{
  "schemaVersion": 3,
  "entityId": "420070",
  "canonicalName": "PRISMA HEALTH TUOMEY HOSPITAL",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "PRISMA HEALTH TUOMEY 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"
  },
  "identifiers": {
    "ccn": "420070",
    "npi": "1326043548",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "PRISMA HEALTH-MIDLANDS",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "PRISMA HEALTH TUOMEY HOSPITAL",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-reportedowner-420070",
      "from_entity_id": "reported owner",
      "to_entity_id": "420070",
      "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": "undefined 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."
    }
  ],
  "acquisitionEvents": [],
  "financialAndUtilizationSeries": [
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      "metric_id": "420070-net_patient_revenue-09-30-2023",
      "entity_id": "420070",
      "metric_name": "net_patient_revenue",
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      "period_end": "09/30/2023",
      "value": "196913700",
      "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": "420070-net_patient_revenue-09-30-2022",
      "entity_id": "420070",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "125561095",
      "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": "420070-net_patient_revenue-09-30-2021",
      "entity_id": "420070",
      "metric_name": "net_patient_revenue",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "507646771",
      "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": "420070-operating_expense-09-30-2023",
      "entity_id": "420070",
      "metric_name": "operating_expense",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "211628303",
      "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": "420070-operating_expense-09-30-2022",
      "entity_id": "420070",
      "metric_name": "operating_expense",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "207502350",
      "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": "420070-operating_expense-09-30-2021",
      "entity_id": "420070",
      "metric_name": "operating_expense",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "250438408",
      "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": "420070-net_income-09-30-2023",
      "entity_id": "420070",
      "metric_name": "net_income",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "-33897052",
      "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": "420070-net_income-09-30-2022",
      "entity_id": "420070",
      "metric_name": "net_income",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "-112916690",
      "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": "420070-net_income-09-30-2021",
      "entity_id": "420070",
      "metric_name": "net_income",
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      "value": "259544301",
      "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": "420070-total_assets-09-30-2023",
      "entity_id": "420070",
      "metric_name": "total_assets",
      "period_start": "10/01/2022",
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      "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": "420070-total_assets-09-30-2022",
      "entity_id": "420070",
      "metric_name": "total_assets",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "51717484",
      "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": "420070-total_assets-09-30-2021",
      "entity_id": "420070",
      "metric_name": "total_assets",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
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      "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": "420070-total_liabilities-09-30-2023",
      "entity_id": "420070",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "5129358",
      "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": "420070-total_liabilities-09-30-2022",
      "entity_id": "420070",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "6426839",
      "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": "420070-total_liabilities-09-30-2021",
      "entity_id": "420070",
      "metric_name": "total_liabilities",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "74714581",
      "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": "420070-contract_labor_direct_patient_care-09-30-2023",
      "entity_id": "420070",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "5922021",
      "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": "420070-contract_labor_direct_patient_care-09-30-2022",
      "entity_id": "420070",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "12968755",
      "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": "420070-contract_labor_direct_patient_care-09-30-2021",
      "entity_id": "420070",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "3517121",
      "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": "420070-fte_employees-09-30-2023",
      "entity_id": "420070",
      "metric_name": "fte_employees",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "938.6",
      "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": "420070-fte_employees-09-30-2022",
      "entity_id": "420070",
      "metric_name": "fte_employees",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "983.1",
      "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": "420070-fte_employees-09-30-2020",
      "entity_id": "420070",
      "metric_name": "fte_employees",
      "period_start": "10/01/2019",
      "period_end": "09/30/2020",
      "value": "1193.47",
      "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": "420070-beds-09-30-2023",
      "entity_id": "420070",
      "metric_name": "beds",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "161",
