{
  "schemaVersion": 4,
  "entityId": "340123",
  "canonicalName": "RANDOLPH HOSPITAL, INC",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "RANDOLPH HOSPITAL, 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": 13,
    "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"
  },
  "identifiers": {
    "ccn": "340123",
    "npi": "1942895081",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "AMERICAN HEALTHCARE SYSTEMS LLC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "RANDOLPH HOSPITAL",
        "alias_type": "cms_care_compare_name",
        "source_id": "source-cms-care-compare"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-conehealth-340123",
      "from_entity_id": "Cone Health",
      "to_entity_id": "340123",
      "relationship_type": "venture_backing",
      "effective_date": "",
      "end_date": "",
      "announcement_date": "",
      "status": "signal",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners|source-pesp-hospital-tracker",
      "plain_english_summary": "Cone Health is reported as an investment backer; this is not treated as a completed ownership claim.",
      "review_notes": "CMS corroborates the current enrolled ownership chain; the sponsor attribution comes from the research tracker."
    },
    {
      "relationship_id": "rel-cms-owner-340123",
      "from_entity_id": "conehealth",
      "to_entity_id": "340123",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2021",
      "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-340123",
      "from_entity_id": "conehealth",
      "to_entity_id": "340123",
      "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-340123",
      "from_entity_id": "conehealth",
      "to_entity_id": "340123",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2021",
      "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-340123",
      "from_entity_id": "conehealth",
      "to_entity_id": "340123",
      "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-340123",
      "from_entity_id": "conehealth",
      "to_entity_id": "340123",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2021",
      "status": "current_context",
      "confidence": "medium",
      "source_ids": "source-cms-hospital-all-owners",
      "plain_english_summary": "CMS Hospital All Owners rows are attached as current owner/control context. They do not by themselves prove private-equity sponsorship unless the row says so or another cited source supports it.",
      "review_notes": ""
    }
  ],
  "acquisitionEvents": [
    {
      "date": "10/01/2021",
      "title": "CMS before/after ownership event",
      "detail": "RANDOLPH HOSPITAL, INC. -> AMERICAN HEALTHCARE SYSTEMS LLC.",
      "sourceIds": [
        "source-cms-hospital-chow"
      ]
    }
  ],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "340123-net_patient_revenue-12-31-2023",
      "entity_id": "340123",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "108510650",
      "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": "340123-net_patient_revenue-12-31-2022",
      "entity_id": "340123",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "119642100",
      "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": "340123-net_patient_revenue-12-31-2021",
      "entity_id": "340123",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "24492145",
      "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": "340123-net_patient_revenue-09-30-2021",
      "entity_id": "340123",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "81335575",
      "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": "340123-operating_expense-12-31-2023",
      "entity_id": "340123",
      "metric_name": "operating_expense",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "111003848",
      "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": "340123-operating_expense-12-31-2022",
      "entity_id": "340123",
      "metric_name": "operating_expense",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "108040573",
      "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": "340123-operating_expense-12-31-2021",
      "entity_id": "340123",
      "metric_name": "operating_expense",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "29740894",
      "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": "340123-operating_expense-09-30-2021",
      "entity_id": "340123",
      "metric_name": "operating_expense",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "114028459",
      "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": "340123-net_income-12-31-2023",
      "entity_id": "340123",
      "metric_name": "net_income",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "20723449",
      "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": "340123-net_income-12-31-2022",
      "entity_id": "340123",
      "metric_name": "net_income",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "15749630",
      "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": "340123-net_income-12-31-2021",
      "entity_id": "340123",
      "metric_name": "net_income",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "-11909764",
      "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": "340123-net_income-09-30-2021",
      "entity_id": "340123",
      "metric_name": "net_income",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "-31823922",
      "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": "340123-total_assets-12-31-2023",
      "entity_id": "340123",
      "metric_name": "total_assets",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "86155943",
      "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": "340123-total_assets-12-31-2022",
      "entity_id": "340123",
      "metric_name": "total_assets",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "58186344",
      "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": "340123-total_assets-12-31-2021",
      "entity_id": "340123",
      "metric_name": "total_assets",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "-28034416",
      "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": "340123-total_assets-09-30-2021",
      "entity_id": "340123",
      "metric_name": "total_assets",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "123217489",
      "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": "340123-total_liabilities-12-31-2023",
      "entity_id": "340123",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "38504540",
      "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": "340123-total_liabilities-12-31-2022",
      "entity_id": "340123",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "30611455",
      "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": "340123-total_liabilities-12-31-2021",
      "entity_id": "340123",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "-16613198",
      "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": "340123-total_liabilities-09-30-2021",
      "entity_id": "340123",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "90842113",
      "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": "340123-contract_labor_direct_patient_care-12-31-2023",
      "entity_id": "340123",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "491270",
      "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": "340123-contract_labor_direct_patient_care-12-31-2022",
      "entity_id": "340123",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "3437968",
      "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": "340123-contract_labor_direct_patient_care-12-31-2021",
      "entity_id": "340123",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "871479",
      "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": "340123-contract_labor_direct_patient_care-09-30-2021",
      "entity_id": "340123",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "2108130",
      "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": "340123-fte_employees-12-31-2023",
      "entity_id": "340123",
      "metric_name": "fte_employees",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "827.93",
      "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": "340123-fte_employees-12-31-2022",
      "entity_id": "340123",
      "metric_name": "fte_employees",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "791.76",
      "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": "340123-fte_employees-12-31-2021",
