{
  "schemaVersion": 3,
  "entityId": "090003",
  "canonicalName": "HOWARD UNIVERSITY HOSPITAL",
  "status": "confirmed_pe",
  "statusLabel": "CMS-corroborated PE ownership record",
  "summary": "HOWARD UNIVERSITY HOSPITAL is listed in the April 3, 2026 PE hospital tracker and matches current CMS enrollment and owner records for HOWARD UNIVERSITY HOSPITAL CORP. The dossier distinguishes the enrolled legal owner from the broader sponsor and portfolio-company chain.",
  "lastReviewed": "2026-06-22",
  "review": {
    "reviewer": "Automated CMS/PESP reconciliation with editorial publication gate",
    "evidence_grade": "government-corroborated",
    "confidence": "medium",
    "source_count": 6,
    "ownership_source_count": 2,
    "identity_match_method": "CCN exact match",
    "publication_decision": "Meets the Phase 3 publication standard for its displayed status"
  },
  "identifiers": {
    "ccn": "090003",
    "npi": "1487740957",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "HOWARD UNIVERSITY HOSPITAL CORP",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "FACULTY PRACTICE PLAN HOWARD UNIVERSITY",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-adventist-090003",
      "from_entity_id": "Adventist HealthCare",
      "to_entity_id": "090003",
      "relationship_type": "owns",
      "effective_date": "February 2020",
      "end_date": "",
      "announcement_date": "",
      "status": "confirmed",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners|source-pesp-hospital-tracker",
      "plain_english_summary": "The tracker identifies Adventist HealthCare in the PE ownership chain, and CMS supplies current enrolled-owner records for the facility.",
      "review_notes": "CMS corroborates the current enrolled ownership chain; the sponsor attribution comes from the research tracker."
    }
  ],
  "acquisitionEvents": [
    {
      "date": "February 2020",
      "title": "Acquisition date reported",
      "detail": "Date supplied by the April 3, 2026 PE hospital tracker snapshot.",
      "sourceIds": [
        "source-pesp-hospital-tracker"
      ]
    }
  ],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "090003-net_patient_revenue-12-31-2023",
      "entity_id": "090003",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "138552455",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-net_patient_revenue-06-30-2023",
      "entity_id": "090003",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "294594748",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-net_patient_revenue-06-30-2022",
      "entity_id": "090003",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "292407881",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-operating_expense-12-31-2023",
      "entity_id": "090003",
      "metric_name": "operating_expense",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "156406818",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-operating_expense-06-30-2023",
      "entity_id": "090003",
      "metric_name": "operating_expense",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "319459453",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-operating_expense-06-30-2022",
      "entity_id": "090003",
      "metric_name": "operating_expense",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "339071738",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-net_income-12-31-2023",
      "entity_id": "090003",
      "metric_name": "net_income",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "-1093845",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-net_income-06-30-2023",
      "entity_id": "090003",
      "metric_name": "net_income",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "16283805",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-net_income-06-30-2022",
      "entity_id": "090003",
      "metric_name": "net_income",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "24011778",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-total_assets-12-31-2023",
      "entity_id": "090003",
      "metric_name": "total_assets",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "159024000",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-total_assets-06-30-2023",
      "entity_id": "090003",
      "metric_name": "total_assets",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "175840300",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-total_assets-06-30-2022",
      "entity_id": "090003",
      "metric_name": "total_assets",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "182429680",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-total_liabilities-12-31-2023",
      "entity_id": "090003",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "123439552",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-total_liabilities-06-30-2023",
      "entity_id": "090003",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "139494235",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-total_liabilities-06-30-2022",
      "entity_id": "090003",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "163848150",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-fte_employees-12-31-2023",
      "entity_id": "090003",
      "metric_name": "fte_employees",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "1607.01",
      "unit": "FTE",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-fte_employees-06-30-2023",
      "entity_id": "090003",
      "metric_name": "fte_employees",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "1574.9",
      "unit": "FTE",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-fte_employees-06-30-2022",
      "entity_id": "090003",
      "metric_name": "fte_employees",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "1521.88",
      "unit": "FTE",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-beds-12-31-2023",
      "entity_id": "090003",
      "metric_name": "beds",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "234",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-beds-06-30-2023",
      "entity_id": "090003",
      "metric_name": "beds",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "215",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-beds-06-30-2022",
      "entity_id": "090003",
      "metric_name": "beds",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "228",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-patient_days-12-31-2023",
      "entity_id": "090003",
      "metric_name": "patient_days",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "20381",
      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-patient_days-06-30-2023",
      "entity_id": "090003",
      "metric_name": "patient_days",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "47622",
      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-patient_days-06-30-2022",
      "entity_id": "090003",
      "metric_name": "patient_days",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "45655",
      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-discharges-12-31-2023",
      "entity_id": "090003",
