{
  "schemaVersion": 3,
  "entityId": "500060",
  "canonicalName": "CASCADE VALLEY HOSPITAL",
  "status": "signal",
  "statusLabel": "Documented investment signal",
  "summary": "CASCADE VALLEY 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": "500060",
    "npi": "1073566246",
    "historicalCcns": [],
    "aliases": [
      {
        "alias": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
        "alias_type": "cms_legal_name",
        "source_id": "source-cms-hospital-enrollments"
      },
      {
        "alias": "CASCADE VALLEY HOSPITAL",
        "alias_type": "cms_dba",
        "source_id": "source-cms-hospital-enrollments"
      }
    ]
  },
  "ownershipHistory": [
    {
      "relationship_id": "rel-wsha-500060",
      "from_entity_id": "Wsha",
      "to_entity_id": "500060",
      "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": "Wsha 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": "500060-net_patient_revenue-12-31-2023",
      "entity_id": "500060",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "92469181",
      "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": "500060-net_patient_revenue-12-31-2022",
      "entity_id": "500060",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "79222580",
      "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": "500060-net_patient_revenue-12-31-2021",
      "entity_id": "500060",
      "metric_name": "net_patient_revenue",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "68024088",
      "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": "500060-operating_expense-12-31-2023",
      "entity_id": "500060",
      "metric_name": "operating_expense",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "69277485",
      "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": "500060-operating_expense-12-31-2022",
      "entity_id": "500060",
      "metric_name": "operating_expense",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "62323883",
      "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": "500060-operating_expense-12-31-2021",
      "entity_id": "500060",
      "metric_name": "operating_expense",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "53563285",
      "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": "500060-net_income-12-31-2023",
      "entity_id": "500060",
      "metric_name": "net_income",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "24534038",
      "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": "500060-net_income-12-31-2022",
      "entity_id": "500060",
      "metric_name": "net_income",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "17651016",
      "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": "500060-net_income-12-31-2021",
      "entity_id": "500060",
      "metric_name": "net_income",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "16317538",
      "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": "500060-total_assets-12-31-2023",
      "entity_id": "500060",
      "metric_name": "total_assets",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "46967812",
      "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": "500060-total_assets-12-31-2022",
      "entity_id": "500060",
      "metric_name": "total_assets",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "-2167204",
      "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": "500060-total_assets-12-31-2021",
      "entity_id": "500060",
      "metric_name": "total_assets",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "45845127",
      "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": "500060-total_liabilities-12-31-2023",
      "entity_id": "500060",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "5274007",
      "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": "500060-total_liabilities-12-31-2022",
      "entity_id": "500060",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "212581",
      "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": "500060-total_liabilities-12-31-2021",
      "entity_id": "500060",
      "metric_name": "total_liabilities",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "2575865",
      "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": "500060-contract_labor_direct_patient_care-12-31-2023",
      "entity_id": "500060",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "7137958",
      "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": "500060-contract_labor_direct_patient_care-12-31-2022",
      "entity_id": "500060",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "7137958",
      "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": "500060-contract_labor_direct_patient_care-12-31-2021",
      "entity_id": "500060",
      "metric_name": "contract_labor_direct_patient_care",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "2297143",
      "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": "500060-fte_employees-12-31-2023",
      "entity_id": "500060",
      "metric_name": "fte_employees",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "255.72",
      "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": "500060-fte_employees-12-31-2022",
      "entity_id": "500060",
      "metric_name": "fte_employees",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "238.51",
      "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": "500060-fte_employees-12-31-2021",
      "entity_id": "500060",
