{
  "schemaVersion": 3,
  "entityId": "360068",
  "canonicalName": "TOLEDO HOSPITAL",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "TOLEDO HOSPITAL appears in the source tracker as a venture-backed investment signal. This dossier does not classify that signal as completed private-equity ownership.",
  "lastReviewed": "2026-06-22",
  "review": {
    "reviewer": "Automated CMS/PESP reconciliation with editorial publication gate",
    "evidence_grade": "government-corroborated",
    "confidence": "medium",
    "source_count": 6,
    "ownership_source_count": 2,
    "identity_match_method": "CCN exact match",
    "publication_decision": "Meets the Phase 3 publication standard for its displayed status"
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    "npi": "1407854771",
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        "alias": "THE TOLEDO HOSPITAL",
        "alias_type": "cms_legal_name",
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      "from_entity_id": "reported owner",
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      "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",
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      "review_notes": "CMS corroborates the current enrolled ownership chain; the sponsor attribution comes from the research tracker."
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      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "08/08/2018",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JAMES BRENNAN",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/22/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DAWN BUSKEY",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/20/2013",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "SARA MCHUGH",
      "role": "CORPORATE DIRECTOR",
      "association_date": "02/06/2020",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TIMOTHY HUSTED",
      "role": "CORPORATE DIRECTOR",
      "association_date": "02/14/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "CHARLES SMITH",
      "role": "CORPORATE DIRECTOR",
      "association_date": "01/24/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JACQUELINE HYLANT BERENWEIG",
      "role": "CORPORATE DIRECTOR",
      "association_date": "02/06/2020",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ARTURO POLIZZI",
      "role": "CORPORATE OFFICER",
      "association_date": "05/24/2022",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PROMEDICA HEALTH SYSTEM INC",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "03/01/2011",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "ANTHONY PACKO",
      "role": "CORPORATE DIRECTOR",
      "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
    }
  ],
  "directConnections": [],
  "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."
  ],
  "unavailableFields": [
    "Precise acquisition date",
    "Official facility URL"
  ],
  "sources": [
    {
      "source_id": "source-hifld-hospitals",
      "title": "Hospitals RAPT",
      "publisher": "Homeland Infrastructure Foundation-Level Data",
      "publication_date": "current public layer",
      "retrieved_at": "2026-06-22",
      "url": "https://hifld-geoplatform.hub.arcgis.com/datasets/geoplatform::hospitals/about",
      "reliability_tier": "government",
      "research_note": "Used for facility location and basic identity context; it does not establish private-equity ownership.",
      "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": "2026-06-22",
      "url": "https://pestakeholder.org/private-equity-hospital-tracker/",
      "reliability_tier": "research",
      "research_note": "Discovery and ownership-chain baseline. A red public status also requires independent corroboration in this dossier.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-enrollments",
      "title": "Hospital Enrollments",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026-05-01",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments",
      "reliability_tier": "government",
      "research_note": "Used to corroborate current enrollment identity, legal name, DBA, CCN, NPI, and location.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hospital-all-owners",
      "title": "Hospital All Owners",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026-05-01",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners",
      "reliability_tier": "government",
      "research_note": "Used to corroborate direct or indirect ownership, control, holding-company, investment-firm, and security-interest records.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-hcris",
      "title": "Hospital Provider Cost Reports",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2015–2024",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
      "reliability_tier": "government",
      "research_note": "Financial, staffing, and utilization values. These descriptive measures do not establish causation.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-cms-care-compare",
      "title": "Hospital General Information",
      "publisher": "Centers for Medicare & Medicaid Services",
      "publication_date": "2026",
      "retrieved_at": "2026-06-22",
      "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u",
      "reliability_tier": "government",
      "research_note": "Used for current facility identity, hospital type, ownership category, and overall rating when available.",
      "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:360068",
        "label": "TOLEDO HOSPITAL",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:promedica-health-system-inc",
        "label": "PROMEDICA HEALTH SYSTEM INC",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:terrence-metzger:0",
        "label": "TERRENCE METZGER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:amir-khan:1",
        "label": "AMIR KHAN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:kevin-sharp:2",
        "label": "KEVIN SHARP",
        "kind": "cms_owner_or_controller",
        "evidence": "OPERATIONAL/MANAGERIAL CONTROL"
      },
      {
        "id": "cms-owner:peter-vavrinek:3",
        "label": "PETER VAVRINEK",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:kent-bishop:4",
        "label": "KENT BISHOP",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:darrell-wachowiak:5",
