{
  "schemaVersion": 4,
  "entityId": "300034",
  "canonicalName": "CATHOLIC MEDICAL CENTER",
  "status": "corporate_chain",
  "statusLabel": "Corporate-chain ownership/accountability warning",
  "summary": "CATHOLIC MEDICAL CENTER 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": 6,
    "ownership_source_count": 11,
    "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": "Voluntary non-profit - Private",
    "directPeOwnership": "Not documented as direct PE ownership in this state-template pass",
    "peRelationship": "No documented PE link in current baseline sources",
    "careLevel": "Acute Care Hospitals",
    "currentCeo": "Needs source-backed local leader research",
    "bottomLine": "CATHOLIC MEDICAL CENTER is shown with official-source baseline context for New Hampshire. Missing fields remain visible instead of being inferred."
  },
  "communityImpact": {
    "populationServedEstimate": 0,
    "populationServedLabel": "Needs system/facility catchment estimate",
    "estimateMethod": "Not estimated in this state-template completion pass",
    "catchmentDescription": "MANCHESTER, HILLSBOROUGH, New Hampshire. Service role should be refined in manual follow-up.",
    "traumaCareLevel": "Acute Care Hospitals",
    "publicFacingCaveat": "Community role is sourced from facility type and location until a deeper local-service review is completed."
  },
  "qualityAndLaborContext": {
    "sourceId": "source-cms-care-compare",
    "cmsOverallRating": "4",
    "emergencyServices": "Yes",
    "hospitalType": "Acute Care Hospitals",
    "careCompareOwnership": "Voluntary non-profit - Private",
    "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.",
    "noCausationClaim": true
  },
  "identifiers": {
    "ccn": "300034",
    "npi": "1972340990",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "MANCHESTER HEALTH SERVICES LLC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "CATHOLIC MEDICAL CENTER",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "CATHOLIC MEDICAL CENTER",
        "alias_type": "cms_care_compare_name",
        "source_id": "source-cms-care-compare"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-cms-owner-300034",
      "from_entity_id": "voluntarynonprofitprivate",
      "to_entity_id": "300034",
      "relationship_type": "cms_owner_context",
      "effective_date": "02/01/2025",
      "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-300034",
      "from_entity_id": "voluntarynonprofitprivate",
      "to_entity_id": "300034",
      "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-300034",
      "from_entity_id": "voluntarynonprofitprivate",
      "to_entity_id": "300034",
      "relationship_type": "cms_owner_context",
      "effective_date": "02/01/2025",
      "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-300034",
      "from_entity_id": "voluntarynonprofitprivate",
      "to_entity_id": "300034",
      "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-300034",
      "from_entity_id": "voluntarynonprofitprivate",
      "to_entity_id": "300034",
      "relationship_type": "cms_owner_context",
      "effective_date": "02/01/2025",
      "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": [],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "300034-net_patient_revenue-09-30-2023",
      "entity_id": "300034",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "480789746",
      "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": "300034-net_patient_revenue-09-30-2022",
      "entity_id": "300034",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "470371108",
      "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": "300034-net_patient_revenue-09-30-2021",
      "entity_id": "300034",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "439948002",
      "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": "300034-net_patient_revenue-09-30-2020",
      "entity_id": "300034",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "375630562",
      "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": "300034-operating_expense-09-30-2023",
      "entity_id": "300034",
      "metric_name": "operating_expense",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "516926781",
      "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": "300034-operating_expense-09-30-2022",
      "entity_id": "300034",
      "metric_name": "operating_expense",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "490096822",
      "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": "300034-operating_expense-09-30-2021",
      "entity_id": "300034",
      "metric_name": "operating_expense",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "438684697",
      "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": "300034-operating_expense-09-30-2020",
      "entity_id": "300034",
      "metric_name": "operating_expense",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "423196234",
      "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": "300034-net_income-09-30-2023",
      "entity_id": "300034",
      "metric_name": "net_income",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "-2333441",
      "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": "300034-net_income-09-30-2022",
      "entity_id": "300034",
      "metric_name": "net_income",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "6543271",
      "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": "300034-net_income-09-30-2021",
      "entity_id": "300034",
      "metric_name": "net_income",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "68107455",
      "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": "300034-net_income-09-30-2020",
      "entity_id": "300034",
      "metric_name": "net_income",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "6903609",
      "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": "300034-total_assets-09-30-2023",
