{
  "schemaVersion": 4,
  "entityId": "05025F",
  "canonicalName": "FRESNO VA MEDICAL CENTER",
  "status": "verified_independent",
  "statusLabel": "No documented PE link in reviewed sources",
  "summary": "Fresno VA Medical Center / VA Central California Health Care System was reviewed in the Fresno custom NEXT-style batch. Project queue has duplicate VA rows sharing the same CCN/address family and public VA control context. Unsupported PE ownership, contract scope, faith affiliation, sibling status, and independence claims remain limited to the cited sources.",
  "lastReviewed": "2026-07-04",
  "review": {
    "reviewer": "Codex Fresno custom NEXT-style batch",
    "evidence_grade": "source-family review completed with explicit unresolved items",
    "confidence": "medium",
    "source_count": 2,
    "ownership_source_count": 2,
    "identity_match_method": "Entity ID 05025F; CCN 05025F",
    "publication_decision": "Merge or alias duplicate VA rows before publication changes",
    "batch_id": "next-50-2026-07-04-fresno-city-001"
  },
  "firstGlance": {
    "taxOwnershipType": "Government / public",
    "operator": "Veterans Health Administration",
    "directPeOwnership": "No documented PE link",
    "peRelationship": "No documented PE link",
    "institutionalShareholderContext": "No direct institutional-shareholder ownership claim is made from this batch.",
    "populationServedEstimate": 0,
    "populationServedLabel": "Not estimated in this Fresno batch",
    "careLevel": "Acute Care - Veterans Administration",
    "currentCeo": "Leadership research pending",
    "previousRelevantCeo": "Not identified in this Fresno batch",
    "operatorType": "Federal government",
    "operatorName": "Veterans Health Administration",
    "parentSystem": "U.S. Department of Veterans Affairs",
    "affiliatedSystem": "U.S. Department of Veterans Affairs",
    "religiousAffiliation": "Secular/no evidence",
    "confidence": "medium",
    "evidenceAsOf": "2026-07-04",
    "bottomLine": "Project queue has duplicate VA rows sharing the same CCN/address family and public VA control context."
  },
  "communityImpact": {
    "populationServedEstimate": 0,
    "populationServedLabel": "Not estimated in this Fresno batch",
    "estimateMethod": "No catchment or access-time model was run for this custom batch.",
    "catchmentDescription": "FRESNO, FRESNO, CA",
    "traumaCareLevel": "Acute Care - Veterans Administration",
    "publicFacingCaveat": "Duplicate rows at same CCN/address family; verify VA facility naming and current VHA hierarchy"
  },
  "religiousAffiliation": {
    "affiliation": "Secular/no evidence",
    "affiliationType": "not_established",
    "sponsorOrOrder": "",
    "faithBasedSystem": "",
    "scope": "not_established",
    "confidence": "medium",
    "sourceIds": [],
    "sourceUrls": [],
    "evidenceAsOf": "2026-07-04",
    "notes": "No current faith-based governance source captured; do not infer beyond this review."
  },
  "qualityAndLaborContext": {
    "immediateJeopardy2026SourceStatus": "Not reviewed in this Fresno batch.",
    "noCausationClaim": true,
    "note": "Contract, ownership, and affiliation signals are presented as context only; this release does not infer quality or labor causation."
  },
  "leadership": [],
  "identifiers": {
    "ccn": "05025F",
    "npi": null,
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "FRESNO VA MEDICAL CENTER / VA CENTRAL CALIFORNIA HEALTH CARE SYSTEM",
        "alias_type": "research_artifact_name",
        "source_id": "cms_enroll_va"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-va-vha",
      "relationship_type": "controls",
      "effective_date": "2026-07-04",
      "end_date": "",
      "status": "current_or_contextual",
      "source_ids": "cms_enroll_va|project_queue_va",
      "plain_english_summary": "Project baseline supports VA/VHA public control but needs duplicate reconciliation"
    }
  ],
  "acquisitionEvents": [],
  "financialAndUtilizationSeries": [],
  "cmsOwnerRecords": [],
  "ownershipChain": {
    "model": "Fresno custom NEXT-style batch relationship graph. Edges are source-backed context, not automatic public label changes.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "05025F",
        "label": "FRESNO VA MEDICAL CENTER",
        "kind": "hospital",
        "evidence": "Reviewed in next-50-2026-07-04-fresno-city-001."
      },
      {
        "id": "veterans-health-administration",
        "label": "veterans health administration",
        "kind": "organization",
        "evidence": "Project baseline supports VA/VHA public control but needs duplicate reconciliation"
      }
    ],
    "edges": [
      {
        "id": "rel-va-vha",
        "from": "05025F",
        "to": "veterans-health-administration",
        "relationship": "federal_public_control",
        "confidence": "medium",
        "sourceIds": [
          "cms_enroll_va",
          "project_queue_va"
        ],
        "note": "Relationship edge is source-backed but public display still requires validation/approval."
