquisitionDate": "",
      "acquisitionYear": "",
      "closureDate": "",
      "closureStatus": "",
      "qualityTrendStatus": "Unknown",
      "qualityLeadMetric": "CMS quality trend not loaded",
      "qualityLeadDisplay": "not available",
      "financialTrendStatus": "Unknown",
      "financialLeadMetric": "Financial trend not available",
      "financialLeadPercentChange": null,
      "financialLeadDisplay": "not available",
      "financialBaselineType": "not_available",
      "financialSourceIds": [],
      "debtAssetFlag": "none_structured",
      "ceoCompensationStatus": "unknown_not_public",
      "sourceCount": 2,
      "evidenceState": "source_backed",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pehw-state-template-completion-2026-07-02"
      ],
      "sourceUrls": [
        "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
        "/data/releases/release-2026-07-02-state-template-complete-001.json"
      ],
      "dossierUrl": "/data/dossiers/0196784976.json",
      "note": "State row is derived from the existing source-backed public hospital dossier."
    }
  ],
  "metricTrendRows": [
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "net_income",
      "label": "Net income",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 3153780,
      "afterValue": 3407350,
      "percentChange": 8.040193038195435,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "total_liabilities",
      "label": "Total liabilities",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 15053812,
      "afterValue": 55627902,
      "percentChange": 269.5270141542886,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "fte_employees",
      "label": "Payroll employees",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 277.9,
      "afterValue": 502.17,
      "percentChange": 80.70169125584745,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "beds",
      "label": "Beds",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 22,
      "afterValue": 22,
      "percentChange": 0,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "patient_days",
      "label": "Patient days",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 2261,
      "afterValue": 1889,
      "percentChange": -16.452896948252985,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "discharges",
      "label": "Discharges",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 711,
      "afterValue": 628,
      "percentChange": -11.673699015471167,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "operating_expense",
      "label": "Operating expense",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 57842905,
      "afterValue": 96192268,
      "percentChange": 66.29916495376573,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 54907439,
      "afterValue": 91965560,
      "percentChange": 67.49198592198044,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "metric": "total_assets",
      "label": "Total assets",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 55345683,
      "afterValue": 108875919,
      "percentChange": 96.71980378307012,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "net_income",
      "label": "Net income",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 9134027,
      "afterValue": -1344264,
      "percentChange": -114.71710123037735,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "total_liabilities",
      "label": "Total liabilities",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 1693813,
      "afterValue": 11881883,
      "percentChange": 601.4872952327087,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "fte_employees",
      "label": "Payroll employees",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 141.97,
      "afterValue": 159.72,
      "percentChange": 12.502641403113335,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "beds",
      "label": "Beds",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 22,
      "afterValue": 20,
      "percentChange": -9.090909090909092,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "patient_days",
      "label": "Patient days",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 2019,
      "afterValue": 2187,
      "percentChange": 8.320950965824665,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "discharges",
      "label": "Discharges",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 303,
      "afterValue": 228,
      "percentChange": -24.752475247524753,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "operating_expense",
      "label": "Operating expense",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 24800276,
      "afterValue": 32981006,
      "percentChange": 32.98644740889174,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 21338041,
      "afterValue": 26154123,
      "percentChange": 22.570403721691225,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "metric": "total_assets",
      "label": "Total assets",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 45721998,
      "afterValue": 54594612,
      "percentChange": 19.405569284176952,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "net_income",
      "label": "Net income",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 13901906,
      "afterValue": 13493783,
      "percentChange": -2.9357341360242257,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "total_liabilities",
      "label": "Total liabilities",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 60663524,
      "afterValue": 42140314,
      "percentChange": -30.53434548246818,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "fte_employees",
      "label": "Payroll employees",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 424.4,
      "afterValue": 427.27,
      "percentChange": 0.6762488218661651,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "beds",
      "label": "Beds",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 25,
      "afterValue": 25,
      "percentChange": 0,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "patient_days",
      "label": "Patient days",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 4851,
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      "percentChange": -13.584827870542156,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "discharges",
      "label": "Discharges",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 930,
      "afterValue": 922,
      "percentChange": -0.8602150537634409,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "net_patient_revenue",
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      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "metric": "total_assets",
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      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
      "city": "DOUGLAS",
      "metric": "net_income",
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      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
      "city": "DOUGLAS",
      "metric": "total_liabilities",
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      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
      "city": "DOUGLAS",
      "metric": "fte_employees",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
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      "metric": "beds",
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      "percentChange": 0,
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
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      "metric": "patient_days",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
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      "metric": "discharges",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
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      "metric": "operating_expense",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531302",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531309",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531309",