      "entity_id": "300034",
      "metric_name": "total_assets",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "433176138",
      "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": "300034-total_assets-09-30-2022",
      "entity_id": "300034",
      "metric_name": "total_assets",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "431370081",
      "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": "300034-total_assets-09-30-2021",
      "entity_id": "300034",
      "metric_name": "total_assets",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "518751919",
      "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": "300034-total_assets-09-30-2020",
      "entity_id": "300034",
      "metric_name": "total_assets",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "530592222",
      "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": "300034-total_liabilities-09-30-2023",
      "entity_id": "300034",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "339205853",
      "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": "300034-total_liabilities-09-30-2022",
      "entity_id": "300034",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "320610539",
      "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": "300034-total_liabilities-09-30-2021",
      "entity_id": "300034",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "400268947",
      "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": "300034-total_liabilities-09-30-2020",
      "entity_id": "300034",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "482212995",
      "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": "300034-contract_labor_direct_patient_care-09-30-2023",
      "entity_id": "300034",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "18692218",
      "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": "300034-contract_labor_direct_patient_care-09-30-2022",
      "entity_id": "300034",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "11830165",
      "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": "300034-contract_labor_direct_patient_care-09-30-2021",
      "entity_id": "300034",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "11291698",
      "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": "300034-contract_labor_direct_patient_care-09-30-2020",
      "entity_id": "300034",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "6690798",
      "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": "300034-fte_employees-09-30-2023",
      "entity_id": "300034",
      "metric_name": "fte_employees",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "2135.68",
      "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": "300034-fte_employees-09-30-2022",
      "entity_id": "300034",
      "metric_name": "fte_employees",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "2183.19",
      "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": "300034-fte_employees-09-30-2021",
      "entity_id": "300034",
      "metric_name": "fte_employees",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "2022",
      "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": "300034-fte_employees-09-30-2020",
      "entity_id": "300034",
      "metric_name": "fte_employees",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "2061.93",
      "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": "300034-beds-09-30-2023",
      "entity_id": "300034",
      "metric_name": "beds",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "262",
      "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": "300034-beds-09-30-2022",
      "entity_id": "300034",
      "metric_name": "beds",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "262",
      "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": "300034-beds-09-30-2021",
      "entity_id": "300034",
      "metric_name": "beds",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "262",
      "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": "300034-beds-09-30-2020",
      "entity_id": "300034",
      "metric_name": "beds",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "250",
      "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": "300034-patient_days-09-30-2023",
      "entity_id": "300034",
      "metric_name": "patient_days",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "63679",
      "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": "300034-patient_days-09-30-2022",
      "entity_id": "300034",
      "metric_name": "patient_days",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "66768",
      "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": "300034-patient_days-09-30-2021",
      "entity_id": "300034",
      "metric_name": "patient_days",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "61473",
      "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": "300034-patient_days-09-30-2020",
      "entity_id": "300034",
      "metric_name": "patient_days",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "58209",
      "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": "300034-discharges-09-30-2023",
      "entity_id": "300034",
      "metric_name": "discharges",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "12407",
      "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": "300034-discharges-09-30-2022",
      "entity_id": "300034",
      "metric_name": "discharges",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "11544",
      "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": "300034-discharges-09-30-2021",
      "entity_id": "300034",
      "metric_name": "discharges",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "11704",
      "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": "300034-discharges-09-30-2020",
      "entity_id": "300034",
