0001104659-24-049117 | 20-F | XBRL Viewer | Concord Medical Services Holdings LTD

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CONSOLIDATED BALANCE SHEETS (Parenthetical) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥) shares	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 CNY (¥) shares
Accounts receivable, allowance	¥ 30,486	$ 4,294	¥ 7,764
Reserve for prepayments and other current assets	59,603	8,395	17,290
Long-term bank and other borrowings, non-current portion	¥ 1,994,014	$ 280,851	¥ 2,471,427
Treasury stock, common shares	12,101,847	12,101,847	12,101,847
Related party
Prepayments and other current assets, due from related party	¥ 151,481	$ 21,335	¥ 169,436
Short-term bank and other borrowings, loan from related party	7,810	1,100	13,105
Long-term bank and other borrowings, current portion, loan from related party	167,283	23,561	133,856
Long-term bank and other borrowings, non-current portion	¥ 69,182	$ 9,744	¥ 122,579
Class A ordinary shares
Ordinary shares, par value per share \| $ / shares		$ 0.0001
Ordinary shares, shares authorized	500,000,000	500,000,000	500,000,000
Ordinary shares, shares issued	96,565,584	96,565,584	96,565,584
Ordinary shares, shares outstanding	84,463,737	84,463,737	84,463,737
Class B ordinary shares
Ordinary shares, par value per share \| $ / shares		$ 0.0001
Ordinary shares, shares authorized	45,787,948	45,787,948	45,787,948
Ordinary shares, shares issued	45,787,948	45,787,948	45,787,948
Ordinary shares, shares outstanding	45,787,948	45,787,948	45,787,948

ACCOUNTS RECEIVABLE

12 Months Ended

Dec. 31, 2023

ACCOUNTS RECEIVABLE

ACCOUNTS RECEIVABLE

6.ACCOUNTS RECEIVABLE


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Accounts receivable	138,035	103,982	14,646
Allowance for credit losses	(7,764)	(30,486)	(4,294)
Accounts receivable, net	130,271	73,496	10,352

The roll forward in the allowance for credit losses were as follows:


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Balance at the beginning of the year	6,473	4,932	7,764	1,094
Provisions for the year	1,463	2,832	22,752	3,204
Reversal of provisions from prior periods due to subsequent cash collection during the year	(983)	—	(30)	(4)
Amounts written off during the year	(2,021)	—	—	—
Balance at the end of the year	4,932	7,764	30,486	4,294

Provisions for allowance for doubtful debts are recorded in “general and administrative expenses” in the consolidated statements of comprehensive loss.

Accounts receivable with carrying value of RMB11,166 and RMB13,312 (US$1,875)were used to secure certain bank borrowings as at December 31, 2022 and 2023 respectively (note 18).

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION - Condensed balance Sheets (Parenthetical) (Details) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Treasury stock, common shares	12,101,847	12,101,847
Class A ordinary shares
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Ordinary shares, par value per share	$ 0.0001	$ 0.0001
Ordinary shares, shares authorized	500,000,000	500,000,000
Ordinary shares, shares issued	96,565,584	96,565,584
Ordinary shares, shares outstanding	84,463,737	84,463,737
Class B ordinary shares
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Ordinary shares, par value per share	$ 0.0001	$ 0.0001
Ordinary shares, shares authorized	45,787,948	45,787,948
Ordinary shares, shares issued	45,787,948	45,787,948
Ordinary shares, shares outstanding	45,787,948	45,787,948
Parent Company
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Treasury stock, common shares	12,101,847	12,101,847
Parent Company \| Class A ordinary shares
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Ordinary shares, par value per share	$ 0.0001	$ 0.0001
Ordinary shares, shares authorized	500,000,000	500,000,000
Ordinary shares, shares issued	96,565,584	96,565,584
Ordinary shares, shares outstanding	84,463,737	84,463,737
Parent Company \| Class B ordinary shares
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Ordinary shares, par value per share	$ 0.0001	$ 0.0001
Ordinary shares, shares authorized	45,787,948	45,787,948
Ordinary shares, shares issued	45,787,948	45,787,948
Ordinary shares, shares outstanding	45,787,948	45,787,948

TAXATION (Tables)

12 Months Ended

Dec. 31, 2023

TAXATION

Schedule of loss before income taxes


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Non – PRC	5,451	45,211	20,824	2,933
PRC	(534,688)	(885,107)	(576,418)	(81,189)
	(529,237)	(839,896)	(555,594)	(78,256)

Schedule of current and deferred components of the income tax expense (benefit)


	For the Year Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Current tax expense (benefit)	4,115	(8,765)	(7,014)	(988)
Deferred tax benefit	(10,680)	(62,141)	(17,559)	(2,473)
	(6,565)	(70,906)	(24,573)	(3,461)

Schedule of reconciliation of the differences between the statutory tax rate and the effective tax rate for EIT


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Loss before income taxes	(529,237)	(839,896)	(555,594)	(78,256)
Income tax computed at the tax rate of 25%	(132,309)	(209,974)	(138,899)	(19,564)
Effect of different tax rates in different jurisdictions	2,798	(20,584)	(5,178)	(728)
Non-deductible expenses	(10,502)	21,543	18,287	2,575
Non-taxable income	9,183	(55,705)	(6,447)	(908)
Statutory income (expense)	3,994	25,419	51,631	7,272
Interest and penalty	(12,918)	(7,254)	(6,121)	(862)
Deferred tax expense	(13,953)	7,056	3,357	473
Changes of valuation allowance	142,806	168,102	58,030	8,173
Withholding tax	4,336	491	767	108
	(6,565)	(70,906)	(24,573)	(3,461)

Schedule of components of deferred taxes


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Deferred tax asset
Net operating loss*	357,483	425,390	59,915
Foreign exchange loss	1,330	2,755	388
Depreciation and amortization	22,535	17,647	2,485
Property, plant and equipment impairment	6,997	2,340	330
Deposits for non-current assets	18,475	17,725	2,496
Allowance for net investment in financing lease	5,137	—	—
Allowance for doubtful accounts	14,746	29,299	4,127
Lease liabilities	58,901	59,875	8,433
Other long-term assets	104,912	94,791	13,351
Equity investment	7,553	7,005	987
Others	13,728	11,770	1,658
Total deferred tax assets	611,797	668,597	94,170
less: Valuation allowance**	(565,022)	(623,044)	(87,754)
Net deferred tax assets	46,775	45,553	6,416

Deferred tax liabilities
Equity investment	(1,170)	(1,091)	(154)
Property, plant and equipment	(1,682)	(2,368)	(334)
Disposal of Beijing Century Friendship	(3,126)	(3,126)	(440)
Intangible assets	(81,336)	(71,825)	(10,116)
Right-of-use assets	(46,873)	(45,626)	(6,426)
Capitalized interest	(19,179)	(18,993)	(2,675)
Others	(5,986)	(2,062)	(291)

Total deferred tax liabilities	(159,352)	(145,091)	(20,436)

Deferred tax assets, net	—	—	—

Deferred tax liabilities, net	(112,577)	(99,538)	(14,020)

* As of December 31, 2023, the Group had net operating losses from several of its PRC and oversea entities of RMB1,703,345 (US$239,911), which can be carried forward to offset future taxable profit. As per filed tax returns, the net operating loss from PRC entities will expire between 2024 to 2028. For the net operating loss from overseas entities, there is no limitation of expiration according to the statute of Hong Kong and US.

** The Group records a valuation allowance on its deferred tax assets that is sufficient to reduce the deferred tax assets to an amount that is more likely than not to be realized. Future reversal of the valuation allowance will be recognized either when the benefit is realized or when it has been determined that it is more likely than not that the benefit in future earnings will be realized.

Schedule of movement of valuation allowance


	For the Year Ended December 31,
	2022	2023	2023
	RMB	RMB	US$
Balance at the beginning of year	(396,919)	(565,022)	(79,582)
Change of valuation allowance in the current year	(168,103)	(58,022)	(8,172)
Balance at the end of year	(565,022)	(623,044)	(87,754)

Schedule of reconciliation of the beginning and ending amount of unrecognized tax benefits excluding the penalty and interest


	For the Years Ended December 31,
	2022	2023	2023
	RMB	RMB	US$
Balance at the beginning of year	81,901	67,172	9,461
Changes based on tax positions related to the current year	322	—	—
Additions related to prior year tax position	1,072	12,084	1,702
Decreases related to prior year tax position	(6,617)	(14,104)	(1,987)
Decrease related to disposal of CMSI	(7,861)	(7,861)	(1,107)
Decreases relating to expiration of applicable statute of limitation	(3,572)	(1,997)	(281)
Foreign currency translation	1,927	8,605	1,212
Balance at the end of year	67,172	63,899	9,000

LONG-TERM INVESTMENTS - Additional information (Details) ¥ in Thousands, $ in Thousands		1 Months Ended				12 Months Ended
	Feb. 28, 2019	Sep. 30, 2023 CNY (¥)	Sep. 30, 2023 USD ($)	May 31, 2022 CNY (¥)	Mar. 31, 2022 CNY (¥)	Dec. 31, 2023 CNY (¥) director	Dec. 31, 2023 USD ($) director	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 28, 2023	Oct. 31, 2022 CNY (¥)	Dec. 31, 2020	Dec. 31, 2019 CNY (¥)	Dec. 31, 2018	Dec. 31, 2017 USD ($)
LONG-TERM INVESTMENTS
Disposal gain						¥ 37,498	$ 5,281	¥ 0	¥ 0
Long-term investments pledged to secure other borrowings						¥ 189,676		¥ 179,231	¥ 167,044	$ 26,715
Investment redeemed				¥ 11,949
SH MZJH
LONG-TERM INVESTMENTS
Capital contributed														¥ 34,540
Beijing Proton Medical Center Co Ltd [Member]
LONG-TERM INVESTMENTS
Equity interest in equity method investment											54.01%
Suzhou Shengshan
LONG-TERM INVESTMENTS
Equity interest in equity method investment						5.15%		5.15%		5.15%			5.15%	5.15%	5.41%	8.13%
Capital contributed \| $																$ 10,000
Proceeds from Dividends Received						¥ 4,022	$ 566
Shanghai Xinhe
LONG-TERM INVESTMENTS
Equity interest in equity method investment					99.99%	72.73%		99.99%		72.73%
Consideration amount						¥ 60,000				$ 8,451
Percentage of shares as consideration					2.05%
Carrying value of shares issued					¥ 45,115
Shanghai Changshengshu \| SH MZJH
LONG-TERM INVESTMENTS
Equity interest in equity method investment												20.00%
Consideration amount												¥ 2,000
Guangzhou Yicheng
LONG-TERM INVESTMENTS
Equity interest in equity method investment						30.00%		30.00%		30.00%
Guangzhou Yicheng \| GCMTIC
LONG-TERM INVESTMENTS
Equity interest in equity method investment								30.00%
Consideration amount								¥ 300
Zhejiang Marine Leasing Ltd
LONG-TERM INVESTMENTS
Equity interest in equity method investment						20.00%		20.00%		20.00%
Proceeds from Dividends Received		¥ 8,000	$ 1,127
China Medical Services Holdings Limited ("CMS Holdings") \| Zhejiang Marine
LONG-TERM INVESTMENTS
Equity interest in equity method investment	20.00%
Equity method investment legal interest percentage	20.00%
Guangdong Hengjian \| Aohua Technology
LONG-TERM INVESTMENTS
Equity interest in equity method investment						14.20%		14.20%		14.20%
Consideration amount						¥ 86,649		¥ 86,649
Number of directors entitled to delegate in the board \| director						2	2
Number of total directors \| director						5	5

FAIR VALUE MEASUREMENTS - Fair value of its derivative liability on a recurring basis using significant unobservable (Level 3) inputs (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
FAIR VALUE MEASUREMENTS
Derivative liability	¥ 163	$ 23	¥ 5,290
Significant unobservable inputs (Level 3)
FAIR VALUE MEASUREMENTS
Derivative liability	¥ 163

GOODWILL

12 Months Ended

Dec. 31, 2023

GOODWILL.

GOODWILL

11.GOODWILL

The goodwill of RMB575,427 and RMB575,427 (US$81,047) as of December 31, 2022 and 2023 represented the goodwill of RMB165,171 generated from the acquisition of GFHM, CMCC, SJYH and BPMC by the Group in 2018, the goodwill of RMB45,272 generated from the acquisition of Tianjin Jiatai Group by the Group in 2019, the goodwill of RMB3,213 generated from the acquisition the New Spring Group in 2020, and the goodwill of RMB368,221 generated from the acquisition the Healthingkon in 2021 (Note 4), and the decrease of goodwill in the amount RMB6,450 generated from the disposal of GFHM in 2022(Note 4).

The changes in the carrying amount of goodwill are as follow:


	For the years ended December 31,
	2022	2023
	RMB	RMB	US$
Balance as of January 1	581,877	575,427	81,047
Addition	—	—	—
Disposal	(6,450)	—	—
Impairment	—	—	—
Balance as of December 31	575,427	575,427	81,047

No impairment was recognized for the years ended December 31, 2021, 2022 and 2023.

SHARE-BASED AWARDS (Schedule of Share-Based Compensation Expense) (Details) - CNY (¥) ¥ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
SHARE-BASED AWARDS
Share-based compensation	¥ (5,919)	¥ 14,680
General and Administrative Expense [Member]
SHARE-BASED AWARDS
Share-based compensation	(6,424)	12,565
Selling Expenses [Member]
SHARE-BASED AWARDS
Share-based compensation	¥ 505	¥ 2,115

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

SEGMENT REPORTING (Tables)

12 Months Ended

Dec. 31, 2023

SEGMENT REPORTING

Schedule of segment information


	For the year ended December 31, 2023
	Network	Hospital	Total
	RMB	RMB	RMB	US$
Revenues from external customers	218,343	319,059	537,402	75,691
Cost of sales	(206,527)	(407,483)	(614,010)	(86,481)
Gross profit (loss)	11,816	(88,424)	(76,608)	(10,790)


	For the year ended December 31, 2022
	Network	Hospital	Total
	RMB	RMB	RMB
Revenues from external customers	254,442	217,643	472,085
Cost of sales	(225,245)	(399,249)	(624,494)
Gross profit (loss)	29,197	(181,606)	(152,409)


	For the year ended December 31, 2021
	Network	Hospital	Total
	RMB	RMB	RMB
Revenues from external customers	324,458	161,175	485,633
Cost of sales	(253,826)	(288,704)	(542,530)
Gross profit (loss)	70,632	(127,529)	(56,897)


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Segment assets
Network	2,048,126	1,769,085	249,170
Hospital	3,956,808	4,284,858	603,510
Total segment assets	6,004,934	6,053,943	852,680

Schedule of total long-lived assets excluding financial instruments, intangible assets, long-term investment and goodwill by country


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
PRC	3,862,975	4,132,784	582,090
Total long-lived assets	3,862,975	4,132,784	582,090

OTHER NON-CURRENT ASSETS (Tables)

12 Months Ended

Dec. 31, 2023

OTHER NON-CURRENT ASSETS

Schedule of other non-current assets


		As at December 31,
	Notes	2022	2023	2023
		RMB	RMB	US$
Deposit-long-term	i)	6,249	3,760	530
Advance to hospitals-noncurrent	ii)	1,002	1,325	187
Others	iii)	7,842	6,341	892
		15,093	11,426	1,609

Impairment losses of RMB2 and RMB28 (US$4) were reversed for the balances as at December 31, 2022 and 2023.

ii)

Impairment losses of RMB102 were provided for the balances as at December 31, 2022, and RMB324 (US$46) were reversed for the balances as at December 31, 2023.

iii)

Impairment losses of RMB797 and nil was provided for the balances as at December 31, 2022 and 2023.