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      "metric": "fte_employees",
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
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    {
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    {
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    {
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    },
    {
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531303",
      "hospital": "WESTON COUNTY HOSPITAL DISTRICT DBA WESTON COUNTY HEALTH SERVICES",
      "city": "NEWCASTLE",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
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      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531303",
      "hospital": "WESTON COUNTY HOSPITAL DISTRICT DBA WESTON COUNTY HEALTH SERVICES",
      "city": "NEWCASTLE",
      "metric": "total_assets",
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      "baselineType": "earliest_latest_no_acquisition_date",
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      "direction": "down",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "net_income",
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      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "total_liabilities",
      "label": "Total liabilities",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "fte_employees",
      "label": "Payroll employees",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "beds",
      "label": "Beds",
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      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "patient_days",
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "discharges",
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "operating_expense",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "metric": "total_assets",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531316",
      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
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      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531316",
      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
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      "metric": "total_liabilities",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531316",
      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
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      "metric": "fte_employees",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "531316",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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    {
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    {
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    {
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    {
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    {
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    },
    {
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    },
    {
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    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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    },
    {
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    },
    {
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    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530012",
      "hospital": "WYOMING MEDICAL CENTER",
      "city": "CASPER",
      "metric": "operating_expense",
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      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530012",
      "hospital": "WYOMING MEDICAL CENTER",
      "city": "CASPER",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "percentChange": 59.87582314103306,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530012",
      "hospital": "WYOMING MEDICAL CENTER",
      "city": "CASPER",
      "metric": "total_assets",
      "label": "Total assets",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
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      "percentChange": -30.504461578777352,
      "direction": "down",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "net_income",
      "label": "Net income",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "beforeValue": 79104114,
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      "percentChange": -32.73406867309075,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "total_liabilities",
      "label": "Total liabilities",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
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      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "contract_labor_direct_patient_care",
      "label": "Direct-care contract labor",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2020",
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      "percentChange": 408.00651219734567,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "fte_employees",
      "label": "Payroll employees",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
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      "beforeValue": 1538.22,
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      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "beds",
      "label": "Beds",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
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      "beforeValue": 170,
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      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "patient_days",
      "label": "Patient days",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 34242,
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      "percentChange": -3.300040885462298,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "discharges",
      "label": "Discharges",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2021",
      "afterPeriod": "06/30/2024",
      "beforeValue": 7792,
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      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "operating_expense",
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      "baselineType": "earliest_latest_no_acquisition_date",
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      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
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      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "metric": "total_assets",
      "label": "Total assets",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
      "city": "GILLETTE",
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      "label": "Net income",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
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      "metric": "total_liabilities",
      "label": "Total liabilities",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
      "city": "GILLETTE",
      "metric": "contract_labor_direct_patient_care",
      "label": "Direct-care contract labor",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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    },
    {
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    {
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    {
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    {
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    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
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    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
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    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
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      "metric": "fte_employees",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
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      "metric": "beds",
      "label": "Beds",
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      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "metric": "patient_days",