      "metric_name": "fte_employees",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "238.27",
      "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": "500060-beds-12-31-2023",
      "entity_id": "500060",
      "metric_name": "beds",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "48",
      "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": "500060-beds-12-31-2022",
      "entity_id": "500060",
      "metric_name": "beds",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "48",
      "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": "500060-beds-12-31-2021",
      "entity_id": "500060",
      "metric_name": "beds",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "48",
      "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": "500060-patient_days-12-31-2023",
      "entity_id": "500060",
      "metric_name": "patient_days",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "9786",
      "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": "500060-patient_days-12-31-2022",
      "entity_id": "500060",
      "metric_name": "patient_days",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "8399",
      "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": "500060-patient_days-12-31-2021",
      "entity_id": "500060",
      "metric_name": "patient_days",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "5288",
      "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": "500060-discharges-12-31-2023",
      "entity_id": "500060",
      "metric_name": "discharges",
      "period_start": "01/01/2023",
      "period_end": "12/31/2023",
      "value": "1983",
      "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": "500060-discharges-12-31-2022",
      "entity_id": "500060",
      "metric_name": "discharges",
      "period_start": "01/01/2022",
      "period_end": "12/31/2022",
      "value": "1625",
      "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": "500060-discharges-12-31-2021",
      "entity_id": "500060",
      "metric_name": "discharges",
      "period_start": "01/01/2021",
      "period_end": "12/31/2021",
      "value": "1292",
      "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": "FREI BURTON",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2019",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PETER BROWNING",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "GARY SHAND",
      "role": "CORPORATE OFFICER",
      "association_date": "11/01/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JOLANDA BARNETT",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "06/01/2016",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "JEFFREY MILLER",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/01/2012",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "DALE RAGAN",
      "role": "CORPORATE OFFICER",
      "association_date": "01/01/2020",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "BRUCE LISSER",
      "role": "CORPORATE DIRECTOR",
      "association_date": "03/01/2012",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
      "role": "5% OR GREATER DIRECT OWNERSHIP INTEREST",
      "association_date": "06/01/2016",
      "percentage_ownership": "100",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "BRIAN IVIE",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "11/01/2017",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    },
    {
      "organization": "TAMARA CESENA",
      "role": "W-2 MANAGING EMPLOYEE",
      "association_date": "01/09/2023",
      "percentage_ownership": "",
      "investment_firm": false,
      "private_equity_company": false,
      "holding_company": false,
      "management_services_company": false,
      "medical_staffing_company": false
    }
  ],
  "directConnections": [
    "Reported parent system or portfolio company: Wsha."
  ],
  "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:500060",
        "label": "CASCADE VALLEY HOSPITAL",
        "kind": "hospital",
        "evidence": "public facility record"
      },
      {
        "id": "organization:public-hospital-dist-no-1-skagit",
        "label": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
        "kind": "portfolio_company_or_operator",
        "evidence": "research tracker or primary organizational source"
      },
      {
        "id": "cms-owner:frei-burton:0",
        "label": "FREI BURTON",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:peter-browning:1",
        "label": "PETER BROWNING",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:gary-shand:2",
        "label": "GARY SHAND",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:jolanda-barnett:3",
        "label": "JOLANDA BARNETT",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:jeffrey-miller:4",
        "label": "JEFFREY MILLER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:dale-ragan:5",
        "label": "DALE RAGAN",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE OFFICER"
      },
      {
        "id": "cms-owner:bruce-lisser:6",
        "label": "BRUCE LISSER",
        "kind": "cms_owner_or_controller",
        "evidence": "CORPORATE DIRECTOR"
      },
      {
        "id": "cms-owner:public-hospital-dist-no-1-skagit:7",
        "label": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
        "kind": "cms_owner_or_controller",
        "evidence": "5% OR GREATER DIRECT OWNERSHIP INTEREST"
      },
      {
        "id": "cms-owner:brian-ivie:8",