TAXATION - Reconciliation of the differences between the statutory tax rate and the effective tax rate for EIT (Parenthetical) (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
TAXATION
Statutory income tax rate	25.00%	25.00%	25.00%

Other long-term liabilities (Tables)

12 Months Ended

Dec. 31, 2023

Other long-term liabilities

Schedule of other long-term liabilities


		As at December 31,
	Notes	2022	2023	2023
		RMB	RMB	US$
Accrued unrecognized tax benefits & surcharge	i)	60,299	44,470	6,263
Lease deposit received from hospital		2,000	2,000	282
Convertible Note	ii)	20,000	20,000	2,818
Others		1,785	2,533	357
		84,084	69,003	9,719

The amounts of unrecognized tax benefit are based on the recognition and measurement criteria of ASC Topic 740. The balance is presented as non-current liability in the consolidated financial statements as at December 31, 2023 due to the fact that the Group does not anticipate payments of cash within one year. The Group recorded accrued unrecognized tax benefits & surcharge amounting to RMB60,299 and RMB44,470 (US$6,263) (note 27) as of December 31, 2022 and 2023, respectively.

ii)

Convertible Note

LONG-TERM INVESTMENTS - Equity investments without readily determinable fair value (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2020	Aug. 31, 2023	Mar. 31, 2021	Dec. 31, 2018	Dec. 31, 2015
LONG-TERM INVESTMENTS
Equity investments with readily determinable fair value	¥ 51,624		¥ 51,524
CHS
LONG-TERM INVESTMENTS
Impairment	0		¥ 0
Percentage of interest held after disposal				90.00%
Business Combination, Consideration Transferred	¥ 26,909	$ 3,790
Concord Healthcare Singapore Pte. Ltd
LONG-TERM INVESTMENTS
Percentage of equity interest sold	8.73		8.73
Equity investments with readily determinable fair value	¥ 22,925		¥ 22,925
Percentage of interest held after disposal			8.73%	10.00%
Legion Healthcare Partners LLC
LONG-TERM INVESTMENTS
Percentage of equity interest sold	5.83		5.83			5.83
Equity investments with readily determinable fair value	¥ 6,439		¥ 6,439
Impairment	¥ 0		¥ 0
Beijing He Xu elderly Care Service Co., LTD
LONG-TERM INVESTMENTS
Percentage of equity interest sold	4.00				4.0
Remaining ownership interest percentage	4.00%
Equity investments with readily determinable fair value	¥ 100
Impairment	¥ 0
Allcure Information
LONG-TERM INVESTMENTS
Percentage of equity interest sold	9.6		9.6				9.6	20
Equity investments with readily determinable fair value	¥ 22,160		¥ 22,160
Impairment	¥ 0		¥ 0

FAIR VALUE MEASUREMENTS (Tables)

12 Months Ended

Dec. 31, 2023

FAIR VALUE MEASUREMENTS

Schedule of fair value of its derivative liability on a recurring basis

The Company measured the fair value of its derivative liability on a recurring basis using significant unobservable (Level 3) inputs as of December 31, 2023.


	Fair Value Measurement at the End of the Reporting Period Using
		Quoted Prices in
		Active	Significance
		Markets for	Other	Significant
	As of	Identical	Observable	Unobservable
	December 31,	Assets	Inputs	Inputs
	2023	(Level 1)	(Level 2)	(Level 3)
	RMB	RMB	RMB	RMB
Liability Items

Derivative liability:	163			163

TAXATION

12 Months Ended

Dec. 31, 2023

TAXATION

TAXATION

20.TAXATION

Enterprise income tax:

Cayman Islands

Under the current laws of the Cayman Islands, the Company is not subject to tax on income or capital gains. In addition, upon payments of dividends by the Company to its shareholders, no Cayman Islands withholding tax will be imposed.

British Virgin Islands

Under the current laws of the British Virgin Islands, subsidiaries in British Virgin Islands are not subject to tax on income or capital gains. In addition, upon payments of dividends by these companies to their shareholders, no British Virgin Islands withholding tax will be imposed.

United States

US Proton is incorporated in the State of Delaware, U.S.A. in 2011. The entity is subject to U.S. Federal and state Income Tax (graduated income tax rate were 21% in 2021, 2022 and 2023 on its taxable income under the current laws of the United States of America. The company’s activities are located solely in the state of Texas, as such it is subject to Texas Franchise Tax. The amount of current income tax for federal and state for US Proton was RMB362, RMB196 and RMB404 (USD$57) for the years ended December 31, 2021, 2022, and 2023.

Singapore

China Medstar is incorporated in Singapore and does not conduct any substantive operations of its own, which was disposed in 2022 as a subsidiary of Guofu Huimei (Note 4). No provision for Singapore profits tax has been made in the consolidated financial statements as the companies have no assessable profits for the years ended December 31, 2021 and 2022. In addition, upon payments of dividends by China Medstar and CHS to its shareholder, no Singapore withholding tax will be imposed.

Hong Kong

Subsidiaries in Hong Kong do not conduct any substantive operations of their own.

No provision for Hong Kong profits tax has been made in the consolidated financial statements as the Group has no assessable profits for the year presented. In addition, upon payment of dividends by these companies to their shareholders, no Hong Kong withholding tax will be imposed.

China

The applicable rate for China entities is subject to the PRC EIT at the rate of 25% for the period since 2012.

Dividends paid by PRC subsidiaries of the Group out of the profits earned after December 31, 2007 to non-PRC tax resident investors would be subject to PRC withholding tax. The withholding tax would be 10%, unless a foreign investor’s tax jurisdiction has a tax treaty with China that provides for a lower withholding tax rate and the foreign investor is qualified as a beneficial owner under the relevant tax treaty.

In general, for circumstances not being tax evasion, the PRC tax authorities will conduct examinations of the PRC entities’ tax filings of up to five years. Accordingly, the PRC entities’ tax years from 2018 to 2023 remain subject to examination by the tax authorities.

Loss before income taxes consists of:


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Non – PRC	5,451	45,211	20,824	2,933
PRC	(534,688)	(885,107)	(576,418)	(81,189)
	(529,237)	(839,896)	(555,594)	(78,256)

The current and deferred components of the income tax expense (benefit) appearing in the consolidated statements of comprehensive loss are as follows:


	For the Year Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Current tax expense (benefit)	4,115	(8,765)	(7,014)	(988)
Deferred tax benefit	(10,680)	(62,141)	(17,559)	(2,473)
	(6,565)	(70,906)	(24,573)	(3,461)

A reconciliation of the differences between the statutory tax rate and the effective tax rate for EIT is as follows:


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Loss before income taxes	(529,237)	(839,896)	(555,594)	(78,256)
Income tax computed at the tax rate of 25%	(132,309)	(209,974)	(138,899)	(19,564)
Effect of different tax rates in different jurisdictions	2,798	(20,584)	(5,178)	(728)
Non-deductible expenses	(10,502)	21,543	18,287	2,575
Non-taxable income	9,183	(55,705)	(6,447)	(908)
Statutory income (expense)	3,994	25,419	51,631	7,272
Interest and penalty	(12,918)	(7,254)	(6,121)	(862)
Deferred tax expense	(13,953)	7,056	3,357	473
Changes of valuation allowance	142,806	168,102	58,030	8,173
Withholding tax	4,336	491	767	108
	(6,565)	(70,906)	(24,573)	(3,461)

Deferred Tax

The components of deferred taxes are as follows:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Deferred tax asset
Net operating loss*	357,483	425,390	59,915
Foreign exchange loss	1,330	2,755	388
Depreciation and amortization	22,535	17,647	2,485
Property, plant and equipment impairment	6,997	2,340	330
Deposits for non-current assets	18,475	17,725	2,496
Allowance for net investment in financing lease	5,137	—	—
Allowance for doubtful accounts	14,746	29,299	4,127
Lease liabilities	58,901	59,875	8,433
Other long-term assets	104,912	94,791	13,351
Equity investment	7,553	7,005	987
Others	13,728	11,770	1,658
Total deferred tax assets	611,797	668,597	94,170
less: Valuation allowance**	(565,022)	(623,044)	(87,754)
Net deferred tax assets	46,775	45,553	6,416

Deferred tax liabilities
Equity investment	(1,170)	(1,091)	(154)
Property, plant and equipment	(1,682)	(2,368)	(334)
Disposal of Beijing Century Friendship	(3,126)	(3,126)	(440)
Intangible assets	(81,336)	(71,825)	(10,116)
Right-of-use assets	(46,873)	(45,626)	(6,426)
Capitalized interest	(19,179)	(18,993)	(2,675)
Others	(5,986)	(2,062)	(291)

Total deferred tax liabilities	(159,352)	(145,091)	(20,436)

Deferred tax assets, net	—	—	—

Deferred tax liabilities, net	(112,577)	(99,538)	(14,020)

The movement of valuation allowance is as follows:


	For the Year Ended December 31,
	2022	2023	2023
	RMB	RMB	US$
Balance at the beginning of year	(396,919)	(565,022)	(79,582)
Change of valuation allowance in the current year	(168,103)	(58,022)	(8,172)
Balance at the end of year	(565,022)	(623,044)	(87,754)

Unrecognized Tax Benefits

The reconciliation of the beginning and ending amount of unrecognized tax benefits excluding the penalty and interest is as follows:


	For the Years Ended December 31,
	2022	2023	2023
	RMB	RMB	US$
Balance at the beginning of year	81,901	67,172	9,461
Changes based on tax positions related to the current year	322	—	—
Additions related to prior year tax position	1,072	12,084	1,702
Decreases related to prior year tax position	(6,617)	(14,104)	(1,987)
Decrease related to disposal of CMSI	(7,861)	(7,861)	(1,107)
Decreases relating to expiration of applicable statute of limitation	(3,572)	(1,997)	(281)
Foreign currency translation	1,927	8,605	1,212
Balance at the end of year	67,172	63,899	9,000

As of December 31, 2022, and 2023, the Group had unrecognized tax benefit of RMB67,172 and RMB63,899 (US$ 9,000), respectively, among which, RMB19,962 and RMB28,712 (US$4,044) were presented on a net basis against the deferred tax assets related to tax losses carry forwards on the consolidated balance sheets. At December 31, 2022 and 2023, there were RMB39,412 and RMB35,421 (US$4,989) of unrecognized tax benefits that if recognized would affect the annual effective tax rate.

The final outcome of the tax uncertainty is dependent upon various matters including tax examinations, interpretation of tax laws or expiration of statute of limitations. However, due to the uncertainties associated with the status of examinations, including the protocols of finalizing audits by the relevant tax authorities, there is a high degree of uncertainty regarding the future cash outflows associated with these tax uncertainties. However, an estimate of the range of the possible change cannot be made at this time.

The Group recognized a decrease amounting to RMB12,918, a decrease amounting to RMB7,254 and a decrease amounting to RMB6,121 (US$862) in interest and penalties during the years ended December 31, 2021, 2022 and 2023, respectively. As of December 31, 2022, and 2023, the Group recognized of interest and penalties of RMB13,091 and RMB9,283 (US$1,307), respectively. Uncertain tax benefits were recorded as other long-term liabilities.

Value-added taxes (“VAT”)

After a new VAT reform came into effect on 1 April 2019, the rental income derived from movable property leasing arrangement is subject to VAT at 13%. The technical service income is subject to VAT at 6%.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
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-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
-Section 50
-Paragraph 21
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-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (SAB TOPIC 6.I.5.Q1)
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

SHARE-BASED AWARDS (Tables)

12 Months Ended

Dec. 31, 2023

SHARE-BASED AWARDS

Schedule of Assumptions Used


	February 18, 2014
Risk-free interest rate	2.33	%
Dividend yield	5	%
Exercise multiple	2.5
Expected volatility range	39.03	%

Summary of Restricted Shares


		Fair Value per Share
		at the Grant
Grant Date	Number of Awards	date (US$)
February 18, 2014	1,370,250	1.93
July 1, 2014	21,132	2.35
August 1, 2014	69,564	2.44
August 7, 2017	1,453,950	1.33
August 8, 2017	3,319,200	1.34
September 13, 2017	45,000	1.33
October 2, 2018	5,992,605	1.19

The Company recognizes the compensation expense on a straight-line basis over the requisite service period for the entire award. Restricted Shares activity for the year ended December 31, 2023 was as follows:


		Weighted
	Numbers	average grant
	of shares	date fair value
	RMB	US$
Outstanding, January 1, 2023	10,785,789	1.31
Granted	—	—
Forfeited	—	—
Exercised	—	—
Outstanding, December 31, 2023	10,785,789	1.31
Exercisable, December 31, 2023	10,785,789	1.31

Schedule of Share-Based Compensation Expense


	For the Years ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
General and administrative expenses	12,565	(6,424)	—	—
Selling expenses	2,115	505	—	—
	14,680	(5,919)	—	—

EMPLOYEE DEFINED CONTRIBUTION PLAN

12 Months Ended

Dec. 31, 2023

EMPLOYEE DEFINED CONTRIBUTION PLAN

EMPLOYEE DEFINED CONTRIBUTION PLAN

26.EMPLOYEE DEFINED CONTRIBUTION PLAN

Full time employees of the Group in the PRC participate in a government mandated defined contribution plan, pursuant to which certain pension benefits, medical care, employee housing fund and other welfare benefits are provided to employees. Chinese labor regulations require that the PRC subsidiaries of the Group make contributions to the government for these benefits based on certain percentages of the employees’ salaries. The Group has no legal obligation for the benefits beyond the contributions made. The total amounts for such employee benefits, which were expensed as incurred, were RMB51,107 and RMB58,623 and RMB57,182 (US$8,054) for the years ended December 31, 2021, 2022 and 2023, respectively.

INTANGIBLE ASSETS, NET - Schedule of Estimated Annual Amortization Expenses (Details) - Dec. 31, 2023 ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
INTANGIBLE ASSETS, NET
2024	¥ 40,759	$ 5,741
2025	35,767	5,038
2026	34,064	4,798
2027	29,142	4,105
2028	¥ 183,555	$ 25,852

TAXATION - Reconciliation of the differences between the statutory tax rate and the effective tax rate for EIT (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
TAXATION
Loss before income taxes	¥ (555,594)	$ (78,256)	¥ (839,896)	¥ (529,237)
Income tax computed at the tax rate of 25%	(138,899)	(19,564)	(209,974)	(132,309)
Effect of different tax rates in different jurisdictions	(5,178)	(728)	(20,584)	2,798
Non-deductible expenses	18,287	2,575	21,543	(10,502)
Non-taxable income	(6,447)	(908)	(55,705)	9,183
Statutory income (expense)	51,631	7,272	25,419	3,994
Interest and penalty	(6,121)	(862)	(7,254)	(12,918)
Deferred tax expense	3,357	473	7,056	(13,953)
Changes of valuation allowance	58,030	8,173	168,102	142,806
Withholding tax	767	108	491	4,336
Income tax expense	¥ (24,573)	$ (3,461)	¥ (70,906)	¥ (6,565)

TAXATION - Reconciliation of the beginning and ending amount of unrecognized tax benefits excluding the penalty and interest (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
TAXATION
Balance at the beginning of year	¥ 67,172	$ 9,461	¥ 81,901
Changes based on tax positions related to the current year	0	0	322
Additions related to prior year tax position	12,084	1,702	1,072
Decreases related to prior year tax position	(14,104)	(1,987)	(6,617)
Decrease related to disposal of CMSI	(7,861)	(1,107)	(7,861)
Decreases relating to expiration of applicable statute of limitation	(1,997)	(281)	(3,572)
Foreign currency translation	8,605	1,212	1,927
Balance at the end of year	¥ 63,899	$ 9,000	¥ 67,172

Revenue

12 Months Ended

Dec. 31, 2023

Revenue

Revenue

24.Revenue

Revenue consists of ASC 606 and ASC 842 revenue. The Group’s revenues, net of value-added tax, disaggregated by revenue source are as follows:


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
ASC 606 revenue:
Management and technical support	64,599	53,341	23,164	3,263
Medical solution	217,375	179,135	178,442	25,133
Medical service	101,854	131,936	218,595	30,788
Medicine income	59,321	85,707	100,464	14,150
ASC 606 revenue	443,149	450,119	520,665	73,334
ASC 842 revenue:
Operating lease income*	35,913	18,226	13,371	1,883
Sales-type lease income*	5,210	3,326	3,366	474
Direct financing lease income*	1,361	414	—	—
ASC 842 revenue	42,484	21,966	16,737	2,357
Total revenue	485,633	472,085	537,402	75,691

* Operating lease income, sales-type lease income and direct financing lease income were recognized under ASC 842, Leases.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Section 50
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-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
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-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

SEGMENT REPORTING (Details)	12 Months Ended
SEGMENT REPORTING (Details)	Dec. 31, 2023 segment	Dec. 31, 2022 segment customer	Dec. 31, 2021 segment customer
SEGMENT REPORTING
Number of operating segments \| segment	2	2	2
Revenue from contract with customer benchmark
SEGMENT REPORTING
Concentration risk percentage	12.80%	12.20%	11.90%
Number of customers \| customer		1	1

TAXATION - Movement of valuation allowance (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
TAXATION
Balance at the beginning of year	¥ (565,022)	$ (79,582)	¥ (396,919)
Change of valuation allowance in the current year	(58,022)	(8,172)	(168,103)
Balance at the end of year	¥ (623,044)	$ (87,754)	¥ (565,022)

SUBSEQUENT EVENTS

12 Months Ended

Dec. 31, 2023

SUBSEQUENT EVENTS

SUBSEQUENT EVENTS

32.SUBSEQUENT EVENTS

Listing of Concord Healthcare on The Stock Exchange of Hong Kong Limited

On January 9, 2024, one of the Company’s subsidiary, Concord Healthcare completed its initial public offering (“IPO”) and Concord Healthcare’s shares have been listed on the Main Board of The Stock Exchange of Hong Kong Limited (the “HKSE”) under the stock code 2453.HK, at an initial public offer price of HK$14.28. The gross proceeds from the initial public offering of Concord Healthcare on the HKSE are HK$562.9 million (approximately US$72.2 million). As of the issuance date of the consolidated financial statements, HK$554,914 (approximately US$71,044) has been received by the Company, among which RMB200,000 (US$28,169) was used to purchase a series of trading securities to make a best use of the proceeds from its IPO, which would be used to repay the loans of the Company after their maturities.

