{
  "schemaVersion": 4,
  "entityId": "300023",
  "canonicalName": "EXETER HOSPITAL INC",
  "status": "corporate_chain",
  "statusLabel": "Major nonprofit health-system accountability warning",
  "summary": "EXETER HOSPITAL INC has a completed New Hampshire state-template dossier baseline with official identity, CMS enrollment/owner context when matched, CMS Care Compare point-in-time context when matched, HCRIS financial/utilization context when matched, and explicit limitations for missing fields. Unsupported ownership, compensation, labor, quality-trend, or causation claims are not inferred.",
  "lastReviewed": "2026-07-02",
  "review": {
    "reviewer": "Five-state state-template completion batch",
    "evidence_grade": "completed state-template official-source baseline",
    "confidence": "medium",
    "source_count": 22,
    "ownership_source_count": 18,
    "identity_match_method": "CMS enrollment match used where available",
    "publication_decision": "Publish state-template completion fields while preserving explicit unavailable/searched-not-found limitations.",
    "batch_id": "state-template-complete-2026-07-02-001"
  },
  "firstGlance": {
    "taxOwnershipType": "Nonprofit",
    "operator": "Beth Israel Lahey Health",
    "directPeOwnership": "Not documented as direct PE ownership in this state-template pass",
    "peRelationship": "No documented PE link found in this pass; warning is major-system/accountability context",
    "institutionalShareholderContext": "Not applicable to a nonprofit Form 990 organization; no public-company shareholder chain.",
    "populationServedEstimate": 0,
    "populationServedLabel": "BILH reports 14 hospitals, 42,000 employees, 4,800+ physicians, and 1.7M patients each year.",
    "careLevel": "New Hampshire hospital in the BILH quick-link system family",
    "currentCeo": "Kevin Tabb, MD, President and CEO of BILH; Peter Healy is listed as President, Beth Israel Deaconess Medical Center.",
    "previousRelevantCeo": "Needs facility-specific historical leadership review",
    "confidence": "High for BILH control/affiliation; high for BIDMC CMS provider 220086 quality point-in-time metrics; medium for facility-specific labor completeness",
    "bottomLine": "Beth Israel/BIDMC is not independent in the map model: it sits inside nonprofit Beth Israel Lahey Health, Inc. as a Form 990 direct/indirect sole-member system. The strongest verified accountability facts are BILH control, nonprofit Form 990 executive compensation, teaching-hospital/resident-fellow training context, CMS provider 220086 quality metrics, and a merger/price-cap history. The alleged current doctors/residents strike remains unverified in this pass."
  },
  "communityImpact": {
    "populationServedEstimate": 0,
    "populationServedLabel": "BILH says the system provides care to 1.7 million patients each year.",
    "estimateMethod": "BILH 2026 leadership-transition release provides the annual patient count and system scale.",
    "catchmentDescription": "BILH links academic, teaching, specialty, and community hospitals across eastern Massachusetts plus Exeter, New Hampshire.",
    "traumaCareLevel": "Needs facility-specific verification",
    "publicFacingCaveat": "Community-impact fields are descriptive and do not imply that system status caused labor, quality, or access outcomes."
  },
  "qualityAndLaborContext": {
    "immediateJeopardy2026SourceStatus": "No CMS 2567/state inspection review completed in this pass.",
    "noCausationClaim": true,
    "note": "CMS Care Compare point-in-time identity/rating context captured for the state template. This is not a quality trend or ownership-causation claim.",
    "sourceId": "source-cms-care-compare",
    "cmsOverallRating": "4",
    "emergencyServices": "Yes",
    "hospitalType": "Acute Care Hospitals",
    "careCompareOwnership": "Voluntary non-profit - Private"
  },
  "identifiers": {
    "ccn": "300023",
    "npi": "1437158433",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "EXETER HOSPITAL INC",
        "alias_type": "public_atlas_name",
        "source_id": "source-cms-hospital-general-information"
      },
      {
        "alias": "Exeter Hospital",
        "alias_type": "BILH_display_name",
        "source_id": "source-bilh-locations"
      },
      {
        "alias": "EXETER HOSPITAL, INC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "EXETER HOSPITAL INC",
        "alias_type": "cms_care_compare_name",
        "source_id": "source-cms-care-compare"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "bilh-sole-member-300023",
      "relationship_type": "sole_member_control",
      "effective_date": "2019",
      "end_date": "",
      "status": "confirmed",
      "source_ids": "source-propublica-bilh-2022-schedule-o",
      "plain_english_summary": "Form 990 Schedule O says Beth Israel Lahey Health, Inc. served as direct or indirect sole member to BIDMC and other BILH affiliates; this is the nonprofit parent/control layer for Exeter Hospital."
    },
    {
      "relationship_id": "bilh-affiliation-300023",
      "relationship_type": "operates",
      "effective_date": "2019",
      "end_date": "",
      "status": "confirmed",
      "source_ids": "source-bilh-about|source-bilh-locations|source-bilh-leadership",
      "plain_english_summary": "Exeter Hospital is displayed as part of Beth Israel Lahey Health's hospital system family."
    },
    {
      "relationship_id": "bilh-no-pe-claim-300023",
      "relationship_type": "contracts_with",
      "effective_date": "",
      "end_date": "",
      "status": "searched_not_found",
      "source_ids": "source-cms-hospital-general-information|source-cms-hospital-all-owners|source-bilh-locations",
      "plain_english_summary": "This pass did not identify a source proving direct private-equity ownership or a PE-backed staffing/management contract for this facility."