      }
    ],
    "caveats": [
      "Duplicate rows at same CCN/address family; verify VA facility naming and current VHA hierarchy",
      "Needs official VA/CMS source refresh and duplicate-row merge/alias before publication.",
      "Research completed structurally for this custom Fresno NEXT-style batch, but no stronger public label should be published without exact approval and validation gates."
    ]
  },
  "ownershipConnections": [
    {
      "entityName": "veterans health administration",
      "entityKind": "organization",
      "relationship": "federal_public_control",
      "classification": "medium",
      "evidenceSourceIds": [
        "cms_enroll_va",
        "project_queue_va"
      ],
      "note": "Project baseline supports VA/VHA public control but needs duplicate reconciliation"
    }
  ],
  "importantLinks": [
    {
      "label": "CMS/HIFLD baseline local queue source",
      "url": "/data/releases/release-2026-07-04-fresno-city-custom-next-001.json",
      "sourceId": "cms_enroll_va",
      "note": "Project baseline rows identify Fresno VA Medical Center / VA Central California Health Care System under public VA control. Limit: Internal queue should be reconciled with official VA/CMS source before a public label change. Audit location: research/queue/all-hospital-review.json; CCN 05025F rows"
    },
    {
      "label": "All-hospital review queue local record",
      "url": "/data/releases/release-2026-07-04-fresno-city-custom-next-001.json",
      "sourceId": "project_queue_va",
      "note": "Project queue has duplicate Fresno VA Medical Center / VA Central California Health Care System rows sharing CCN/address family. Limit: Internal queue is not an external source for ownership. Audit location: research/queue/all-hospital-review.json; Entity ID 05025F duplicate rows"
    }
  ],
  "descriptiveTrends": [],
  "systemConnections": [
    {
      "systemName": "veterans health administration",
      "relationship": "federal_public_control",
      "evidenceSourceIds": [
        "cms_enroll_va",
        "project_queue_va"
      ],
      "facilities": [
        {
          "name": "FRESNO VA MEDICAL CENTER",
          "role": "Project baseline supports VA/VHA public control but needs duplicate reconciliation",
          "city": "FRESNO",
          "state": "CA",
          "recordId": "05025F",
          "note": "Relationship edge is source-backed but public display still requires validation/approval."
        }
      ]
    }
  ],
  "directConnections": [
    "U.S. Department of Veterans Affairs / Veterans Health Administration public control",
    "No private contract exposure resolved in this pass",
    "Project baseline supports VA/VHA public control but needs duplicate reconciliation"
  ],
  "actions": [],
  "contradictions": [
    {
      "topic": "Project queue has duplicate Fresno VA / VA Central California rows sharing CCN/address family.",
      "claim_a": "Project queue has duplicate Fresno VA / VA Central California rows sharing CCN/address family.",
      "claim_b": "Sources: project_queue_va|cms_enroll_va",
      "resolution_status": "Merge or alias duplicate rows before publication changes."
    }
  ],
  "limitations": [
    "Duplicate rows at same CCN/address family; verify VA facility naming and current VHA hierarchy",
    "Needs official VA/CMS source refresh and duplicate-row merge/alias before publication.",
    "Research completed structurally for this custom Fresno NEXT-style batch, but no stronger public label should be published without exact approval and validation gates."
  ],
  "unavailableFields": [
    "Duplicate rows at same CCN/address family; verify VA facility naming and current VHA hierarchy",
    "Needs official VA/CMS source refresh and duplicate-row merge/alias before publication.",
    "Research completed structurally for this custom Fresno NEXT-style batch, but no stronger public label should be published without exact approval and validation gates."
  ],
  "sources": [
    {
      "source_id": "cms_enroll_va",
      "title": "CMS/HIFLD baseline local queue source",
      "publisher": "PE Healthcare Watch internal baseline",
      "publication_date": "2026-06-24",
      "retrieved_at": "2026-07-04",
      "url": "/data/releases/release-2026-07-04-fresno-city-custom-next-001.json",
      "reliability_tier": "internal",
      "research_note": "Project baseline rows identify Fresno VA Medical Center / VA Central California Health Care System under public VA control. Limit: Internal queue should be reconciled with official VA/CMS source before a public label change. Audit location: research/queue/all-hospital-review.json; CCN 05025F rows"
    },
    {
      "source_id": "project_queue_va",
      "title": "All-hospital review queue local record",
      "publisher": "PE Healthcare Watch",
      "publication_date": "2026-07-01",
      "retrieved_at": "2026-07-04",
      "url": "/data/releases/release-2026-07-04-fresno-city-custom-next-001.json",
      "reliability_tier": "internal",
      "research_note": "Project queue has duplicate Fresno VA Medical Center / VA Central California Health Care System rows sharing CCN/address family. Limit: Internal queue is not an external source for ownership. Audit location: research/queue/all-hospital-review.json; Entity ID 05025F duplicate rows"
    }
  ]
}