{
  "schemaVersion": 4,
  "entityId": "340003",
  "canonicalName": "NORTHERN REGIONAL HOSPITAL",
  "status": "verified_independent",
  "statusLabel": "No documented PE link",
  "summary": "NORTHERN REGIONAL HOSPITAL has a completed North Carolina 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": 8,
    "ownership_source_count": 15,
    "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": "Government / public",
    "operator": "Northern Regional Hospital",
    "directPeOwnership": "Not documented as direct PE ownership in this state-template pass",
    "peRelationship": "No documented PE link in current baseline sources",
    "institutionalShareholderContext": "No public-company shareholder layer found; use legal owner, parent-system, and governance context instead.",
    "populationServedEstimate": 0,
    "populationServedLabel": "Needs system/facility catchment estimate",
    "careLevel": "Acute Care Hospitals",
    "currentCeo": "Needs source-backed local leader research",
    "previousRelevantCeo": "Not identified in this automated NC pass",
    "confidence": "medium",
    "bottomLine": "NORTHERN REGIONAL HOSPITAL is connected to Northern Regional Hospital. No public-company shareholder layer was found in this pass. Institutional shareholder names are context only and do not override facility-level ownership evidence."
  },
  "communityImpact": {
    "populationServedEstimate": 0,
    "populationServedLabel": "Needs system/facility catchment estimate",
    "estimateMethod": "Not estimated in automated NC pass",
    "catchmentDescription": "MOUNT AIRY, SURRY, North Carolina. 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": {
    "immediateJeopardy2026SourceStatus": "Not specifically identified in this automated NC 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": "Government - Hospital District or Authority"
  },
  "leadership": [],
  "identifiers": {
    "ccn": "340003",
    "npi": "1366449282",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "NORTHERN HOSPITAL OF SURRY COUNTY",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "NORTHERN REGIONAL HOSPITAL",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "NORTHERN REGIONAL HOSPITAL",
        "alias_type": "cms_care_compare_name",
        "source_id": "source-cms-care-compare"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-legal-owner-340003",
      "from_entity_id": "northern-hospital-of-surry-county",
      "to_entity_id": "northern-regional-hospital",
      "relationship_type": "operates",
      "effective_date": "",
      "end_date": "",
      "announcement_date": "",
      "status": "current",
      "confidence": "high",
      "source_ids": "source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-nc-baseline-queue",
      "plain_english_summary": "NORTHERN HOSPITAL OF SURRY COUNTY is the best available legal-owner or enrolled-operator layer for NORTHERN REGIONAL HOSPITAL.",
      "review_notes": "This legal-owner layer is separate from ultimate parent, public-company shareholders, and PE sponsor context."
    },
    {
      "relationship_id": "rel-operator-340003",
      "from_entity_id": "northern-regional-hospital",
      "to_entity_id": "northern-regional-hospital",
      "relationship_type": "operates",
      "effective_date": "",
      "end_date": "",
      "announcement_date": "",
      "status": "current",
      "confidence": "medium",
      "source_ids": "source-nc-baseline-queue",
      "plain_english_summary": "Northern Regional Hospital is shown as the operator or parent-system layer for this facility.",
      "review_notes": ""
    },
    {
      "relationship_id": "rel-cms-owner-340003",
      "from_entity_id": "northernregional",
      "to_entity_id": "340003",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2013",
      "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-340003",
      "from_entity_id": "northernregional",
      "to_entity_id": "340003",
      "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-340003",
      "from_entity_id": "northernregional",
      "to_entity_id": "340003",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2013",
      "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-340003",
      "from_entity_id": "northernregional",
      "to_entity_id": "340003",
      "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-340003",
      "from_entity_id": "northernregional",
      "to_entity_id": "340003",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2013",
      "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": "340003-net_patient_revenue-09-30-2023",
      "entity_id": "340003",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "104470320",
      "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": "340003-net_patient_revenue-09-30-2022",
      "entity_id": "340003",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "97098577",
      "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": "340003-net_patient_revenue-09-30-2021",
      "entity_id": "340003",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "107059044",
      "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": "340003-net_patient_revenue-09-30-2020",
      "entity_id": "340003",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "89590986",
      "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": "340003-operating_expense-09-30-2023",
      "entity_id": "340003",
      "metric_name": "operating_expense",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "131821201",
      "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": "340003-operating_expense-09-30-2022",
      "entity_id": "340003",
      "metric_name": "operating_expense",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "120902010",
      "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": "340003-operating_expense-09-30-2021",
      "entity_id": "340003",
      "metric_name": "operating_expense",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "117365331",
      "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": "340003-operating_expense-09-30-2020",
      "entity_id": "340003",