      "entity_id": "340123",
      "metric_name": "fte_employees",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "173.01",
      "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": "340123-fte_employees-09-30-2021",
      "entity_id": "340123",
      "metric_name": "fte_employees",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "605.33",
      "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": "340123-beds-12-31-2023",
      "entity_id": "340123",
      "metric_name": "beds",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "145",
      "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": "340123-beds-12-31-2022",
      "entity_id": "340123",
      "metric_name": "beds",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "145",
      "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": "340123-beds-12-31-2021",
      "entity_id": "340123",
      "metric_name": "beds",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "145",
      "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": "340123-beds-09-30-2021",
      "entity_id": "340123",
      "metric_name": "beds",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "145",
      "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": "340123-patient_days-12-31-2023",
      "entity_id": "340123",
      "metric_name": "patient_days",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "17168",
      "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": "340123-patient_days-12-31-2022",
      "entity_id": "340123",
      "metric_name": "patient_days",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "18681",
      "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": "340123-patient_days-12-31-2021",
      "entity_id": "340123",
      "metric_name": "patient_days",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "5016",
      "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": "340123-patient_days-09-30-2021",
      "entity_id": "340123",
      "metric_name": "patient_days",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "14840",
      "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": "340123-discharges-12-31-2023",
      "entity_id": "340123",
      "metric_name": "discharges",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "5725",
      "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": "340123-discharges-12-31-2022",
      "entity_id": "340123",
      "metric_name": "discharges",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "5733",
      "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": "340123-discharges-12-31-2021",
      "entity_id": "340123",
      "metric_name": "discharges",
      "period_start": "10/01/2021",
      "period_end": "12/31/2021",
      "value": "1555",
      "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": "340123-discharges-09-30-2021",
      "entity_id": "340123",
      "metric_name": "discharges",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "4960",
      "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": "LORETTA LONG",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2021",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TIMOTHY FORD",
      "role": "CORPORATE OFFICER",
      "association_date": "09/30/2020",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TIMOTHY FORD",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "09/30/2020",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHARLES WEST",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2021",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TREMONTEO CRAWFORD",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2021",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "AMERICAN HEALTHCARE SYSTEMS CORP INC",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "03/30/2020",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ANGELA BURGESS",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "FAISAL GILL",
      "role": "CORPORATE DIRECTOR",
      "association_date": "09/30/2020",
      "percentage_ownership": "0",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MIKE SARIAN",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "10/01/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MIKE SARIAN",
      "role": "CORPORATE OFFICER",
      "association_date": "09/30/2020",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MIKE SARIAN",
      "role": "CORPORATE DIRECTOR",
      "association_date": "09/30/2020",
      "percentage_ownership": "50",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [
    "Reported parent system or portfolio company: Cone Health.",
    "Operator/owner context: Cone Health.",
    "CMS Care Compare ownership category: Voluntary non-profit - Private."
  ],
  "actions": [],
  "contradictions": [],
  "limitations": [
    "CMS corroborates an enrolled ownership chain, but its owner names do not independently reproduce every sponsor or portfolio-company name from the tracker.",
    "The investment signal does not establish completed private-equity ownership or a pending sale.",
    "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": [
    "Precise acquisition date",
    "Official facility URL",
    "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-pesp-hospital-tracker",
      "title": "Private Equity Hospital Tracker",
      "publisher": "Private Equity Stakeholder Project",
      "publication_date": "2026-04-03 snapshot",
      "retrieved_at": "2026-07-02",
      "url": "https://pestakeholder.org/private-equity-hospital-tracker/",
      "reliability_tier": "research",
      "research_note": "Discovery source for PE, contract, and transaction-signal follow-up; not enough by itself for direct control claims.",
      "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-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-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-hospital-chow",
      "title": "Hospital Change of Ownership",
      "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-change-of-ownership",
      "reliability_tier": "government",
      "research_note": "Used for before/after ownership and enrollment transfer events when a matching CHOW row exists.",
      "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": "Sponsor, operator, CMS legal-owner/control records, and facility are shown as separate evidence layers.",
    "confidence": "medium",
    "nodes": [
      {
        "id": "facility:340123",
        "label": "RANDOLPH HOSPITAL, INC",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:cone-health",
        "label": "Cone Health",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:loretta-long:0",
        "label": "LORETTA LONG",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:timothy-ford:1",
        "label": "TIMOTHY FORD",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:timothy-ford:2",
        "label": "TIMOTHY FORD",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:charles-west:3",
        "label": "CHARLES WEST",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:tremonteo-crawford:4",
        "label": "TREMONTEO CRAWFORD",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:american-healthcare-systems-corp-inc:5",
        "label": "AMERICAN HEALTHCARE SYSTEMS CORP INC",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:angela-burgess:6",
        "label": "ANGELA BURGESS",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:faisal-gill:7",
        "label": "FAISAL GILL",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:mike-sarian:8",
        "label": "MIKE SARIAN",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER INDIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:mike-sarian:9",
        "label": "MIKE SARIAN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:mike-sarian:10",
        "label": "MIKE SARIAN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      }
    ],
    "edges": [
      {
        "id": "organization:cone-health->facility:340123",
        "from": "organization:cone-health",
        "to": "facility:340123",
        "relationship": "reported ownership or operating chain",
        "confidence": "medium",
        "sourceIds": [
          "source-cms-hospital-all-owners",
          "source-pesp-hospital-tracker"
        ],
        "note": "The platform attribution comes from the research tracker and is displayed separately from CMS legal-owner rows."