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      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "metric": "discharges",
      "label": "Discharges",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "percentChange": 80,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
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      "metric": "operating_expense",
      "label": "Operating expense",
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "metric": "total_assets",
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      "sourceIds": [
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
      "city": "RIVERTON",
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      "sourceIds": [
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
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      "city": "RIVERTON",
      "metric": "total_liabilities",
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      "direction": "better",
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        "source-cms-hcris"
      ],
      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
      "city": "RIVERTON",
      "metric": "contract_labor_direct_patient_care",
      "label": "Direct-care contract labor",
      "baselineType": "earliest_latest_no_pre_acquisition_period",
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      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
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      "baselineType": "earliest_latest_no_pre_acquisition_period",
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      "sourceIds": [
        "source-cms-hcris"
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
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        "source-cms-hcris"
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "530008",
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No compatible pre-acquisition HCRIS period is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
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    },
    {
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    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
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    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
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    {
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    {
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    {
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    {
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    {
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    },
    {
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    {
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    },
    {
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    },
    {
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      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "534004",
      "hospital": "UHS OF WYOMING INC DBA WYOMING BEHAVIORAL INSTITUTE",
      "city": "CASPER",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 19008384,
      "afterValue": 21136880,
      "percentChange": 11.19766940735204,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "534004",
      "hospital": "UHS OF WYOMING INC DBA WYOMING BEHAVIORAL INSTITUTE",
      "city": "CASPER",
      "metric": "total_assets",
      "label": "Total assets",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 20462268,
      "afterValue": 20150459,
      "percentChange": -1.5238242407928584,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "metric": "net_income",
      "label": "Net income",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2020",
      "afterPeriod": "06/30/2023",
      "beforeValue": -2085763,
      "afterValue": 1724818,
      "percentChange": 182.69482199080144,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "metric": "beds",
      "label": "Beds",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2020",
      "afterPeriod": "06/30/2023",
      "beforeValue": 73,
      "afterValue": 72,
      "percentChange": -1.36986301369863,
      "direction": "flat",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "metric": "patient_days",
      "label": "Patient days",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2020",
      "afterPeriod": "06/30/2023",
      "beforeValue": 19751,
      "afterValue": 17230,
      "percentChange": -12.763910688066426,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "metric": "discharges",
      "label": "Discharges",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2020",
      "afterPeriod": "06/30/2023",
      "beforeValue": 128,
      "afterValue": 61,
      "percentChange": -52.34375,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "metric": "operating_expense",
      "label": "Operating expense",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2020",
      "afterPeriod": "06/30/2023",
      "beforeValue": 33985763,
      "afterValue": 35759761,
      "percentChange": 5.219826902223734,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "06/30/2020",
      "afterPeriod": "06/30/2023",
      "beforeValue": 31900000,
      "afterValue": 37484579,
      "percentChange": 17.50651724137931,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "net_income",
      "label": "Net income",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": -1878761,
      "afterValue": 1027376,
      "percentChange": 154.68369845871828,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "total_liabilities",
      "label": "Total liabilities",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 148681965,
      "afterValue": 46909237,
      "percentChange": -68.44994818302274,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "contract_labor_direct_patient_care",
      "label": "Direct-care contract labor",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 2559649,
      "afterValue": 14513755,
      "percentChange": 467.02129862336596,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "fte_employees",
      "label": "Payroll employees",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 1144.12,
      "afterValue": 726.64,
      "percentChange": -36.48917945670034,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "beds",
      "label": "Beds",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 226,
      "afterValue": 249,
      "percentChange": 10.176991150442479,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "patient_days",
      "label": "Patient days",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 20327,
      "afterValue": 36868,
      "percentChange": 81.37452649185812,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "discharges",
      "label": "Discharges",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 4094,
      "afterValue": 8915,
      "percentChange": 117.75769418661454,
      "direction": "better",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "operating_expense",
      "label": "Operating expense",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 130179380,
      "afterValue": 249048915,
      "percentChange": 91.31210718625331,
      "direction": "worse",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "net_patient_revenue",
      "label": "Net patient revenue",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 147893095,
      "afterValue": 236445303,
      "percentChange": 59.87582314103306,
      "direction": "up",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "metric": "total_assets",
      "label": "Total assets",
      "baselineType": "earliest_latest_no_acquisition_date",
      "beforePeriod": "12/31/2020",
      "afterPeriod": "12/31/2023",
      "beforeValue": 327411119,
      "afterValue": 227536120,
      "percentChange": -30.504461578777352,
      "direction": "down",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "No documented acquisition date is present in this public dossier; shown as earliest-to-latest context only."