      "metric_name": "discharges",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "3465",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-discharges-06-30-2023",
      "entity_id": "090003",
      "metric_name": "discharges",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "7068",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-discharges-06-30-2022",
      "entity_id": "090003",
      "metric_name": "discharges",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "7412",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-contract_labor_direct_patient_care-12-31-2023",
      "entity_id": "090003",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "07/01/2023",
      "period_end": "12/31/2023",
      "value": "16608148",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-contract_labor_direct_patient_care-06-30-2023",
      "entity_id": "090003",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "22450115",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "090003-contract_labor_direct_patient_care-06-30-2022",
      "entity_id": "090003",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "07/01/2021",
      "period_end": "06/30/2022",
      "value": "30030710",
      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    }
  ],
  "cmsOwnerRecords": [
    {
      "organization": "RICHARD BESSER",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HOWARD UNIVERSITY",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "01/01/2024",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MARIE JOHNS",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MINNIE BAYLOR-HENRY",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHRISTIE TAYLOR",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "STEPHEN GRAHAM",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "AMY TAYLOR",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KEVIN LOFTON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "LINDA GREENE",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HUGH MIGHTY",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [
    "Reported investment sponsor: Adventist HealthCare."
  ],
  "actions": [],
  "contradictions": [],
  "limitations": [
    "CMS corroborates an enrolled ownership chain, but its owner names do not independently reproduce every sponsor or portfolio-company name from the tracker."
  ],
  "unavailableFields": [
    "Official facility URL"
  ],
  "sources": [
    {
      "source_id": "source-hifld-hospitals",
      "title": "Hospitals RAPT",
      "publisher": "Homeland Infrastructure Foundation-Level Data",
      "publication_date": "current public layer",
      "retrieved_at": "2026-06-22",
      "url": "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
      "reliability_tier": "government",
      "research_note": "Used for facility location and basic identity context; it does not establish private-equity ownership.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-pesp-hospital-tracker",
      "title": "Private Equity Hospital Tracker",
      "publisher": "Private Equity Stakeholder Project",
      "publication_date": "2026-04-03 snapshot",
      "retrieved_at": "2026-06-22",
      "url": "https://pestakeholder.org/private-equity-hospital-tracker/",
      "reliability_tier": "research",
      "research_note": "Discovery and ownership-chain baseline. A red public status also requires independent corroboration in this dossier.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-enrollments",
      "title": "Hospital Enrollments",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026-05-01",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "reliability_tier": "government",
      "research_note": "Used to corroborate current enrollment identity, legal name, DBA, CCN, NPI, and location.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-all-owners",
      "title": "Hospital All Owners",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026-05-01",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "reliability_tier": "government",
      "research_note": "Used to corroborate direct or indirect ownership, control, holding-company, investment-firm, and security-interest records.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hcris",
      "title": "Hospital Provider Cost Reports",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2015–2024",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
      "reliability_tier": "government",
      "research_note": "Financial, staffing, and utilization values. These descriptive measures do not establish causation.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-care-compare",
      "title": "Hospital General Information",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "reliability_tier": "government",
      "research_note": "Used for current facility identity, hospital type, ownership category, and overall rating when available.",
      "source_type": "public_record"
    }
  ],
  "ownershipChain": {
    "model": "Sponsor, operator, CMS legal-owner/control records, and facility are shown as separate evidence layers.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "facility:090003",
        "label": "HOWARD UNIVERSITY HOSPITAL",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:adventist-healthcare",
        "label": "Adventist HealthCare",
        "kind": "pe_sponsor",
        "evidence": "research tracker or primary portfolio source"
      },
      {
        "id": "organization:howard-university",
        "label": "Howard University",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:richard-besser:0",
        "label": "RICHARD BESSER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:howard-university:1",
        "label": "HOWARD UNIVERSITY",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:marie-johns:2",
        "label": "MARIE JOHNS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:minnie-baylor-henry:3",
        "label": "MINNIE BAYLOR-HENRY",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:christie-taylor:4",
        "label": "CHRISTIE TAYLOR",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:stephen-graham:5",
        "label": "STEPHEN GRAHAM",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:amy-taylor:6",
        "label": "AMY TAYLOR",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:kevin-lofton:7",
        "label": "KEVIN LOFTON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:linda-greene:8",
        "label": "LINDA GREENE",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:hugh-mighty:9",
        "label": "HUGH MIGHTY",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      }
    ],
    "edges": [
      {
        "id": "organization:adventist-healthcare->organization:howard-university",
        "from": "organization:adventist-healthcare",
        "to": "organization:howard-university",
        "relationship": "sponsors",
        "confidence": "medium",
        "sourceIds": [
          "source-cms-hospital-all-owners",
          "source-pesp-hospital-tracker"
        ],
        "note": "The tracker supplies the sponsor-to-platform attribution; CMS does not independently reproduce every sponsor name."
