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Ownership (PECOS All Owners)

Who owns and controls Medicare-enrolled hospitals, nursing homes, FQHCs, rural health clinics, hospices and home health agencies, by NPI: roles, shares, private equity and REIT flags, and ownership chains.

Version 2026-10-01Updated 2026-10-25Lag 0 h of 3 dFresh
SourceCMS (Hospital All Owners and the SNF, FQHC, RHC, hospice and home health agency All Owners files, from PECOS)
Source idcms-pecos-all-owners
Release cadenceQuarterly (all six files together)
LicensePublic domain (US government work)
Endpoint/v1/providers/{npi}/ownership
MCP toolget_provider_ownership
PlansPro and Team (403 plan-upgrade-required below Pro)

When a hospital, skilled nursing facility, federally qualified health center, rural health clinic, hospice or home health agency enrolls in Medicare, it discloses who owns and controls it. CMS publishes those disclosures quarterly: about 57,500 enrollments and 840,000 owner rows. Each owner has a type (individual or organization), a role (a direct or indirect ownership interest, operational or managerial control, an officer or director, a managing employee, a mortgage or security interest, a partnership interest), the ownership percentage, the date it became associated with the facility, and for organizations the business address and organization-type flags, among them private equity company and REIT.

curl "https://api.healthcare.dev/v1/providers/1154392231/ownership?depth=2" \
  -H "Authorization: Bearer $HDEV_API_KEY"
{
  "data": {
    "npi": "1154392231",
    "listed": true,
    "facilities_total": 1,
    "ownership_completeness": "Ownership is what each facility disclosed to CMS in its Medicare enrollment (PECOS All Owners files), as of the file's date. Public private equity and REIT data is known to be incomplete: ...",
    "derivation": "source_stated",
    "as_of": "2026-10-01",
    "facilities": [
      {
        "enrollment_id": "O20031010000033",
        "organization_name": "MAYO CLINIC ARIZONA",
        "facility_type": "hospital",
        "linked_by": "enrollment",
        "owners": [
          {
            "associate_id": "6507778255",
            "type": "organization",
            "name": { "display": "MAYO CLINIC" },
            "role": "OPERATIONAL/MANAGERIAL CONTROL",
            "role_kind": "operational_control",
            "percentage": 0,
            "association_date": "2010-01-01",
            "flags": { "private_equity": false, "reit": false, "non_profit": true },
            "owners_listed": true
          }
        ],
        "upstream": [
          {
            "associate_id": "6507778255",
            "organization_name": "MAYO CLINIC",
            "depth": 1,
            "path": ["7012829930", "6507778255"],
            "owners": ["..."]
          }
        ],
        "chain": { "depth_limit": 2, "truncated": false, "cycles": [] },
        "summary": { "owners": 19, "private_equity": false, "reit": false }
      }
    ]
  }
}

How an NPI is linked

The All Owners files list enrollments, not NPIs. The NPI is linked through CMS's public Medicare enrollment file: the organization enrollments that list the NPI (as their NPI or one of their additional NPIs). When none of those has ownership disclosures, the organization's other enrollments (same PECOS associate id) are used instead, marked linked_by: "associate_id"; a group practice is linked to the hospital or hospice it runs this way. One answer lists at most 20 facilities (facilities_total counts them all).

Individual NPIs (physicians, nurse practitioners) are not linked to the groups they bill through: an individual's NPI answers 200 with listed: false. CMS's reassignment file would make that link; it isn't loaded yet.

Chains

Where an owner is itself an organization with its own disclosures (the same PECOS associate id appears as a facility in the files), owners_listed is true and its owners are in upstream, nearest first, up to depth levels (default 3, at most 5; 0 for the facility's own owners only). Each organization appears once, at the depth the chain first reached it, with the path of associate ids that led there. When an owner leads back to an organization already on the chain (a facility owned by its own hospital, which lists the facility in turn, or an organization that lists itself), the chain stops there and chain.cycles names it. chain.truncated says that an owner at the depth limit lists owners of its own.

Percentages are what each facility disclosed for each owner, never multiplied along the chain: CMS already lists indirect owners with their indirect share. Officers, directors and managing employees are usually listed with 0 or no percentage.

What public ownership data leaves out

Show ownership_completeness with every answer. The flags are organization types the facility reported about its owners; owners below 5% and investors behind holding companies may not be listed, and private equity firms often own through holding companies that don't check the private equity box. A false or null flag, or summary.private_equity: false, means none was disclosed, never that there is no private equity or REIT owner. derivation: "source_stated": the owners, roles, shares and flags are as disclosed; we add nothing to them, and the chain only follows the associate ids CMS lists.

Limits

Ownership is a derived lookup: each account (all its keys together) can look up a limited number of different NPIs a day (daily lookup limits); repeats don't count. Owners of equal role and share come in an order that is stable for your account.

Possible exclusion matches

The same feature covers entity matching for OIG exclusions: most records in the OIG exclusions list carry no NPI. We match those to NPIs by rules, and the joined provider answer lists the results as exclusion_matches: possible matches, derived, never a finding that a provider is excluded.

  • A candidate needs the same name (last and first name, or business name, once case, spacing, punctuation and legal-form words like "Inc" are set aside) in the same state, from NPPES or CMS's enrollment file. Date of birth is never used: we don't store it.
  • A different middle name means another person, and a specialty that can't be the same profession (an aide and a surgeon) rules a candidate out.
  • What else agrees raises confidence: middle name, the same street address or ZIP code, a specialty that fits. evidence says field by field what matched, and candidates how many providers matched the record.
  • One candidate with strong evidence is published as derivation: "derived". Several candidates, or one with weaker evidence, are checked by a person first and only then shown, as derivation: "reviewed". Name and state alone are never shown.

Confirm any possible match with OIG's online search (exclusions.oig.hhs.gov), which verifies SSN or EIN. exclusion_recorded and matched_by: "npi_as_listed" keep meaning what they always did.

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