{
  "schemaVersion": 3,
  "entityId": "180078",
  "canonicalName": "PAINTSVILLE ARH HOSPITAL",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "PAINTSVILLE ARH HOSPITAL 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": "180078",
    "npi": "1437813441",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "ARH TUG VALLEY HEALTH SERVICES INC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "PAINTSVILLE ARH HOSPITAL",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-reportedowner-180078",
      "from_entity_id": "reported owner",
      "to_entity_id": "180078",
      "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": [],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "180078-net_patient_revenue-06-30-2024",
      "entity_id": "180078",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "30242039",
      "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": "180078-net_patient_revenue-06-30-2023",
      "entity_id": "180078",
      "metric_name": "net_patient_revenue",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "30273517",
      "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": "180078-net_patient_revenue-06-30-2022",
      "entity_id": "180078",
      "metric_name": "net_patient_revenue",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "18868957",
      "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": "180078-operating_expense-06-30-2024",
      "entity_id": "180078",
      "metric_name": "operating_expense",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "35439180",
      "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": "180078-operating_expense-06-30-2023",
      "entity_id": "180078",
      "metric_name": "operating_expense",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "38705430",
      "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": "180078-operating_expense-06-30-2022",
      "entity_id": "180078",
      "metric_name": "operating_expense",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "20045447",
      "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": "180078-net_income-06-30-2024",
      "entity_id": "180078",
      "metric_name": "net_income",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "11664039",
      "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": "180078-net_income-06-30-2023",
      "entity_id": "180078",
      "metric_name": "net_income",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "3620904",
      "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": "180078-net_income-06-30-2022",
      "entity_id": "180078",
      "metric_name": "net_income",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "-5373482",
      "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": "180078-total_assets-06-30-2024",
      "entity_id": "180078",
      "metric_name": "total_assets",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "10387426",
      "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": "180078-total_assets-06-30-2023",
      "entity_id": "180078",
      "metric_name": "total_assets",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "10453657",
      "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": "180078-total_assets-06-30-2022",
      "entity_id": "180078",
      "metric_name": "total_assets",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "15425394",
      "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": "180078-total_liabilities-06-30-2024",
      "entity_id": "180078",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "-3012675",
      "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": "180078-total_liabilities-06-30-2023",
      "entity_id": "180078",
      "metric_name": "total_liabilities",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "-987674",
      "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": "180078-total_liabilities-06-30-2022",
      "entity_id": "180078",
      "metric_name": "total_liabilities",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "-344943",
      "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": "180078-contract_labor_direct_patient_care-06-30-2024",
      "entity_id": "180078",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "647695",
      "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": "180078-contract_labor_direct_patient_care-06-30-2023",
      "entity_id": "180078",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "1928546",
      "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": "180078-contract_labor_direct_patient_care-06-30-2022",
      "entity_id": "180078",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "1902681",
      "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": "180078-fte_employees-06-30-2024",
      "entity_id": "180078",
      "metric_name": "fte_employees",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "179.24",
      "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": "180078-fte_employees-06-30-2023",
      "entity_id": "180078",
      "metric_name": "fte_employees",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "185.39",
      "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": "180078-fte_employees-06-30-2022",
      "entity_id": "180078",
      "metric_name": "fte_employees",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "98.01",
      "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": "180078-beds-06-30-2024",
      "entity_id": "180078",
      "metric_name": "beds",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "39",
      "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": "180078-beds-06-30-2023",
      "entity_id": "180078",
      "metric_name": "beds",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "39",
      "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": "180078-beds-06-30-2022",
      "entity_id": "180078",
      "metric_name": "beds",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "47",
      "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": "180078-patient_days-06-30-2024",
      "entity_id": "180078",
      "metric_name": "patient_days",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "5126",
      "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": "180078-patient_days-06-30-2023",
      "entity_id": "180078",
      "metric_name": "patient_days",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "4260",
      "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": "180078-patient_days-06-30-2022",
      "entity_id": "180078",
      "metric_name": "patient_days",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "3471",