      "metric_name": "discharges",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "10750",
      "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"
    }
  ],
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 375630562,
      "latestValue": 480789746,
      "absoluteChange": 105159184,
      "percentChange": 27.995374881131212,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 423196234,
      "latestValue": 516926781,
      "absoluteChange": 93730547,
      "percentChange": 22.148246952500056,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 6903609,
      "latestValue": -2333441,
      "absoluteChange": -9237050,
      "percentChange": -133.80030647738016,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 530592222,
      "latestValue": 433176138,
      "absoluteChange": -97416084,
      "percentChange": -18.359877880004053,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 482212995,
      "latestValue": 339205853,
      "absoluteChange": -143007142,
      "percentChange": -29.656426409661563,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 6690798,
      "latestValue": 18692218,
      "absoluteChange": 12001420,
      "percentChange": 179.37202707360169,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 2061.93,
      "latestValue": 2135.68,
      "absoluteChange": 73.75,
      "percentChange": 3.576746058304599,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 250,
      "latestValue": 262,
      "absoluteChange": 12,
      "percentChange": 4.8,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 58209,
      "latestValue": 63679,
      "absoluteChange": 5470,
      "percentChange": 9.397172258585442,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 10750,
      "latestValue": 12407,
      "absoluteChange": 1657,
      "percentChange": 15.413953488372092,
      "unit": "discharges"
    }
  ],
  "cmsOwnerRecords": [
    {
      "organization": "HCA SQUARED LLC",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "02/01/2025",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HCA INC",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "02/01/2025",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ERIC SMITH",
      "role": "CONTRACTED MANAGING EMPLOYEE",
      "association_date": "02/01/2025",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JOHN SKEVINGTON",
      "role": "CORPORATE OFFICER",
      "association_date": "02/01/2025",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JOHN SKEVINGTON",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "02/01/2025",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HCA HOLDINGS INC",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "02/01/2025",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HEALTHTRUST INC - THE HOSPITAL COMPANY",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "02/01/2025",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HOSPITAL CORP LLC",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "02/01/2025",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HERCULES HOLDING II",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "02/01/2025",
      "percentage_ownership": "27",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": true,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PAMELA MARTEL",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "02/01/2025",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "FRISCO HOLDING II",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "02/01/2025",
      "percentage_ownership": "14.31",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [
    "Operator/owner context: Voluntary non-profit - Private.",
    "CMS Care Compare ownership category: Voluntary non-profit - Private."
  ],
  "actions": [],
  "contradictions": [],
  "limitations": [
    "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": [
    "source-backed local CEO/current leader",
    "official CEO image URL",
    "facility-level CEO compensation amount"
  ],
  "sources": [
    {
      "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-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-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"
    }
  ],
  "ownershipChain": {
    "model": "State-template baseline separates facility record, operator/owner context, CMS owner rows, and PE status evidence. Context nodes do not create new ownership claims.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "300034",
        "label": "CATHOLIC MEDICAL CENTER",
        "type": "hospital",
        "sourceIds": [
          "source-hifld-hospitals"
        ]
      },
      {
        "id": "voluntarynonprofitprivate",
        "label": "Voluntary non-profit - Private",
        "type": "organization",
        "sourceIds": [
          "source-pehw-state-template-completion-2026-07-02",
          "source-cms-hospital-enrollments",
          "source-cms-hospital-all-owners",
          "source-cms-care-compare"
        ]
      }
    ],
    "edges": [
      {
        "id": "edge-state-template-operator-300034",
        "from": "voluntarynonprofitprivate",
        "to": "300034",
        "relationship": "operates",
        "confidence": "medium",
        "sourceIds": [
          "source-pehw-state-template-completion-2026-07-02",
          "source-cms-hospital-enrollments",
          "source-cms-hospital-all-owners",
          "source-cms-care-compare"
        ],
        "note": "Baseline operator/owner context for state-page completion; not an inferred PE ownership claim."
      }
    ],
    "caveats": [
      "CMS owner rows identify enrolled owner/control roles but may not name every ultimate financial sponsor.",
      "Missing local CEO, compensation, state-regulator, Form 990, or quality-trend fields remain explicit.",
      "This chain is a template baseline and should be superseded by deeper source-family research when available."
    ]
  }
}