{
  "schemaVersion": 3,
  "entityId": "130049",
  "canonicalName": "KOOTENAI HEALTH",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "KOOTENAI HEALTH appears in the source tracker as a venture-backed investment signal. This dossier does not classify that signal as completed private-equity ownership.",
  "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": "130049",
    "npi": "1992798409",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "KOOTENAI HEALTH INC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-reportedowner-130049",
      "from_entity_id": "reported owner",
      "to_entity_id": "130049",
      "relationship_type": "venture_backing",
      "effective_date": "",
      "end_date": "",
      "announcement_date": "",
      "status": "signal",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners|source-pesp-hospital-tracker",
      "plain_english_summary": "undefined is reported as an investment backer; this is not treated as a completed ownership claim.",
      "review_notes": "CMS corroborates the current enrolled ownership chain; the sponsor attribution comes from the research tracker."
    }
  ],
  "acquisitionEvents": [],
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      "unit": "USD",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
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      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "130049-net_patient_revenue-12-31-2022",
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      "period_end": "12/31/2022",
      "value": "656534784",
      "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": "130049-net_patient_revenue-12-31-2021",
      "entity_id": "130049",
      "metric_name": "net_patient_revenue",
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      "period_end": "12/31/2021",
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      "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": "130049-operating_expense-12-31-2023",
      "entity_id": "130049",
      "metric_name": "operating_expense",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "856306116",
      "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.",
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    },
    {
      "metric_id": "130049-operating_expense-12-31-2022",
      "entity_id": "130049",
      "metric_name": "operating_expense",
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      "period_end": "12/31/2022",
      "value": "817941308",
      "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": "130049-operating_expense-12-31-2021",
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      "unit": "USD",
      "better_when": "context_dependent",
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    },
    {
      "metric_id": "130049-net_income-12-31-2023",
      "entity_id": "130049",
      "metric_name": "net_income",
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      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "130049-net_income-12-31-2022",
      "entity_id": "130049",
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    },
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      "entity_id": "130049",
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    },
    {
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      "source_id": "source-cms-hcris",
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      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "130049-total_liabilities-12-31-2022",
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    },
    {
      "metric_id": "130049-total_liabilities-12-31-2021",
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    },
    {
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    {
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    {
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      "unit": "FTE",
      "better_when": "context_dependent",
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    },
    {
      "metric_id": "130049-fte_employees-12-31-2022",
      "entity_id": "130049",
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      "better_when": "context_dependent",
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      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "130049-fte_employees-12-31-2021",
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      "better_when": "context_dependent",
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    },
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      "metric_id": "130049-beds-12-31-2023",
      "entity_id": "130049",
      "metric_name": "beds",
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      "period_end": "12/31/2023",
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      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
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      "comparable_to_prior": "review_required"
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    {
      "metric_id": "130049-beds-12-31-2022",
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      "value": "324",
      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
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      "comparable_to_prior": "review_required"
    },
    {
      "metric_id": "130049-beds-12-31-2021",
      "entity_id": "130049",
      "metric_name": "beds",
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      "period_end": "12/31/2021",
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      "unit": "beds",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
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      "comparable_to_prior": "review_required"
    },
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      "unit": "days",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
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    {
      "metric_id": "130049-patient_days-12-31-2022",
      "entity_id": "130049",
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      "unit": "days",
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      "unit": "days",
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      "source_id": "source-cms-hcris",
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    },
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      "entity_id": "130049",
      "metric_name": "discharges",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "16921",
      "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": "130049-discharges-12-31-2022",
      "entity_id": "130049",
      "metric_name": "discharges",
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      "period_end": "12/31/2022",
      "value": "15578",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
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      "metric_name": "discharges",
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      "period_end": "12/31/2021",
      "value": "14813",
      "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"
    }
  ],
  "cmsOwnerRecords": [
    {
      "organization": "CINDY CLARK",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "THOMAS DETAR",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DAVID BOBBITT",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KATIE BRODIE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "STEVEN MATHESON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "LISA GOODWIN",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MICHELE BOUIT",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "03/11/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROBERT COLVIN",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROBERT MCFARLAND",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TERI FARR",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ELIZABETH GODBEHERE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [],
  "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.",
    "The investment signal does not establish completed private-equity ownership or a pending sale."