    }
  ],
  "documentedDebtEvents": [],
  "financialStressSignals": [
    {
      "hospitalId": "531316",
      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
      "city": "RAWLINS",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -885.8975348244174,
      "display": "Net income -885.9%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 753.5731753121648,
      "display": "Direct-care contract labor +753.6%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530034",
      "hospital": "SUMMIT MEDICAL CENTER LLC",
      "city": "CASPER",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 627.2168792102699,
      "display": "Direct-care contract labor +627.2%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530012",
      "hospital": "WYOMING MEDICAL CENTER",
      "city": "CASPER",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 467.02129862336596,
      "display": "Direct-care contract labor +467.0%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "status": "Critical",
      "leadMetric": "Direct-care contract labor",
      "percentChange": 467.02129862336596,
      "display": "Direct-care contract labor +467.0%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
      "city": "RIVERTON",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -290.1362362620126,
      "display": "Net income -290.1%",
      "baselineType": "earliest_latest_no_pre_acquisition_period",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "status": "Critical",
      "leadMetric": "Total liabilities",
      "percentChange": 269.5270141542886,
      "display": "Total liabilities +269.5%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
      "city": "GILLETTE",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -248.082428508448,
      "display": "Net income -248.1%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -144.33779171379624,
      "display": "Net income -144.3%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531303",
      "hospital": "WESTON COUNTY HOSPITAL DISTRICT DBA WESTON COUNTY HEALTH SERVICES",
      "city": "NEWCASTLE",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -140.72704478237125,
      "display": "Net income -140.7%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -114.71710123037735,
      "display": "Net income -114.7%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531307",
      "hospital": "COMMUNITY HOSPITAL",
      "city": "TORRINGTON",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -107.97364161450862,
      "display": "Net income -108.0%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531304",
      "hospital": "HOT SPRINGS COUNTY HOSPITAL DBA HOT SPRINGS COUNTY MEMORIAL HOSPITAL",
      "city": "THERMOPOLIS",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -104.09839034085596,
      "display": "Net income -104.1%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531309",
      "hospital": "NORTH BIG HORN HOSPITAL DISTRICT",
      "city": "LOVELL",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -69.85242972272859,
      "display": "Net income -69.9%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
      "city": "DOUGLAS",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -63.259512305223296,
      "display": "Net income -63.3%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530015",
      "hospital": "TETON COUNTY HOSPITAL DISTRICT - ST JOHN'S HEALTH - ST JOHN'S MEDICAL CENTER",
      "city": "JACKSON",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -57.353608333496965,
      "display": "Net income -57.4%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "status": "Declining",
      "leadMetric": "Discharges",
      "percentChange": -52.34375,
      "display": "Discharges -52.3%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531314",
      "hospital": "NIOBRARA COUNTY HOSPITAL DISTRICT",
      "city": "LUSK",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -42.991527080483976,
      "display": "Net income -43.0%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "0003382609",
      "hospital": "ELKHORN VALLEY REHABILITATION HOSPITAL LLC",
      "city": "CASPER",
      "status": "Declining",
      "leadMetric": "Total liabilities",
      "percentChange": 42.3075813996096,
      "display": "Total liabilities +42.3%",
      "baselineType": "earliest_latest_no_pre_acquisition_period",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "status": "Critical",
      "leadMetric": "Net income",
      "percentChange": -32.73406867309075,
      "display": "Net income -32.7%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "530006",
      "hospital": "MEMORIAL HOSPITAL OF SHERIDAN COUNTY DBA SHERIDAN MEMORIAL HOSPITAL",
      "city": "SHERIDAN",
      "status": "Critical",
      "leadMetric": "Total liabilities",
      "percentChange": 29.12886361603398,
      "display": "Total liabilities +29.1%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "status": "Declining",
      "leadMetric": "Patient days",
      "percentChange": -13.584827870542156,
      "display": "Patient days -13.6%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "531306",
      "hospital": "WASHAKIE MEDICAL CENTER",
      "city": "WORLAND",
      "status": "Declining",
      "leadMetric": "Patient days",
      "percentChange": -9.576968272620446,
      "display": "Patient days -9.6%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    },
    {
      "hospitalId": "534004",
      "hospital": "UHS OF WYOMING INC DBA WYOMING BEHAVIORAL INSTITUTE",
      "city": "CASPER",
      "status": "Declining",
      "leadMetric": "Discharges",
      "percentChange": -8.956014838367778,
      "display": "Discharges -9.0%",
      "baselineType": "earliest_latest_no_acquisition_date",
      "sourceIds": [
        "source-cms-hcris"
      ],
      "note": "Financial stress signal from HCRIS trend fields. This is not a documented debt-extraction claim and is not causal evidence."