    },
    {
      "relationship_id": "rel-cms-owner-300023",
      "from_entity_id": "bethisraellaheyhealth",
      "to_entity_id": "300023",
      "relationship_type": "cms_owner_context",
      "effective_date": "01/01/2022",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners",
      "plain_english_summary": "CMS Hospital All Owners rows are attached as current owner/control context. They do not by themselves prove private-equity sponsorship unless the row says so or another cited source supports it.",
      "review_notes": ""
    },
    {
      "relationship_id": "rel-state-template-operator-300023",
      "from_entity_id": "bethisraellaheyhealth",
      "to_entity_id": "300023",
      "relationship_type": "operates",
      "effective_date": "",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-pehw-state-template-completion-2026-07-02|source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-cms-care-compare",
      "plain_english_summary": "State-template baseline operator/owner context assembled from current hospital fields and matched official sources where available. This is not a new PE ownership claim.",
      "review_notes": "Used to keep the public dossier graph explicit while preserving limitations for unmatched source families."
    },
    {
      "relationship_id": "rel-cms-owner-300023",
      "from_entity_id": "bethisraellaheyhealth",
      "to_entity_id": "300023",
      "relationship_type": "cms_owner_context",
      "effective_date": "01/01/2022",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners",
      "plain_english_summary": "CMS Hospital All Owners rows are attached as current owner/control context. They do not by themselves prove private-equity sponsorship unless the row says so or another cited source supports it.",
      "review_notes": ""
    },
    {
      "relationship_id": "rel-state-template-operator-300023",
      "from_entity_id": "bethisraellaheyhealth",
      "to_entity_id": "300023",
      "relationship_type": "operates",
      "effective_date": "",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-pehw-state-template-completion-2026-07-02|source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-cms-care-compare",
      "plain_english_summary": "State-template baseline operator/owner context assembled from current hospital fields and matched official sources where available. This is not a new PE ownership claim.",
      "review_notes": "Used to keep the public dossier graph explicit while preserving limitations for unmatched source families."
    },
    {
      "relationship_id": "rel-cms-owner-300023",
      "from_entity_id": "bethisraellaheyhealth",
      "to_entity_id": "300023",
      "relationship_type": "cms_owner_context",
      "effective_date": "01/01/2022",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners",
      "plain_english_summary": "CMS Hospital All Owners rows are attached as current owner/control context. They do not by themselves prove private-equity sponsorship unless the row says so or another cited source supports it.",
      "review_notes": ""
    }
  ],
  "acquisitionEvents": [
    {
      "date": "2018-11-30",
      "title": "Merger approval covered by price-cap reporting",
      "detail": "Axios reported that the Beth Israel Deaconess/Lahey merger was approved with a seven-year price-cap condition and Massachusetts Attorney General settlement framing.",
      "sourceIds": [
        "source-axios-bilh-price-cap"
      ]
    },
    {
      "date": "2019",
      "title": "BILH system family modeled",
      "detail": "Official BILH pages now connect the Beth Israel, Lahey, Beverly/Addison Gilbert/BayRidge, Mount Auburn, New England Baptist, Winchester, Anna Jaques, and Exeter hospital family in the map.",
      "sourceIds": [
        "source-bilh-about",
        "source-bilh-locations"
      ]
    },
    {
      "date": "2024-08-14",
      "title": "Form 990 Schedule O sole-member language reviewed",
      "detail": "ProPublica-rendered Schedule O states BILH served as direct or indirect sole member to BIDMC and other BILH affiliates, which is the clearest parent/control evidence for the connection map.",
      "sourceIds": [
        "source-propublica-bilh-2022-schedule-o"
      ]
    },
    {
      "date": "2025-08-15",
      "title": "FY2024 Form 990 executive compensation extract filed/displayed",
      "detail": "ProPublica displays BILH FY2024 extracted financial data including $27.1M executive compensation and Kevin Tabb with $4.31M compensation plus $1.10M other compensation.",
      "sourceIds": [
        "source-propublica-bilh-990"
      ]
    },
    {
      "date": "2026-03-04",
      "title": "Kevin Tabb transition announced",
      "detail": "BILH said Kevin Tabb gave notice that he would step down in a year and continue until a successor is selected; BILH reported 14 hospitals, 42,000 employees, 4,800+ physicians, and 1.7M patients annually.",
      "sourceIds": [
        "source-bilh-kevin-transition-2026"
      ]
    },
    {
      "date": "2026-06-25",
      "title": "Strike claim handled as unverified lead",
      "detail": "The research pass did not find reliable source support for an active BIDMC doctors/residents strike on this date. The dossier keeps the labor/accountability context visible without asserting the strike as fact.",
      "sourceIds": [
        "source-bilh-medical-education"
      ]
    }
  ],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "300023-net_patient_revenue-09-30-2023",
      "entity_id": "300023",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "295623876",
      "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": "300023-net_patient_revenue-09-30-2022",
      "entity_id": "300023",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "282035885",
      "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": "300023-net_patient_revenue-09-30-2021",
      "entity_id": "300023",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "278670922",
      "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": "300023-net_patient_revenue-09-30-2020",
      "entity_id": "300023",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "250108394",
      "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": "300023-operating_expense-09-30-2023",
      "entity_id": "300023",
      "metric_name": "operating_expense",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "295255832",
      "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": "300023-operating_expense-09-30-2022",
      "entity_id": "300023",
      "metric_name": "operating_expense",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "290955395",
      "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": "300023-operating_expense-09-30-2021",
      "entity_id": "300023",
      "metric_name": "operating_expense",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "257706906",
      "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": "300023-operating_expense-09-30-2020",
      "entity_id": "300023",
      "metric_name": "operating_expense",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "250681411",
      "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": "300023-net_income-09-30-2023",
      "entity_id": "300023",
      "metric_name": "net_income",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "-19868400",
      "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": "300023-net_income-09-30-2022",
      "entity_id": "300023",
      "metric_name": "net_income",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "-10187070",
      "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": "300023-net_income-09-30-2021",
      "entity_id": "300023",