New bank loans and other borrowings

In December 2023, the Company’s subsidiary, CMCC entered into a contract with maximum credit limit with Xiamen International Bank Co., Ltd., in which CMCC was granted maximum loan credit in the amount of RMB10,000 (US$1,408). Subsequent to the maximum credit limit contract, two loan notes were sealed between both parties in a total amount of RMB10,000 (US$1,408) to meet the purchase of drugs and medical consumables, and payment of staff salaries and other working capital needs of CMCC. The period of the loan is from January 3, 2024 to July 3, 2024. The interest rate for the loan is fixed at 5.5% per annum.

In February 2024, the Company’s subsidiary, Shanghai Medstar entered into a loan contract with Inner Mongolia Hongxin Yubang supply chain Co., Ltd. in the amount of RMB50,000 (US$7,042) to meet working capital needs of Shanghai Medstar. The period of the loan is from February 1, 2024 to July 31, 2024. The interest rate for the loan is fixed at 6.0% per annum. In addition, Shanghai Medstar entered into another loan contract with Shanghai Linen in the amount of RMB10,000 (US$1,408) on March 19, and the period of which is from March 19, 2024 to April 30, 2024. The interest rate for this loan is fixed at 15.0% per annum. The loan principal and related interest of the two loans should be paid in one lump sum at maturity.

In March 2024, the Company’s subsidiaries, CMCC entered into a loan contract with Bank of Shanghai in the amount of RMB10,000 (US$1,408) to meet working capital needs of CMCC. The period of the loan is from March 25, 2024 to March 25, 2025. The interest rate for the loan is fixed at 4.2% per annum. The loan interest should be paid quarterly and the principal in one lump sum at maturity.

In March 2024, the Company’s subsidiaries, SH MZJH entered into a loan contract with Bank of Shanghai in the amount of RMB9,980 (US$1,406) to meet working capital needs of SH MZJH. The period of the loan is from March 21, 2024 to March 21, 2025. The interest rate for the loan is fixed at 4.5% per annum. The loan interest should be paid quarterly and the principal in one lump sum at maturity. This bank borrowing is secured by certain equipment and operating revenue of SH MZJH and certain equity investments of SH MZJH held by Healthingkon, Concord Healthcare and Global Medical Imaging (HongKong) Ltd. In addition, Concord Healthcare and Shanghai policy Financing Guarantee Fund Management center for small, medium and micro enterprises provided a joint and several liability guarantee and guarantee for this loan, respectively.

As of the date of issuance of the consolidated financial statements, all principals of the bank loans and other borrowings mentioned above was received by the Company.

Capital injection to HCCH

On January 19, 2024, the Company made a capital injection in the amount of RMB102,000 (US$14,366) to Hebei CSPC Concord Hospital Management Co., Ltd. (“HCCH”), in order to improve economic benefits and expand business scale in high-end cancer hospitals in the Beijing-Tianjin-Hebei region.

The Company has evaluated subsequent events through April 19, 2024, the date of issuance of the consolidated financial statements, except for the events mentioned above the Company did not identify any subsequent events with material financial impact on the Company’s consolidated financial statements.

LEASE

12 Months Ended

Dec. 31, 2023

LEASE

LEASE

10.LEASE

A. Leases of medical equipment as lessor

The following table presents the lease receivables derive from the Group’s operating, sales-type and direct financing leases:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Current
Account receivable - Operating lease	14,230	14,683	2,068
Account receivable - Sales-type lease	906	1,515	213

Total	15,136	16,198	2,281

Lease receivables for operating and sales-type leases are presented in accounts receivable on the consolidated balance sheets. Lease receivables for direct financing leases are presented as net investment in direct financing leases. As of December 31, 2022 and 2023, the allowance of lease receivables was RMB2,175 and RMB2,175 (US$306), respectively. Accordingly, risk of default with respect to these receivables is remote.

Lease receivables with carrying value of RMB340 and RMB1,759 (US$248) (note 18) were pledged as collaterals for bank and other borrowings of RMB47,409 and RMB40,066 (US$5,643) as of December 31, 2022 and 2023, respectively.

The following table presents the lease income recognized relating to the Group’s operating, sales-type and direct financing leases:


	For the Year Ended December 31, 2023
			Direct financing
	Sales-type leases		leases		Operating leases
	RMB	US$	RMB	US$	RMB	US$
Selling loss recognized at the commencement date	—	—	—	—	—	—

Interest income on net investment in the lease	3,366	474	—	—	—	—
Including: Income relating to variable lease payments not included in the measurement of the net investment in a lease	3,366	474	—	—	—	—

Lease income relating to lease payments					13,371	1,883
Including: Income relating to variable lease payments not included in the measurement of lease receivable	—	—	—	—	13,371	1,883


	For the Year Ended December 31, 2022
			Direct financing
	Sales-type leases		leases		Operating leases
	RMB	US$	RMB	US$	RMB	US$

Selling loss recognized at the commencement date	—	—	—	—	—	—

Interest income on net investment in the lease	3,326	482	414	60	—	—
Including: Income relating to variable lease payments not included in the measurement of the net investment in a lease	3,326	482	—	—	—	—

Lease income relating to lease payments					18,226	2,643
Including: Income relating to variable lease payments not included in the measurement of lease receivable	—	—	—	—	18,226	2,643

The Group’s lease assets do not contain material residual value by the end of the lease term. In order to mitigate the risks associated with the residual value of its leased assets, the Group usually enters into arrangements where the lease terms are approximate to the economic useful life of the leased assets so as to minimize their residual value.

The future minimum lease payments to be received from such non-cancelable operating leases are as follows:


	Future minimum
	operating lease payments
	RMB	US$
2024	1,396	197
2025	1,396	197
2026	931	131
2027	—	—
2028	—	—
Above 5 years	—	—

Lease payments for the Group’s sales-type lease payments are all variable based on the profit or revenue generated from the underlying assets thus the Group does not recognize any net investment in the lease at commencement.

B. Failed sales-leaseback transactions as seller-lessee

The Group has failed sales-leaseback transactions in which the Group acts as seller-lessee but does not effectively transfer control of the underlying asset to the buyer-lessor. The Group accounts for failed sales-leaseback transactions as financings. The Group recorded RMB301,681 (US$42,491) and RMB202,178 (US$28,476) under “Long-term bank and other borrowings, current portion” and “Long-term bank and other borrowings, non-current portion”, respectively as of December 31, 2023. The effective interest rate used in the computation of interest expense ranged from 2.08% to 11.70%. Interest expenses recorded in the Group’s consolidated statement of comprehensive loss amounted to RMB39,876, RMB47,049, and RMB74,024 (US$10,426) for the years ended December 31, 2021, 2022 and 2023, respectively.

C. Operating leases as lessee

The components of lease cost were as follows:


	For the year ended December 31, 2023
	RMB	US$
Operating lease cost	41,158	5,797
Short term lease cost	41	6

Total	41,199	5,803

For the year ended December 31, 2023, total operating and short-term lease costs of RMB19,834 (US$2,794) and RMB21,365 (US$3,009) were recorded in cost of revenue and general and administrative expenses, respectively.

Other information


	For the year
	ended December 31, 2023
	RMB		US$
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	18,147		2,556
ROU assets obtained in exchange for operating lease liabilities*	15,060		2,121
Weighted-average remaining lease terms (in years)	3		3
Weighted-average discount rate	5.87	%	5.87	%

* Includes new leases entered into during the year ended December 31, 2023. Changes in the ROU asset and liability are presented net within operating activities.

Future minimum lease payments for operating leases as of December 31, 2023 are as follows:


	Minimum Lease Payments
	RMB	US$
Year ending December 31,
2024	57,992	8,168
2025	29,134	4,103
2026	24,046	3,387
2027	21,723	3,060
2028	22,097	3,112
Thereafter	167,181	23,547
Total future lease payments	322,173	45,377
Less: Imputed interest	82,674	11,645
Total lease liability balance	239,499	33,732

The Group did not have any leasing transactions with related parties.

Land use rights

The following table presents the original cost payment, accumulated amortization and net carrying value of the Group’s land use rights for the periods presented:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
	Right-of-use	Right-of-use	Right-of-use
	Asset	asset	asset

Land use rights	464,209	464,209	65,382
Less: accumulated amortization	(56,723)	(66,350)	(9,345)
Net carrying value	407,486	397,859	56,037

As of December 31, 2022 and 2023, the Group recorded land lease payment under “Right-of-use assets, net” of RMB407,486 and RMB397,859 (US$56,037), respectively. Amortization expenses for the years ended December 31, 2021, 2022 and 2023 were RMB9,621, RMB9,627 and RMB9,627 (US$1,356), respectively.

The net book value of the Group’s land use right payments pledged to secure bank and other borrowings was RMB395,973 and RMB386,614 (US$ 54,453) (note 18) as of December 31, 2022 and 2023, respectively.

The estimated annual amortization expenses for the land leases payment for each of the five succeeding years are as follows:


	Amortization
	RMB	US$
2024	9,627	1,356
2025	9,627	1,356
2026	9,627	1,356
2027	9,627	1,356
2028	9,627	1,356

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION - Condensed statements of comprehensive loss (Parenthetical) (Details) - CNY (¥) ¥ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Foreign currency translation, net of tax	¥ 0	¥ 0	¥ 0
Parent Company
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Foreign currency translation, net of tax	¥ 0	¥ 0	¥ 0

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION (Tables)

12 Months Ended

Dec. 31, 2023

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION

Schedule of condensed balance sheets

Condensed balance sheets


	As at December 31
	2022	2023	2023
	RMB	RMB	US$
ASSETS
Current assets:
Cash and cash equivalent	1,510	17,466	2,460
Prepayments and other current assets	24,271	24,999	3,521
Total current assets	25,781	42,465	5,981
Total assets	25,781	42,465	5,981

LIABILITIES AND SHAREHOLDERS’ EQUITY
Current liabilities:
Short term loan	32,417	41,179	5,800
Long-term debts due within one year	111,028	110,574	15,574
Accrued expenses and other liabilities	11,649	20,483	2,885
Derivative liability	5,290	163	23
Amounts due to subsidiaries	1,729,363	1,992,011	280,568
Total current liabilities	1,889,747	2,164,410	304,850
Total liabilities	1,889,747	2,164,410	304,850

Shareholders’ equity (deficit):
Class A ordinary shares (par value of US$0.0001per share; authorized shares-500,000,000; issued shares-96,565,584 and 96,565,584 as of December 31, 2022 and 2023; outstanding shares-84,463,737 and 84,463,737 as of December 31, 2022 and 2023, respectively)	68	68	10
Class B ordinary shares (par value of US$0.0001per share; authorized shares‑45,787,948; issued shares-45,787,948 and 45,787,948 as of December 31, 2022 and 2023; outstanding shares- 45,787,948 and 45,787,948 as of December 31, 2022 and 2023, respectively)	37	37	5
Treasury stock (12,101,847 and 12,101,847 shares as of December 31, 2022 and 2023, respectively)	(7)	(7)	(1)
Additional paid-in capital	1,930,633	2,007,965	282,816
Accumulated other comprehensive loss	(27,766)	(65,419)	(9,214)
Accumulated deficit	(3,766,931)	(4,064,589)	(572,485)
Total shareholders’ equity (deficit)	(1,863,966)	(2,121,945)	(298,869)
Total liabilities and shareholders’ equity (deficit)	25,781	42,465	5,981

Schedule of condensed statements of comprehensive loss

Condensed statements of comprehensive loss


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Revenues	—	—	—	—
Cost of revenues	—	—	—	—
General and administrative expenses	(14,428)	5,242	(2,414)	(340)
Selling expenses	(2,090)	(524)	—	—
Operating loss	(16,518)	4,718	(2,414)	(340)
Equity in loss of subsidiaries	(793,117)	(605,175)	(314,122)	(44,246)
Interest income	—	—	14	2
Interest expense	(1,459)	(10,394)	(9,926)	(1,398)
Changes in fair value of derivatives	—	1,055	5,282	744
Other income, net	—	96,609	(1,008)	(142)
Foreign exchange gain(loss)	(9,527)	23,526	24,516	3,453
Net loss	(820,621)	(489,661)	(297,658)	(41,927)
Other comprehensive income (loss)
Foreign currency translation, net of tax of nil	14,821	(53,964)	(6,480)	(913)
Unrealized losses on available-for-sale securities, net	—	—	(31,173)	(4,391)
Total other comprehensive (loss) income	14,821	(53,964)	(37,653)	(5,304)
Comprehensive loss	(805,800)	(543,625)	(335,311)	(47,231)

Schedule of condensed statements of cash flows

Condensed statements of cash flows


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Net cash (used in) generated from operating activities	(9,301)	(2,047)	(1,258)	(177)
Net cash (used in) generated from investing activities	(88,546)	(29,335)	15,655	2,205
Net cash (used in) generated from financing activities	110,876	16,591	1,590	224

Exchange rate effect on cash	(50)	1,243	(31)	(5)

Net (decrease) increase in cash	12,979	(13,548)	15,956	2,247
Cash at beginning of the year	2,079	15,058	1,510	213

Cash at end of the year	15,058	1,510	17,466	2,460

RELATED PARTY TRANSACTIONS - Related party transactions (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
RELATED PARTY TRANSACTIONS
Interest income	¥ 10,832	$ 1,526	¥ 10,021	¥ 5,894
Interest expense to:	165,669	23,334	120,357	73,789
Related party
RELATED PARTY TRANSACTIONS
Loan to:	200	28	16,800	142,895
Interest income	6,813	960	6,961	3,447
Loan from:	22,150	3,120	220,369	24,432
Interest expense to:	14,308	2,015	16,790	13,532
Repayment to:	61,777	8,701	82,915	80,886
Repayment from:	0	0	0	2,430
Related party \| JYADK
RELATED PARTY TRANSACTIONS
Interest income	0	0	0	650
Repayment from:	0	0	0	2,430
Related party \| Guangdong Proton International Hospital Management Co., Ltd
RELATED PARTY TRANSACTIONS
Loan to:	200	28	16,800	142,895
Interest income	6,813	960	6,961	2,797
Related party \| Cherrylane Investment Limited
RELATED PARTY TRANSACTIONS
Loan from:	0	0	0	15,932
Interest expense to:	423	60	1,334	554
Repayment to:	19,710	2,776	0	3,824
Related party \| Zhejiang Marine Leasing Ltd
RELATED PARTY TRANSACTIONS
Loan from:	4,400	620	220,369	8,500
Interest expense to:	13,683	1,927	15,456	12,978
Repayment to:	32,127	4,525	82,915	77,062
Related party \| Morgancreek investment Holdings Limited
RELATED PARTY TRANSACTIONS
Loan from:	17,750	2,500	0	0
Interest expense to:	202	28	0	0
Repayment to:	¥ 9,940	$ 1,400	¥ 0	¥ 0