      "metric_name": "operating_expense",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "103791943",
      "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": "340003-net_income-09-30-2023",
      "entity_id": "340003",
      "metric_name": "net_income",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "4126899",
      "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": "340003-net_income-09-30-2022",
      "entity_id": "340003",
      "metric_name": "net_income",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "-12824343",
      "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": "340003-net_income-09-30-2021",
      "entity_id": "340003",
      "metric_name": "net_income",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "3228611",
      "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": "340003-net_income-09-30-2020",
      "entity_id": "340003",
      "metric_name": "net_income",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "4800304",
      "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": "340003-total_assets-09-30-2023",
      "entity_id": "340003",
      "metric_name": "total_assets",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "158379562",
      "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": "340003-total_assets-09-30-2022",
      "entity_id": "340003",
      "metric_name": "total_assets",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "144417393",
      "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": "340003-total_assets-09-30-2021",
      "entity_id": "340003",
      "metric_name": "total_assets",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "169866790",
      "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": "340003-total_assets-09-30-2020",
      "entity_id": "340003",
      "metric_name": "total_assets",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "163529309",
      "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": "340003-total_liabilities-09-30-2023",
      "entity_id": "340003",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "60630078",
      "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": "340003-total_liabilities-09-30-2022",
      "entity_id": "340003",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "50585899",
      "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": "340003-total_liabilities-09-30-2021",
      "entity_id": "340003",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "63210961",
      "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": "340003-total_liabilities-09-30-2020",
      "entity_id": "340003",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "60102080",
      "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": "340003-contract_labor_direct_patient_care-09-30-2023",
      "entity_id": "340003",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "5407051",
      "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": "340003-contract_labor_direct_patient_care-09-30-2022",
      "entity_id": "340003",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "4908499",
      "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": "340003-contract_labor_direct_patient_care-09-30-2021",
      "entity_id": "340003",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "3143561",
      "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": "340003-contract_labor_direct_patient_care-09-30-2020",
      "entity_id": "340003",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "2530868",
      "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": "340003-fte_employees-09-30-2023",
      "entity_id": "340003",
      "metric_name": "fte_employees",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "758.89",
      "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": "340003-fte_employees-09-30-2022",
      "entity_id": "340003",
      "metric_name": "fte_employees",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "738.58",
      "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": "340003-fte_employees-09-30-2021",
      "entity_id": "340003",
      "metric_name": "fte_employees",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "752.21",
      "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": "340003-fte_employees-09-30-2020",
      "entity_id": "340003",
      "metric_name": "fte_employees",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "683.11",
      "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": "340003-beds-09-30-2023",
      "entity_id": "340003",
      "metric_name": "beds",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "100",
      "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": "340003-beds-09-30-2022",
      "entity_id": "340003",
      "metric_name": "beds",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "100",
      "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": "340003-beds-09-30-2021",
      "entity_id": "340003",
      "metric_name": "beds",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "100",
      "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": "340003-beds-09-30-2020",
      "entity_id": "340003",
      "metric_name": "beds",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "100",
      "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": "340003-patient_days-09-30-2023",
      "entity_id": "340003",
      "metric_name": "patient_days",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "15527",
      "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": "340003-patient_days-09-30-2022",
      "entity_id": "340003",
      "metric_name": "patient_days",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "18069",
      "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": "340003-patient_days-09-30-2021",
      "entity_id": "340003",
      "metric_name": "patient_days",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "18208",
      "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": "340003-patient_days-09-30-2020",
      "entity_id": "340003",
      "metric_name": "patient_days",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "14362",