      "metric_name": "net_income",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "76705822",
      "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": "300023-net_income-09-30-2020",
      "entity_id": "300023",
      "metric_name": "net_income",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "27903763",
      "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": "300023-total_assets-09-30-2023",
      "entity_id": "300023",
      "metric_name": "total_assets",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "277979791",
      "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": "300023-total_assets-09-30-2022",
      "entity_id": "300023",
      "metric_name": "total_assets",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "282631034",
      "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": "300023-total_assets-09-30-2021",
      "entity_id": "300023",
      "metric_name": "total_assets",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "369586382",
      "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": "300023-total_assets-09-30-2020",
      "entity_id": "300023",
      "metric_name": "total_assets",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "314845316",
      "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": "300023-total_liabilities-09-30-2023",
      "entity_id": "300023",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "92409411",
      "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": "300023-total_liabilities-09-30-2022",
      "entity_id": "300023",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "78044792",
      "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": "300023-total_liabilities-09-30-2021",
      "entity_id": "300023",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "106303439",
      "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": "300023-total_liabilities-09-30-2020",
      "entity_id": "300023",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "144471571",
      "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": "300023-contract_labor_direct_patient_care-09-30-2023",
      "entity_id": "300023",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "6981654",
      "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": "300023-contract_labor_direct_patient_care-09-30-2022",
      "entity_id": "300023",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
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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": "300023-contract_labor_direct_patient_care-09-30-2021",
      "entity_id": "300023",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "2727348",
      "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": "300023-contract_labor_direct_patient_care-09-30-2020",
      "entity_id": "300023",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "2224088",
      "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": "300023-fte_employees-09-30-2023",
      "entity_id": "300023",
      "metric_name": "fte_employees",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "1255.62",
      "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": "300023-fte_employees-09-30-2022",
      "entity_id": "300023",
      "metric_name": "fte_employees",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "1238",
      "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": "300023-fte_employees-09-30-2021",
      "entity_id": "300023",
      "metric_name": "fte_employees",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "1237.95",
      "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": "300023-fte_employees-09-30-2020",
      "entity_id": "300023",
      "metric_name": "fte_employees",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "1211.44",
      "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": "300023-beds-09-30-2023",
      "entity_id": "300023",
      "metric_name": "beds",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "99",
      "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": "300023-beds-09-30-2022",
      "entity_id": "300023",
      "metric_name": "beds",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "99",
      "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": "300023-beds-09-30-2021",
      "entity_id": "300023",
      "metric_name": "beds",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "99",
      "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": "300023-beds-09-30-2020",
      "entity_id": "300023",
      "metric_name": "beds",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "99",
      "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": "300023-patient_days-09-30-2023",
      "entity_id": "300023",
      "metric_name": "patient_days",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "25058",
      "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": "300023-patient_days-09-30-2022",
      "entity_id": "300023",
      "metric_name": "patient_days",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "24308",
      "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": "300023-patient_days-09-30-2021",
      "entity_id": "300023",
      "metric_name": "patient_days",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "21720",
      "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": "300023-patient_days-09-30-2020",
      "entity_id": "300023",
      "metric_name": "patient_days",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "20460",
      "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": "300023-discharges-09-30-2023",
      "entity_id": "300023",
      "metric_name": "discharges",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "4926",
      "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": "300023-discharges-09-30-2022",
      "entity_id": "300023",
      "metric_name": "discharges",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "4305",
      "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": "300023-discharges-09-30-2021",
      "entity_id": "300023",
      "metric_name": "discharges",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "4570",
      "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": "300023-discharges-09-30-2020",
      "entity_id": "300023",
      "metric_name": "discharges",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "4670",
      "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"
    }
  ],
  "ownershipChain": {
    "model": "Sponsor, operator, CMS legal-owner/control records, and facility are shown as separate evidence layers.",
    "confidence": "high",
    "nodes": [
      {
        "id": "facility:300023",
        "label": "EXETER HOSPITAL INC",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:beth-israel-lahey-health",
        "label": "Beth Israel Lahey Health",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      }
    ],
    "edges": [
      {
        "id": "organization:beth-israel-lahey-health->facility:300023",
        "from": "organization:beth-israel-lahey-health",
        "to": "facility:300023",
        "relationship": "reported ownership or operating chain",
        "confidence": "high",
        "sourceIds": [
          "source-propublica-bilh-2022-schedule-o",
          "source-bilh-about",
          "source-bilh-locations",
          "source-bilh-leadership",
          "source-cms-hospital-general-information",
          "source-cms-hospital-all-owners",
          "source-bilh-locations"
        ],
        "note": "The platform attribution comes from the research tracker and is displayed separately from CMS legal-owner rows."
      }
    ],
    "caveats": [
      "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor."