ACQUISITIONS AND DISPOSALS - Disposal of Guofu Huimei and its subsidiaries (Details) - Guofu Huimei and its subsidiaries ("GFHM disposal group") ¥ in Thousands, $ in Thousands	Dec. 31, 2022 CNY (¥)	Dec. 31, 2022 USD ($)	Dec. 26, 2022 CNY (¥)	Dec. 26, 2022 USD ($)
ACQUISITIONS AND DISPOSALS
Disposition of net assets			¥ 189,402	$ 27,460
Goodwill			¥ 6,450	$ 935
Shanghai Epu and Shanghai Rongsheng
ACQUISITIONS AND DISPOSALS
Disposal group, cash consideration	¥ 190,000	$ 27,547

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥) ¥ / shares shares	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 CNY (¥) ¥ / shares shares	Dec. 31, 2021 CNY (¥) ¥ / shares shares
Revenues, net of value-added tax	¥ 537,402	$ 75,691	¥ 472,085	¥ 485,633
Cost of revenues	(614,010)	(86,481)	(624,494)	(542,530)
Gross loss	(76,608)	(10,790)	(152,409)	(56,897)
Operating expenses:
Selling expenses	(56,299)	(7,930)	(61,479)	(53,675)
General and administrative expenses	(330,078)	(46,491)	(311,160)	(347,746)
Impairment of long-lived assets \| ¥	0		0	0
Operating loss	(462,985)	(65,211)	(525,048)	(458,318)
Interest expense (including interest expense to related party amounting to RMB13,532, RMB16,790 and RMB14,308 (US$2,015) for the years ended December 31, 2021, 2022 and 2023, respectively)	(165,669)	(23,334)	(120,357)	(73,789)
Foreign exchange (loss) gain, net	10,149	1,429	54,982	(19,925)
(loss) Gain on disposal of long-lived assets	62	9	(3)
Interest income (including interest income from related party amounting to RMB3,447, RMB6,961 and RMB6,813 (US$960) for the years ended December 31, 2021, 2022 and 2023, respectively)	10,832	1,526	10,021	5,894
Change in fair value of derivative liability	5,207	733	1,015	(39)
Income from equity method investments	20,789	2,928	17,647	18,163
Loss on disposal of a subsidiary	(638)	(90)	(61,546)	0
Other expenses, net	(10,839)	(1,527)	(216,607)	(1,223)
Gain on sale of partial interests in an equity method investment	37,498	5,281	0	0
Loss before income tax	(555,594)	(78,256)	(839,896)	(529,237)
Income tax benefit	24,573	3,461	70,906	6,565
Net loss	(531,021)	(74,795)	(768,990)	(522,672)
Net loss attributable to noncontrolling interests	233,363	32,868	279,329	251,245
Net loss attributable to Concord Medical Services Holdings Limited	¥ (297,658)	$ (41,927)	¥ (489,661)	¥ (271,427)
Loss per share for Class A and Class B ordinary shares:
Basic \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)
Diluted \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)
Weighted average number of class A and class B ordinary shares outstanding:
Basic	131,053,858	131,053,858	131,053,858	131,053,858
Diluted	131,053,858	131,053,858	131,053,858	131,053,858
Other comprehensive income (loss), net of tax of nil
Foreign currency translation, net tax of nil	¥ (6,480)	$ (913)	¥ (53,964)	¥ 14,821
Unrealized losses on available-for-sale securities, net	(31,173)	(4,391)
Total other comprehensive income (loss), net of tax	(37,653)	(5,304)	(53,964)	14,821
Comprehensive loss	(568,674)	(80,099)	(822,954)	(507,851)
Comprehensive loss attributable to noncontrolling interests	(233,363)	(32,868)	(279,329)	(251,245)
Comprehensive loss attributable to Concord Medical Services Holdings Limited	(335,311)	(47,231)	(543,625)	(256,606)
Equipment leasing revenues
Revenues, net of value-added tax	16,737	2,357	21,966	42,484
Cost of revenues	(14,824)	(2,088)	(18,905)	(40,539)
Services and other revenues
Revenues, net of value-added tax	420,201	59,184	364,412	383,828
Cost of revenues	(500,068)	(70,433)	(518,500)	(441,510)
Medicine income
Revenues, net of value-added tax	100,464	14,150	85,707	59,321
Cost of revenues	¥ (99,118)	$ (13,960)	¥ (87,089)	¥ (60,481)

EMPLOYEE DEFINED CONTRIBUTION PLAN (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
PRC
EMPLOYEE DEFINED CONTRIBUTION PLAN
Contributions to defined contribution plans	¥ 57,182	$ 8,054	¥ 58,623	¥ 51,107

OTHER NON-CURRENT ASSETS - Additional information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
OTHER NON-CURRENT ASSETS
Deposit - long term, impairment loss	¥ 28	$ 4	¥ 2
Advance to hospitals-non current, impairment loss	324	$ 46	102
Other	¥ 0		¥ 797

SEGMENT REPORTING - Segment information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2023 USD ($)
SEGMENT REPORTING
Total Revenues	¥ 537,402	$ 75,691	¥ 472,085	¥ 485,633
Cost of sales	(614,010)	(86,481)	(624,494)	(542,530)
Gross profit (loss)	(76,608)	$ (10,790)	(152,409)	(56,897)
Total assets	6,053,943		6,004,934		$ 852,680
Network Segment
SEGMENT REPORTING
Total Revenues	218,343		254,442	324,458
Cost of sales	(206,527)		(225,245)	(253,826)
Gross profit (loss)	11,816		29,197	70,632
Hospital
SEGMENT REPORTING
Total Revenues	319,059		217,643	161,175
Cost of sales	(407,483)		(399,249)	(288,704)
Gross profit (loss)	(88,424)		(181,606)	¥ (127,529)
Operation segment
SEGMENT REPORTING
Total assets	6,053,943		6,004,934		852,680
Operation segment \| Network Segment
SEGMENT REPORTING
Total assets	1,769,085		2,048,126		249,170
Operation segment \| Hospital
SEGMENT REPORTING
Total assets	¥ 4,284,858		¥ 3,956,808		$ 603,510

- Definition

Sum of the carrying amounts as of the balance sheet date of all assets that are recognized. Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 810
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (bb)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481203/810-10-50-3

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 810
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 25
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481231/810-10-45-25

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 323
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
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+ Details

INTANGIBLE ASSETS, NET - Additional Information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
INTANGIBLE ASSETS, NET
Amortization expenses	¥ 36,705	$ 5,170	¥ 34,495	¥ 30,171
Acquired finite lived intangible assets
INTANGIBLE ASSETS, NET
Amortization expenses	36,705	$ 5,170	34,495	30,171
Impairment loss on intangible assets	¥ 0		¥ 0	¥ 0

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)

12 Months Ended

Dec. 31, 2023

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Basis of presentation

The accompanying consolidated financial statements have been prepared in accordance with United States generally accepted accounting principles (“U.S. GAAP”).

Going Concern

The Company experienced net loss from continuing operations of RMB522,672, RMB768,990, and RMB531,021 (US$74,795) for the years ended December 31, 2021, 2022 and 2023, respectively, and negative cash flows from operating activities of approximately RMB216,694 and RMB276,471 (US$38,944) for the years ended December 31, 2022 and 2023, respectively. As of December 31, 2023, the Company had cash position of RMB58,139 (US$8,189), negative working capital of RMB1,334,186 (US$187,914), an accumulated deficit of RMB4,064,589 (US$572,485).

These adverse conditions indicate that there is substantial doubt about the Company’s ability to continue as a going concern. As of the issuance date of the consolidated financial statements, HK$554,914 (approximately US$71,044)has been received by the Company through the effective list of Concord Healthcare on Main Board of The Stock Exchange of Hong Kong Limited (Note 32). In addition, From January 2024 to March 2024, the Company entered into five loan contracts with the amount of RMB89,980 (US$12,672), all principals has been received as of the date of this annual report. The Group will focus on the following activities: (1) the Group plans to seek additional equity and debt financing from new investors into the hospital and network business operation and extend the terms of current loans; (2) the Group plans to improve the profitability of network business and hospital business through upgrading cloud system solutions, accelerating the transformation of scientific research and training achievements into clinical application and so on; (3) the Group is currently focusing on improving operation efficiency and cost reduction to standardize operations, enhance internal controls, and create synergy of the Company’s resources. Therefore, management believed that the substantial doubt about the Company’s ability to continue as a going concern within one year after the date the financial statements are issued has been alleviated.

Based on cash flows projection from operating and financing activities and existing balance of cash and cash equivalents, management concludes that the Company has sufficient funds for sustainable operation and it will be able to meet its payment obligations from operations and debt related commitments for the next twelve months from the issuance of the consolidated financial statements. Based on the above considerations, the accompanying financial statements have been prepared in accordance with U.S. GAAP, on a going concern basis, which contemplates the realization of assets and the satisfaction of liabilities and commitments in the normal course of business. The financial statements do not include any adjustments relating to the recoverability and classification of asset and amounts and classification of liabilities that may be necessary should the Company be unable to continue as a going concern.

Use of estimates

Use of estimates

The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosures of contingent assets and liabilities at the balance sheet dates and the reported amounts of revenues and expenses during the reporting periods. Significant estimates and assumptions reflected in the Company’s financial statements include, but are not limited to, impairment of long-lived assets and goodwill, expected credit losses for accounts receivable and other receivables included in prepayments and other current assets, purchase price allocation, measurement of available for sale debt securities, unrecognized tax benefits, realization of deferred tax assets, incremental borrowing rate of right-of-use assets and related lease obligation, and fair value measurement of derivative liability. Actual results could materially differ from those estimates.

Principles of consolidation

The consolidated financial statements of the Group include the financial statements of the Company, its subsidiaries and the VIE and its subsidiaries for which the Company or a subsidiary of the Company is the primary beneficiary. All transactions and balances between the Company, subsidiaries and VIE and its subsidiaries have been eliminated upon consolidation. Results of acquired subsidiaries and its VIE and its subsidiaries are consolidated from the date on which control is transferred to the Company.

Foreign currency translation and transactions

The Company’s PRC subsidiaries determine their functional currencies to be the Chinese Renminbi (“RMB”) based on the criteria of ASC 830, Foreign Currency Matters (“ASC 830”). The Group uses the RMB as its reporting currency. Generally, the Company and other subsidiaries incorporated outside PRC use their local currency as functional currency. The Company and the subsidiaries whose functional currency is not RMB use the monthly average exchange rate for the year and the exchange rate at the balance sheet date to translate the operating results and financial position, respectively. Translation differences are recorded in accumulated other comprehensive income (loss), a component of shareholders’ equity.

Transactions denominated in foreign currencies are remeasured into the functional currency at the exchange rates prevailing on the transaction dates. Foreign currency denominated financial assets and liabilities are remeasured at the exchange rates prevailing at the balance sheet date. Exchange gains and losses are included in the consolidated statements of comprehensive loss.

Accumulated other comprehensive loss represents the cumulative foreign currency translation adjustments at each balance sheet date.

Convenience translation

Amounts in U.S. dollars are presented for the convenience of the reader and are translated at the noon buying rate of RMB7.0999 to US$1.00 on December 29, 2023 as published on the website of the Federal Reserve Board. No representation is made that the RMB amounts could have been, or could be, converted into US$ at such rate.

Business combination and noncontrolling interests

The Group accounts for business combinations using the purchase method of accounting in accordance with ASC 805, Business Combinations. ASC 805 requires the Group to recognize separately from goodwill the assets acquired, the liabilities assumed and the noncontrolling interest at their acquisition date fair values. Goodwill as of the acquisition date is measured as the excess of consideration transferred and the net of the acquisition date fair values of the assets acquired and the liabilities assumed. In cases where the Group acquires less than 100% ownership interest, the Group will derive the fair value of the acquired business as a whole, which will typically include a control premium and subtract the consideration transferred by the Group for the controlling interest to identify the fair value of the noncontrolling interest. In addition, the share purchase agreements entered into may contain contingent consideration provisions obligating the Group to pay additional purchase consideration, upon the acquired business’s achievement of certain agreed upon operating performance-based milestones. Under ASC 805, these contingent consideration arrangements are required to be recognized and measured at fair value at the acquisition date as either a liability or as an equity instrument, with liability instruments being required to be remeasured at each reporting period through the Company’s statements of comprehensive income (loss) until such time as to when the contingency is resolved. Where the fair value of the net assets acquired exceeds the consideration paid, a gain as a result of the bargain purchase will be recognized through the consolidated statements of comprehensive loss at the close of the transaction.

The Group derives estimates of the fair value of assets acquired and liabilities assumed using reasonable assumptions based on historical experiences and on the information obtained from management of the acquired companies. Critical estimates in valuing certain of the intangible assets and pre-existing agreements included but were not limited to the following: deriving estimates of future expected cash flows from the acquired business, the determination of an appropriate discount rate, deriving assumptions regarding the period of time that the related benefits would continue and the initial measurement and recognition of any contingent consideration arrangements and the evaluation of whether contingent consideration arrangement is in substance compensation for future services. Unanticipated events may occur which may affect the accuracy or validity of such assumptions or estimates.

In a business combination achieved in stages, the Group re-measures the previously held equity interest in the acquiree immediately before obtaining control at its acquisition date fair value and the re-measurement gain or loss, if any, is recognized in the consolidated income statements.

For the Company’s non-wholly owned subsidiaries, a noncontrolling interest is recognized to reflect portion of equity that is not attributable, directly or indirectly, to the Company. When the noncontrolling interest is contingently redeemable upon the occurrence of a conditional event, which is not solely within the control of the Company, the noncontrolling interest is classified as mezzanine equity. The Company accretes changes in the redemption value over the period from the date that it becomes probable that the mezzanine equity will become redeemable to the earliest redemption date using the effective interest method. When the noncontrolling interest is mandatory redeemable on a fixed or determinable date, the noncontrolling interest is classified as liabilities.

If a transaction does not meet the definition of a business, the transaction is recorded as an asset acquisition. Accordingly, the identifiable assets acquired and liabilities assumed are measured at the fair value of the consideration paid, based on their relative fair values at the acquisition date. Acquisition-related costs are included in the consideration paid and capitalized. Any contingent consideration payable that is dependent on the purchaser’s future activity is not included in the consideration paid until the activity requiring the payment is performed. Any resulting future amounts payable are recognized in profit or loss when incurred. No goodwill and no deferred tax asset or liability arising from the assets acquired and liabilities assumed are recognized upon the acquisition of assets.

Cash and cash equivalents

Cash and cash equivalents consist of cash on hand and demand deposits placed with banks which are unrestricted as to withdrawal and use and have original maturities less than three months. All highly liquid investments with a stated maturity of 90 days or less from the date of purchase are classified as cash equivalents.

Restricted cash

Restricted cash represents cash deposits pledged as security for the Group’s daily operation, such as performance of contracts, and proceeds from specialized bank borrowings for hospital construction and commercial acceptance bill. Such restricted cash is not available to fund the general liquidity needs of the Group. And the restriction will lapse when the of obligation of contracts has been performed or the bank borrowings has been used for construction of hospital.

Long-term investments

The Group’s long-term investments consist of equity investments without readily determinable fair value, equity method investments and available-for-sale debt securities.

The Group adopted ASC 321, Investments-Equity Securities, (“ASC 321”) on January 1, 2018 and the cumulative effect of adopting the new standard on opening accumulated deficit was not material. Pursuant to ASC 321, equity investments, except for those accounted for under the equity method and those that result in consolidation of the investee and certain other investments, are measured at fair value, and any changes in fair value are recognized in earnings. For equity securities without readily determinable fair value and do not qualify for the existing practical expedient in ASC Topic 820, Fair Value Measurements and Disclosures, (“ASC 820”), the Group elected to use the measurement alternative to measure those investments at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions for identical or similar investments of the same issuer, if any. The Group makes a qualitative assessment of whether the investment is impaired at each reporting date. If a qualitative assessment indicates that the investment is impaired, the Group estimates the investment’s fair value in accordance with the principles of ASC 820. The Group recognizes an impairment loss in net income equal to the difference between the carrying value and fair value if the investment’s fair value is less than carrying value.