    }
  ],
  "compensationRows": [
    {
      "hospitalId": "0196784473",
      "hospital": "90TH MEDICAL GROUP",
      "city": "F.E. WARREN AFB",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "53004F",
      "hospital": "CHEYENNE VA MEDICAL CENTER",
      "city": "CHEYENNE",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531313",
      "hospital": "STAR VALLEY HEALTH",
      "city": "AFTON",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0004282410",
      "hospital": "SOUTH BIG HORN COUNTY CRITICAL ACCESS HOSPITAL",
      "city": "BASIN",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531308",
      "hospital": "JOHNSON COUNTY MEMORIAL HOSPITAL DBA JOHNSON COUNTY HEALTHCARE CENTER",
      "city": "BUFFALO",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531312",
      "hospital": "WEST PARK HOSPITAL DISTRICT DBA CODY REGIONAL HEALTH",
      "city": "CODY",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531302",
      "hospital": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
      "city": "DOUGLAS",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0001983101",
      "hospital": "SOUTH LINCOLN HOSPITAL DISTRICT DBA SOUTH LINCOLN MEDICAL CENTER",
      "city": "KEMMERER",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531309",
      "hospital": "NORTH BIG HORN HOSPITAL DISTRICT",
      "city": "LOVELL",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531314",
      "hospital": "NIOBRARA COUNTY HOSPITAL DISTRICT",
      "city": "LUSK",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531303",
      "hospital": "WESTON COUNTY HOSPITAL DISTRICT DBA WESTON COUNTY HEALTH SERVICES",
      "city": "NEWCASTLE",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531310",
      "hospital": "POWELL VALLEY HOSPITAL",
      "city": "POWELL",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531316",
      "hospital": "MEMORIAL HOSPITAL OF CARBON COUNTY",
      "city": "RAWLINS",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0002582729",
      "hospital": "CROOK COUNTY MEDICAL SERVICES DISTRICT",
      "city": "SUNDANCE",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531304",
      "hospital": "HOT SPRINGS COUNTY HOSPITAL DBA HOT SPRINGS COUNTY MEMORIAL HOSPITAL",
      "city": "THERMOPOLIS",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531307",
      "hospital": "COMMUNITY HOSPITAL",
      "city": "TORRINGTON",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0002782201",
      "hospital": "PLATTE COUNTY MEMORIAL HOSPITAL",
      "city": "WHEATLAND",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531306",
      "hospital": "WASHAKIE MEDICAL CENTER",
      "city": "WORLAND",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0003382609",
      "hospital": "ELKHORN VALLEY REHABILITATION HOSPITAL LLC",
      "city": "CASPER",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530034",
      "hospital": "SUMMIT MEDICAL CENTER LLC",
      "city": "CASPER",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530012",
      "hospital": "WYOMING MEDICAL CENTER",
      "city": "CASPER",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530014",
      "hospital": "MEMORIAL HOSPITAL OF LARAMIE COUNTY DBA CHEYENNE REGIONAL MEDICAL CENTER",
      "city": "CHEYENNE",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "531319",
      "hospital": "EVANSTON REGIONAL HOSPITAL",
      "city": "EVANSTON",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530002",
      "hospital": "CAMPBELL COUNTY HOSPITAL DISTRICT DBA CAMPBELL COUNTY HEALTH",
      "city": "GILLETTE",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530015",
      "hospital": "TETON COUNTY HOSPITAL DISTRICT - ST JOHN'S HEALTH - ST JOHN'S MEDICAL CENTER",
      "city": "JACKSON",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530025",