    ]
  },
  "ownershipConnections": [
    {
      "entityName": "Beth Israel Lahey Health, Inc.",
      "entityKind": "501(c)(3) nonprofit parent system",
      "relationship": "direct or indirect sole member / system parent",
      "classification": "Nonprofit parent-control layer",
      "evidenceSourceIds": [
        "source-propublica-bilh-2022-schedule-o",
        "source-bilh-about",
        "source-bilh-locations"
      ],
      "note": "BILH is not shareholder-owned in the public-company sense; Form 990 and official pages show a nonprofit sole-member/system-parent control layer."
    },
    {
      "entityName": "BILH Board of Trustees",
      "entityKind": "Nonprofit governing board",
      "relationship": "governs parent system",
      "classification": "Governance layer",
      "evidenceSourceIds": [
        "source-bilh-kevin-tabb-profile",
        "source-bilh-kevin-transition-2026"
      ],
      "note": "BILH identifies Kevin Tabb as an ex officio trustee; the 2026 transition notice says the Board of Trustees is responsible for selecting and hiring the next President and CEO."
    },
    {
      "entityName": "Kevin Tabb, MD",
      "entityKind": "System executive",
      "relationship": "President and CEO / ex officio trustee",
      "classification": "Leadership and compensation context",
      "evidenceSourceIds": [
        "source-bilh-kevin-tabb-profile",
        "source-bilh-leadership",
        "source-propublica-bilh-990"
      ],
      "note": "Official BILH profile image: https://bilh.org/-/media/team-members/bilh/leadership/kevin-tabb-md.jpeg. ProPublica displays FY2024 $4,313,387 compensation plus $1,097,028 other compensation for Kevin Tabb."
    },
    {
      "entityName": "Peter Healy",
      "entityKind": "Hospital executive",
      "relationship": "President, Beth Israel Deaconess Medical Center",
      "classification": "BIDMC leadership context",
      "evidenceSourceIds": [
        "source-bilh-leadership"
      ],
      "note": "BILH lists Peter Healy as Divisional President, Metro Boston and President, Beth Israel Deaconess Medical Center."
    },
    {
      "entityName": "Massachusetts Attorney General settlement / price-cap context",
      "entityKind": "Regulatory context",
      "relationship": "merger approval condition",
      "classification": "Historical accountability context",
      "evidenceSourceIds": [
        "source-axios-bilh-price-cap"
      ],
      "note": "Reporting describes merger approval with a seven-year price-cap condition; use as context, not a current ownership change."
    }
  ],
  "importantLinks": [
    {
      "label": "About Beth Israel Lahey Health",
      "url": "https://bilh.org/about",
      "sourceId": "source-bilh-about",
      "note": "Official system overview; BILH describes a coordinated system with academic medical centers, teaching hospitals, specialty and community hospitals, more than 4,700 physicians, and 39,000 employees."
    },
    {
      "label": "Beth Israel Lahey Health Locations",
      "url": "https://bilh.org/locations",
      "sourceId": "source-bilh-locations",
      "note": "Official hospital quick links used to connect Anna Jaques, BID Milton, BID Needham, BID Plymouth, BIDMC, Beverly/Addison Gilbert/BayRidge, Exeter, Lahey, Mount Auburn, New England Baptist, and Winchester."
    },
    {
      "label": "Senior Leadership Team",
      "url": "https://bilh.org/about/leadership/executive-team",
      "sourceId": "source-bilh-leadership",
      "note": "Official leadership page identifying Kevin Tabb as President and CEO, Peter Healy as BIDMC president, and hospital presidents for BILH facilities."
    },
    {
      "label": "Kevin Tabb, MD",
      "url": "https://bilh.org/about/leadership/executive-team/kevin-tabb-md",
      "sourceId": "source-bilh-kevin-tabb-profile",
      "note": "Official profile and headshot source; BILH says Kevin Tabb serves as President and CEO and is an ex officio Board of Trustees member."
    },
    {
      "label": "Beth Israel Lahey Health President and CEO Kevin Tabb, MD, Announces Leadership Transition",
      "url": "https://bilh.org/about/news-and-stories/all-news-and-stories/news/2026/03/bilh-president-ceo-kevin-tabb-announces-leadership-transition",
      "sourceId": "source-bilh-kevin-transition-2026",
      "note": "BILH says Tabb gave notice to step down in a year, will remain until a successor is selected, and that BILH includes 14 hospitals, 42,000 employees, 4,800+ physicians, and 1.7M patients annually."
    },
    {
      "label": "Affiliates and Community Partners",
      "url": "https://bidmc.org/about/affiliates-community-partners",
      "sourceId": "source-bidmc-affiliates-bilh",
      "note": "BIDMC states that BIDMC is part of BILH and describes the system as academic/teaching hospitals, providers, ambulatory surgery, urgent care, community hospitals, home care, behavioral health, and more."
    },
    {
      "label": "Medical Education and Teaching Hospitals",
      "url": "https://bilh.org/research-education/medical-education",
      "sourceId": "source-bilh-medical-education",
      "note": "Official medical education page confirming BILH training opportunities for medical students, residents, and fellows and listing BIDMC, Lahey, Mount Auburn, and New England Baptist as academic/teaching hospitals."
    },
    {
      "label": "TY 2022 Form 990 Schedule O",
      "url": "https://projects.propublica.org/nonprofits/full_text/202412279349301501/IRS990ScheduleO",
      "sourceId": "source-propublica-bilh-2022-schedule-o",
      "note": "Rendered Form 990 Schedule O states BILH served as direct or indirect sole member to BIDMC, Mount Auburn, New England Baptist, BID Milton, BID Needham, BID Plymouth, Lahey entities, Winchester, Northeast, Anna Jaques, Joslin, BILH Pharmacy, and Exeter/EHRI after July 1, 2023."
