{
  "meta": {
    "issuance_period": "2024",
    "computed_at": "2026-05-24T16:08:26.307+00:00",
    "methodology_version": "hospital-distress-rural/v1",
    "margin_version": "hospital-margin/v1",
    "state_note": "Per-state breakdown pending — run hcris-ingest.ts to populate state column"
  },
  "national": {
    "total_hospitals": 1000,
    "avg_margin_pct": -7.5,
    "distressed_count": 396,
    "distress_rate_pct": 39.6
  },
  "byState": [],
  "topDistressed": [
    {
      "ccn": "174022",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -5305.315,
      "total_margin_pct": -34.2698,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "314013",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -4326.3933,
      "total_margin_pct": null,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "100298",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -3799.2874,
      "total_margin_pct": null,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "314016",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -2799.3493,
      "total_margin_pct": null,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "104001",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -2295.2616,
      "total_margin_pct": null,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "314005",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -2083.8658,
      "total_margin_pct": null,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "500052",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1761.8404,
      "total_margin_pct": -1744.7584,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2024-12-31"
    },
    {
      "ccn": "064003",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1724.8673,
      "total_margin_pct": null,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "494021",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1381.2835,
      "total_margin_pct": -8.0744,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "254009",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1378.6178,
      "total_margin_pct": -5.656,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "104007",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1293.9751,
      "total_margin_pct": null,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "294002",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1083.1351,
      "total_margin_pct": -8.846,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "344026",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1068.2385,
      "total_margin_pct": 52.1082,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "344033",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -1066.9218,
      "total_margin_pct": -48.8199,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "154018",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -990.0449,
      "total_margin_pct": -972.6832,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "494017",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -983.6294,
      "total_margin_pct": -3.3171,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "284003",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -885.1612,
      "total_margin_pct": -884.6955,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "222027",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -871.7305,
      "total_margin_pct": -728.2133,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2024-04-30"
    },
    {
      "ccn": "374026",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -821.4063,
      "total_margin_pct": -85.4594,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2025-06-30"
    },
    {
      "ccn": "154005",
      "hospital_name": null,
      "state": null,
      "operating_margin_pct": -773.4157,
      "total_margin_pct": 52.9541,
      "distress_flag": true,
      "beds_certified": null,
      "fiscal_year_end": "2024-12-31"
    }
  ]
}