  ],
  "unavailableFields": [
    "Precise acquisition date"
  ],
  "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:130049",
        "label": "KOOTENAI HEALTH",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:kootenai-health",
        "label": "Kootenai Health",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:cindy-clark:0",
        "label": "CINDY CLARK",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:thomas-detar:1",
        "label": "THOMAS DETAR",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:david-bobbitt:2",
        "label": "DAVID BOBBITT",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:katie-brodie:3",
        "label": "KATIE BRODIE",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:steven-matheson:4",
        "label": "STEVEN MATHESON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:lisa-goodwin:5",
        "label": "LISA GOODWIN",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:michele-bouit:6",
        "label": "MICHELE BOUIT",
        "kind": "cms_owner_or_controller",
        "evidence": "OPERATIONAL/MANAGERIAL CONTROL"
      },
      {
        "id": "cms-owner:robert-colvin:7",
        "label": "ROBERT COLVIN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:robert-mcfarland:8",
        "label": "ROBERT MCFARLAND",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:teri-farr:9",
        "label": "TERI FARR",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:elizabeth-godbehere:10",
        "label": "ELIZABETH GODBEHERE",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      }
    ],
    "edges": [
      {
        "id": "organization:kootenai-health->facility:130049",
        "from": "organization:kootenai-health",
        "to": "facility:130049",
        "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:cindy-clark:0->facility:130049",
        "from": "cms-owner:cindy-clark:0",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:thomas-detar:1->facility:130049",
        "from": "cms-owner:thomas-detar:1",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:david-bobbitt:2->facility:130049",
        "from": "cms-owner:david-bobbitt:2",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:katie-brodie:3->facility:130049",
        "from": "cms-owner:katie-brodie:3",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:steven-matheson:4->facility:130049",
        "from": "cms-owner:steven-matheson:4",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:lisa-goodwin:5->facility:130049",
        "from": "cms-owner:lisa-goodwin:5",
        "to": "facility:130049",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 05/01/2023"
      },
      {
        "id": "cms-owner:michele-bouit:6->facility:130049",
        "from": "cms-owner:michele-bouit:6",
        "to": "facility:130049",
        "relationship": "controls or manages",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "OPERATIONAL/MANAGERIAL CONTROL · associated 03/11/2024"
      },
      {
        "id": "cms-owner:robert-colvin:7->facility:130049",
        "from": "cms-owner:robert-colvin:7",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:robert-mcfarland:8->facility:130049",
        "from": "cms-owner:robert-mcfarland:8",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:teri-farr:9->facility:130049",
        "from": "cms-owner:teri-farr:9",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      },
      {
        "id": "cms-owner:elizabeth-godbehere:10->facility:130049",
        "from": "cms-owner:elizabeth-godbehere:10",
        "to": "facility:130049",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/01/2023"
      }
    ],
    "caveats": [
      "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor."
    ]
  },
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 639175483,
      "latestValue": 714353889,
      "absoluteChange": 75178406,
      "percentChange": 11.761778728925371,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 737268080,
      "latestValue": 856306116,
      "absoluteChange": 119038036,
      "percentChange": 16.14582798701932,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 29158436,
      "latestValue": 56528094,
      "absoluteChange": 27369658,
      "percentChange": 93.8653156842843,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 818515264,
      "latestValue": 805997373,
      "absoluteChange": -12517891,
      "percentChange": -1.5293411803741268,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 272508849,
      "latestValue": 273534380,
      "absoluteChange": 1025531,
      "percentChange": 0.376329430682084,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 12982600,
      "latestValue": 20148046,
      "absoluteChange": 7165446,
      "percentChange": 55.192688675611976,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 3131.17,
      "latestValue": 3274,
      "absoluteChange": 142.82999999999993,
      "percentChange": 4.5615536684370355,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 329,
      "latestValue": 326,
      "absoluteChange": -3,
      "percentChange": -0.911854103343465,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 88949,
      "latestValue": 79104,
      "absoluteChange": -9845,
      "percentChange": -11.068140170209896,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 14813,
      "latestValue": 16921,
      "absoluteChange": 2108,
      "percentChange": 14.23074326605009,
      "unit": "discharges"
    }
  ]
}
