{
  "schemaVersion": 3,
  "entityId": "450035",
  "canonicalName": "ST JOSEPH MEDICAL CENTER",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "ST JOSEPH MEDICAL CENTER 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": "450035",
    "npi": "1639992514",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "HSA ST. JOSEPH, LLC",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "ST. JOSEPH MEDICAL CENTER",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-reportedowner-450035",
      "from_entity_id": "reported owner",
      "to_entity_id": "450035",
      "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": [
    {
      "metric_id": "450035-net_patient_revenue-10-31-2023",
      "entity_id": "450035",
      "metric_name": "net_patient_revenue",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "200925783",
      "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": "450035-net_patient_revenue-10-31-2022",
      "entity_id": "450035",
      "metric_name": "net_patient_revenue",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "242610115",
      "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": "450035-net_patient_revenue-10-31-2021",
      "entity_id": "450035",
      "metric_name": "net_patient_revenue",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "234036949",
      "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": "450035-operating_expense-10-31-2023",
      "entity_id": "450035",
      "metric_name": "operating_expense",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "238086328",
      "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": "450035-operating_expense-10-31-2022",
      "entity_id": "450035",
      "metric_name": "operating_expense",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "257591871",
      "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": "450035-operating_expense-10-31-2021",
      "entity_id": "450035",
      "metric_name": "operating_expense",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "257870598",
      "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": "450035-net_income-10-31-2023",
      "entity_id": "450035",
      "metric_name": "net_income",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "-36831706",
      "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": "450035-net_income-10-31-2022",
      "entity_id": "450035",
      "metric_name": "net_income",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "-6063312",
      "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": "450035-net_income-10-31-2021",
      "entity_id": "450035",
      "metric_name": "net_income",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "1904680",
      "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": "450035-total_assets-10-31-2023",
      "entity_id": "450035",
      "metric_name": "total_assets",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "280763100",
      "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": "450035-total_assets-10-31-2022",
      "entity_id": "450035",
      "metric_name": "total_assets",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "254436323",
      "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": "450035-total_assets-10-31-2021",
      "entity_id": "450035",
      "metric_name": "total_assets",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "88488868",
      "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": "450035-total_liabilities-10-31-2023",
      "entity_id": "450035",
      "metric_name": "total_liabilities",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "592573757",
      "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": "450035-total_liabilities-10-31-2022",
      "entity_id": "450035",
      "metric_name": "total_liabilities",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "528834937",
      "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": "450035-total_liabilities-10-31-2021",
      "entity_id": "450035",
      "metric_name": "total_liabilities",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "346878060",
      "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": "450035-contract_labor_direct_patient_care-10-31-2023",
      "entity_id": "450035",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "1181738",
      "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": "450035-contract_labor_direct_patient_care-10-31-2022",
      "entity_id": "450035",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "6078787",
      "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": "450035-contract_labor_direct_patient_care-10-31-2021",
      "entity_id": "450035",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "10581357",
      "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": "450035-fte_employees-10-31-2023",
      "entity_id": "450035",
      "metric_name": "fte_employees",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "901",
      "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": "450035-fte_employees-10-31-2022",
      "entity_id": "450035",
      "metric_name": "fte_employees",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "983.05",
      "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": "450035-fte_employees-10-31-2021",
      "entity_id": "450035",
      "metric_name": "fte_employees",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "1056.89",
      "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": "450035-beds-10-31-2023",
      "entity_id": "450035",
      "metric_name": "beds",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "156",
      "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": "450035-beds-10-31-2022",
      "entity_id": "450035",
      "metric_name": "beds",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "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": "450035-beds-10-31-2021",
      "entity_id": "450035",
      "metric_name": "beds",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "181",
      "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": "450035-patient_days-10-31-2023",
      "entity_id": "450035",
      "metric_name": "patient_days",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "37377",
      "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": "450035-patient_days-10-31-2022",
      "entity_id": "450035",
      "metric_name": "patient_days",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "43715",