      "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": "340003-discharges-09-30-2023",
      "entity_id": "340003",
      "metric_name": "discharges",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "3588",
      "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": "340003-discharges-09-30-2022",
      "entity_id": "340003",
      "metric_name": "discharges",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "3805",
      "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": "340003-discharges-09-30-2021",
      "entity_id": "340003",
      "metric_name": "discharges",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "4518",
      "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": "340003-discharges-09-30-2020",
      "entity_id": "340003",
      "metric_name": "discharges",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "3962",
      "unit": "discharges",
      "better_when": "context_dependent",
      "source_id": "source-cms-hcris",
      "methodology_note": "Hospital Provider Cost Report value. Compare only like fields and compatible fiscal periods; no causal inference is implied.",
      "comparable_to_prior": "review_required"
    }
  ],
  "cmsOwnerRecords": [
    {
      "organization": "PAUL PATTERSON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2013",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHRIS LUMSDEN",
      "role": "CORPORATE OFFICER",
      "association_date": "07/23/2018",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "BRIAN JOHNSON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "04/16/2018",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MICHAEL GENTRY",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "01/01/2022",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ANN VAUGHN",
      "role": "CORPORATE DIRECTOR",
      "association_date": "08/27/2018",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TOMMY RIGGS",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/04/1999",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DEREK WHITE",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "10/18/1999",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "WILLIAM WOLTZ",
      "role": "CORPORATE DIRECTOR",
      "association_date": "12/27/1989",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PHILLIP COOK",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/1999",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TERESA LEWIS",
      "role": "CORPORATE DIRECTOR",
      "association_date": "12/01/2014",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MONTY VENABLE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2003",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ANDREA HICKLING",
      "role": "CORPORATE OFFICER",
      "association_date": "08/01/2013",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DAVID GILLESPIE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/1999",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PHILLIP SNOW",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/04/2003",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "ownershipChain": {
    "model": "Facility legal owner, operator, parent company, ultimate controller, PE sponsor, and institutional shareholder context are separate evidence layers.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "northern-hospital-of-surry-county",
        "label": "Northern Hospital Of Surry County",
        "kind": "organization",
        "evidence": "source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-nc-baseline-queue"
      },
      {
        "id": "northern-regional-hospital",
        "label": "NORTHERN REGIONAL HOSPITAL",
        "kind": "hospital",
        "evidence": "source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-nc-baseline-queue"
      }
    ],
    "edges": [
      {
        "id": "rel-legal-owner-340003",
        "from": "northern-hospital-of-surry-county",
        "to": "northern-regional-hospital",
        "relationship": "operates",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-enrollments",
          "source-cms-hospital-all-owners",
          "source-nc-baseline-queue"
        ],
        "note": "NORTHERN HOSPITAL OF SURRY COUNTY is the best available legal-owner or enrolled-operator layer for NORTHERN REGIONAL HOSPITAL."
      },
      {
        "id": "rel-operator-340003",
        "from": "northern-regional-hospital",
        "to": "northern-regional-hospital",
        "relationship": "operates",
        "confidence": "medium",
        "sourceIds": [
          "source-nc-baseline-queue"
        ],
        "note": "Northern Regional Hospital is shown as the operator or parent-system layer for this facility."
      }
    ],
    "caveats": [
      "Institutional shareholders such as Vanguard, BlackRock, and State Street are context nodes only; they are not hospital operators unless direct control evidence is found.",
      "CMS owner rows identify enrolled owner/control roles but may not name every ultimate financial sponsor.",
      "Sibling/system affiliation does not cause a facility to inherit another hospital’s red status."
    ]
  },
  "ownershipConnections": [
    {
      "entityName": "NORTHERN HOSPITAL OF SURRY COUNTY",
      "entityKind": "Facility legal owner / enrollment layer",
      "relationship": "legal owner or enrolled operator",
      "classification": "Legal-owner layer",
      "evidenceSourceIds": [
        "source-cms-hospital-enrollments",
        "source-cms-hospital-all-owners",
        "source-nc-baseline-queue"
      ],
      "note": "NORTHERN HOSPITAL OF SURRY COUNTY is shown separately from the parent system and ultimate financial/control context."
    },
    {
      "entityName": "Northern Regional Hospital",
      "entityKind": "Hospital operator or parent system",
      "relationship": "operator / parent-system context",
      "classification": "Operator layer",
      "evidenceSourceIds": [
        "source-nc-baseline-queue"
      ],
      "note": "This connection identifies the operating or system layer used for the public map and dossier."