Investments in equity investees represent investments in entities in which the Group can exercise significant influence but does not own a majority equity interest or control are accounted for using the equity method of accounting in accordance with ASC Subtopic 323-10, Investments-Equity Method and Joint Ventures: Overall, (“ASC 323-10”). The Group applies the equity method of accounting that is consistent with ASC 323-10 in limited partnerships in which the Group holds a three percent or greater interest. Under the equity method, the Group initially records its investment at cost and prospectively recognizes its proportionate share of each equity investee’s net profit or loss into its consolidated statements of operations. The Group evaluates its equity method investments for impairment under ASC 323-10. An impairment loss on the equity method investments is recognized in the consolidated statements of operations when the decline in value is determined to be other-than-temporary.

Debt securities that the Group has the intent to hold the security for a long period or may sell the security in response to the changes in economic conditions are classified as available-for-sale. The Company reported it at fair value which was estimated using the net asset value in accordance with ASC 820-10-15-4 and the unrealized gains or losses from the changes in fair values are included in accumulated other comprehensive income. Upon sale, realized gains and losses are reported in net income.

Goodwill

Goodwill represents the excess of the purchase price over the amounts assigned to the fair value of the assets acquired and the liabilities assumed of an acquired business. In accordance with ASC Topic 350, Goodwill and Other Intangible Assets, (“ASC 350”), recorded goodwill amounts are not amortized, but rather are tested for impairment annually or more frequently if there are indicators of impairment present.

In accordance with ASC 350, the Group assigned and assessed goodwill for impairment at the reporting unit level. A reporting unit is an operating segment or one level below the operating segment. After the disposal of the CHS in 2020, the Group divided its business into two reporting units, including network business and hospital business as of December 31, 2020 and 2021. Goodwill resulted from the acquisitions of subsidiaries during the years ended December 31, 2020 was assigned to hospital business reporting unit. And the goodwill resulted from the acquisitions of subsidiaries during the years ended December 31, 2021 was assigned to network business reporting unit. As of December 31, 2022 and 2023, there are still two reporting units after the disposal of the GFHM, which was divided into hospital business before disposal(Note 4).

The Group early adopted ASU No. 2017-04, Simplifying the Test for Goodwill Impairment, (“ASU 2017-04”). Under the new guidance, the Group has the option to either assess qualitative factors first to determine whether it is necessary to perform the two-step test, or the Group has an unconditional option to bypass the qualitative assessment for any reporting unit in any period and proceed directly to performing the quantitative goodwill impairment test by calculating the fair value of the reporting unit and comparing that value with its carrying amount, in accordance with ASC 350-20. If the Group believes, as a result of the qualitative assessment, that it is more-likely-than-not that the fair value of the reporting unit is less than carrying amount, the two-step quantitative impairment test described above is required. Otherwise, no further testing is required. If a reporting unit’s carrying amount exceeds its fair value, an entity will record an impairment charge based on that difference. The impairment charge will be limited to the amount of goodwill allocated to that reporting unit.

For the year ended December 31, 2022 and 2023, the Company elected to bypass the qualitative assessment and proceed directly to performing the quantitative goodwill impairment testing. The Company considered the future discounted cash flows expected to be generated by the hospital business and network business respectively to determine the fair value of each reporting unit. In determine the fair value of each reporting unit, the Company estimated significant assumptions including revenue growth rate, operating margin, capital expenditure, terminal growth rate and discount rate. The assumptions may be significantly affected by unexpected changes in future economic and market conditions, as well as regulatory requirements. The Company did not record any impairment loss for the years ended December 31, 2022 and 2023 as the fair value of the reporting unit is in excess of its carrying value.

Accounts receivable and credit losses for doubtful accounts

Accounts receivable are recognized and carried at the original carrying amount less allowance for credit losses. The Group maintains an allowance for credit losses for accounts receivable and other receivables included in prepayments and other current assets, which is recorded as an offset to accounts receivable and other receivables included in prepayments and other current assets, and the estimated credit losses charged to the allowance is classified as “General and administrative expenses” in the consolidated statements of comprehensive loss. When similar risk characteristics exist, the Group assesses collectability and measure expected credit losses on a collective basis for a pool of assets, whereas if similar risk characteristics do not exist, the Group assesses collectability and measures expected credit losses on an individual asset basis. The provision for expected credit losses is estimated based on the types of receivables and relevant customers, management’s experience with collection trends and the current and expected economic and business conditions. The Group evaluates the provision for expected credit losses on a regular basis and adjusts the provision based on changes in the customers’ circumstances and other available information. In determining the amount of the allowance for credit losses, the Group considers historic collection experience, the age of the accounts receivable and other receivables included in prepayments and other current assets, credit quality of the Group’s customers or creditors, current economic conditions, reasonable and supportable forecasts of future economic conditions, and other factors that may affect the customer’s ability to pay. The significant assumptions used includes the disaggregation criteria and the estimated loss rates related to account receivables, and the credit rating of debtors’ probability of default and loss rates given default related to other receivables.

The receivable balances are written off when they are deemed uncollectible. The Group generally does not require collateral from its customers.

Inventories

Inventories, consisting of medicine, medical supplies and low-value consumables, are accounted for using the individual pricing method, and are valued at the lower of cost or market.

Loan receivables

Loan receivables represented the loans to related parties and third parties, which were measured at amortized cost and reported in the consolidated balance sheets at outstanding principle. Loan receivables with collection period within one year are classified as prepayments and other current assets in the consolidated balance sheets. Cash paid for loan originations and cash received from loan repayments are classified as operating activities in the consolidated statements of cash flows.

Leases

Lessee Accounting

The Group leases office space, and land use rights. The Group’s offices leases generally have lease terms between 1 to 20 years. The Group’s lease agreements include fixed and variable lease payments and do not contain material residual value guarantees. The Group’s leases do not contain restrictions or covenants that restrict the Group from incurring other financial obligation. The Group also makes upfront payments to acquire the leased land from the owners, with lease periods of 50 years (“land use right”). There is no ongoing payment under the terms of these land use rights.

The Group determines if an arrangement is a lease at inception and classifies leases as operating or finance leases in accordance with the recognition criteria in ASC 842-20-25-2. The Group classifies a lease as a finance lease if the lease meets any one of the following criteria:

a. The lease transfers ownership of the underlying asset to the lessee by the end of the lease term.

b. The lease grants the lessee an option to purchase the underlying asset that the lessee is reasonably certain to exercise.

c. The lease term is for a major part of the remaining economic life of the underlying asset.

d. The present value of the sum of the lease payments and any residual value guaranteed by the lessee that is not already included in the lease payments equals or exceeds substantially all of the fair value of the underlying asset.

e. The underlying asset is of such a specialized nature that it is expected to have no alternative use to the lessor at the end of the lease term.

The Group classifies a lease as an operating lease when it does not meet any one of these criteria.

For operating leases, the Group recognizes a right-of-use (“ROU”) asset and a lease liability based on the present value of the lease payments over the lease term on the consolidated balance sheets at commencement date. Lease expense is recorded on a straight-line basis over the lease term. As the Group’s leases do not provide an implicit rate, the Group estimates its incremental borrowing rate based on the information available at the commencement date in determining the present value of lease payments. In estimating its incremental borrowing rate, the Group considers its credit rating, nature of underlying asset, and publicly available data of borrowing rates for loans of similar amount, currency and term as the lease.

When the Group enters into sale-leaseback transactions as lessee, it first assesses whether the effectively transferred the underlying asset using the guidance in ASC 606. If the Group transfers the control of the leased asset to the buyer-lessor, the Group accounts for the sale of the underlying asset in accordance with ASC606. The subsequent leaseback of the asset is accounted for in accordance with ASC842 in the same manner as any other lease. If the seller-lessee does not transfer the control of the leased asset to the buyer-lessor, it is a failed sales-leaseback transaction and subsequently accounted for as a financing arrangement.

Lessor Accounting

The Group provides sales-type, direct financing and operating leases of various medical equipment primarily to hospitals in the PRC for periods ranging from 5 to 20 years. The Group classifies a lease as a sales-type lease in accordance with the recognition criteria in ASC 842-20-25 if the lease meets any one of the criteria mentioned above when determining a finance lease. For sales-type leases, the Group derecognizes the underlying asset and recognizes the net investment in the lease which is the sum of the lease receivable when collectability is probable at lease commencement. All initial direct costs are expensed at commencement date. The Group subsequently recognize interest income over the lease term using the effective interest method. Many of the Group’s leases contain variable lease payments based on the revenue or profit generated from the hospitals’ use of the underlying assets, the specific amounts of which are agreed monthly with the hospitals and settled based on the Group’s payment terms. In such circumstances, the Group recognizes a selling loss at commencement for the difference between the net investment in the lease and the carrying amount of the underlying asset. The Group does not include variable lease payments in the net investment in the lease and such payments are recognized as income in profit or loss in the period when the facts and circumstances on which the variable lease payments are based occur.

When none of the criteria in ASC 842-20-25-2 are met, the Group classifies a lease as either a direct financing lease or an operating lease. The Group classifies as a direct financing lease if (i) the present value of the sum of lease payments and any residual value guarantee equals or exceeds substantially all the fair value of the underlying asset; and (ii) it is probable at inception that it will collect the lease payments plus any amount necessary to satisfy a residual value guarantee. If both of the criteria above are not met, the lease is classified as an operating lease.

A general description of the Group’s lease income for each type of lease arrangement was as follows:

i.Sales-type lease income

The Group provides diagnostic imaging and/or radiation oncology system (“medical equipment”) to hospitals in the PRC through lease arrangements ranging from 5 to 20 years. In certain circumstances, the Group also provides full-time qualified system technician responsible for certain management services related to the radiotherapy or diagnostic services being performed by the hospital centers’ doctors to their patients. The Group receives a portion of the hospital’s revenue or profits from delivering the diagnostic imaging and / or radiation oncology services to patients, based on the revenue-sharing or profit-sharing formula predetermined in the contracts.

The Group evaluates such arrangements at inception to determine whether they contain a lease and the lease classification under ASC 842. Most of such arrangements are classified as sales-type leases since these agreements often include an option to the hospitals to purchase the underlying asset which the hospitals are reasonably certain to exercise. Variable lease payments are fully constrained at inception of the contract. Variable fees are included in the arrangement transaction price when significant reversal is not expected to occur, which is the time when the hospital calculates the profit sharing under the arrangement and agreed upon by both parties, typically at month end.

The Group’s arrangements may contain lease and non-lease components. Non-lease components primarily include payments for maintenance, update and consultation services related to the medical equipment. The Group allocates the lease and non-lease components of the contract consideration on a relative standalone selling price basis.

ii.Operating lease income

The Group elected the package of practical expedients which allowed the Group not to separate lease and non-lease components for diagnostic imaging and /or radiation oncology systems assets and recognizes profit sharing revenue under ASC 842. If there is a non-lease component whose pattern and timing is not the same the Group allocates the consideration on a relative standalone selling price basis.

iii.Direct financing lease income

The Group purchases hospital equipment from third party equipment manufacturers which is installed at various hospitals throughout the PRC. The hospitals utilize the hospital equipment radiotherapy or diagnostic services being performed by the hospital centers’ doctors to their patients. These lease arrangements include either title transfer upon maturity of the lease term or bargain purchase option held by the hospital. The Group receives fixed monthly rental payments from the hospital, which on a discounted basis does not give rise to any dealer profit. The Group records revenue attributable to direct financing leases so as to produce a constant rate of return on the balance of the net investment in the lease.

Property, plant and equipment, net

Property, plant and equipment are stated at cost and are depreciated using the straight-line method over the estimated useful lives of the assets, as follows:


		Estimated
		residual
Category	Estimated useful life	value
Buildings	20‑50 years	—
Medical equipment*	5‑20 years	—
Electronic and office equipment	3‑5 years	—
Motor vehicles	5 years	—
Leasehold improvement and building improvement	shorter of lease term or 5 years	—

* The cost of the asset is amortized over the estimated useful life. However, if ownership is transferred at the end of the lease term, the cost of the asset is amortized over the shorter of customer contract or the useful life of the asset which ranges from 5 to 20 years.

Repair and maintenance costs are charged to expense as incurred, whereas the cost of renewals and betterments that extends the useful lives of property, plant and equipment is capitalized as additions to the related assets. Retirements, sales and disposals of assets are recorded by removing the cost and accumulated depreciation from the asset and accumulated depreciation accounts with any resulting gain or loss reflected in the consolidated statements of comprehensive loss.

Costs incurred in constructing new facilities, including progress payment, interest and other costs relating to the construction are capitalized and transferred to fixed assets upon completion. During the years ended December 31, 2021, 2022 and 2023 total interest costs incurred amounted to RMB139,873, RMB180,847 and RMB223,936 (US$31,541), respectively, in which interest costs capitalized amounted to RMB66,084, RMB60,490 and RMB58,267 (US$8,207), respectively.

Intangible assets, net

Intangible assets are carried at cost less accumulated amortization and any recorded impairment. Intangible assets acquired in a business combination were recognized initially at fair value at the date of acquisition. The operating license relates to the medical business qualification and permission for medical equipment operation. The favorable leases relate to favorable lease terms as lessee based on market conditions that exist on the date of acquisition and are amortized over the remaining term of the leases. The customer relationship assets relate to the ability to sell existing and future services to existing customers and have been estimated using the income method. Operating leases relate to favorable operating lease terms based on market conditions that exist on the date of acquisition and are amortized over the remaining term of the leases. The technology relates to AI technology. The estimated useful life for the intangible assets is as follows:


		Estimated
		useful life
Operating license		20 years
Favorable leases		12-17 years
Customer relationship		5‑16 years
Operating leases		9‑16 years
Software		3‑5 years
Technology		10 years

Impairment of long-lived assets

The Group evaluates its long-lived assets or asset group including acquired intangibles with finite lives for impairment whenever events or changes in circumstances (such as a significant adverse change to market conditions that will impact the future use of the assets) indicate that the carrying amount of a group of long-lived assets may not be fully recoverable. When these events occur, the Group evaluates the impairment by comparing the carrying amount of the assets to future undiscounted cash flows expected to result from the use of the assets and their eventual disposition. If the sum of the expected undiscounted cash flows is less than the carrying amount of the assets, the Group recognizes an impairment loss based on the excess of the carrying amount of the asset group over its fair value, generally based upon discounted cash flows or market prices, management utilizes significant assumptions including revenue growth rate operating margin, capital expenditure and discount rate. These assumptions might be affected by expectations about future market and economic conditions, as well as regulatory requirements.

Impairment loss on long-lived assets of nil, nil and nil was recognized for the years ended December 31, 2021, 2022 and 2023, respectively.

Derivative liability

The Group evaluates its borrowings to determine if the contract or embedded component of the contract qualifies as derivatives to be separately accounted for in accordance with ASC 815, “Derivatives and Hedging”. The result of this accounting treatment is that the fair value of the embedded derivative, if required to be bifurcated, is marked-to-market at each balance sheet date and recorded as a liability. The change in fair value is recorded as fair value change from derivative in the financial statements (note 21).

Treasury stock

The Company has share repurchase programs where the shares are acquired and subject to cancellation. When a corporation’s stock is repurchased for constructive retirement with or without an intention to retire the stock formally in accordance with applicable laws, an excess of par or stated value over the cost of treasury shares shall be credited to additional paid-in capital.

Fair value of financial instruments

Financial instruments include cash and cash equivalents, restricted cash, accounts receivable, certain other current assets, net investment in direct financing leases, certain long-term investments, certain other non-current assets, short-term and long-term bank and other borrowings, accounts payables, certain other current liabilities, dividend payable, derivative liability and certain other long-term liabilities. The carrying amounts of the Group’s cash and cash equivalents, accounts receivable, certain other current assets and accounts payable approximate fair value because of their short maturities. The available for sale debt securities are recorded at fair value that measured using net asset value per share as a practical expedient shall not be categorized within the fair value hierarchy in accordance with ASC 820-10-35-54B. The derivative liability is recorded at fair value in accordance with ASC 815. The carrying amounts of the Group’s short-term and long-term bank and other borrowing and secured borrowings mostly bear interest at floating rates and therefore approximate the fair value of these obligations. For those bank borrowings with fixed interest rates, management uses the discounted cash flow technique based on market interest rate for similar instruments at the balance sheet date and concludes that the carrying value approximates the fair value.