      "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": "450035-patient_days-10-31-2021",
      "entity_id": "450035",
      "metric_name": "patient_days",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "56924",
      "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": "450035-discharges-10-31-2023",
      "entity_id": "450035",
      "metric_name": "discharges",
      "period_start": "11/01/2022",
      "period_end": "10/31/2023",
      "value": "8061",
      "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": "450035-discharges-10-31-2022",
      "entity_id": "450035",
      "metric_name": "discharges",
      "period_start": "11/01/2021",
      "period_end": "10/31/2022",
      "value": "9194",
      "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": "450035-discharges-10-31-2021",
      "entity_id": "450035",
      "metric_name": "discharges",
      "period_start": "11/01/2020",
      "period_end": "10/31/2021",
      "value": "10701",
      "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": "HEALTHCARE SYSTEMS OF AMERICA -TEXAS LLC",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "10/30/2024",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "HEALTHCARE SYSTEMS OF AMERICA",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "10/30/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "AIMEE GILL",
      "role": "CONTRACTED MANAGING EMPLOYEE",
      "association_date": "10/30/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "AIMEE GILL",
      "role": "OPERATIONAL/MANAGERIAL CONTROL",
      "association_date": "10/30/2024",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "MIKE SARIAN",
      "role": "5% OR GREATER INDIRECT OWNERSHIP INTEREST",
      "association_date": "10/30/2024",
      "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:450035",
        "label": "ST JOSEPH MEDICAL CENTER",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:healthcare-systems-of-america",
        "label": "Healthcare Systems of America",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:healthcare-systems-of-america-texas-llc:0",
        "label": "HEALTHCARE SYSTEMS OF AMERICA -TEXAS LLC",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:healthcare-systems-of-america:1",
        "label": "HEALTHCARE SYSTEMS OF AMERICA",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER INDIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:aimee-gill:2",
        "label": "AIMEE GILL",
        "kind": "cms_owner_or_controller",
        "evidence": "CONTRACTED MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:aimee-gill:3",
        "label": "AIMEE GILL",
        "kind": "cms_owner_or_controller",
        "evidence": "OPERATIONAL/MANAGERIAL CONTROL"
      },
      {
        "id": "cms-owner:mike-sarian:4",
        "label": "MIKE SARIAN",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER INDIRECT OWNERSHIP INTEREST"
      }
    ],
    "edges": [
      {
        "id": "organization:healthcare-systems-of-america->facility:450035",
        "from": "organization:healthcare-systems-of-america",
        "to": "facility:450035",
        "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:healthcare-systems-of-america-texas-llc:0->facility:450035",
        "from": "cms-owner:healthcare-systems-of-america-texas-llc:0",
        "to": "facility:450035",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 10/30/2024"
      },
      {
        "id": "cms-owner:healthcare-systems-of-america:1->facility:450035",
        "from": "cms-owner:healthcare-systems-of-america:1",
        "to": "facility:450035",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER INDIRECT OWNERSHIP INTEREST · associated 10/30/2024"
      },
      {
        "id": "cms-owner:aimee-gill:2->facility:450035",
        "from": "cms-owner:aimee-gill:2",
        "to": "facility:450035",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CONTRACTED MANAGING EMPLOYEE · associated 10/30/2024"
      },
      {
        "id": "cms-owner:aimee-gill:3->facility:450035",
        "from": "cms-owner:aimee-gill:3",
        "to": "facility:450035",
        "relationship": "controls or manages",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "OPERATIONAL/MANAGERIAL CONTROL · associated 10/30/2024"
      },
      {
        "id": "cms-owner:mike-sarian:4->facility:450035",
        "from": "cms-owner:mike-sarian:4",
        "to": "facility:450035",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER INDIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 10/30/2024"
      }
    ],
    "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": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 234036949,
      "latestValue": 200925783,
      "absoluteChange": -33111166,
      "percentChange": -14.14783697252864,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 257870598,
      "latestValue": 238086328,
      "absoluteChange": -19784270,
      "percentChange": -7.672169744609658,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 1904680,
      "latestValue": -36831706,
      "absoluteChange": -38736386,
      "percentChange": -2033.7477161517945,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 88488868,
      "latestValue": 280763100,
      "absoluteChange": 192274232,
      "percentChange": 217.28635064017317,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 346878060,
      "latestValue": 592573757,
      "absoluteChange": 245695697,
      "percentChange": 70.83056708746584,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 10581357,
      "latestValue": 1181738,
      "absoluteChange": -9399619,
      "percentChange": -88.83188611819827,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 1056.89,
      "latestValue": 901,
      "absoluteChange": -155.8900000000001,
      "percentChange": -14.749879363036841,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 181,
      "latestValue": 156,
      "absoluteChange": -25,
      "percentChange": -13.812154696132598,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 56924,
      "latestValue": 37377,
      "absoluteChange": -19547,
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      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "10/31/2021",
      "latestPeriod": "10/31/2023",
      "earliestValue": 10701,
      "latestValue": 8061,
      "absoluteChange": -2640,
      "percentChange": -24.670591533501543,
      "unit": "discharges"
    }
  ]
}