    }
  ],
  "importantLinks": [
    {
      "label": "Hospitals RAPT",
      "url": "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
      "sourceId": "source-hifld-hospitals",
      "note": "Facility location and identity source; does not establish ownership or control."
    },
    {
      "label": "North Carolina hospital license data",
      "url": "https://info.ncdhhs.gov/dhsr/mfp/data/hospital.html",
      "sourceId": "source-nc-dhsr-hospital-license-data",
      "note": "State-level hospital licensing context for North Carolina facilities."
    },
    {
      "label": "Hospital Enrollments",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "sourceId": "source-cms-hospital-enrollments",
      "note": "Used for legal name, DBA, CCN, NPI, enrollment identity, and location matching."
    },
    {
      "label": "Hospital All Owners",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "sourceId": "source-cms-hospital-all-owners",
      "note": "Used for current CMS owner, officer, managerial, holding-company, investment-firm, and security-interest rows."
    },
    {
      "label": "Hospital General Information",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "sourceId": "source-cms-care-compare",
      "note": "Facility type, ownership category, emergency services, and overall rating context."
    },
    {
      "label": "Hospital Provider Cost Reports",
      "url": "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
      "sourceId": "source-cms-hcris",
      "note": "Financial, staffing, and utilization values; descriptive only and not causal evidence."
    }
  ],
  "systemConnections": [],
  "directConnections": [
    "Legal/enrollment layer: NORTHERN HOSPITAL OF SURRY COUNTY.",
    "Operator layer: Northern Regional Hospital.",
    "Ultimate parent/controller context: Northern Regional Hospital.",
    "Operator/owner context: Northern Regional Hospital.",
    "CMS Care Compare ownership category: Government - Hospital District or Authority."
  ],
  "actions": [],
  "contradictions": [],
  "limitations": [
    "This automated NC pass searched mandatory official/source systems and records missing items; it does not claim the entire internet was exhausted.",
    "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 CEO/current leader",
    "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-nc-baseline-queue",
      "title": "North Carolina baseline classification queue",
      "publisher": "PE Healthcare Watch",
      "publication_date": "2026-06-24",
      "retrieved_at": "2026-06-26",
      "url": "/data/releases/release-2026-06-24-nc-baseline.json",
      "reliability_tier": "research",
      "research_note": "Internal queue used to ensure every current NC map record receives a dossier package.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-nc-dhsr-hospital-license-data",
      "title": "North Carolina hospital license data",
      "publisher": "North Carolina Division of Health Service Regulation",
      "publication_date": "current public listing",
      "retrieved_at": "2026-06-26",
      "url": "https://info.ncdhhs.gov/dhsr/mfp/data/hospital.html",
      "reliability_tier": "government",
      "research_note": "State-level hospital licensing context for North Carolina facilities.",
      "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"
    }
  ],
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 89590986,
      "latestValue": 104470320,
      "absoluteChange": 14879334,
      "percentChange": 16.60807036993655,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 103791943,
      "latestValue": 131821201,
      "absoluteChange": 28029258,
      "percentChange": 27.005234886102862,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 4800304,
      "latestValue": 4126899,
      "absoluteChange": -673405,
      "percentChange": -14.028382369116624,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 163529309,
      "latestValue": 158379562,
      "absoluteChange": -5149747,
      "percentChange": -3.1491278422756617,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 60102080,
      "latestValue": 60630078,
      "absoluteChange": 527998,
      "percentChange": 0.8785020418594499,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 2530868,
      "latestValue": 5407051,
      "absoluteChange": 2876183,
      "percentChange": 113.64413315905848,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 683.11,
      "latestValue": 758.89,
      "absoluteChange": 75.77999999999997,
      "percentChange": 11.093381739397751,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 100,
      "latestValue": 100,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 14362,
      "latestValue": 15527,
      "absoluteChange": 1165,
      "percentChange": 8.111683609525135,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 3962,
      "latestValue": 3588,
      "absoluteChange": -374,
      "percentChange": -9.439676930843008,
      "unit": "discharges"
    }
  ]
}
