{
  "schemaVersion": 4,
  "entityId": "344007",
  "canonicalName": "OLD VINEYARD YOUTH SERVICES",
  "status": "corporate_chain",
  "statusLabel": "Corporate-chain ownership/accountability warning",
  "summary": "OLD VINEYARD YOUTH SERVICES 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": 10,
    "ownership_source_count": 17,
    "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": "For-profit",
    "operator": "Universal Health Services",
    "directPeOwnership": "Not documented as direct PE ownership in this state-template pass",
    "peRelationship": "No documented PE link in current baseline sources",
    "institutionalShareholderContext": "UHS is public. Its 2026 proxy contains Miller family/control context plus BlackRock and State Street references. Treat institutional holders as shareholder context, not facility operators.",
    "populationServedEstimate": 0,
    "populationServedLabel": "Needs system/facility catchment estimate",
    "careLevel": "Psychiatric",
    "currentCeo": "Marc D. Miller",
    "previousRelevantCeo": "Not identified in this automated NC pass",
    "confidence": "medium",
    "bottomLine": "OLD VINEYARD YOUTH SERVICES is connected to Universal Health Services. UHS is public. Its 2026 proxy contains Miller family/control context plus BlackRock and State Street references. Treat institutional holders as shareholder context, not facility operators. 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": "WINSTON-SALEM, FORSYTH, North Carolina. Service role should be refined in manual follow-up.",
    "traumaCareLevel": "Psychiatric",
    "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": "Not Available",
    "emergencyServices": "No",
    "hospitalType": "Psychiatric",
    "careCompareOwnership": "Proprietary"
  },
  "leadership": [
    {
      "name": "Marc D. Miller",
      "role": "Universal Health Services President and Chief Executive Officer",
      "context": "Official UHS leadership source identifies Marc D. Miller as president and CEO; Alan B. Miller remains founder and executive chairman context.",
      "imageUrl": "placeholder://official-image-unavailable",
      "imageAlt": "Marc D. Miller official image",
      "imageStatus": "official image unavailable in this automated NC pass",
      "sourceId": "source-uhs-marc-miller-leadership",
      "compensation": "Corporate executive compensation is disclosed in the UHS 2026 proxy.",
      "compensationSourceId": "source-sec-uhs-proxy-2026"
    }
  ],
  "identifiers": {
    "ccn": "344007",
    "npi": "1922038082",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "KEYSTONE WSNC LLC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "OLD VINEYARD BEHAVIORAL HEALTH SERVICES",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "OLD VINEYARD YOUTH SERVICES",
        "alias_type": "cms_care_compare_name",
        "source_id": "source-cms-care-compare"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-legal-owner-344007",
      "from_entity_id": "keystone-wsnc-llc",
      "to_entity_id": "old-vineyard-youth-services",
      "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": "KEYSTONE WSNC LLC is the best available legal-owner or enrolled-operator layer for OLD VINEYARD YOUTH SERVICES.",
      "review_notes": "This legal-owner layer is separate from ultimate parent, public-company shareholders, and PE sponsor context."
