{
  "schemaVersion": 3,
  "entityId": "491305",
  "canonicalName": "VALLEY HEALTH SHENANDOAH MEMORIAL HOSPITAL",
  "status": "pe_contract",
  "statusLabel": "PE-backed service contract",
  "summary": "VALLEY HEALTH SHENANDOAH MEMORIAL HOSPITAL is part of the Valley Health case. The documented PE relationship is a clinical staffing or management contract with SCP Health, an Onex portfolio company; it is not a sale of the hospital.",
  "lastReviewed": "2026-06-22",
  "review": {
    "reviewer": "Automated CMS/PESP reconciliation with editorial publication gate",
    "evidence_grade": "primary-source contract documentation",
    "confidence": "high",
    "source_count": 9,
    "ownership_source_count": 3,
    "identity_match_method": "CCN exact match",
    "publication_decision": "Meets the Phase 3 publication standard for its displayed status"
  },
  "identifiers": {
    "ccn": "491305",
    "npi": "1033166442",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "SHENANDOAH MEMORIAL HOSPITAL, INC.",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-scp-health-491305",
      "from_entity_id": "scp-health",
      "to_entity_id": "491305",
      "relationship_type": "manages",
      "effective_date": "2026-09-30",
      "end_date": "",
      "announcement_date": "2026-04-07",
      "status": "announced",
      "confidence": "high",
      "source_ids": "source-valley-contract-reporting|source-onex-scp|source-acep-valley",
      "plain_english_summary": "Valley Health announced a clinical staffing and management transition to SCP Health. This is not an ownership transfer.",
      "review_notes": ""
    }
  ],
  "acquisitionEvents": [],
  "financialAndUtilizationSeries": [
    {
      "metric_id": "491305-net_patient_revenue-12-31-2023",
      "entity_id": "491305",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "85466156",
      "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": "491305-net_patient_revenue-12-31-2022",
      "entity_id": "491305",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "78230257",
      "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": "491305-net_patient_revenue-12-31-2021",
      "entity_id": "491305",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "72305322",
      "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": "491305-operating_expense-12-31-2023",
      "entity_id": "491305",
      "metric_name": "operating_expense",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "75198497",
      "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": "491305-operating_expense-12-31-2022",
      "entity_id": "491305",
      "metric_name": "operating_expense",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "72308116",
      "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": "491305-operating_expense-12-31-2021",
      "entity_id": "491305",
      "metric_name": "operating_expense",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "68359581",
      "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": "491305-net_income-12-31-2023",
      "entity_id": "491305",
      "metric_name": "net_income",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "20279568",
      "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": "491305-net_income-12-31-2022",
      "entity_id": "491305",
      "metric_name": "net_income",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "5514331",
      "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": "491305-net_income-12-31-2021",
      "entity_id": "491305",
      "metric_name": "net_income",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "12037058",
      "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": "491305-total_assets-12-31-2023",
      "entity_id": "491305",
      "metric_name": "total_assets",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "132980021",
      "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": "491305-total_assets-12-31-2022",
      "entity_id": "491305",
      "metric_name": "total_assets",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "122262284",
      "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": "491305-total_assets-12-31-2021",
      "entity_id": "491305",
      "metric_name": "total_assets",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "118984128",
      "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": "491305-total_liabilities-12-31-2023",
      "entity_id": "491305",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "32760142",
      "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": "491305-total_liabilities-12-31-2022",
      "entity_id": "491305",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "25173360",
      "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": "491305-total_liabilities-12-31-2021",
      "entity_id": "491305",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "33639777",
      "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": "491305-fte_employees-12-31-2023",
      "entity_id": "491305",
      "metric_name": "fte_employees",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "290.17",
      "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": "491305-fte_employees-12-31-2022",
      "entity_id": "491305",
      "metric_name": "fte_employees",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "239.59",
      "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": "491305-fte_employees-12-31-2021",
      "entity_id": "491305",
      "metric_name": "fte_employees",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "247.52",
      "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": "491305-beds-12-31-2023",
      "entity_id": "491305",
      "metric_name": "beds",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "25",
      "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": "491305-beds-12-31-2022",
      "entity_id": "491305",
      "metric_name": "beds",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "25",
      "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": "491305-beds-12-31-2021",
      "entity_id": "491305",
      "metric_name": "beds",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "25",
      "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": "491305-patient_days-12-31-2023",
      "entity_id": "491305",
      "metric_name": "patient_days",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "7120",
      "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": "491305-patient_days-12-31-2022",
      "entity_id": "491305",
      "metric_name": "patient_days",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "6625",
      "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": "491305-patient_days-12-31-2021",
      "entity_id": "491305",
      "metric_name": "patient_days",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "6135",
      "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": "491305-discharges-12-31-2023",
      "entity_id": "491305",
      "metric_name": "discharges",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "1366",
      "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": "491305-discharges-12-31-2022",
      "entity_id": "491305",
      "metric_name": "discharges",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "1239",
      "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": "491305-discharges-12-31-2021",
      "entity_id": "491305",
      "metric_name": "discharges",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "1159",
      "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": "JILL CHAMBERS",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "09/01/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "THOMAS KLUGE",
      "role": "CORPORATE OFFICER",
      "association_date": "01/21/2021",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [
    "SCP Health is the announced clinical staffing and management contractor.",
    "Onex identifies SCP Health as a portfolio company."