Revenue recognition

The Group recognizes revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the Group expects to receive in exchange for those goods or services using the five steps defined under ASC Topic 606. The Group performs the following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price, including variable consideration, if any; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. The Group only applies the five-step model to contracts when it is probable that the Group will collect the consideration to which it is entitled in exchange for the goods or services it transfers to the customer.

Once a contract is determined to be within the scope of ASC 606 at contract inception, the Group reviews the contract to determine which performance obligations it must deliver and which of these performance obligations are distinct. The Group recognizes revenue based on the amount of the transaction price that is allocated to each performance obligation when that performance obligation is satisfied or as it is satisfied.

The Group is a principal and records revenue on a gross basis when the Group is primarily responsible for fulfilling the service, has discretion in establish pricing and controls the promised service before transferring that service to customers. Otherwise, the Group records revenue at the net amounts as commissions.

The Group recognizes revenues net of value added taxes (“VAT”). If revenue recognition is deferred to a later period, the related VAT are also deferred and will be recognized only upon recognition of the deferred revenue.

ASC 606 revenue

i.Management and Technical Support

The Group provides stand-alone management and technical support services to certain hospitals which already possess radiotherapy and diagnostic equipment. Management support services typically include the provision of diagnosis and treatment techniques, expert support, advertising and promotion as well as comprehensive operational management services. Technical support services mainly include maintenance and upgrade of the radiotherapy and diagnostic equipment. Combining the Group’s management and technical support services, planned cloud system solutions provides a more comprehensive set of services, from pre-purchasing consultation to equipment installation and maintenance. The fees for management and technical support are calculated based on a predetermined percentage of monthly revenue generated by the hospital unit or in limited instances on a fixed monthly fee. Variable fees are fully constrained at contract inception due to the uncertainty of the hospital units’ monthly revenue. Variable fees are included in the transaction price when a significant reversal of revenue recognized is not expected to occur, typically upon receipt of the monthly revenue statement from hospitals. Fixed monthly fees are recognized ratably over the service term.

ii.Medical solution

Medical solution represented sales of different sets of medical equipment like CT machines, DR machines and respirators to procurement agent of the hospitals in PRC, and the sales of consumables such as surgical supplies to certain hospitals in PRC. For most of the medical solution contracts, the Group is primarily responsible for fulfilling the promise to provide the specified medical equipment with the inventory risk before the equipment has been transferred, and the Group also has the discretion in establishing the price. As a result, the Group acts as a principal under these contracts and management recognizes revenue on a gross basis. While under some of the medical solution contracts, the Group acts primarily as a reseller and does not have pricing authority or have title to the inventory prior to delivery to the hospital. The Group is an agent and generally records revenue related to consumables sales on a net basis when the consumables are delivered to the customer and the sales price is determinable.

iii.Medical service

Hospital revenue consists of medicine income and medical service income. Medical service income include revenue generated from outpatients, which mainly consist of activities for physical examinations, treatments, surgeries and tests, as well as that generated from inpatients, which mainly consist of activities for clinical examinations and treatments, surgeries, and other fees such as room charges and nursing care. The Group is a principal as it is primarily responsible for providing medical services to the income, controls the promised services before transferring to patients, and has pricing discretion. The Group generally records revenue generated from medical service on a gross basis.

In limited instances, the patient services are provided by visiting consultants, who are doctors/medical experts without labor contracts with the Group and not considered as the Group’s employees. As the visiting consultants have the discretion to take their patients to other hospital for the required treatment and set their own consultation fee charged to patients, the Group is an agent in such arrangement. The Group collects fees on behalf of the visiting consultants and records revenue at the net amounts as commissions.

iv.Medicine income

Medicine income includes medicine prescribed to patients during or after treatment by the doctors in the Group’s hospital business. The Group is a principal as it is primarily responsible for providing medicine to the patients and has pricing discretion. The Group generally records medicine income on a gross basis.

Cost of revenue

A.Network costs

Network costs mainly consist of the amortization of acquired intangibles, depreciation of medical equipment purchased, installed and operated in the network of centers and other costs, including salaries and material costs of medical supplies.

(1) Costs of lease and management service arrangements

Cost of medical equipment that is leased under an operating lease is included in property, plant and equipment in the balance sheet. The medical equipment is depreciated using the Group’s depreciation policies. The cost of the management service component is recognized as an expense as incurred.

(2) Cost of sales-type lease

Cost of sales-type lease as a lessor is recorded as the carrying value of the underlying asset at lease commencement.

(3) Cost of management and technical support

Cost of management and technical support mainly include labor costs, and, where applicable, medical consumables and maintenance expenses which are expensed as incurred.

(4) Cost of medical solution

Cost of medical solution, recorded either gross or net against the related revenue, includes the cost of the medical equipment and consumables purchased, and other direct costs involved in the consumables sales.

B.Hospital costs

Hospital costs mainly include medicine costs, medical consumables, labor costs of doctors, nurses and other staff involved in the care or treatment of patients, depreciation, hospital buildings rental fee, utilities as well as other related costs incurred in the normal business of a hospital.

Income taxes

The Group follows the liability method of accounting for income taxes. Under this method, deferred tax assets and liabilities are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates that will be in effect in the period in which the differences are expected to reverse. The Group records a valuation allowance to offset deferred tax assets if based on the weight of available evidence, it is more-likely-than-not that some portion, or all, of the deferred tax assets will not be realized. The effect on deferred taxes of a change in tax rate is recognized in tax expense in the period that includes the enactment date of the change in tax rate.

The Group adopted ASC 740, Income Taxes (“ASC 740”), which clarifies the accounting and disclosure for uncertainty in income taxes. Interests and penalties arising from underpayment of income taxes shall be computed in accordance with the applicable tax laws. The amount of interest expense is computed by applying the applicable statutory rate of interest to the difference between the tax position recognized and the amount previously taken or expected to be taken in a tax return. Interests and penalties recognized in accordance with ASC 740 is classified in the financial statements as a component of income tax expense. The adoption of this accounting standard resulted in an adjustment to beginning accumulated deficit for deferred tax liability and beginning accumulated deficit. This deferred tax liability is entirely offset and therefore resulted in a change to beginning accumulated deficit. The cumulative effect of changes made to the Group’s consolidated balance sheet as of January 1, 2018 for the adoption of ASU 2016 16 was RMB5,632.

In accordance with the provisions of ASC 740, the Group recognizes in its financial statements the impact of a tax position if a tax return position or future tax position is “more likely than not” to prevail based on the facts and technical merits of the position. Tax positions that meet the “more likely than not” recognition threshold is measured at the largest amount of tax benefit that has a greater than fifty percent likelihood of being realized upon settlement. The Group’s estimated liability for unrecognized tax positions which are included in the “accrued expenses and other liabilities” account and “accrued unrecognized tax benefits and surcharges, non-current portion” accounts are periodically assessed for adequacy and may be affected by changing interpretations of laws, rulings by tax authorities, changes and/or developments with respect to tax audits, and expiration of the statute of limitations. The outcome for a particular audit cannot be determined with certainty prior to the conclusion of the audit and, in some cases, appeal or litigation process. The actual benefits ultimately realized may differ from the Group’s estimates. As each audit is concluded, adjustments, if any, are recorded in the Group’s financial statements. Additionally, in future periods, changes in facts, circumstances, and new information may require the Group to adjust the recognition and measurement estimates with regard to individual tax positions. Changes in recognition and measurement estimates are recognized in the period in which the changes occur.

Share-based compensation

Share-based awards and restricted shares granted to employees are accounted for under ASC 718, Compensation-Stock Compensation (“ASC 718”).

In accordance with ASC 718, the Company determines whether a share option should be classified and accounted for as a liability award or equity award. All grants of share-based awards to employees classified as equity awards are recognized in the financial statements based on their grant date fair values which are calculated using an option pricing model. The Group has elected to recognize compensation expense using the straight-line method for all share options granted with graded vesting based on service conditions. To the extent the required vesting conditions are not met resulting in the forfeiture of the share-based awards, previously recognized compensation expense relating to those awards are reversed. Forfeitures were accounted as they occur. Share-based compensation expense is recorded net of estimated forfeitures such that expense is recorded only for those share-based awards that are expected to vest.

The Group adopted ASU 2018-07 on January 1, 2019 using the modified retrospective method and measures equity awards using their fair value on grant date. The impact of adopting the new standard was insignificant.

Loss per share

The Company computes earnings per Class A and Class B ordinary shares in accordance with ASC Topic 260, Earnings Per Share (“ASC 260”), using the two-class method. Under the provisions of ASC 260, basic earnings per share is computed using the weighted average number of ordinary shares outstanding during the period except that it does not include unvested ordinary shares subject to repurchase or cancellation. The Company adjusts for the accretion of the redeemable noncontrolling interests in the calculation of income available to ordinary shareholders of the Company used in the earnings per share calculation.

Loss per share is computed in accordance with ASC 260, Earnings Per Share (“ASC 260”). Basic loss per ordinary share for continuing operations is computed by dividing loss for continuing operations attributable to holders of ordinary shares by the weighted average number of ordinary shares outstanding during the period. Basic loss per ordinary share for discontinuing operations is computed by dividing loss for discontinuing operations attributable to holders of ordinary shares by the weighted average number of ordinary shares outstanding during the period. Diluted loss per share for continuing operations is calculated by dividing net loss for continuing operations attributable to ordinary shareholders as adjusted for the effect of dilutive ordinary equivalent shares, if any, by the weighted average number of ordinary and dilutive ordinary equivalent shares outstanding during the period. Ordinary equivalent shares consist of the ordinary shares issuable upon the conversion of the share-based awards, using the treasury stock method and the ordinary shares issuable upon the conversion of convertible debt instruments, using if-converted method. Ordinary share equivalents are excluded from the computation of diluted per share if their effects would be anti-dilutive.

The liquidation and dividend rights of the holders of the Company’s Class A and Class B ordinary shares are identical, except with respect to voting rights. As a result, and in accordance with ASC 260, the undistributed earnings for each year are allocated based on the contractual participation rights of the Class A and Class B ordinary shares as if the earnings for the year had been distributed. As the liquidation and dividend rights are identical, the undistributed earnings are allocated on a proportionate basis.

For the purposes of calculating the Company’s basic and diluted earnings per Class A and Class B ordinary shares, the ordinary shares relating to the options that were exercised are assumed to have been outstanding from the date of exercise of such options.

Comprehensive loss

Comprehensive loss is defined to include all changes in equity except those resulting from investments by owners and distributions to owners. Among other disclosures, ASC 220, Comprehensive Income (“ASC 220”), requires that all items that are required to be recognized under current accounting standards as components of comprehensive loss be reported in a financial statement that is displayed with the same prominence as other financial statements. During the periods presented, the Group’s comprehensive loss includes net loss and foreign currency translation adjustments and is presented in the consolidated statements of comprehensive loss.

Segment reporting

In accordance with ASC 280, Segment Reporting (“ASC 280”), the Group’s chief operating decision maker (“CODM”) has been identified as the Chief Executive Officer, who is also the executive chairman of the board of directors. The Group’s CODM evaluates segment performance based on revenues and profit by the network and hospital segments. After the disposal of CHS on November 19, 2020, the Group’s hospital reporting segment is only consisted of hospitals located in the PRC. Substantially all of the Group’s revenue and long-lived assets (mainly include property, plant and equipment) are derived from the PRC.

Recently adopted accounting pronouncements

In October 2021, the FASB issued ASU 2021-08, Topic 805 “Business Combinations” – Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. The amendments in this update require that an entity (acquirer) recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Topic 606. At the acquisition date, an acquirer should account for the related revenue contracts in accordance with Topic 606 as if it had originated the contracts. To achieve this, an acquirer may assess how the acquiree applied Topic 606 to determine what to record for the acquired revenue contracts. The Group adopted this standard on January 1, 2023 with no material impact on its condensed consolidated financial statements and related disclosures as a result of adopting the standard.

Recent accounting pronouncement pending adoption

In November 2023, the FASB issued ASU 2023-07, Improvements to Reportable Segment Disclosures (Topic 280). This ASU updates reportable segment disclosure requirements by requiring disclosures of significant reportable segment expenses that are regularly provided to the Chief Operating Decision Maker (“CODM”) and included within each reported measure of a segment’s profit or loss. This ASU also requires disclosure of the title and position of the individual identified as the CODM and an explanation of how the CODM uses the reported measures of a segment’s profit or loss in assessing segment performance and deciding how to allocate resources. The ASU is effective for annual periods beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Adoption of the ASU should be applied retrospectively to all prior periods presented in the financial statements. Early adoption is also permitted. This ASU will likely result in us including the additional required disclosures when adopted. The Group are currently evaluating the potential effect that the updated standard will have on our financial statement disclosures.

In December 2023, the FASB issued ASU 2023-09 “Income Taxes (Topics 740): Improvements to Income Tax Disclosures” to expand the disclosure requirements for income taxes, specifically related to the rate reconciliation and income taxes paid. The ASU is effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Group are currently evaluating the potential effect that the updated standard will have on our financial statement disclosures.

LEASE - Schedule of Estimated Annual Amortization Expenses (Details) - Dec. 31, 2023 ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
LEASE
2024	¥ 9,627	$ 1,356
2025	9,627	1,356
2026	9,627	1,356
2027	9,627	1,356
2028	¥ 9,627	$ 1,356

DEPOSITS FOR NON-CURRENT ASSETS (Tables)

12 Months Ended

Dec. 31, 2023

DEPOSITS FOR NON-CURRENT ASSETS

Schedule of deposits for non-current assets


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Deposits for purchases of property, plant and equipment*	8,932	4,646	654
	8,932	4,646	654

* The amount represented interest-free non-refundable partial payments to suppliers of medical equipment and to construction engineering group for construction of hospitals. The remaining contractual obligations associated with these purchase contracts that the suppliers need to undertake are approximately RMB220,972 and RMB271,876 (US$38,293)as at December 31, 2022 and 2023 respectively, which are included in the amount disclosed as purchase commitments in note 27. The Group recognized impairment loss on deposits for non-current assets of nil, nil and nil for the years ended December 31, 2021, 2022 and 2023, respectively. The amount of written off for the gross amount of deposits and the allowance is nil and nil for the years ended December 31, 2022 and 2023, respectively.

PREPAYMENTS AND OTHER CURRENT ASSETS

12 Months Ended

Dec. 31, 2023

PREPAYMENTS AND OTHER CURRENT ASSETS

PREPAYMENTS AND OTHER CURRENT ASSETS

7.PREPAYMENTS AND OTHER CURRENT ASSETS

Prepayments and other current assets consist of the following:


		As at December 31,
	Notes	2022	2023	2023
		RMB	RMB	US$
Due from suppliers	i)	31,660	66,893	9,422
Loan receivables	ii)	294,130	312,036	43,949
Advances to employees		2,601	2,213	312
Dividend receivable		1,643	-	-
Deductible value-added tax		44,268	43,355	6,106
Tax refund		234	241	34
Due from hospital		1,138	1,087	153
Deferred expenses		200	317	45
Others		26,767	46,407	6,536
		402,641	472,549	66,557

Allowance for credit losses		(17,290)	(59,603)	(8,395)

		385,351	412,946	58,162

The Group records allowance for doubtful debts in “general and administrative expenses” in the consolidated statements of comprehensive loss.

Amounts due from suppliers represented prepayments made for orders and returnable deposits of cancelled orders. The risk of loss arising from non-performance by or bankruptcy of suppliers is assessed prior to the order of the equipment. The Group has provided reserve for bad debt amounting to nil and nil on the amounts due from suppliers as at December 31, 2022 and 2023, respectively.

ii)

Loan receivables represented the loans to other parties, including loans to related parties such as the Guangdong Proton International Hospital Management Co., Ltd., and Beijing Allcure Medical Information Technology Co., Ltd. (“Allcure Information”) of total amount of RMB178,453 and RMB185,466 (US$26,122) as at December 31, 2022 and 2023, and third parties of RMB115,677 and RMB126,570 (US$17,827) as at December 31, 2022 and 2023, respectively. For the loans to related parties, the Group recorded allowance for doubtful debts amounting to RMB9,017 and RMB33,985 (US$4,787) as at December 31, 2022 and 2023, respectively. Besides the credit losses provided to the balances to related parties, the Group recorded allowance for credit losses amounting to RMB3,011 and RMB20,496 (US$2,887) as of December 31, 2022 and 2023, respectively to balances to third parties.

