{
  "schemaVersion": 4,
  "entityId": "050710",
  "canonicalName": "KAISER FOUNDATION HOSPITAL - FRESNO",
  "status": "corporate_chain",
  "statusLabel": "Corporate-chain/accountability context",
  "summary": "Kaiser Foundation Hospital - Fresno was reviewed in the Fresno custom NEXT-style batch. Kaiser Foundation Hospitals nonprofit/system control; no external staffing or PE contract claim proved in this pass. 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": "high",
    "source_count": 3,
    "ownership_source_count": 3,
    "identity_match_method": "Entity ID 050710; CCN 050710",
    "publication_decision": "Keep Kaiser system-control baseline; no PE/contract label change",
    "batch_id": "next-50-2026-07-04-fresno-city-001"
  },
  "firstGlance": {
    "taxOwnershipType": "Nonprofit",
    "operator": "Kaiser Foundation Hospitals",
    "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 Hospitals",
    "currentCeo": "Leadership research pending",
    "previousRelevantCeo": "Not identified in this Fresno batch",
    "operatorType": "Integrated health system",
    "operatorName": "Kaiser Foundation Hospitals",
    "parentSystem": "Kaiser Permanente",
    "affiliatedSystem": "Kaiser Permanente",
    "religiousAffiliation": "Secular/no evidence",
    "confidence": "high",
    "evidenceAsOf": "2026-07-04",
    "bottomLine": "Kaiser Foundation Hospitals nonprofit/system control; no external staffing or PE contract claim proved in this pass."
  },
  "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 Hospitals",
    "publicFacingCaveat": "If desired, add integrated Kaiser system edge and verify current Permanente Medical Group relationship separately"
  },
  "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": "050710",
    "npi": null,
    "historicalCcns": [],
    "aliases": []
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-kaiser-system",
      "relationship_type": "controls",
      "effective_date": "2026-07-04",
      "end_date": "",
      "status": "current_or_contextual",
      "source_ids": "cms_enroll_kaiser|cms_owner_kaiser|hcai_kaiser",
      "plain_english_summary": "CMS/HCAI support Kaiser Foundation Hospitals control of Fresno facility"
    }
  ],
  "acquisitionEvents": [],
  "financialAndUtilizationSeries": [],
  "cmsOwnerRecords": [],
  "ownershipChain": {
    "model": "Fresno custom NEXT-style batch relationship graph. Edges are source-backed context, not automatic public label changes.",
    "confidence": "high",
    "nodes": [
      {
        "id": "050710",
        "label": "KAISER FOUNDATION HOSPITAL - FRESNO",
        "kind": "hospital",
        "evidence": "Reviewed in next-50-2026-07-04-fresno-city-001."
      },
      {
        "id": "kaiser-foundation-hospitals",
        "label": "kaiser foundation hospitals",
        "kind": "organization",
        "evidence": "CMS/HCAI support Kaiser Foundation Hospitals control of Fresno facility"
      }
    ],
    "edges": [
      {
        "id": "rel-kaiser-system",
        "from": "050710",
        "to": "kaiser-foundation-hospitals",
        "relationship": "system_control",
        "confidence": "high",
        "sourceIds": [
          "cms_enroll_kaiser",
          "cms_owner_kaiser",
          "hcai_kaiser"
        ],
        "note": "Relationship edge is source-backed but public display still requires validation/approval."