    },
    {
      "label": "Beth Israel Lahey Health Inc HCSR - Nonprofit Explorer",
      "url": "https://projects.propublica.org/nonprofits/organizations/832671600",
      "sourceId": "source-propublica-bilh-990",
      "note": "FY2024 Form 990 extract: revenue $876.1M, expenses $928.6M, executive compensation $27.1M, and Kevin Tabb displayed with $4.31M compensation plus $1.10M other compensation."
    },
    {
      "label": "A hospital merger with price caps",
      "url": "https://www.axios.com/2018/11/30/beth-israel-deaconess-lahey-hospital-merger-price-cap",
      "sourceId": "source-axios-bilh-price-cap",
      "note": "Contemporary reporting on the merger approval, seven-year price-cap condition, and Massachusetts Attorney General settlement framing."
    },
    {
      "label": "CMS Hospital General Information",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "sourceId": "source-cms-hospital-general-information",
      "note": "Used for facility identity, ownership category, and baseline hospital characteristics already present in the public atlas."
    },
    {
      "label": "Beth Israel Deaconess Medical Center CMS provider number",
      "url": "https://www.cms.gov/medicare/medicare-general-information/medicareapprovedfacilitie/vad-destination-therapy-facilities-aug2007-items/-beth-israel-deaconess-medical-center",
      "sourceId": "source-cms-bidmc-provider-220086",
      "note": "CMS lists Beth Israel Deaconess Medical Center at 330 Brookline Avenue, Boston, with provider number 22-0086 and 2025-09-17 recertification for this CMS page."
    },
    {
      "label": "CMS HCAHPS Patient Survey",
      "url": "https://data.cms.gov/provider-data/dataset/dgck-syfz",
      "sourceId": "source-cms-bidmc-hcahps",
      "note": "Provider 220086 HCAHPS period 2024-07-01 to 2025-06-30: 4,978 completed surveys, 23% response rate, 4-star summary, 5-star recommend, and 2-star quietness."
    },
    {
      "label": "CMS Healthcare-Associated Infections",
      "url": "https://data.cms.gov/provider-data/dataset/77hc-ibv8",
      "sourceId": "source-cms-bidmc-hai",
      "note": "Provider 220086 HAI period 2024-07-01 to 2025-06-30: CLABSI, MRSA, and C. diff better than national benchmark; CAUTI and colon SSI no different; abdominal hysterectomy SSI worse."
    },
    {
      "label": "CMS Complications and Deaths",
      "url": "https://data.cms.gov/provider-data/dataset/ynj2-r877",
      "sourceId": "source-cms-bidmc-mortality-safety",
      "note": "Provider 220086 shows hybrid hospital-wide mortality better than national at 2.8% for 2023-07-01 to 2024-06-30; postoperative hemorrhage/hematoma is worse than national."
    },
    {
      "label": "CMS Unplanned Hospital Visits",
      "url": "https://data.cms.gov/provider-data/dataset/632h-zaca",
      "sourceId": "source-cms-bidmc-readmissions",
      "note": "Provider 220086 hybrid hospital-wide readmission is worse than national at 16.0% for 2023-07-01 to 2024-06-30."
    },
    {
      "label": "CMS Hospital All Owners",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "sourceId": "source-cms-hospital-all-owners",
      "note": "Searched for ownership/control context where available; this pass did not identify a PE owner row that changes the BILH public label into a PE ownership claim."
    }
  ],
  "systemConnections": [
    {
      "systemName": "Beth Israel Lahey Health",
      "relationship": "official hospital quick-link / leadership system family",
      "evidenceSourceIds": [
        "source-bilh-locations",
        "source-bilh-leadership"
      ],
      "facilities": [
        {
          "name": "Anna Jaques Hospital",
          "role": "Community hospital",
          "city": "NEWBURYPORT",
          "state": "MA",
          "recordId": "220029",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Beth Israel Deaconess Hospital-Needham",
          "role": "Community hospital",
          "city": "NEEDHAM",
          "state": "MA",
          "recordId": "220083",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Beth Israel Deaconess Hospital-Plymouth",
          "role": "Community hospital",
          "city": "PLYMOUTH",
          "state": "MA",
          "recordId": "220060",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Beth Israel Deaconess Hospital-Milton",
          "role": "Community hospital",
          "city": "MILTON",
          "state": "MA",
          "recordId": "220108",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Beth Israel Deaconess Medical Center - East Campus",
          "role": "Academic medical center campus",
          "city": "BOSTON",
          "state": "MA",
          "recordId": "0000502215",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Beth Israel Deaconess Medical Center - West Campus",
          "role": "Academic medical center campus",
          "city": "BOSTON",
          "state": "MA",
          "recordId": "0001202215",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Addison Gilbert Hospital",
          "role": "Community hospital campus",
          "city": "GLOUCESTER",
          "state": "MA",
          "recordId": "0008201930",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Beverly Hospital",
          "role": "Community hospital campus",
          "city": "BEVERLY",
          "state": "MA",
          "recordId": "0005601915",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Lahey Hospital and Medical Center",
          "role": "Teaching hospital",
          "city": "BURLINGTON",
          "state": "MA",
          "recordId": "0008001805",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Lahey Medical Center, Peabody",
          "role": "Lahey hospital campus",
          "city": "PEABODY",
          "state": "MA",
          "recordId": "0001801960",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Mount Auburn Hospital",
          "role": "Teaching hospital",
          "city": "CAMBRIDGE",
          "state": "MA",
          "recordId": "220002",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "New England Baptist Hospital",
          "role": "Specialty teaching hospital",
          "city": "BOSTON",
          "state": "MA",
          "recordId": "220088",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Winchester Hospital",
          "role": "Community hospital",
          "city": "WINCHESTER",
          "state": "MA",
          "recordId": "220105",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "BayRidge Hospital",
          "role": "Behavioral health hospital affiliated with Beverly Hospital",
          "city": "LYNN",
          "state": "MA",
          "recordId": "0012101904",
          "note": "Connected by BILH official locations/quick links and leadership pages."