      },
      {
        "id": "cms-owner:loretta-long:0->facility:340123",
        "from": "cms-owner:loretta-long:0",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 0% reported ownership · associated 10/01/2021"
      },
      {
        "id": "cms-owner:timothy-ford:1->facility:340123",
        "from": "cms-owner:timothy-ford:1",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 0% reported ownership · associated 09/30/2020"
      },
      {
        "id": "cms-owner:timothy-ford:2->facility:340123",
        "from": "cms-owner:timothy-ford:2",
        "to": "facility:340123",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 100% reported ownership · associated 09/30/2020"
      },
      {
        "id": "cms-owner:charles-west:3->facility:340123",
        "from": "cms-owner:charles-west:3",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 0% reported ownership · associated 10/01/2021"
      },
      {
        "id": "cms-owner:tremonteo-crawford:4->facility:340123",
        "from": "cms-owner:tremonteo-crawford:4",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 0% reported ownership · associated 10/01/2021"
      },
      {
        "id": "cms-owner:american-healthcare-systems-corp-inc:5->facility:340123",
        "from": "cms-owner:american-healthcare-systems-corp-inc:5",
        "to": "facility:340123",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · associated 03/30/2020"
      },
      {
        "id": "cms-owner:angela-burgess:6->facility:340123",
        "from": "cms-owner:angela-burgess:6",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 10/01/2021"
      },
      {
        "id": "cms-owner:faisal-gill:7->facility:340123",
        "from": "cms-owner:faisal-gill:7",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 0% reported ownership · associated 09/30/2020"
      },
      {
        "id": "cms-owner:mike-sarian:8->facility:340123",
        "from": "cms-owner:mike-sarian:8",
        "to": "facility:340123",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER INDIRECT OWNERSHIP INTEREST · associated 10/01/2021"
      },
      {
        "id": "cms-owner:mike-sarian:9->facility:340123",
        "from": "cms-owner:mike-sarian:9",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · 100% reported ownership · associated 09/30/2020"
      },
      {
        "id": "cms-owner:mike-sarian:10->facility:340123",
        "from": "cms-owner:mike-sarian:10",
        "to": "facility:340123",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 50% reported ownership · associated 09/30/2020"
      }
    ],
    "caveats": [
      "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor."
    ]
  },
  "descriptiveTrends": [
    {
      "metric": "net_patient_revenue",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 81335575,
      "latestValue": 108510650,
      "absoluteChange": 27175075,
      "percentChange": 33.41105660100147,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 114028459,
      "latestValue": 111003848,
      "absoluteChange": -3024611,
      "percentChange": -2.652505371488007,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": -31823922,
      "latestValue": 20723449,
      "absoluteChange": 52547371,
      "percentChange": 165.11909185800545,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 123217489,
      "latestValue": 86155943,
      "absoluteChange": -37061546,
      "percentChange": -30.078153921802446,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 90842113,
      "latestValue": 38504540,
      "absoluteChange": -52337573,
      "percentChange": -57.613777653983014,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2108130,
      "latestValue": 491270,
      "absoluteChange": -1616860,
      "percentChange": -76.69640866549976,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 605.33,
      "latestValue": 827.93,
      "absoluteChange": 222.5999999999999,
      "percentChange": 36.773330249615896,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 145,
      "latestValue": 145,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 14840,
      "latestValue": 17168,
      "absoluteChange": 2328,
      "percentChange": 15.687331536388141,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 4960,
      "latestValue": 5725,
      "absoluteChange": 765,
      "percentChange": 15.423387096774194,
      "unit": "discharges"
    }
  ],
  "firstGlance": {
    "taxOwnershipType": "Nonprofit",
    "operator": "Cone Health",
    "directPeOwnership": "Not documented as direct PE ownership in this state-template pass",
    "peRelationship": "Watchlist signal",
    "careLevel": "Acute Care Hospitals",
    "currentCeo": "Needs source-backed local leader research",
    "bottomLine": "RANDOLPH HOSPITAL, INC is shown with official-source baseline context for North Carolina. 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": "ASHEBORO, RANDOLPH, 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": {
    "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
  }
}