  ],
  "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 documented relationship is a clinical service contract. Valley Health remains a nonprofit system; this is not an ownership claim."
  ],
  "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"
    },
    {
      "source_id": "source-valley-contract-reporting",
      "title": "Virginia system consolidates physician management, closes observation unit",
      "publisher": "Becker's Hospital Review",
      "publication_date": "2026-04-07",
      "retrieved_at": "2026-06-22",
      "url": "https://www.beckershospitalreview.com/quality/hospital-physician-relationships/virginia-system-to-close-observation-unit-shift-physician-staffing/",
      "reliability_tier": "reporting",
      "research_note": "Documents the contract scope, transition dates, stated rationale, and expected savings.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-onex-scp",
      "title": "SCP Health portfolio profile",
      "publisher": "Onex",
      "publication_date": "current portfolio page",
      "retrieved_at": "2026-06-22",
      "url": "https://www.onex.com/portfolio/OP-OpCo-SCPHealth",
      "reliability_tier": "primary",
      "research_note": "Primary-source confirmation that SCP Health is held through Onex Partners.",
      "source_type": "public_record"
    },
    {
      "source_id": "source-acep-valley",
      "title": "Joint statement on due process, transparency, and due diligence in emergency medicine contracting",
      "publisher": "ACEP and VACEP",
      "publication_date": "2026-04-16",
      "retrieved_at": "2026-06-22",
      "url": "https://www.acep.org/news/acep-newsroom-articles/4-16-26-joint-statement-from-the-american-college-of-emergency-physicians-and-virginia-college-of-emergency-physicians",
      "reliability_tier": "primary",
      "research_note": "Professional-association response requesting notice, transparency, and physician involvement.",
      "source_type": "public_record"
    }
  ],
  "ownershipChain": {
    "model": "Sponsor, operator, CMS legal-owner/control records, and facility are shown as separate evidence layers.",
    "confidence": "high",
    "nodes": [
      {
        "id": "facility:491305",
        "label": "VALLEY HEALTH SHENANDOAH MEMORIAL HOSPITAL",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:onex-partners",
        "label": "Onex Partners",
        "kind": "pe_sponsor",
        "evidence": "research tracker or primary portfolio source"
      },
      {
        "id": "organization:shenandoah-memorial-hospital-inc",
        "label": "SHENANDOAH MEMORIAL HOSPITAL, INC.",
        "kind": "contractor",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:jill-chambers:0",
        "label": "JILL CHAMBERS",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:thomas-kluge:1",
        "label": "THOMAS KLUGE",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      }
    ],
    "edges": [
      {
        "id": "organization:onex-partners->organization:shenandoah-memorial-hospital-inc",
        "from": "organization:onex-partners",
        "to": "organization:shenandoah-memorial-hospital-inc",
        "relationship": "sponsors",
        "confidence": "high",
        "sourceIds": [
          "source-valley-contract-reporting",
          "source-onex-scp",
          "source-acep-valley"
        ],
        "note": "Primary portfolio evidence identifies the contractor as a sponsor portfolio company."
      },
      {
        "id": "organization:shenandoah-memorial-hospital-inc->facility:491305",
        "from": "organization:shenandoah-memorial-hospital-inc",
        "to": "facility:491305",
        "relationship": "manages or staffs under contract",
        "confidence": "high",
        "sourceIds": [
          "source-valley-contract-reporting",
          "source-onex-scp",
          "source-acep-valley"
        ],
        "note": "This is a service contract, not an ownership transfer."
      },
      {
        "id": "cms-owner:jill-chambers:0->facility:491305",
        "from": "cms-owner:jill-chambers:0",
        "to": "facility:491305",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 09/01/2017"
      },
      {
        "id": "cms-owner:thomas-kluge:1->facility:491305",
        "from": "cms-owner:thomas-kluge:1",
        "to": "facility:491305",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/21/2021"
      }
    ],
    "caveats": [
      "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor.",
      "Sponsor and portfolio-company labels come from the cited tracker or primary portfolio evidence.",
      "A management or staffing contract is not hospital ownership."
    ]
  },
  "descriptiveTrends": [
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      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
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      "unit": "USD"
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      "metric": "net_income",
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      "metric": "total_assets",
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      "metric": "total_liabilities",
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      "metric": "fte_employees",
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      "metric": "beds",
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      "metric": "patient_days",
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      "metric": "discharges",
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}