        "label": "DARRELL WACHOWIAK",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:amanda-kert:6",
        "label": "AMANDA KERT",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:thadius-wadsworth:7",
        "label": "THADIUS WADSWORTH",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:nancy-kabat:8",
        "label": "NANCY KABAT",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:thomas-win:9",
        "label": "THOMAS WIN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:brain-dolsey:10",
        "label": "BRAIN DOLSEY",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:aaron-buerk:11",
        "label": "AARON BUERK",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:mark-fox:12",
        "label": "MARK FOX",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:donald-crescenzo:13",
        "label": "DONALD CRESCENZO",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:sara-swisher:14",
        "label": "SARA SWISHER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:christina-stansfield:15",
        "label": "CHRISTINA STANSFIELD",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      }
    ],
    "edges": [
      {
        "id": "organization:promedica-health-system-inc->facility:360068",
        "from": "organization:promedica-health-system-inc",
        "to": "facility:360068",
        "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:terrence-metzger:0->facility:360068",
        "from": "cms-owner:terrence-metzger:0",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 05/14/2023"
      },
      {
        "id": "cms-owner:amir-khan:1->facility:360068",
        "from": "cms-owner:amir-khan:1",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 02/06/2020"
      },
      {
        "id": "cms-owner:kevin-sharp:2->facility:360068",
        "from": "cms-owner:kevin-sharp:2",
        "to": "facility:360068",
        "relationship": "controls or manages",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "OPERATIONAL/MANAGERIAL CONTROL · associated 03/01/2020"
      },
      {
        "id": "cms-owner:peter-vavrinek:3->facility:360068",
        "from": "cms-owner:peter-vavrinek:3",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2022"
      },
      {
        "id": "cms-owner:kent-bishop:4->facility:360068",
        "from": "cms-owner:kent-bishop:4",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2025"
      },
      {
        "id": "cms-owner:darrell-wachowiak:5->facility:360068",
        "from": "cms-owner:darrell-wachowiak:5",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 02/11/2021"
      },
      {
        "id": "cms-owner:amanda-kert:6->facility:360068",
        "from": "cms-owner:amanda-kert:6",
        "to": "facility:360068",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 01/01/2025"
      },
      {
        "id": "cms-owner:thadius-wadsworth:7->facility:360068",
        "from": "cms-owner:thadius-wadsworth:7",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 02/11/2021"
      },
      {
        "id": "cms-owner:nancy-kabat:8->facility:360068",
        "from": "cms-owner:nancy-kabat:8",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2023"
      },
      {
        "id": "cms-owner:thomas-win:9->facility:360068",
        "from": "cms-owner:thomas-win:9",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2023"
      },
      {
        "id": "cms-owner:brain-dolsey:10->facility:360068",
        "from": "cms-owner:brain-dolsey:10",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2022"
      },
      {
        "id": "cms-owner:aaron-buerk:11->facility:360068",
        "from": "cms-owner:aaron-buerk:11",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 02/14/2019"
      },
      {
        "id": "cms-owner:mark-fox:12->facility:360068",
        "from": "cms-owner:mark-fox:12",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/22/2019"
      },
      {
        "id": "cms-owner:donald-crescenzo:13->facility:360068",
        "from": "cms-owner:donald-crescenzo:13",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/01/2025"
      },
      {
        "id": "cms-owner:sara-swisher:14->facility:360068",
        "from": "cms-owner:sara-swisher:14",
        "to": "facility:360068",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 01/22/2019"
      },
      {
        "id": "cms-owner:christina-stansfield:15->facility:360068",
        "from": "cms-owner:christina-stansfield:15",
        "to": "facility:360068",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 08/08/2018"
      }
    ],
    "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": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 1281970718,
      "latestValue": 1478852382,
      "absoluteChange": 196881664,
      "percentChange": 15.357734871445011,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 1209475221,
      "latestValue": 1403502474,
      "absoluteChange": 194027253,
      "percentChange": 16.042267723317003,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": -154775891,
      "latestValue": 237968003,
      "absoluteChange": 392743894,
      "percentChange": 253.75004560626303,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2262037148,
      "latestValue": 1627181662,
      "absoluteChange": -634855486,
      "percentChange": -28.065652527471226,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2442475493,
      "latestValue": 2145246342,
      "absoluteChange": -297229151,
      "percentChange": -12.169176388948113,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "12/31/2019",
      "latestPeriod": "12/31/2021",
      "earliestValue": 6471618,
      "latestValue": 26372154,
      "absoluteChange": 19900536,
      "percentChange": 307.50480019061695,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 5138.87,
      "latestValue": 5208,
      "absoluteChange": 69.13000000000011,
      "percentChange": 1.3452373770887396,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 708,
      "latestValue": 730,
      "absoluteChange": 22,
      "percentChange": 3.1073446327683616,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 194230,
      "latestValue": 184359,
      "absoluteChange": -9871,
      "percentChange": -5.082119137105493,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 31615,
      "latestValue": 33135,
      "absoluteChange": 1520,
      "percentChange": 4.807844377668828,
      "unit": "discharges"
    }
  ]
}