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION - Condensed balance sheets (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2020 CNY (¥)
Current assets:
Cash and cash equivalent	¥ 58,139	$ 8,189	¥ 158,283
Prepayments and other current assets	412,946	58,162	385,351
Total current assets	617,208	86,933	759,800
Total assets	6,053,943	852,680	6,004,934
Current liabilities:
Long-term, current portion	722,563	101,771	343,982
Accrued expenses and other liabilities	731,793	103,070	419,881
Derivative liability	163	23	5,290
Other payables	171,127	24,103	142,305
Total current liabilities	1,951,394	274,847	1,121,236
Non-current liabilities:
Long-term bank and other borrowings, non-current portion	1,994,014	280,851	2,471,427
Total liabilities	4,306,956	606,621	3,989,277
Shareholders' equity (deficit):
Treasury stock (12,101,847 and 12,101,847 shares as of December 31, 2022 and 2023, respectively)	(7)	(1)	(7)
Additional paid-in capital	2,007,965	282,816	1,930,633
Accumulated other comprehensive loss	(65,419)	(9,214)	(27,766)
Accumulated deficit	(4,064,589)	(572,485)	(3,766,931)
Total Concord Medical Services Holdings Limited shareholders' deficit	(2,121,945)	(298,869)	(1,863,966)
Total liabilities and equity	6,053,943	852,680	6,004,934
Common Class A
Shareholders' equity (deficit):
Ordinary shares	68	10	68
Common Class B
Shareholders' equity (deficit):
Ordinary shares	37	5	37
Related Party [Member]
Current assets:
Amounts due to subsidiaries	151,481	21,335	169,453
Current liabilities:
Other payables	9,671	1,362	13,105
Non-current liabilities:
Long-term bank and other borrowings, non-current portion	69,182	9,744	122,579
Subsidiaries [Member]
Current assets:
Amounts due to subsidiaries	185,466	26,122	178,453
Parent Company
Current assets:
Cash and cash equivalent	17,466	2,460	1,510	$ 213	¥ 15,058	¥ 2,079
Prepayments and other current assets	24,999	3,521	24,271
Total current assets	42,465	5,981	25,781
Total assets	42,465	5,981	25,781
Current liabilities:
Short term loan	41,179	5,800	32,417
Long-term, current portion	110,574	15,574	111,028
Accrued expenses and other liabilities	20,483	2,885	11,649
Derivative liability	163	23	5,290
Total current liabilities	2,164,410	304,850	1,889,747
Non-current liabilities:
Total liabilities	2,164,410	304,850	1,889,747
Shareholders' equity (deficit):
Treasury stock (12,101,847 and 12,101,847 shares as of December 31, 2022 and 2023, respectively)	(7)	(1)	(7)
Additional paid-in capital	2,007,965	282,816	1,930,633
Accumulated other comprehensive loss	(65,419)	(9,214)	(27,766)
Accumulated deficit	(4,064,589)	(572,485)	(3,766,931)
Total Concord Medical Services Holdings Limited shareholders' deficit	(2,121,945)	(298,869)	(1,863,966)
Total liabilities and equity	42,465	5,981	25,781
Parent Company \| Common Class A
Shareholders' equity (deficit):
Ordinary shares	68	10	68
Parent Company \| Common Class B
Shareholders' equity (deficit):
Ordinary shares	37	5	37
Parent Company \| Subsidiaries [Member]
Current liabilities:
Other payables	¥ 1,992,011	$ 280,568	¥ 1,729,363

TAXATION - Components of deferred taxes (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
Deferred tax asset
Net operating loss	¥ 425,390	$ 59,915	¥ 357,483
Foreign exchange loss	2,755	388	1,330
Depreciation and amortization	17,647	2,485	22,535
Property, plant and equipment impairment	2,340	330	6,997
Deposits for non-current assets	17,725	2,496	18,475
Allowance for net investment in financing lease	0	0	5,137
Allowance for doubtful accounts	29,299	4,127	14,746
Lease liabilities	59,875	8,433	58,901
Other long-term assets	94,791	13,351	104,912
Equity investment	7,005	987	7,553
Others	11,770	1,658	13,728
Total deferred tax assets	668,597	94,170	611,797
less: Valuation allowance	(623,044)	(87,754)	(565,022)
Net deferred tax assets	45,553	6,416	46,775
Deferred tax liabilities
Equity investment	(1,091)	(154)	(1,170)
Property, plant and equipment	(2,368)	(334)	(1,682)
Disposal of Beijing Century Friendship	(3,126)	(440)	(3,126)
Intangible assets	(71,825)	(10,116)	(81,336)
Right-of-use assets	(45,626)	(6,426)	(46,873)
Capitalized interest	(18,993)	(2,675)	(19,179)
Others	(2,062)	(291)	(5,986)
Total deferred tax liabilities	(145,091)	(20,436)	(159,352)
Deferred tax assets, net	0	0	0
Deferred tax liabilities, net	¥ (99,538)	$ (14,020)	¥ (112,577)

LOSS PER SHARE

12 Months Ended

Dec. 31, 2023

LOSS PER SHARE

LOSS PER SHARE

29.LOSS PER SHARE

A reconciliation of net loss attributable to the Company in the consolidated statements of comprehensive loss to the numerator for the computation of basic and diluted loss per share for the years ended December 31, 2021, 2022 and 2023 is as follows:


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$

Net loss attributable to Concord Medical Services Holdings Limited	(271,427)	(489,661)	(297,658)	(41,927)
Accretion of contingently redeemable noncontrolling interests	(549,194)	—	—	—
Numerator for EPS computation	(820,621)	(489,661)	(297,658)	(41,927)


	For the Years Ended December 31
	2021		2022		2023		2023
	Class A	Class B	Class A	Class B	Class A	Class A	Class B	Class B
	RMB	RMB	RMB	RMB	RMB	USD	RMB	USD
Numerator
Net loss attributable to ordinary shareholders used in calculating loss per ordinary share – basic and diluted	(533,909)	(286,712)	(318,582)	(171,079)	(193,661)	(27,279)	(103,997)	(14,648)
Denominator:
Weighted average number of ordinary shares outstanding used in calculating loss per share – basic and diluted	85,265,910	45,787,948	85,265,910	45,787,948	85,265,910	85,265,910	45,787,948	45,787,948
Loss per share – basic and diluted	(6.26)	(6.26)	(3.74)	(3.74)	(2.27)	(0.32)	(2.27)	(0.32)

The effects of share options and restricted shares have been excluded from the computation of diluted loss per share for the years ended December 31, 2021, 2022 and 2023 as their effects would be anti-dilutive.

CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (DEFICIT) ¥ in Thousands, $ in Thousands	Ordinary shares CNY (¥) shares	Ordinary shares USD ($) shares	Treasury stock CNY (¥)	Treasury stock USD ($)	Additional paid-in capital CNY (¥)	Additional paid-in capital USD ($)	Accumulated other comprehensive loss CNY (¥)	Accumulated other comprehensive loss USD ($)	Accumulated deficit CNY (¥)	Accumulated deficit USD ($)	Noncontrolling interests CNY (¥)	Noncontrolling interests USD ($)	Contingently redeemable noncontrolling Interest CNY (¥)	CNY (¥)	USD ($)
Balance at Dec. 31, 2020	¥ 105		¥ (8)		¥ 1,840,026		¥ (46,429)		¥ (2,456,649)		¥ 150,110		¥ 2,913,675	¥ (512,845)
Balance, shares at Dec. 31, 2020 \| shares	130,251,685	130,251,685
Net loss									(271,427)		(251,245)			(522,672)
Other comprehensive income			1				16,933							16,934
Accretion of contingently redeemable noncontrolling interests									(549,194)		182,087		367,107	(367,107)
Share-based compensation					14,680									14,680
Contribution from noncontrolling interest											1,500			1,500
Contribution from contingently redeemable noncontrolling interests													400,000
Acquisition of additional shares of non-wholly owned subsidiaries					81,846						355,184			437,030
Redemption of 15% equity of Global Medical Imaging (Hong Kong) Limited held by GE Healthcare Pte. Ltd. to reduce minority shareholders' equity											(4,581)			(4,581)
Balance at Dec. 31, 2021	¥ 105		(7)		1,936,552		(29,496)		(3,277,270)		433,055		3,680,782	(937,061)
Balance, shares at Dec. 31, 2021 \| shares	130,251,685	130,251,685
Net loss									(489,661)		(279,329)			(768,990)
Other comprehensive income							1,730							1,730
Accretion of contingently redeemable noncontrolling interests											3,680,782		¥ (3,680,782)	3,680,782
Share-based compensation					(5,919)									(5,919)
Investment in equity instrument(Note 14)											45,115			45,115
Balance at Dec. 31, 2022	¥ 105		(7)		1,930,633		(27,766)		(3,766,931)		3,879,623			2,015,657
Balance, shares at Dec. 31, 2022 \| shares	130,251,685	130,251,685
Net loss									(297,658)		(233,363)			(531,021)	$ (74,795)
Other comprehensive income							(37,653)							(37,653)
Disposal partial interest of a subsidiary					(18,110)						18,110
Capital injection from a noncontrolling interests					95,442						204,562			300,004
Balance at Dec. 31, 2023	¥ 105	$ 15	¥ (7)	$ (1)	¥ 2,007,965	$ 282,816	¥ (65,419)	$ (9,214)	¥ (4,064,589)	$ (572,485)	¥ 3,868,932	$ 544,928		¥ 1,746,987	$ 246,059
Balance, shares at Dec. 31, 2023 \| shares	130,251,685	130,251,685

INVENTORIES (Tables)

12 Months Ended

Dec. 31, 2023

INVENTORIES

Schedule of inventories


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Medicine	9,896	4,036	568
Medical material	72,971	36,037	5,076
Low-value consumables	2,575	849	120
	85,442	40,922	5,764

Less: inventory provision	(607)	(575)	(81)

	84,835	40,347	5,683

LONG-TERM INVESTMENTS

12 Months Ended

Dec. 31, 2023

LONG-TERM INVESTMENTS

LONG-TERM INVESTMENTS

14.LONG-TERM INVESTMENTS

Long-term investments held by the Group consisted of the following:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Equity investments without readily determinable fair value	51,524	51,624	7,271
Equity method investments	336,254	324,163	45,657
Available-for-sale debt securities	50,096	18,924	2,665
Less: Impairment loss	—	—	—
Total	437,874	394,711	55,593

Equity investments without readily determinable fair value:


		Equity interest owned by the
		Group
		As at December 31,
	Note	2022			2023
		RMB			RMB
Allcure Information	i)	22,160	9.6	%	22,160	9.6	%
Concord Healthcare Singapore Pte. Ltd.	ii)	22,925	8.73	%	22,925	8.73	%
Legion Healthcare Partners LLC	iii)	6,439	5.83	%	6,439	5.83	%
Beijing He Xu elderly Care Service Co., Ltd.	iv)	—	—	%	100	4.00	%
Total		51,524			51,624

20% equity interest of Allcure Information was obtained in 2015. During year ended December 31, 2018, Allcure Information issued new shares to other investors and diluted the share ownership of the Group to 9.6%. As of December 31, 2022 and 2023, the share ownership of the Group remained 9.6%. As of December 31, 2022 and 2023, no impairment was recorded for the investment.

ii)

The balance represented 10.0% interests in CHS after the disposal of 90.0% interests by the Group in 2020, which has been diluted to 8.73% due to a new capital injection from another shareholder as of December 31, 2022. As of December 31, 2022 and 2023, no impairment was recorded for the investment. In December 2023, the Group entered into a shares transfer agreement with a third party to sell all the shares it held in CHS with the consideration of RMB26,909 (US$3,790), and the disposal transaction was completed on January 5, 2024.

iii)

In March, 2021, the Group obtained the 5.83% equity interest of Legion Healthcare Partners LLC through purchase. As of December 31, 2022 and 2023, the share ownership of the Group remained 5.83%. As of December 31, 2022 and 2023, no impairment was recorded for the investment.

iv)

In August, 2023, the Group obtained the 4.0% equity interest of Beijing He Xu elderly Care Service Co., Ltd. through equity purchase. As of December 31, 2023, the share ownership of the Group remained 4.0% and no impairment was recorded for the investment.

The Group did not record any unrealized gains (upward adjustments) and losses (downward adjustments and impairment) for equity investments without readily determinable fair values for the years presented.

Equity method investments:


		Equity interest owned by the
		Group
		as at December 31,
	Notes	2022			2023
		RMB			RMB
Xi’an JiangyuanAndike Ltd. (“JYADK”)		10,496	29.70	%	14,925	29.70	%
Suzhou Shengshan Huiying Venture Capital Investment LLP. (“Suzhou Shengshan”)	i)	12,939	5.15	%	9,413	5.15	%
Zhejiang Marine Leasing Ltd.	ii)	179,231	20.00	%	189,676	20.00	%
Guangdong Hengjian Proton Medical Industry Co., Ltd. (“Guangdong Hengjian”)	iii)	86,315	14.20	%	86,185	14.20	%
Shanghai Xinhe Enterprise Management Center (Limited Partnership) (“Shanghai Xinhe”)	iv)	45,005	99.99	%	22,448	72.73	%
Shanghai Changshengshu Management Co. Ltd. (“Shanghai Changshengshu”)	v)	1,968	20.00	%	1,216	20.00	%
Guangzhou Yicheng Biological Immune Technology Co. Ltd. (“Guangzhou Yicheng”)	vi)	300	30.00	%	300	30.00	%
Total		336,254			324,163

In 2017, the Group entered into a partnership agreement to subscribe for 8.13% interest in Suzhou Shengshan, a partnership engaged in equity and capital investment, with a subscription amount of RMB10,000. In 2018, 2019 and 2020, with the subscribed capital injection from new investors, the equity interest that the Group shared in Suzhou Shengshan was diluted to 5.41%, 5.15% and 5.15% respectively as of December 31, 2018, 2019 and 2020. As of December 31, 2022 and 2023, the percentage the Group held remained unchanged. According to the partnership agreement, the Group acts as a limited partner and has significant influence over Suzhou Shengshan’s daily operation due to it’s agreed that all issue of operation and management shall be subject to the unanimous consent of all partners. In 2023, the Group received cash distribution from Suzhou Shengshan in the amount of RMB4,022 (US$566).

ii)

On February 28, 2019, China Medical Service Holdings Ltd. (HK), a subsidiary of the Group, entered into a shares purchase agreement with Merge Limited to purchase 20% equity interests of Zhejiang Marine. As the Group held 20% equity share and had the ability to exercise significant influence over the Zhejiang Marine, the Group applied the equity method of accounting to the investment. The registration change was completed on June 10, 2020 and Zhejiang Marine became an associate company of the Group since then. In September 2023, the Group received dividends from Zhejiang Marine in the amount of RMB8,000 (US$1,127). As of December 31, 2022 and 2023, the percentage the Group held remained unchanged. The total book value of the Group’s long-term investments pledged to secure other borrowings as of December 31, 2021, 2022 and 2023 was RMB167,044, RMB179,231 and RMB189,676 (US$26,715) (note 18), respectively.

iii)

In December 2020, Aohua Technology, a subsidiary of the Group, entered into a capital increase agreement with Guangdong Hengjian and the original shareholders of Guangdong Hengjian to obtain shares of Guangdong Hengjian. The registration change was completed on January 13, 2021, and as of December 31, 2022 and 2023, RMB86,649 has been paid, which takes 14.20% shares. The Group has significant influence over Guangdong Hengjian due to the Group was entitled to delegate 2 out of 5 directors in the board and participated in policy-making processes of Guangdong Hengjian.

iv)

In March 2022, Shanghai Medstar, a subsidiary of the Group, established Shanghai Xinhe with Shanghai Xinfu Enterprise Management Center (Limited Partnership), and acted as a limited partner. The Group obtained 99.99% shares of Shanghai Xinhe in the consideration of 2.05% shares in Concord Healthcare, the carrying value of which was RMB45,115. The Group cannot consolidate Shanghai Xinhe as neither Shanghai Xinhe is a VIE nor the Group owns a majority kick-out right in Shanghai Xinhe. The Group has significant influence over Shanghai Xinhe derived from 99.99% ownership in the partnership as a limited partner from the initial recognition. In 2023, Shanghai Medstar entered into a share transfer agreement with Shanghai Linen International Trading Co. Ltd. (“Shanghai Linen”), in which Shanghai Medstar hereby transferred partial of Shanghai Medstar’s shares and related rights, interests and obligations in Shanghai Xinhe to Shanghai Linen with the consideration of RMB60,000 (US$8,451). The consideration has been received as of December 31, 2023. After this transfer, Shanghai Medstar holds 72.73% shares of Shanghai Xinhe.