    },
    {
      "relationship_id": "rel-operator-344007",
      "from_entity_id": "universal-health-services",
      "to_entity_id": "old-vineyard-youth-services",
      "relationship_type": "operates",
      "effective_date": "",
      "end_date": "",
      "announcement_date": "",
      "status": "current",
      "confidence": "medium",
      "source_ids": "source-nc-baseline-queue|source-sec-uhs-proxy-2026|source-uhs-marc-miller-leadership",
      "plain_english_summary": "Universal Health Services is shown as the operator or parent-system layer for this facility.",
      "review_notes": ""
    },
    {
      "relationship_id": "rel-cms-owner-344007",
      "from_entity_id": "universalhealthservices",
      "to_entity_id": "344007",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2019",
      "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-344007",
      "from_entity_id": "universalhealthservices",
      "to_entity_id": "344007",
      "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-344007",
      "from_entity_id": "universalhealthservices",
      "to_entity_id": "344007",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2019",
      "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-344007",
      "from_entity_id": "universalhealthservices",
      "to_entity_id": "344007",
      "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-344007",
      "from_entity_id": "universalhealthservices",
      "to_entity_id": "344007",
      "relationship_type": "cms_owner_context",
      "effective_date": "10/01/2019",
      "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": "344007-net_patient_revenue-12-31-2023",
      "entity_id": "344007",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "37464338",
      "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": "344007-net_patient_revenue-12-31-2022",
      "entity_id": "344007",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "36171959",
      "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": "344007-net_patient_revenue-12-31-2021",
      "entity_id": "344007",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "35447622",
      "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": "344007-net_patient_revenue-12-31-2020",
      "entity_id": "344007",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "31905352",
      "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": "344007-operating_expense-12-31-2023",
      "entity_id": "344007",
      "metric_name": "operating_expense",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "29775539",
      "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": "344007-operating_expense-12-31-2022",
      "entity_id": "344007",
      "metric_name": "operating_expense",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "27874546",
      "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": "344007-operating_expense-12-31-2021",
      "entity_id": "344007",
      "metric_name": "operating_expense",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "27347746",
      "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": "344007-operating_expense-12-31-2020",
      "entity_id": "344007",
      "metric_name": "operating_expense",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "26907778",
      "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": "344007-net_income-12-31-2023",
      "entity_id": "344007",
      "metric_name": "net_income",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "7759686",
      "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": "344007-net_income-12-31-2022",
      "entity_id": "344007",
      "metric_name": "net_income",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "8329886",
      "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": "344007-net_income-12-31-2021",
      "entity_id": "344007",
      "metric_name": "net_income",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "8269627",
      "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": "344007-net_income-12-31-2020",
      "entity_id": "344007",
      "metric_name": "net_income",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "6167800",
      "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": "344007-total_assets-12-31-2023",
      "entity_id": "344007",
      "metric_name": "total_assets",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "23371138",
      "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": "344007-total_assets-12-31-2022",
      "entity_id": "344007",
      "metric_name": "total_assets",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "24866463",
      "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": "344007-total_assets-12-31-2021",
      "entity_id": "344007",
      "metric_name": "total_assets",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "24651014",
      "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": "344007-total_assets-12-31-2020",
      "entity_id": "344007",
      "metric_name": "total_assets",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "24432483",
      "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": "344007-total_liabilities-12-31-2023",
      "entity_id": "344007",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "-54700319",
      "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": "344007-total_liabilities-12-31-2022",
      "entity_id": "344007",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "-45445307",
      "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": "344007-total_liabilities-12-31-2021",
      "entity_id": "344007",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "-34488045",
      "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": "344007-total_liabilities-12-31-2020",
      "entity_id": "344007",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "-29279771",
      "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": "344007-fte_employees-12-31-2023",
      "entity_id": "344007",
      "metric_name": "fte_employees",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "265.3",
      "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": "344007-fte_employees-12-31-2022",
      "entity_id": "344007",
      "metric_name": "fte_employees",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "257.6",
      "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": "344007-fte_employees-12-31-2020",
      "entity_id": "344007",
      "metric_name": "fte_employees",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "262.99",
      "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": "344007-fte_employees-12-31-2019",
      "entity_id": "344007",
      "metric_name": "fte_employees",
      "period_start": "01/01/2019",
      "period_end": "12/31/2019",