        },
        {
          "name": "Exeter Hospital",
          "role": "New Hampshire hospital in the BILH quick-link system family",
          "city": "EXETER",
          "state": "NH",
          "recordId": "300023",
          "note": "Current selected facility."
        }
      ]
    }
  ],
  "directConnections": [
    "Exeter Hospital -> Beth Israel Lahey Health, Inc.: nonprofit parent/system family connection.",
    "Beth Israel Lahey Health, Inc. -> BIDMC and affiliates: Form 990 direct-or-indirect sole-member control evidence.",
    "BILH Board of Trustees -> BILH: nonprofit governance layer.",
    "No source in this pass established direct private-equity ownership.",
    "No source in this pass established a PE-backed staffing/management contract.",
    "Operator/owner context: Beth Israel Lahey Health.",
    "CMS Care Compare ownership category: Voluntary non-profit - Private."
  ],
  "actions": [
    "Add a union, NLRB, hospital, or reputable news source before publishing any active BIDMC doctors/residents strike claim.",
    "Next pass: run facility-specific CMS quality, CMS 2567, HCRIS staffing, charity-care, and cost-report work for this related BILH hospital.",
    "If public messaging discusses compensation, say \"Form 990 displayed compensation plus other compensation\" rather than salary."
  ],
  "contradictions": [
    {
      "topic": "active doctors/residents strike",
      "claim_a": "User-supplied lead says doctors and residents are on strike at Beth Israel/BIDMC.",
      "claim_b": "This pass did not find reliable source support for an active BIDMC doctors/residents strike as of 2026-06-25.",
      "resolution_status": "unverified_lead_do_not_publish_as_fact_until_sourced"
    }
  ],
  "limitations": [
    "This is a system affiliation and accountability dossier, not a complete facility-specific quality investigation.",
    "No active doctors/residents strike was verified in reliable sources during this pass.",
    "No direct PE ownership or PE-backed staffing/management contract was found in reviewed sources.",
    "CMS ownership rows were not re-downloaded in this script; it relies on the current public atlas/CMS source references and official BILH pages.",
    "BIDMC quality metrics should not be assigned to this related hospital unless that facility-specific CMS CCN is separately reviewed.",
    "This five-state template completion pass used official cached CMS/HIFLD/PESP/HCRIS sources and records missing items; it does not claim the entire internet was exhausted."
  ],
  "unavailableFields": [
    "facility_specific_catchment_estimate",
    "facility_specific_cms_quality_review",
    "facility_specific_hcris_staffing_trends",
    "active_strike_primary_source",
    "source-backed local CEO/current leader",
    "official CEO image URL",
    "facility-level CEO compensation amount"
  ],
  "sources": [
    {
      "source_id": "source-bilh-about",
      "title": "About Beth Israel Lahey Health",
      "publisher": "Beth Israel Lahey Health",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://bilh.org/about",
      "reliability_tier": "primary",
      "research_note": "Official system overview; BILH describes a coordinated system with academic medical centers, teaching hospitals, specialty and community hospitals, more than 4,700 physicians, and 39,000 employees."
    },
    {
      "source_id": "source-bilh-locations",
      "title": "Beth Israel Lahey Health Locations",
      "publisher": "Beth Israel Lahey Health",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://bilh.org/locations",
      "reliability_tier": "primary",
      "research_note": "Official hospital quick links used to connect Anna Jaques, BID Milton, BID Needham, BID Plymouth, BIDMC, Beverly/Addison Gilbert/BayRidge, Exeter, Lahey, Mount Auburn, New England Baptist, and Winchester."
    },
    {
      "source_id": "source-bilh-leadership",
      "title": "Senior Leadership Team",
      "publisher": "Beth Israel Lahey Health",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://bilh.org/about/leadership/executive-team",
      "reliability_tier": "primary",
      "research_note": "Official leadership page identifying Kevin Tabb as President and CEO, Peter Healy as BIDMC president, and hospital presidents for BILH facilities."
    },
    {
      "source_id": "source-bilh-kevin-tabb-profile",
      "title": "Kevin Tabb, MD",
      "publisher": "Beth Israel Lahey Health",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://bilh.org/about/leadership/executive-team/kevin-tabb-md",
      "reliability_tier": "primary",
      "research_note": "Official profile and headshot source; BILH says Kevin Tabb serves as President and CEO and is an ex officio Board of Trustees member."
    },
    {
      "source_id": "source-bilh-kevin-transition-2026",
      "title": "Beth Israel Lahey Health President and CEO Kevin Tabb, MD, Announces Leadership Transition",
      "publisher": "Beth Israel Lahey Health",
      "publication_date": "2026-03-04",
      "retrieved_at": "2026-06-25",
      "url": "https://bilh.org/about/news-and-stories/all-news-and-stories/news/2026/03/bilh-president-ceo-kevin-tabb-announces-leadership-transition",
      "reliability_tier": "primary",
      "research_note": "BILH says Tabb gave notice to step down in a year, will remain until a successor is selected, and that BILH includes 14 hospitals, 42,000 employees, 4,800+ physicians, and 1.7M patients annually."