      }
    ],
    "caveats": [
      "If desired, add integrated Kaiser system edge and verify current Permanente Medical Group relationship separately",
      "If needed, separately verify Permanente Medical Group relationship and any material outsourced service lines.",
      "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": "kaiser foundation hospitals",
      "entityKind": "organization",
      "relationship": "system_control",
      "classification": "high",
      "evidenceSourceIds": [
        "cms_enroll_kaiser",
        "cms_owner_kaiser",
        "hcai_kaiser"
      ],
      "note": "CMS/HCAI support Kaiser Foundation Hospitals control of Fresno facility"
    }
  ],
  "importantLinks": [
    {
      "label": "CMS Hospital Enrollments local cache",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "sourceId": "cms_enroll_kaiser",
      "note": "Kaiser Foundation Hospitals is enrolled as Kaiser Foundation Hospital Fresno, corporation/nonprofit, at 7300 N Fresno St. Limit: Does not prove no external contracts. Audit location: research/cache/hospital-enrollments.csv; CCN 050710 row"
    },
    {
      "label": "CMS Hospital All Owners local cache",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "sourceId": "cms_owner_kaiser",
      "note": "CMS owner cache shows Kaiser Foundation Hospitals nonprofit/system control and managing/officer rows for the Kaiser hospital family. Limit: Does not show all Permanente medical-group arrangements or external service contracts. Audit location: research/cache/hospital-all-owners.csv; Kaiser Foundation Hospitals owner/control rows"
    },
    {
      "label": "Kaiser Foundation Hospital - Fresno profile",
      "url": "https://hcai.ca.gov/facility/kaiser-foundation-hospital-fresno/",
      "sourceId": "hcai_kaiser",
      "note": "Kaiser Foundation Hospital - Fresno is open, licensed as a general acute care hospital, with 169 licensed beds. Limit: Does not show all Permanente group relationships. Hospital profile lines 205-216"
    }
  ],
  "descriptiveTrends": [],
  "systemConnections": [
    {
      "systemName": "kaiser foundation hospitals",
      "relationship": "system_control",
      "evidenceSourceIds": [
        "cms_enroll_kaiser",
        "cms_owner_kaiser",
        "hcai_kaiser"
      ],
      "facilities": [
        {
          "name": "KAISER FOUNDATION HOSPITAL - FRESNO",
          "role": "CMS/HCAI support Kaiser Foundation Hospitals control of Fresno facility",
          "city": "FRESNO",
          "state": "CA",
          "recordId": "050710",
          "note": "Relationship edge is source-backed but public display still requires validation/approval."
        }
      ]
    }
  ],
  "directConnections": [
    "Kaiser Foundation Hospitals nonprofit/system control",
    "HCAI lists open 169-bed hospital; no private-equity or external staffing contract proven in this pass",
    "CMS/HCAI support Kaiser Foundation Hospitals control of Fresno facility"
  ],
  "actions": [],
  "contradictions": [],
  "limitations": [
    "If desired, add integrated Kaiser system edge and verify current Permanente Medical Group relationship separately",
    "If needed, separately verify Permanente Medical Group relationship and any material outsourced service lines.",
    "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": [
    "If desired, add integrated Kaiser system edge and verify current Permanente Medical Group relationship separately",
    "If needed, separately verify Permanente Medical Group relationship and any material outsourced service lines.",
    "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_kaiser",
      "title": "CMS Hospital Enrollments local cache",
      "publisher": "CMS",
      "publication_date": "2026-06-24",
      "retrieved_at": "2026-07-04",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "reliability_tier": "high",
      "research_note": "Kaiser Foundation Hospitals is enrolled as Kaiser Foundation Hospital Fresno, corporation/nonprofit, at 7300 N Fresno St. Limit: Does not prove no external contracts. Audit location: research/cache/hospital-enrollments.csv; CCN 050710 row"
    },
    {
      "source_id": "cms_owner_kaiser",
      "title": "CMS Hospital All Owners local cache",
      "publisher": "CMS",
      "publication_date": "2026-06-24",
      "retrieved_at": "2026-07-04",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "reliability_tier": "high",
      "research_note": "CMS owner cache shows Kaiser Foundation Hospitals nonprofit/system control and managing/officer rows for the Kaiser hospital family. Limit: Does not show all Permanente medical-group arrangements or external service contracts. Audit location: research/cache/hospital-all-owners.csv; Kaiser Foundation Hospitals owner/control rows"
    },
    {
      "source_id": "hcai_kaiser",
      "title": "Kaiser Foundation Hospital - Fresno profile",
      "publisher": "HCAI",
      "publication_date": "2026",
      "retrieved_at": "2026-07-04",
      "url": "https://hcai.ca.gov/facility/kaiser-foundation-hospital-fresno/",
      "reliability_tier": "high",
      "research_note": "Kaiser Foundation Hospital - Fresno is open, licensed as a general acute care hospital, with 169 licensed beds. Limit: Does not show all Permanente group relationships. Hospital profile lines 205-216"
    }
  ]
}