      "value": "273.88",
      "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": "344007-beds-12-31-2023",
      "entity_id": "344007",
      "metric_name": "beds",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "164",
      "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": "344007-beds-12-31-2022",
      "entity_id": "344007",
      "metric_name": "beds",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "164",
      "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": "344007-beds-12-31-2021",
      "entity_id": "344007",
      "metric_name": "beds",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "164",
      "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": "344007-beds-12-31-2020",
      "entity_id": "344007",
      "metric_name": "beds",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "164",
      "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": "344007-patient_days-12-31-2023",
      "entity_id": "344007",
      "metric_name": "patient_days",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "51726",
      "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": "344007-patient_days-12-31-2022",
      "entity_id": "344007",
      "metric_name": "patient_days",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "50956",
      "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": "344007-patient_days-12-31-2021",
      "entity_id": "344007",
      "metric_name": "patient_days",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "50143",
      "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": "344007-patient_days-12-31-2020",
      "entity_id": "344007",
      "metric_name": "patient_days",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "49319",
      "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": "344007-discharges-12-31-2023",
      "entity_id": "344007",
      "metric_name": "discharges",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "6309",
      "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": "344007-discharges-12-31-2022",
      "entity_id": "344007",
      "metric_name": "discharges",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "5656",
      "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": "344007-discharges-12-31-2021",
      "entity_id": "344007",
      "metric_name": "discharges",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "5752",
      "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": "344007-discharges-12-31-2020",
      "entity_id": "344007",
      "metric_name": "discharges",
      "period_start": "01/01/2020",
      "period_end": "12/31/2020",
      "value": "5672",
      "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": "GABRIELLE LEE",
      "role": "CONTRACTED MANAGING EMPLOYEE",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "GABRIELLE LEE",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "GEORGE BRUNNER",
      "role": "CORPORATE OFFICER",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MATTHEW KLEIN",
      "role": "CORPORATE OFFICER",
      "association_date": "10/01/2010",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MATTHEW PETERSON",
      "role": "CORPORATE OFFICER",
      "association_date": "09/19/2019",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MATTHEW PETERSON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "09/19/2019",
      "percentage_ownership": "33.3",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MATTHEW PETERSON",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "09/19/2019",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KEYS GROUP HOLDINGS, LLC",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "THOMAS DAY",
      "role": "CORPORATE OFFICER",
      "association_date": "07/20/2021",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "THOMAS DAY",
      "role": "CORPORATE DIRECTOR",
      "association_date": "07/20/2021",
      "percentage_ownership": "33.3",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "STEVE FILTON",
      "role": "CORPORATE OFFICER",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "STEVE FILTON",
      "role": "CORPORATE DIRECTOR",
      "association_date": "08/14/2006",
      "percentage_ownership": "33.3",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "STEVE FILTON",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KELLY THACKER",
      "role": "CONTRACTED MANAGING EMPLOYEE",
      "association_date": "01/01/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KELLY THACKER",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHERYL RAMAGANO",
      "role": "CORPORATE OFFICER",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHERYL RAMAGANO",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ROBERT ZURAD",
      "role": "CORPORATE OFFICER",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "UNIVERSAL HEALTH SERVICES INC",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JAMES COLEMAN",
      "role": "CONTRACTED MANAGING EMPLOYEE",
      "association_date": "08/14/2006",
      "percentage_ownership": "50",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KEYSTONE EDUCATION AND YOUTH SERVICES LLC",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "UHS CHILDREN SERVICES INC",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "UHS OF DELAWARE INC",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "08/14/2006",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ALAN MILLER",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "01/01/2021",
      "percentage_ownership": "85",
      "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": "keystone-wsnc-llc",
        "label": "Keystone Wsnc Llc",
        "kind": "organization",
        "evidence": "source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-nc-baseline-queue"
      },
      {
        "id": "old-vineyard-youth-services",
        "label": "OLD VINEYARD YOUTH SERVICES",
        "kind": "hospital",
        "evidence": "source-cms-hospital-enrollments|source-cms-hospital-all-owners|source-nc-baseline-queue"
      },
      {
        "id": "universal-health-services",
        "label": "Universal Health Services",
        "kind": "organization",
        "evidence": "source-nc-baseline-queue|source-sec-uhs-proxy-2026|source-uhs-marc-miller-leadership"
      }
    ],
    "edges": [
      {
        "id": "rel-legal-owner-344007",
        "from": "keystone-wsnc-llc",
        "to": "old-vineyard-youth-services",
        "relationship": "controls",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-enrollments",
          "source-cms-hospital-all-owners",
          "source-nc-baseline-queue"
        ],
        "note": "KEYSTONE WSNC LLC is the best available legal-owner or enrolled-operator layer for OLD VINEYARD YOUTH SERVICES."
