{ "schemaVersion": 4, "entityId": "340051", "canonicalName": "WATAUGA MEDICAL CENTER, INC", "status": "corporate_chain", "statusLabel": "Corporate-chain ownership/accountability warning", "summary": "WATAUGA MEDICAL CENTER, INC 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": "Appalachian Regional Healthcare System", "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": "WATAUGA MEDICAL CENTER, INC is connected to Appalachian Regional Healthcare System. 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": "BOONE, WATAUGA, 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": "3", "emergencyServices": "Yes", "hospitalType": "Acute Care Hospitals", "careCompareOwnership": "Government - Local" }, "leadership": [], "identifiers": { "ccn": "340051", "npi": "1205859766", "historicalCcns": [], "aliases": [ { "alias": "WATAUGA MEDICAL CENTER INC", "alias_type": "cms_legal_name", "source_id": "source-cms-hospital-enrollments" }, { "alias": "WATAUGA MEDICAL CENTER", "alias_type": "cms_care_compare_name", "source_id": "source-cms-care-compare" } ] }, "ownershipHistory": [ { "relationship_id": "rel-legal-owner-340051", "from_entity_id": "watauga-medical-center-inc", "to_entity_id": "watauga-medical-center-inc", "relationship_type": "controls", "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": "WATAUGA MEDICAL CENTER INC is the best available legal-owner or enrolled-operator layer for WATAUGA MEDICAL CENTER, INC.", "review_notes": "This legal-owner layer is separate from ultimate parent, public-company shareholders, and PE sponsor context." }, { "relationship_id": "rel-operator-340051", "from_entity_id": "appalachian-regional-healthcare-system", "to_entity_id": "watauga-medical-center-inc", "relationship_type": "operates", "effective_date": "", "end_date": "", "announcement_date": "", "status": "current", "confidence": "medium", "source_ids": "source-nc-baseline-queue", "plain_english_summary": "Appalachian Regional Healthcare System is shown as the operator or parent-system layer for this facility.", "review_notes": "" }, { "relationship_id": "rel-cms-owner-340051", "from_entity_id": "appalachianregionalsystem", "to_entity_id": "340051", "relationship_type": "cms_owner_context", "effective_date": "06/01/2004", "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-340051", "from_entity_id": "appalachianregionalsystem", "to_entity_id": "340051", "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-340051", "from_entity_id": "appalachianregionalsystem", "to_entity_id": "340051", "relationship_type": "cms_owner_context", "effective_date": "06/01/2004", "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-340051", "from_entity_id": "appalachianregionalsystem", "to_entity_id": "340051", "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-340051", "from_entity_id": "appalachianregionalsystem", "to_entity_id": "340051", "relationship_type": "cms_owner_context", "effective_date": "06/01/2004", "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": "340051-net_patient_revenue-06-30-2024", "entity_id": "340051", "metric_name": "net_patient_revenue", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "205534057", "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": "340051-net_patient_revenue-06-30-2023", "entity_id": "340051", "metric_name": "net_patient_revenue", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "131671678", "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": "340051-net_patient_revenue-09-30-2022", "entity_id": "340051", "metric_name": "net_patient_revenue", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "187289833", "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": "340051-net_patient_revenue-09-30-2021", "entity_id": "340051", "metric_name": "net_patient_revenue", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "180524875", "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": "340051-operating_expense-06-30-2024", "entity_id": "340051", "metric_name": "operating_expense", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "207390442", "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": "340051-operating_expense-06-30-2023", "entity_id": "340051", "metric_name": "operating_expense", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "144274142", "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": "340051-operating_expense-09-30-2022", "entity_id": "340051", "metric_name": "operating_expense", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "182818047", "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": "340051-operating_expense-09-30-2021", "entity_id": "340051", "metric_name": "operating_expense", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "164126776", "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": "340051-net_income-06-30-2024", "entity_id": "340051", "metric_name": "net_income", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "9065828", "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": "340051-net_income-06-30-2023", "entity_id": "340051", "metric_name": "net_income", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "-9653967", "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": "340051-net_income-09-30-2022", "entity_id": "340051", "metric_name": "net_income", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "-915860", "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": "340051-net_income-09-30-2021", "entity_id": "340051", "metric_name": "net_income", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "29983934", "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": "340051-total_assets-06-30-2024", "entity_id": "340051", "metric_name": "total_assets", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "350534256", "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": "340051-total_assets-06-30-2023", "entity_id": "340051", "metric_name": "total_assets", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "341982332", "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": "340051-total_assets-09-30-2022", "entity_id": "