      },
      {
        "id": "organization:howard-university->facility:090003",
        "from": "organization:howard-university",
        "to": "facility:090003",
        "relationship": "reported ownership or operating chain",
        "confidence": "medium",
        "sourceIds": [
          "source-cms-hospital-all-owners",
          "source-pesp-hospital-tracker"
        ],
        "note": "The platform attribution comes from the research tracker and is displayed separately from CMS legal-owner rows."
      },
      {
        "id": "cms-owner:richard-besser:0->facility:090003",
        "from": "cms-owner:richard-besser:0",
        "to": "facility:090003",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      },
      {
        "id": "cms-owner:howard-university:1->facility:090003",
        "from": "cms-owner:howard-university:1",
        "to": "facility:090003",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 01/01/2024"
      },
      {
        "id": "cms-owner:marie-johns:2->facility:090003",
        "from": "cms-owner:marie-johns:2",
        "to": "facility:090003",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      },
      {
        "id": "cms-owner:minnie-baylor-henry:3->facility:090003",
        "from": "cms-owner:minnie-baylor-henry:3",
        "to": "facility:090003",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      },
      {
        "id": "cms-owner:christie-taylor:4->facility:090003",
        "from": "cms-owner:christie-taylor:4",
        "to": "facility:090003",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/01/2024"
      },
      {
        "id": "cms-owner:stephen-graham:5->facility:090003",
        "from": "cms-owner:stephen-graham:5",
        "to": "facility:090003",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      },
      {
        "id": "cms-owner:amy-taylor:6->facility:090003",
        "from": "cms-owner:amy-taylor:6",
        "to": "facility:090003",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 01/01/2024"
      },
      {
        "id": "cms-owner:kevin-lofton:7->facility:090003",
        "from": "cms-owner:kevin-lofton:7",
        "to": "facility:090003",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2024"
      },
      {
        "id": "cms-owner:linda-greene:8->facility:090003",
        "from": "cms-owner:linda-greene:8",
        "to": "facility:090003",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 01/01/2024"
      },
      {
        "id": "cms-owner:hugh-mighty:9->facility:090003",
        "from": "cms-owner:hugh-mighty:9",
        "to": "facility:090003",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/01/2024"
      }
    ],
    "caveats": [
      "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor.",
      "Sponsor and portfolio-company labels come from the cited tracker or primary portfolio evidence."
    ]
  },
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 292407881,
      "latestValue": 138552455,
      "absoluteChange": -153855426,
      "percentChange": -52.61671657885309,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 339071738,
      "latestValue": 156406818,
      "absoluteChange": -182664920,
      "percentChange": -53.87205700995346,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 24011778,
      "latestValue": -1093845,
      "absoluteChange": -25105623,
      "percentChange": -104.55545191197419,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 182429680,
      "latestValue": 159024000,
      "absoluteChange": -23405680,
      "percentChange": -12.829973719188676,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 163848150,
      "latestValue": 123439552,
      "absoluteChange": -40408598,
      "percentChange": -24.6622241386308,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 30030710,
      "latestValue": 16608148,
      "absoluteChange": -13422562,
      "percentChange": -44.6961194057683,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 1521.88,
      "latestValue": 1607.01,
      "absoluteChange": 85.12999999999988,
      "percentChange": 5.593739322417003,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 228,
      "latestValue": 234,
      "absoluteChange": 6,
      "percentChange": 2.631578947368421,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 45655,
      "latestValue": 20381,
      "absoluteChange": -25274,
      "percentChange": -55.35866827291643,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "12/31/2023",
      "earliestValue": 7412,
      "latestValue": 3465,
      "absoluteChange": -3947,
      "percentChange": -53.25148407987048,
      "unit": "discharges"
    }
  ]
}