    },
    {
      "source_id": "source-bidmc-affiliates-bilh",
      "title": "Affiliates and Community Partners",
      "publisher": "Beth Israel Deaconess Medical Center",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://bidmc.org/about/affiliates-community-partners",
      "reliability_tier": "primary",
      "research_note": "BIDMC states that BIDMC is part of BILH and describes the system as academic/teaching hospitals, providers, ambulatory surgery, urgent care, community hospitals, home care, behavioral health, and more."
    },
    {
      "source_id": "source-bilh-medical-education",
      "title": "Medical Education and Teaching Hospitals",
      "publisher": "Beth Israel Lahey Health",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://bilh.org/research-education/medical-education",
      "reliability_tier": "primary",
      "research_note": "Official medical education page confirming BILH training opportunities for medical students, residents, and fellows and listing BIDMC, Lahey, Mount Auburn, and New England Baptist as academic/teaching hospitals."
    },
    {
      "source_id": "source-propublica-bilh-2022-schedule-o",
      "title": "TY 2022 Form 990 Schedule O",
      "publisher": "ProPublica Nonprofit Explorer / IRS Form 990 rendered text",
      "publication_date": "2024-08-14",
      "retrieved_at": "2026-06-25",
      "url": "https://projects.propublica.org/nonprofits/full_text/202412279349301501/IRS990ScheduleO",
      "reliability_tier": "government-derived",
      "research_note": "Rendered Form 990 Schedule O states BILH served as direct or indirect sole member to BIDMC, Mount Auburn, New England Baptist, BID Milton, BID Needham, BID Plymouth, Lahey entities, Winchester, Northeast, Anna Jaques, Joslin, BILH Pharmacy, and Exeter/EHRI after July 1, 2023."
    },
    {
      "source_id": "source-propublica-bilh-990",
      "title": "Beth Israel Lahey Health Inc HCSR - Nonprofit Explorer",
      "publisher": "ProPublica Nonprofit Explorer / IRS Form 990 extract",
      "publication_date": "2025-08-15",
      "retrieved_at": "2026-06-25",
      "url": "https://projects.propublica.org/nonprofits/organizations/832671600",
      "reliability_tier": "government-derived",
      "research_note": "FY2024 Form 990 extract: revenue $876.1M, expenses $928.6M, executive compensation $27.1M, and Kevin Tabb displayed with $4.31M compensation plus $1.10M other compensation."
    },
    {
      "source_id": "source-axios-bilh-price-cap",
      "title": "A hospital merger with price caps",
      "publisher": "Axios",
      "publication_date": "2018-11-30",
      "retrieved_at": "2026-06-25",
      "url": "https://www.axios.com/2018/11/30/beth-israel-deaconess-lahey-hospital-merger-price-cap",
      "reliability_tier": "reporting",
      "research_note": "Contemporary reporting on the merger approval, seven-year price-cap condition, and Massachusetts Attorney General settlement framing."
    },
    {
      "source_id": "source-cms-hospital-general-information",
      "title": "CMS Hospital General Information",
      "publisher": "Centers for Medicare and Medicaid Services",
      "publication_date": "",
      "retrieved_at": "2026-06-24",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "reliability_tier": "government",
      "research_note": "Used for facility identity, ownership category, and baseline hospital characteristics already present in the public atlas."
    },
    {
      "source_id": "source-cms-bidmc-provider-220086",
      "title": "Beth Israel Deaconess Medical Center CMS provider number",
      "publisher": "Centers for Medicare and Medicaid Services",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://www.cms.gov/medicare/medicare-general-information/medicareapprovedfacilitie/vad-destination-therapy-facilities-aug2007-items/-beth-israel-deaconess-medical-center",
      "reliability_tier": "government",
      "research_note": "CMS lists Beth Israel Deaconess Medical Center at 330 Brookline Avenue, Boston, with provider number 22-0086 and 2025-09-17 recertification for this CMS page."
    },
    {
      "source_id": "source-cms-bidmc-hcahps",
      "title": "CMS HCAHPS Patient Survey",
      "publisher": "Centers for Medicare and Medicaid Services",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://data.cms.gov/provider-data/dataset/dgck-syfz",
      "reliability_tier": "government",
      "research_note": "Provider 220086 HCAHPS period 2024-07-01 to 2025-06-30: 4,978 completed surveys, 23% response rate, 4-star summary, 5-star recommend, and 2-star quietness."
    },
    {
      "source_id": "source-cms-bidmc-hai",
      "title": "CMS Healthcare-Associated Infections",
      "publisher": "Centers for Medicare and Medicaid Services",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://data.cms.gov/provider-data/dataset/77hc-ibv8",
      "reliability_tier": "government",
      "research_note": "Provider 220086 HAI period 2024-07-01 to 2025-06-30: CLABSI, MRSA, and C. diff better than national benchmark; CAUTI and colon SSI no different; abdominal hysterectomy SSI worse."