340051", "metric_name": "total_assets", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "355861227", "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": "340051-total_assets-09-30-2021", "entity_id": "340051", "metric_name": "total_assets", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "374751449", "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": "340051-total_liabilities-06-30-2024", "entity_id": "340051", "metric_name": "total_liabilities", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "163406498", "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": "340051-total_liabilities-06-30-2023", "entity_id": "340051", "metric_name": "total_liabilities", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "163662371", "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": "340051-total_liabilities-09-30-2022", "entity_id": "340051", "metric_name": "total_liabilities", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "167887299", "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": "340051-total_liabilities-09-30-2021", "entity_id": "340051", "metric_name": "total_liabilities", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "185859299", "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": "340051-contract_labor_direct_patient_care-06-30-2024", "entity_id": "340051", "metric_name": "contract_labor_direct_patient_care", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "11930699", "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": "340051-contract_labor_direct_patient_care-06-30-2023", "entity_id": "340051", "metric_name": "contract_labor_direct_patient_care", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "8946145", "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": "340051-contract_labor_direct_patient_care-09-30-2022", "entity_id": "340051", "metric_name": "contract_labor_direct_patient_care", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "11685230", "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": "340051-contract_labor_direct_patient_care-09-30-2021", "entity_id": "340051", "metric_name": "contract_labor_direct_patient_care", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "3273964", "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": "340051-fte_employees-06-30-2024", "entity_id": "340051", "metric_name": "fte_employees", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "682", "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": "340051-fte_employees-06-30-2023", "entity_id": "340051", "metric_name": "fte_employees", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "672.51", "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": "340051-fte_employees-09-30-2022", "entity_id": "340051", "metric_name": "fte_employees", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "628.52", "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": "340051-fte_employees-09-30-2021", "entity_id": "340051", "metric_name": "fte_employees", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "634", "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": "340051-beds-06-30-2024", "entity_id": "340051", "metric_name": "beds", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "121", "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": "340051-beds-06-30-2023", "entity_id": "340051", "metric_name": "beds", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "121", "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": "340051-beds-09-30-2022", "entity_id": "340051", "metric_name": "beds", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "95", "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": "340051-beds-09-30-2021", "entity_id": "340051", "metric_name": "beds", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "95", "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": "340051-patient_days-06-30-2024", "entity_id": "340051", "metric_name": "patient_days", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "17655", "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": "340051-patient_days-06-30-2023", "entity_id": "340051", "metric_name": "patient_days", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "12976", "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": "340051-patient_days-09-30-2022", "entity_id": "340051", "metric_name": "patient_days", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "18796", "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": "340051-patient_days-09-30-2021", "entity_id": "340051", "metric_name": "patient_days", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "16644", "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": "340051-discharges-06-30-2024", "entity_id": "340051", "metric_name": "discharges", "period_start": "07/01/2023", "period_end": "06/30/2024", "value": "4452", "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": "340051-discharges-06-30-2023", "entity_id": "340051", "metric_name": "discharges", "period_start": "10/01/2022", "period_end": "06/30/2023", "value": "2973", "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": "340051-discharges-09-30-2022", "entity_id": "340051", "metric_name": "discharges", "period_start": "10/01/2021", "period_end": "09/30/2022", "value": "3784", "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": "340051-discharges-09-30-2021", "entity_id": "340051", "metric_name": "discharges", "period_start": "10/01/2020", "period_end": "09/30/2021", "value": "3964", "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": "APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC", "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST", "association_date": "06/01/2004", "percentage_ownership": "", "investment_firm": false, "private_equity_company": false, "holding_company": false, "management_services_company": false, "medical_staffing_company": false }, { "organization": "SAM ADAMS", "role": "CORPORATE DIRECTOR", "association_date": "01/01/2008", "percentage_ownership": "0", "investment_firm": false, "private_equity_company": false, "holding_company": false, "management_services_company": false, "medical_staffing_company": false }, { "organization": "JOHN LEWIS", "role": "CORPORATE OFFICER", "association_date": "07/01/2022", "percentage_ownership": "", "investment_firm": false, "private_equity_company": false, "holding_company": false, "management_services_company": false, "medical_staffing_company": false }, { "organization": "UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM", "role": "OPERATIONAL/MANAGERIAL CONTROL", "association_date": "07/01/2022", "percentage_ownership": "", "investment_firm": false, "private_equity_company": false, "holding_company": false, "management_services_company": false, "medical_staffing_company": false }, { "organization": "MARY LONG", "role": "W-2 MANAGING EMPLOYEE", "association_date": "10/21/2008", "percentage_ownership": "0", "investment_firm": false, "private_equity_company": false, "holding_company": false, "management_services_company": false, "medical_staffing_company": false }, { "organization": "RICHARD CASSADY", "role": "CORPORATE OFFICER", "association_date": "11/28/2022", "percentage_ownership": "", "investment_firm": false, "private_equity_company": false, "holding_company": false, "management_services_company": false, "medical_staffing_company": false }, { "organization": "ARVIL BURKS", "role": "CORPORATE OFFICER", "association_date": "07/01/2022", "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": "watauga-medical-center-inc", "label": "WATAUGA MEDICAL CENTER, INC", "kind": "organization", "evidence": "source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-nc-baseline-queue" }, { "id": "appalachian-regional-healthcare-system", "label": "Appalachian Regional Healthcare System", "kind": "organization", "evidence": "source-nc-baseline-queue" } ], "edges": [ { "id": "rel-legal-owner-340051", "from": "watauga-medical-center-inc", "to": "watauga-medical-center-inc", "relationship": "controls", "confidence": "high", "sourceIds": [ "source-cms-hospital-enrollments", "source-cms-hospital-all-owners", "source-nc-baseline-queue" ], "note": "WATAUGA MEDICAL CENTER INC is the best available legal-owner or enrolled-operator layer for WATAUGA MEDICAL CENTER, INC." }, { "id": "rel-operator-340051", "from": "appalachian-regional-healthcare-system", "to": "watauga-medical-center-inc", "relationship": "operates", "confidence": "medium", "sourceIds": [ "source-nc-baseline-queue" ], "note": "Appalachian Regional Healthcare System 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": "WATAUGA MEDICAL CENTER INC", "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": "WATAUGA MEDICAL CENTER INC is shown separately from the parent system and ultimate financial/control context." }, { "entityName": "Appalachian Regional Healthcare System", "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": [ { "systemName": "Appalachian Regional Healthcare System", "relationship": "shared North Carolina system / branch family", "evidenceSourceIds": [ "source-nc-baseline-queue" ], "facilities": [ { "name": "APPALACHIAN REGIONAL BEHAVIORAL HEALTHCARE", "role": "connected NC facility", "city": "LINVILLE", "state": "NC", "recordId": "344034", "note": "Connected by shared parent/operator/system field; status remains facility-specific." }, { "name": "CHARLES A. CANNON JR. MEMORIAL HOSPITAL, INCORPORATED", "role": "connected NC facility", "city": "LINVILLE", "state": "NC", "recordId": "341323", "note": "Connected by shared parent/operator/system field; status remains facility-specific." }, { "name": "WATAUGA MEDICAL CENTER, INC", "role": "current record", "city": "BOONE", "state": "NC", "recordId": "340051", "note": "This facility is the center of the dossier." } ] } ], "directConnections": [ "Legal/enrollment layer: WATAUGA MEDICAL CENTER INC.", "Operator layer: Appalachian Regional Healthcare System.", "Ultimate parent/controller context: Appalachian Regional Healthcare System.", "Operator/owner context: Appalachian Regional Healthcare System.", "CMS Care Compare ownership category: Government - Local." ], "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": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 180524875, "latestValue": 205534057, "absoluteChange": 25009182, "percentChange": 13.853593306739583, "unit": "USD" }, { "metric": "operating_expense", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 164126776, "latestValue": 207390442, "absoluteChange": 43263666, "percentChange": 26.3599072950778, "unit": "USD" }, { "metric": "net_income", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 29983934, "latestValue": 9065828, "absoluteChange": -20918106, "percentChange": -69.76438115158604, "unit": "USD" }, { "metric": "total_assets", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 374751449, "latestValue": 350534256, "absoluteChange": -24217193, "percentChange": -6.462201297585909, "unit": "USD" }, { "metric": "total_liabilities", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 185859299, "latestValue": 163406498, "absoluteChange": -22452801, "percentChange": -12.080536793588143, "unit": "USD" }, { "metric": "contract_labor_direct_patient_care", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 3273964, "latestValue": 11930699, "absoluteChange": 8656735, "percentChange": 264.41142908107724, "unit": "USD" }, { "metric": "fte_employees", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 634, "latestValue": 682, "absoluteChange": 48, "percentChange": 7.570977917981073, "unit": "FTE" }, { "metric": "beds", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 95, "latestValue": 121, "absoluteChange": 26, "percentChange": 27.368421052631582, "unit": "beds" }, { "metric": "patient_days", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 16644, "latestValue": 17655, "absoluteChange": 1011, "percentChange": 6.074260994953136, "unit": "days" }, { "metric": "discharges", "earliestPeriod": "09/30/2021", "latestPeriod": "06/30/2024", "earliestValue": 3964, "latestValue": 4452, "absoluteChange": 488, "percentChange": 12.31079717457114, "unit": "discharges" } ] }