      "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": "420070-beds-09-30-2022",
      "entity_id": "420070",
      "metric_name": "beds",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "185",
      "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": "420070-beds-09-30-2021",
      "entity_id": "420070",
      "metric_name": "beds",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "237",
      "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": "420070-patient_days-09-30-2023",
      "entity_id": "420070",
      "metric_name": "patient_days",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "38559",
      "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": "420070-patient_days-09-30-2022",
      "entity_id": "420070",
      "metric_name": "patient_days",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "38120",
      "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": "420070-patient_days-09-30-2021",
      "entity_id": "420070",
      "metric_name": "patient_days",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "43496",
      "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": "420070-discharges-09-30-2023",
      "entity_id": "420070",
      "metric_name": "discharges",
      "period_start": "10/01/2022",
      "period_end": "09/30/2023",
      "value": "8090",
      "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": "420070-discharges-09-30-2022",
      "entity_id": "420070",
      "metric_name": "discharges",
      "period_start": "10/01/2021",
      "period_end": "09/30/2022",
      "value": "7408",
      "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": "420070-discharges-09-30-2021",
      "entity_id": "420070",
      "metric_name": "discharges",
      "period_start": "10/01/2020",
      "period_end": "09/30/2021",
      "value": "7659",
      "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": "KRISTI LAWRENCE",
      "role": "CORPORATE DIRECTOR",
      "association_date": "10/01/2025",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "KRISTI LAWRENCE",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "10/01/2025",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PRISMA HEALTH-MIDLANDS",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "10/01/2025",
      "percentage_ownership": "100",
      "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"
  ],
  "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:420070",
        "label": "PRISMA HEALTH TUOMEY HOSPITAL",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:prisma-health",
        "label": "Prisma Health",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:kristi-lawrence:0",
        "label": "KRISTI LAWRENCE",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:kristi-lawrence:1",
        "label": "KRISTI LAWRENCE",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:prisma-health-midlands:2",
        "label": "PRISMA HEALTH-MIDLANDS",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      }
    ],
    "edges": [
      {
        "id": "organization:prisma-health->facility:420070",
        "from": "organization:prisma-health",
        "to": "facility:420070",
        "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:kristi-lawrence:0->facility:420070",
        "from": "cms-owner:kristi-lawrence:0",
        "to": "facility:420070",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · 100% reported ownership · associated 10/01/2025"
      },
      {
        "id": "cms-owner:kristi-lawrence:1->facility:420070",
        "from": "cms-owner:kristi-lawrence:1",
        "to": "facility:420070",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · 100% reported ownership · associated 10/01/2025"
      },
      {
        "id": "cms-owner:prisma-health-midlands:2->facility:420070",
        "from": "cms-owner:prisma-health-midlands:2",
        "to": "facility:420070",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 10/01/2025"
      }
    ],
    "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": "09/30/2023",
      "earliestValue": 507646771,
      "latestValue": 196913700,
      "absoluteChange": -310733071,
      "percentChange": -61.2104890154024,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 250438408,
      "latestValue": 211628303,
      "absoluteChange": -38810105,
      "percentChange": -15.49686619953278,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 259544301,
      "latestValue": -33897052,
      "absoluteChange": -293441353,
      "percentChange": -113.06021818602751,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 155515827,
      "latestValue": 107126711,
      "absoluteChange": -48389116,
      "percentChange": -31.11523562164512,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 74714581,
      "latestValue": 5129358,
      "absoluteChange": -69585223,
      "percentChange": -93.13472961857339,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 3517121,
      "latestValue": 5922021,
      "absoluteChange": 2404900,
      "percentChange": 68.37694807770333,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "09/30/2020",
      "latestPeriod": "09/30/2023",
      "earliestValue": 1193.47,
      "latestValue": 938.6,
      "absoluteChange": -254.87,
      "percentChange": -21.355375501688354,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 237,
      "latestValue": 161,
      "absoluteChange": -76,
      "percentChange": -32.06751054852321,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 43496,
      "latestValue": 38559,
      "absoluteChange": -4937,
      "percentChange": -11.350469008644474,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "09/30/2021",
      "latestPeriod": "09/30/2023",
      "earliestValue": 7659,
      "latestValue": 8090,
      "absoluteChange": 431,
      "percentChange": 5.627366496931714,
      "unit": "discharges"
    }
  ]
}