      },
      {
        "id": "rel-operator-344007",
        "from": "universal-health-services",
        "to": "old-vineyard-youth-services",
        "relationship": "operates",
        "confidence": "medium",
        "sourceIds": [
          "source-nc-baseline-queue",
          "source-sec-uhs-proxy-2026",
          "source-uhs-marc-miller-leadership"
        ],
        "note": "Universal Health Services 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": "KEYSTONE WSNC LLC",
      "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": "KEYSTONE WSNC LLC is shown separately from the parent system and ultimate financial/control context."
    },
    {
      "entityName": "Universal Health Services",
      "entityKind": "Public for-profit hospital and behavioral-health company",
      "relationship": "corporate owner/operator",
      "classification": "Operator layer",
      "evidenceSourceIds": [
        "source-nc-baseline-queue",
        "source-sec-uhs-proxy-2026",
        "source-uhs-marc-miller-leadership"
      ],
      "note": "This connection identifies the operating or system layer used for the public map and dossier."
    },
    {
      "entityName": "Institutional shareholders / governance context",
      "entityKind": "Shareholder or governance context",
      "relationship": "context only, not hospital operation",
      "classification": "Shareholder context",
      "evidenceSourceIds": [
        "source-sec-uhs-proxy-2026",
        "source-uhs-marc-miller-leadership"
      ],
      "note": "UHS is public. Its 2026 proxy contains Miller family/control context plus BlackRock and State Street references. Treat institutional holders as shareholder context, not facility operators."
    }
  ],
  "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."
    },
    {
      "label": "Universal Health Services 2026 proxy statement",
      "url": "https://www.sec.gov/Archives/edgar/data/352915/000119312526148814/uhs-20260403.htm",
      "sourceId": "source-sec-uhs-proxy-2026",
      "note": "Public-company governance, Miller family/control, and shareholder context."
    },
    {
      "label": "Marc D. Miller leadership profile",
      "url": "https://uhs.com/about-universal-health-services/leadership/marc-d-miller/",
      "sourceId": "source-uhs-marc-miller-leadership",
      "note": "Official UHS page identifying Marc D. Miller as president and CEO."
    }
  ],
  "systemConnections": [
    {
      "systemName": "Universal Health Services",
      "relationship": "shared North Carolina system / branch family",
      "evidenceSourceIds": [
        "source-nc-baseline-queue"
      ],
      "facilities": [
        {
          "name": "BRYNN MARR HOSPITAL",
          "role": "connected NC facility",
          "city": "JACKSONVILLE",
          "state": "NC",
          "recordId": "344016",
          "note": "Connected by shared parent/operator/system field; status remains facility-specific."
        },
        {
          "name": "HOLLY HILL HOSPITAL, LLC",
          "role": "connected NC facility",
          "city": "RALEIGH",
          "state": "NC",
          "recordId": "0168327610",
          "note": "Connected by shared parent/operator/system field; status remains facility-specific."
        },
        {
          "name": "OLD VINEYARD YOUTH SERVICES",
          "role": "current record",
          "city": "WINSTON-SALEM",
          "state": "NC",
          "recordId": "344007",
          "note": "This facility is the center of the dossier."
        },
        {
          "name": "RALEIGH OAKS BEHAVIORAL HEALTH",
          "role": "connected NC facility",
          "city": "GARNER",
          "state": "NC",
          "recordId": "344035",
          "note": "Connected by shared parent/operator/system field; status remains facility-specific."
        }
      ]
    }
  ],
  "directConnections": [
    "Legal/enrollment layer: KEYSTONE WSNC LLC.",
    "Operator layer: Universal Health Services.",
    "Ultimate parent/controller context: Universal Health Services, Inc..",
    "Shareholder/governance context: UHS is public. Its 2026 proxy contains Miller family/control context plus BlackRock and State Street references. Treat institutional holders as shareholder context, not facility operators.",
    "Operator/owner context: Universal Health Services.",
    "CMS Care Compare ownership category: Proprietary."
  ],
  "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": [
    "official CEO image URL",
    "source-backed local CEO/current leader",
    "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",
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