      "hospital": "IVINSON MEMORIAL HOSPITAL",
      "city": "LARAMIE",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
      "city": "RIVERTON",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0004182901",
      "hospital": "ASPEN MOUNTAIN MEDICAL CENTER LLC",
      "city": "ROCK SPRINGS",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "530006",
      "hospital": "MEMORIAL HOSPITAL OF SHERIDAN COUNTY DBA SHERIDAN MEMORIAL HOSPITAL",
      "city": "SHERIDAN",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0000882902",
      "hospital": "MEMORIAL HOSPITAL OF SWEETWATER COUNTY DBA COUNTY OF SWEETWATER",
      "city": "ROCK SPRINGS",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "534004",
      "hospital": "UHS OF WYOMING INC DBA WYOMING BEHAVIORAL INSTITUTE",
      "city": "CASPER",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0004382931",
      "hospital": "WYOMING STATE HOSPITAL",
      "city": "EVANSTON",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0001182520",
      "hospital": "SAGEWEST HEALTH CARE - LANDER",
      "city": "LANDER",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0017182801",
      "hospital": "VA MEDICAL CENTER - SHERIDAN",
      "city": "SHERIDAN",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0003982240",
      "hospital": "ST JOSEPH'S CHILDREN'S HOME",
      "city": "TORRINGTON",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0002182601",
      "hospital": "WYOMING RECOVER LLC",
      "city": "CASPER",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    },
    {
      "hospitalId": "0196784976",
      "hospital": "PLATTE VALLEY HEALTHCARE PROJECT",
      "city": "SARATOGA",
      "leaderName": "unknown_not_public",
      "title": "unknown_not_public",
      "compensationLatestYear": "",
      "compensationLatestAmount": "",
      "status": "unknown_not_public",
      "sourceId": "",
      "sourceUrl": "",
      "note": "No Form 990, SEC, official, or public-filing compensation amount is structured for this hospital in the current state package."
    }
  ],
  "closureRows": [],
  "timelineRows": [
    {
      "date": "May 2020",
      "hospitalId": "531319",
      "hospital": "EVANSTON REGIONAL HOSPITAL",
      "eventType": "acquisition_or_control_event",
      "title": "EVANSTON REGIONAL HOSPITAL acquisition/control event",
      "summary": "GoldenTree Asset Management, Davidson Kempner / Quorum Health Corporation",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-care-compare",
        "source-pehw-state-template-completion-2026-07-02"
      ]
    },
    {
      "date": "November 2018",
      "hospitalId": "530008",
      "hospital": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE",
      "eventType": "acquisition_or_control_event",
      "title": "RIVERTON MEMORIAL HOSPITAL LLC DBA SAGEWEST HEALTH CARE acquisition/control event",
      "summary": "Apollo Global Management / ScionHealth",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-hcris",
        "source-cms-care-compare",
        "source-pehw-state-template-completion-2026-07-02"
      ]
    },
    {
      "date": "October 2018",
      "hospitalId": "0003382609",
      "hospital": "ELKHORN VALLEY REHABILITATION HOSPITAL LLC",
      "eventType": "acquisition_or_control_event",
      "title": "ELKHORN VALLEY REHABILITATION HOSPITAL LLC acquisition/control event",
      "summary": "One Equity Partners / Ernest Health",
      "sourceIds": [
        "source-hifld-hospitals",
        "source-pesp-hospital-tracker",
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-cms-hcris",
        "source-pehw-state-template-completion-2026-07-02"
      ]
    }
  ],
  "sourceCoverage": {
    "sourceBackedRows": 37,
    "notAvailableRows": 0,
    "totalSourceIds": 8
  }
}