      "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": "180078-discharges-06-30-2024",
      "entity_id": "180078",
      "metric_name": "discharges",
      "period_start": "07/01/2023",
      "period_end": "06/30/2024",
      "value": "1408",
      "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": "180078-discharges-06-30-2023",
      "entity_id": "180078",
      "metric_name": "discharges",
      "period_start": "07/01/2022",
      "period_end": "06/30/2023",
      "value": "1170",
      "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": "180078-discharges-06-30-2022",
      "entity_id": "180078",
      "metric_name": "discharges",
      "period_start": "12/01/2021",
      "period_end": "06/30/2022",
      "value": "879",
      "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": "HOLLIE HARRIS",
      "role": "CORPORATE OFFICER",
      "association_date": "05/10/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HOLLIE HARRIS",
      "role": "CORPORATE DIRECTOR",
      "association_date": "05/10/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "APPALACHIAN REGIONAL HEALTHCARE INC",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "07/19/2013",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JONATHAN COLLINS",
      "role": "CORPORATE OFFICER",
      "association_date": "11/30/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "BYRON GABBARD",
      "role": "CORPORATE OFFICER",
      "association_date": "11/28/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "VANESSA JOHNSON",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "08/01/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROCCO MASSEY",
      "role": "CORPORATE DIRECTOR",
      "association_date": "08/01/2017",
      "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",
    "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:180078",
        "label": "PAINTSVILLE ARH HOSPITAL",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:appalachian-regional-healthcare",
        "label": "Appalachian Regional Healthcare",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:hollie-harris:0",
        "label": "HOLLIE HARRIS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:hollie-harris:1",
        "label": "HOLLIE HARRIS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:appalachian-regional-healthcare-inc:2",
        "label": "APPALACHIAN REGIONAL HEALTHCARE INC",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:jonathan-collins:3",
        "label": "JONATHAN COLLINS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:byron-gabbard:4",
        "label": "BYRON GABBARD",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:vanessa-johnson:5",
        "label": "VANESSA JOHNSON",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:rocco-massey:6",
        "label": "ROCCO MASSEY",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      }
    ],
    "edges": [
      {
        "id": "organization:appalachian-regional-healthcare->facility:180078",
        "from": "organization:appalachian-regional-healthcare",
        "to": "facility:180078",
        "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:hollie-harris:0->facility:180078",
        "from": "cms-owner:hollie-harris:0",
        "to": "facility:180078",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 05/10/2021"
      },
      {
        "id": "cms-owner:hollie-harris:1->facility:180078",
        "from": "cms-owner:hollie-harris:1",
        "to": "facility:180078",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 05/10/2021"
      },
      {
        "id": "cms-owner:appalachian-regional-healthcare-inc:2->facility:180078",
        "from": "cms-owner:appalachian-regional-healthcare-inc:2",
        "to": "facility:180078",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 07/19/2013"
      },
      {
        "id": "cms-owner:jonathan-collins:3->facility:180078",
        "from": "cms-owner:jonathan-collins:3",
        "to": "facility:180078",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 11/30/2022"
      },
      {
        "id": "cms-owner:byron-gabbard:4->facility:180078",
        "from": "cms-owner:byron-gabbard:4",
        "to": "facility:180078",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 11/28/2023"
      },
      {
        "id": "cms-owner:vanessa-johnson:5->facility:180078",
        "from": "cms-owner:vanessa-johnson:5",
        "to": "facility:180078",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 08/01/2017"
      },
      {
        "id": "cms-owner:rocco-massey:6->facility:180078",
        "from": "cms-owner:rocco-massey:6",
        "to": "facility:180078",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 08/01/2017"
      }
    ],
    "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": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 18868957,
      "latestValue": 30242039,
      "absoluteChange": 11373082,
      "percentChange": 60.274036344457194,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 20045447,
      "latestValue": 35439180,
      "absoluteChange": 15393733,
      "percentChange": 76.79416178646453,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": -5373482,
      "latestValue": 11664039,
      "absoluteChange": 17037521,
      "percentChange": 317.0666804131846,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 15425394,
      "latestValue": 10387426,
      "absoluteChange": -5037968,
      "percentChange": -32.66022248767195,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": -344943,
      "latestValue": -3012675,
      "absoluteChange": -2667732,
      "percentChange": -773.3834285664587,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 1902681,
      "latestValue": 647695,
      "absoluteChange": -1254986,
      "percentChange": -65.95882336555628,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 98.01,
      "latestValue": 179.24,
      "absoluteChange": 81.23,
      "percentChange": 82.87929803081319,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 47,
      "latestValue": 39,
      "absoluteChange": -8,
      "percentChange": -17.02127659574468,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 3471,
      "latestValue": 5126,
      "absoluteChange": 1655,
      "percentChange": 47.680783635839816,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "06/30/2022",
      "latestPeriod": "06/30/2024",
      "earliestValue": 879,
      "latestValue": 1408,
      "absoluteChange": 529,
      "percentChange": 60.18202502844141,
      "unit": "discharges"
    }
  ]
}