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  "canonicalName": "THE MEDICAL CENTER AT FRANKLIN",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "THE MEDICAL CENTER AT FRANKLIN 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"
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    "npi": "1831173467",
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      },
      {
        "alias": "THE MEDICAL CENTER AT FRANKLIN",
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      "effective_date": "",
      "end_date": "",
      "announcement_date": "",
      "status": "signal",
      "confidence": "medium",
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      "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."
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      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "WILLIAM MOSS",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MOHAMMED KAZIMUDDIN",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/01/2015",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DAVID GRAY",
      "role": "CORPORATE OFFICER",
      "association_date": "08/19/2020",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DAVID GRAY",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "08/19/2020",
      "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:181318",
        "label": "THE MEDICAL CENTER AT FRANKLIN",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:commonwealth-health-corporation-inc",
        "label": "COMMONWEALTH HEALTH CORPORATION, INC.",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:eli-jackson:0",
        "label": "ELI JACKSON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:wade-stone:1",
        "label": "WADE STONE",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:wade-stone:2",
        "label": "WADE STONE",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:paul-cook:3",
        "label": "PAUL COOK",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:janet-johnson:4",
        "label": "JANET JOHNSON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:joe-natcher:5",
        "label": "JOE NATCHER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:commonwealth-health-corporation-inc:6",
        "label": "COMMONWEALTH HEALTH CORPORATION, INC.",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:commonwealth-health-corporation-inc:7",
        "label": "COMMONWEALTH HEALTH CORPORATION, INC.",
        "kind": "cms_owner_or_controller",
        "evidence": "OPERATIONAL/MANAGERIAL CONTROL"
      },
      {
        "id": "cms-owner:william-borders:8",
        "label": "WILLIAM BORDERS",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:douglas-thomson:9",
        "label": "DOUGLAS THOMSON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:cathy-bishop:10",
        "label": "CATHY BISHOP",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:donna-blackburn:11",
        "label": "DONNA BLACKBURN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:michele-lawless:12",
        "label": "MICHELE LAWLESS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:michele-lawless:13",
        "label": "MICHELE LAWLESS",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:thomas-loving:14",
        "label": "THOMAS LOVING",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:connie-smith:15",
        "label": "CONNIE SMITH",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      }
    ],
    "edges": [
      {
        "id": "organization:commonwealth-health-corporation-inc->facility:181318",
        "from": "organization:commonwealth-health-corporation-inc",
        "to": "facility:181318",
        "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:eli-jackson:0->facility:181318",
        "from": "cms-owner:eli-jackson:0",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2000"
      },
      {
        "id": "cms-owner:wade-stone:1->facility:181318",
        "from": "cms-owner:wade-stone:1",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 11/14/2012"
      },
      {
        "id": "cms-owner:wade-stone:2->facility:181318",
        "from": "cms-owner:wade-stone:2",
        "to": "facility:181318",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 11/14/2012"
      },
      {
        "id": "cms-owner:paul-cook:3->facility:181318",
        "from": "cms-owner:paul-cook:3",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/1982"
      },
      {
        "id": "cms-owner:janet-johnson:4->facility:181318",
        "from": "cms-owner:janet-johnson:4",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 03/01/2005"
      },
      {
        "id": "cms-owner:joe-natcher:5->facility:181318",
        "from": "cms-owner:joe-natcher:5",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/1992"
      },
      {
        "id": "cms-owner:commonwealth-health-corporation-inc:6->facility:181318",
        "from": "cms-owner:commonwealth-health-corporation-inc:6",
        "to": "facility:181318",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 04/01/2024"
      },
      {
        "id": "cms-owner:commonwealth-health-corporation-inc:7->facility:181318",
        "from": "cms-owner:commonwealth-health-corporation-inc:7",
        "to": "facility:181318",
        "relationship": "controls or manages",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "OPERATIONAL/MANAGERIAL CONTROL · associated 04/01/2024"
      },
      {
        "id": "cms-owner:william-borders:8->facility:181318",
        "from": "cms-owner:william-borders:8",
        "to": "facility:181318",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 12/14/2023"
      },
      {
        "id": "cms-owner:douglas-thomson:9->facility:181318",
        "from": "cms-owner:douglas-thomson:9",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2014"
      },
      {
        "id": "cms-owner:cathy-bishop:10->facility:181318",
        "from": "cms-owner:cathy-bishop:10",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2000"
      },
      {
        "id": "cms-owner:donna-blackburn:11->facility:181318",
        "from": "cms-owner:donna-blackburn:11",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2004"
      },
      {
        "id": "cms-owner:michele-lawless:12->facility:181318",
        "from": "cms-owner:michele-lawless:12",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 08/19/2020"
      },
      {
        "id": "cms-owner:michele-lawless:13->facility:181318",
        "from": "cms-owner:michele-lawless:13",
        "to": "facility:181318",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 0% reported ownership · associated 08/19/2020"
      },
      {
        "id": "cms-owner:thomas-loving:14->facility:181318",
        "from": "cms-owner:thomas-loving:14",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2014"
      },
      {
        "id": "cms-owner:connie-smith:15->facility:181318",
        "from": "cms-owner:connie-smith:15",
        "to": "facility:181318",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 11/17/2010"
      }
    ],
    "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": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 31852978,
      "latestValue": 38317144,
      "absoluteChange": 6464166,
      "percentChange": 20.29375714886062,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 26753089,
      "latestValue": 29139570,
      "absoluteChange": 2386481,
      "percentChange": 8.92039420195552,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 6264342,
      "latestValue": 9524074,
      "absoluteChange": 3259732,
      "percentChange": 52.036303254196525,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 40066611,
      "latestValue": 38445081,
      "absoluteChange": -1621530,
      "percentChange": -4.0470854897111215,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 5620045,
      "latestValue": 4205837,
      "absoluteChange": -1414208,
      "percentChange": -25.163641928134027,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 109.15,
      "latestValue": 107.92,
      "absoluteChange": -1.230000000000004,
      "percentChange": -1.1268896014658762,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 18,
      "latestValue": 25,
      "absoluteChange": 7,
      "percentChange": 38.88888888888889,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 4579,
      "latestValue": 5163,
      "absoluteChange": 584,
      "percentChange": 12.753876392225378,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "03/31/2022",
      "latestPeriod": "03/31/2024",
      "earliestValue": 239,
      "latestValue": 138,
      "absoluteChange": -101,
      "percentChange": -42.25941422594142,
      "unit": "discharges"
    }
  ]
}