        "label": "BRIAN IVIE",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      },
      {
        "id": "cms-owner:tamara-cesena:9",
        "label": "TAMARA CESENA",
        "kind": "cms_owner_or_controller",
        "evidence": "W-2 MANAGING EMPLOYEE"
      }
    ],
    "edges": [
      {
        "id": "organization:public-hospital-dist-no-1-skagit->facility:500060",
        "from": "organization:public-hospital-dist-no-1-skagit",
        "to": "facility:500060",
        "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:frei-burton:0->facility:500060",
        "from": "cms-owner:frei-burton:0",
        "to": "facility:500060",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/01/2019"
      },
      {
        "id": "cms-owner:peter-browning:1->facility:500060",
        "from": "cms-owner:peter-browning:1",
        "to": "facility:500060",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/01/2017"
      },
      {
        "id": "cms-owner:gary-shand:2->facility:500060",
        "from": "cms-owner:gary-shand:2",
        "to": "facility:500060",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 11/01/2017"
      },
      {
        "id": "cms-owner:jolanda-barnett:3->facility:500060",
        "from": "cms-owner:jolanda-barnett:3",
        "to": "facility:500060",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 06/01/2016"
      },
      {
        "id": "cms-owner:jeffrey-miller:4->facility:500060",
        "from": "cms-owner:jeffrey-miller:4",
        "to": "facility:500060",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 03/01/2012"
      },
      {
        "id": "cms-owner:dale-ragan:5->facility:500060",
        "from": "cms-owner:dale-ragan:5",
        "to": "facility:500060",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE OFFICER · associated 01/01/2020"
      },
      {
        "id": "cms-owner:bruce-lisser:6->facility:500060",
        "from": "cms-owner:bruce-lisser:6",
        "to": "facility:500060",
        "relationship": "governs",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "CORPORATE DIRECTOR · associated 03/01/2012"
      },
      {
        "id": "cms-owner:public-hospital-dist-no-1-skagit:7->facility:500060",
        "from": "cms-owner:public-hospital-dist-no-1-skagit:7",
        "to": "facility:500060",
        "relationship": "owns an interest in",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "5% OR GREATER DIRECT OWNERSHIP INTEREST · 100% reported ownership · associated 06/01/2016"
      },
      {
        "id": "cms-owner:brian-ivie:8->facility:500060",
        "from": "cms-owner:brian-ivie:8",
        "to": "facility:500060",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 11/01/2017"
      },
      {
        "id": "cms-owner:tamara-cesena:9->facility:500060",
        "from": "cms-owner:tamara-cesena:9",
        "to": "facility:500060",
        "relationship": "is associated with",
        "confidence": "high",
        "sourceIds": [
          "source-cms-hospital-all-owners"
        ],
        "note": "W-2 MANAGING EMPLOYEE · associated 01/09/2023"
      }
    ],
    "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": 68024088,
      "latestValue": 92469181,
      "absoluteChange": 24445093,
      "percentChange": 35.935936399470734,
      "unit": "USD"
    },
    {
      "metric": "operating_expense",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 53563285,
      "latestValue": 69277485,
      "absoluteChange": 15714200,
      "percentChange": 29.33763304472457,
      "unit": "USD"
    },
    {
      "metric": "net_income",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 16317538,
      "latestValue": 24534038,
      "absoluteChange": 8216500,
      "percentChange": 50.35379724563841,
      "unit": "USD"
    },
    {
      "metric": "total_assets",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 45845127,
      "latestValue": 46967812,
      "absoluteChange": 1122685,
      "percentChange": 2.448864412568865,
      "unit": "USD"
    },
    {
      "metric": "total_liabilities",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2575865,
      "latestValue": 5274007,
      "absoluteChange": 2698142,
      "percentChange": 104.74702672694416,
      "unit": "USD"
    },
    {
      "metric": "contract_labor_direct_patient_care",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 2297143,
      "latestValue": 7137958,
      "absoluteChange": 4840815,
      "percentChange": 210.73198316343388,
      "unit": "USD"
    },
    {
      "metric": "fte_employees",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 238.27,
      "latestValue": 255.72,
      "absoluteChange": 17.44999999999999,
      "percentChange": 7.323624459646615,
      "unit": "FTE"
    },
    {
      "metric": "beds",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 48,
      "latestValue": 48,
      "absoluteChange": 0,
      "percentChange": 0,
      "unit": "beds"
    },
    {
      "metric": "patient_days",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 5288,
      "latestValue": 9786,
      "absoluteChange": 4498,
      "percentChange": 85.06051437216338,
      "unit": "days"
    },
    {
      "metric": "discharges",
      "earliestPeriod": "12/31/2021",
      "latestPeriod": "12/31/2023",
      "earliestValue": 1292,
      "latestValue": 1983,
      "absoluteChange": 691,
      "percentChange": 53.482972136222905,
      "unit": "discharges"
    }
  ]
}