    },
    {
      "source_id": "source-cms-bidmc-mortality-safety",
      "title": "CMS Complications and Deaths",
      "publisher": "Centers for Medicare and Medicaid Services",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://data.cms.gov/provider-data/dataset/ynj2-r877",
      "reliability_tier": "government",
      "research_note": "Provider 220086 shows hybrid hospital-wide mortality better than national at 2.8% for 2023-07-01 to 2024-06-30; postoperative hemorrhage/hematoma is worse than national."
    },
    {
      "source_id": "source-cms-bidmc-readmissions",
      "title": "CMS Unplanned Hospital Visits",
      "publisher": "Centers for Medicare and Medicaid Services",
      "publication_date": "",
      "retrieved_at": "2026-06-25",
      "url": "https://data.cms.gov/provider-data/dataset/632h-zaca",
      "reliability_tier": "government",
      "research_note": "Provider 220086 hybrid hospital-wide readmission is worse than national at 16.0% for 2023-07-01 to 2024-06-30."
    },
    {
      "source_id": "source-cms-hospital-all-owners",
      "title": "Hospital All Owners",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "current cached official file",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "reliability_tier": "government",
      "research_note": "Used for current CMS owner, officer, managerial, holding-company, investment-firm, and security-interest rows.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-hifld-hospitals",
      "title": "Hospitals RAPT",
      "publisher": "Homeland Infrastructure Foundation-Level Data",
      "publication_date": "current public layer",
      "retrieved_at": "2026-07-02",
      "url": "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
      "reliability_tier": "government",
      "research_note": "Facility location and identity source; does not establish ownership or control.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-enrollments",
      "title": "Hospital Enrollments",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "current cached official file",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "reliability_tier": "government",
      "research_note": "Used for legal name, DBA, CCN, NPI, enrollment identity, and location matching.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-care-compare",
      "title": "Hospital General Information",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "current cached official file",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "reliability_tier": "government",
      "research_note": "Facility type, ownership category, emergency services, and overall rating context.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hcris",
      "title": "Hospital Provider Cost Reports",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2015-2024 cached official files",
      "retrieved_at": "2026-07-02",
      "url": "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
      "reliability_tier": "government",
      "research_note": "Financial, staffing, and utilization values; descriptive only and not causal evidence.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-pehw-state-template-completion-2026-07-02",
      "title": "PE Healthcare Watch five-state template completion batch",
      "publisher": "PE Healthcare Watch",
      "publication_date": "2026-07-02",
      "retrieved_at": "2026-07-02",
      "url": "/data/releases/release-2026-07-02-state-template-complete-001.json",
      "reliability_tier": "research",
      "research_note": "Internal public release marker for the five-state template completion. It documents scope and limitations; it is not independent ownership evidence.",
      "source_type": "public_record"
    }
  ],
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 250108394,
      "latestValue": 295623876,
      "absoluteChange": 45515482,
      "percentChange": 18.198302452815717,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 250681411,
      "latestValue": 295255832,
      "absoluteChange": 44574421,
      "percentChange": 17.78130289844268,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 27903763,
      "latestValue": -19868400,
      "absoluteChange": -47772163,
      "percentChange": -171.2032997126588,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 314845316,
      "latestValue": 277979791,
      "absoluteChange": -36865525,
      "percentChange": -11.709091139853578,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 144471571,
      "latestValue": 92409411,
      "absoluteChange": -52062160,
      "percentChange": -36.03626626306984,
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    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 2224088,
      "latestValue": 6981654,
      "absoluteChange": 4757566,
      "percentChange": 213.9108704331843,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 1211.44,
      "latestValue": 1255.62,
      "absoluteChange": 44.179999999999836,
      "percentChange": 3.64689955755133,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 99,
      "latestValue": 99,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 20460,
      "latestValue": 25058,
      "absoluteChange": 4598,
      "percentChange": 22.473118279569892,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 4670,
      "latestValue": 4926,
      "absoluteChange": 256,
      "percentChange": 5.481798715203426,
      "unit": "discharges"
    }
  ],
  "cmsOwnerRecords": [
    {
      "organization": "ALLISON CASASSA",
      "role": "CORPORATE OFFICER",
      "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": "ALLISON CASASSA",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "02/12/2006",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CINDY RIOS",
      "role": "CORPORATE OFFICER",
      "association_date": "07/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CYNTHIA DOMINGUEZ",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/27/2020",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JAMIE KATZ",
      "role": "CORPORATE OFFICER",
      "association_date": "07/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "EXETER HEALTH RESOURCES INC",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "07/01/2023",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MICHAEL PANGAN",
      "role": "CORPORATE DIRECTOR",
      "association_date": "04/01/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KEVIN TABB",
      "role": "CORPORATE OFFICER",
      "association_date": "07/01/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DAVID FALCK",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/27/2020",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "BETH ISRAEL LAHEY HEALTH, INC.",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "07/01/2023",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROBERT EBERLE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/31/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "SALLY WARD",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/31/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DEBRA CRESTA",
      "role": "CORPORATE OFFICER",
      "association_date": "07/17/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CONSTANCE SPRAUER",
      "role": "CORPORATE OFFICER",
      "association_date": "10/02/2005",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "NICHOLAS TOUMPAS",
      "role": "CORPORATE DIRECTOR",
      "association_date": "04/01/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "SUSAN DESJARDINS",
      "role": "CORPORATE DIRECTOR",
      "association_date": "09/25/2015",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "RICHARD HOLLISTER",
      "role": "CORPORATE DIRECTOR",
      "association_date": "04/01/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROBERT HEVERT",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/26/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "AMY CASE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "09/25/2015",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHARLES DAVIS FARMER",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/26/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ]
}