In October 2022, SH MZJH, a subsidiary of the Group, entered into a capital increase agreement with Shanghai Changshengshu to purchase 20% equity interests of Shanghai Changshengshu with the consideration amount of RMB2,000. The Group has significant influence over Shanghai Changshengshu due to the voting power from shareholder to the policy-making processes of Shanghai Changshengshu. As of December 31, 2022 and 2023, the percentage the Group held remained unchanged.

vi)

In December 2022, GCMTIC, a subsidiary of the Group, entered into a capital purchase agreement with Guangzhou Yicheng to purchase 30% equity interests of Guangzhou Yicheng with the consideration amount of RMB300. The Group has significant influence over Guangzhou Yicheng due to the Group was entitled to delegate 1 out of 3 directors in the board and participated in policy-making processes of Guangzhou Yicheng. As of December 31, 2022 and 2023, the percentage the Group held remained unchanged.

Available-for-sale debt securities:


	As at December 31, 2023
		Redemption	Redemption Notice
	Fair value	Frequency	Period
	RMB
Private equity funds	18,924	Annually	5-9 days
	18,924

Available-for-sale debt securities represent an investment in a private equity fund made in the year ended December 31, 2020. In May 2022, the Company redeemed RMB11,949 investment in the private equity fund. The private equity fund was controlled by a third-party fund management company. The fund was founded on June 27, 2016. The private equity fund invested into debt securities of a third-party company. The investment cannot be redeemed during the fund closed period. The Open Day was the annual date of the foundation date of the fund.

This investment is carried at fair values which was estimated using the net asset value, and the unrealized gains or losses from the changes in fair values are included in accumulated other comprehensive loss.

RESTRICTED NET ASSETS (Details) - 12 months ended Dec. 31, 2023 ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
RESTRICTED NET ASSETS
Percentage of after-tax profit to general reserve	10.00%
Amount of net assets restricted	¥ 4,015,583	$ 565,583
Foreign tax authority
RESTRICTED NET ASSETS
Percentage of after-tax profit to general reserve	10.00%
Percentage of general reserve registered capital	50.00%
Domestic tax authority
RESTRICTED NET ASSETS
Percentage of after-tax profit to general reserve	10.00%
Percentage of general reserve registered capital	50.00%

Other long-term liabilities

12 Months Ended

Dec. 31, 2023

Other long-term liabilities

Other long-term liabilities

22.Other long-term liabilities


		As at December 31,
	Notes	2022	2023	2023
		RMB	RMB	US$
Accrued unrecognized tax benefits & surcharge	i)	60,299	44,470	6,263
Lease deposit received from hospital		2,000	2,000	282
Convertible Note	ii)	20,000	20,000	2,818
Others		1,785	2,533	357
		84,084	69,003	9,719

ii)

Convertible Note

In December 2021, Healthingkon, a subsidiary of the Company, issued RMB20.0 million convertible note (“2021 Convertible Note”) to a single investor. Healthingkon received proceeds of RMB20.0 million on December 7, 2021 with no issuance costs. The Convertible Note bear interest of 4.75% per annum and have terms of 5 years upon the receipt of the principal. As of December 31, 2022 and 2023, 2021 Convertible Note has not been paid or converted into ordinary shares of Healthingkon.

Conversion Features and Rates

The 2021 Convertible Note can be converted, at the holder’s option, into ordinary shares of Healthingkon. The holder has the option to choose when to convert: 1) If the holder choose to convert in the first 3 years upon the receipt of the principal, the 2021 Convertible Note could be converted into 2.5% ordinary shares of Healthingkon; or 2) If the holder choose to convert in the fourth or fifth year upon the receipt of the principal, the 2021 Convertible Note could be converted into the percentage of ordinary shares equal to RMB20,000 divided by the sum of 20,000 and 80% of the fair value of Healthingkon in the latest round of financing at that time.

Contingent Redemption Feature

The outstanding principal and any accrued but unpaid interest at 4.75% will become due and payable in full upon the occurrence of any of events of default.

Accounting for the 2021 Convertible Note

The 2021 Convertible Note was recorded as liability in accordance with ASC 470.

The Group evaluated the embedded conversion feature and determined that it does not qualify for derivative accounting as the underlying ordinary shares which the 2021 Convertible Note could be converted into were not publicly traded nor could they be readily convertible into cash in accordance with ASC 815-15 and ASC 815-40. Therefore, the conversion feature is not required to be bifurcated. In addition, no beneficial conversion feature (“BCF”) was recorded at the issuance date of the 2021 Convertible Note since it is a contingent BCF which should be measured at the commitment date.

The Group further evaluated the embedded Contingent Redemption Feature in accordance with ASC 815 and concluded that it is not required to be bifurcated because it is considered to be clearly and closely related to the debt host, as the Note was not issued at a substantial discount and are redeemable at par. There were no other embedded derivatives that are required to be bifurcated.

DEPOSITS FOR NON-CURRENT ASSETS - Additional Information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2021 CNY (¥)
DEPOSITS FOR NON-CURRENT ASSETS
Total non-current assets		¥ 5,245,134	¥ 5,436,735	$ 765,747
Capital addition purchase commitments
DEPOSITS FOR NON-CURRENT ASSETS
Commitments to purchase certain medical equipment		220,972	271,876	$ 38,293
Impairment loss on deposit assets		0	0		¥ 0
Write off for gross amount of deposits and allowance	$ 0	0
Total non-current assets		0	0
Principal amount		¥ 0	¥ 0

- Definition

Sum of the carrying amounts as of the balance sheet date of all assets that are expected to be realized in cash, sold or consumed after one year or beyond the normal operating cycle, if longer.

+ References

+ Details

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Schedule of estimated useful life for the intangible assets (Details)	Dec. 31, 2023
Operating license
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	20 years
Favorable leases \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	12 years
Favorable leases \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	17 years
Customer relationship \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	5 years
Customer relationship \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	16 years
Operating leases \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	9 years
Operating leases \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	16 years
Software \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	3 years
Software \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	5 years
Technology
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Amortization period	10 years

COMMITMENTS AND CONTINGENCIES (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
COMMITMENTS AND CONTINGENCIES
Unrecognized tax positions	¥ 44,470	$ 6,263
Capital addition purchase commitments
COMMITMENTS AND CONTINGENCIES
Commitments to purchase certain medical equipment	¥ 271,876	$ 38,293	¥ 220,972

INVENTORIES (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
INVENTORIES
Inventory, gross	¥ 40,922	$ 5,764	¥ 85,442
Less: inventory provision	(575)	(81)	(607)
Total inventories	40,347	5,683	84,835
Medicine
INVENTORIES
Inventory, gross	4,036	568	9,896
Medical material
INVENTORIES
Inventory, gross	36,037	5,076	72,971
Low-value consumables
INVENTORIES
Inventory, gross	¥ 849	$ 120	¥ 2,575

INTANGIBLE ASSETS, NET

12 Months Ended

Dec. 31, 2023

INTANGIBLE ASSETS, NET

INTANGIBLE ASSETS, NET

12.INTANGIBLE ASSETS, NET

Intangible assets consist of the following:


	Customer	Operating	Operating	Favorable
	relationship	lease	license	lease
	intangibles	intangibles	intangibles	intangibles	Technology	Others	Total
	RMB	RMB	RMB	RMB	RMB	RMB	RMB
Intangible assets, net at January 1, 2022	—	—	490,296	16,256	118,971	32,314	657,837
Addition of software	—	—	—	—	—	3,334	3,334
Decrease from cooperation termination with a cooperative hospital	—	—	(272,910)				(272,910)
Foreign Exchange Gain	—	—	—	—	—	—	—
Amortization expenses	—	—	(12,672)	(1,564)	(13,139)	(7,120)	(34,495)
Intangible Asset impairment	—	—	—	—	—	—	—
Intangible assets, net at December 31, 2022	—	—	204,714	14,692	105,832	28,528	353,766

Addition of software	—	—	—	—	—	6,226	6,296
Amortization expenses	—	—	(12,672)	(1,564)	(13,219)	(9,250)	(36,705)
Intangible assets, net at December 31, 2023	—	—	192,042	13,128	92,613	25,504	323,287
Intangible assets, net at December 31, 2023, in US$	—	—	27,049	1,849	13,044	3,592	45,534


At December 31, 2023
Intangible assets, cost	32,449	418	253,440	21,010	132,190	53,555	493,062
Less: accumulated amortization	(31,486)	(418)	(61,398)	(7,882)	(39,577)	(28,051)	(168,812)
Less: intangible asset impairment	(963)	—	—	—	—	—	(963)
Intangible assets, net at December 31, 2023	—	—	192,042	13,128	92,613	25,504	323,287

Amortization expenses for intangibles were RMB30,171, RMB34,495 and RMB36,705 (US$5,170) for the years ended December 31, 2021, 2022 and 2023, respectively. Impairment loss on intangible assets was nil, nil and nil for the years ended December 31, 2021, 2022 and 2023, respectively.

The estimated annual amortization expenses for the above intangible assets for each of the five succeeding years are as follows:


	Amortization
	RMB	US$
2024	40,759	5,741
2025	35,767	5,038
2026	34,064	4,798
2027	29,142	4,105
2028	183,555	25,852

BANK AND OTHER BORROWINGS - Additional information (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
Derivative liability
Lease receivables	¥ 1,759	$ 248	¥ 340
Long-term investments pledged to secure other borrowings	¥ 189,676	$ 26,715	¥ 179,231	¥ 167,044
Short-term bank borrowings, weighted average interest rate	8.19%	8.19%	6.60%
Bank loans	¥ 151,753	$ 21,374	¥ 156,555
Other borrowings	2,884,449	406,266	2,827,455
Long term debt
Derivative liability
Property and equipment pledged as collateral	391,056	55,079	412,683
Land
Derivative liability
Property and equipment pledged as collateral	386,614	54,453	395,973
Construction in Progress
Derivative liability
Property and equipment pledged as collateral	2,027,277	285,536	1,754,217
Long-term investments pledged to secure other borrowings	189,676	26,715	179,231
Asset pledged as collateral without right \| Accounts receivable
Derivative liability
Other assets	¥ 13,312	$ 1,875	¥ 11,166
Long-term bank and other borrowings
Derivative liability
Long-term bank and other borrowings, weighted average interest rate	7.42%	7.42%	6.48%
Short term bank credit lines
Derivative liability
Unutilized bank credit lines	¥ 0
Long-term bank credits lines
Derivative liability
Unutilized bank credit lines	¥ 930,000	$ 130,988

SHARE-BASED AWARDS (Schedule of Assumptions Used) (Details)	Feb. 18, 2014
SHARE-BASED AWARDS
Risk-free interest rate	2.33%
Dividend yield	5.00%
Exercise multiple	2.50%
Expected volatility range	39.03%

ORGANIZATION AND BASIS OF PRESENTATION

12 Months Ended

Dec. 31, 2023

ORGANIZATION AND BASIS OF PRESENTATION

ORGANIZATION AND BASIS OF PRESENTATION

1.ORGANIZATION AND BASIS OF PRESENTATION

The accompanying consolidated financial statements include the financial statements of Concord Medical Services Holdings Limited (the “Company”) and its subsidiaries, which are collectively referred to as the “Group”. The Company was incorporated under the laws of the Cayman Islands on November 27, 2007.

The Group is principally engaged in the leasing of radiotherapy and diagnostic imaging equipment, provision of management services to hospitals, medicine sales and provision of premium cancer and proton treatment services.

(a)Details of the Company’s principal subsidiaries as of December 31, 2023 are as follows:


			Percentage of
	Date of	Place of	ownership by
Entities	establishment/acquisition	establishment	the Company		Principal activities
Subsidiaries
Ascendium Group Limited (“Ascendium”)	September 10, 2007	British Virgin Islands (“BVI”)	100	%	Investment holding
China Medical Services Holdings Limited (“CMS Holdings”)	July 18, 2008	Hong Kong	100	%	Investment holding
Shenzhen Aohua Medical Technology Development Co., Ltd. (“Aohua Technology ”) **	February 21, 2008	PRC	42.09	%	Leasing of medical equipment and provision of management services
Shanghai Medstar Financial Leasing Company Limited (“Shanghai Medstar”)	March 21, 2003	PRC	98.19	%	Leasing of medical equipment and provision of management services
Concord Healthcare Group Co., Ltd. (“Concord Healthcare”) (formerly known as Meizhong Jiahe Medical Technology Development Group Co., Ltd.) *	July 23, 2008	PRC	42.09	%	Provision of management services
Beijing Yundu Internet Technology Co., Ltd. (“Yundu”) **	July 26, 2007	PRC	42.09	%	Provision of management services
Tianjin Concord Medical Technology Limited (“Tianjin Concord Medical”)	April 22, 2010	PRC	98.19	%	Leasing of medical equipment and provision of management services
Guangzhou Concord Cancer Center Co., Ltd. (“Guangzhou Concord Cancer Hospital”) **	June 29, 2011	PRC	33.67	%	Medical treatment and service business
CCM (Hong Kong) Medical Investments Limited (“CCM (HK)”)	June 03, 2013	Hong Kong	85.71	%	Investment holding
Shanghai Concord Cancer Center Co., Ltd. (“SHC”) **	March 17, 2014	PRC	44.10	%	Medical treatment and service business
Datong Meizhong Jiahe Cancer Center (“DTMZ”) **	October 23, 2014	PRC	42.09	%	Medical treatment and service business
Wuxi Concord Medical Development Ltd. (“Wuxi Concord”)	December 29, 2015	PRC	100	%	Provision of management services


			Percentage of
	Date of	Place of	ownership by
Entities	establishment/acquisition	establishment	the Company		Principal activities
Beijing Concord Medical Technology Ltd.(“BJCMT”)	January 4, 2016	PRC	100	%	Provision of management services
Beijing Century Friendship Science & Technology Development Co., Ltd. (“Beijing Century Friendship”)**	October 8, 2018	PRC	98.19	%	Provision of management services and investment holding
Beijing Proton Medical Center Co., Ltd. (“BPMC”)	October 8, 2018	PRC	54.01	%	Medical treatment and service business
Shanghai Meizhong Jiahe Cancer Center Co., Ltd. (“CMCC”)**	October 8, 2018	PRC	39.94	%	Medical treatment and service business
Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. (“SH MZJH”) **	November 18,2019	PRC	18.70	%	Medical treatment and service business
Wuxi Meizhong Jiahe Cancer Center Co., Ltd. (“Wuxi MZJH”)	November 18,2019	PRC	98.45	%	Medical treatment and service business
Yinchuan Meizhong Jiahe Internet Hospital Ltd. (“YCIH”) **	October 18, 2020	PRC	42.09	%	Medical treatment and service business
US Proton Therapy Holdings Limited (“Proton BVI”)	May 16, 2011	BVI	100	%	Investment holding
US Proton Therapy Holdings Limited (“US Proton”)	June 29, 2011	United States of America	100	%	Investment holding
Guangzhou Concord Hospital Management Co., Ltd. (“GCHM”) (formerly known as Guangzhou New Spring Hospital Management Ltd.) (note 4) **	April 21, 2020	China	29.46	%	Investment holding
Guangzhou Concord Medical Cancer Ltd. (“GCMC”) (formerly known as Guangzhou New Spring Medical Cancer Ltd) (note 4) **	April 21, 2020	China	29.46	%	Medical treatment and service business
Beijing Healthingkon Technology Co., Ltd. (“Healthingkon”) (note 4) **	January 4, 2021	China	11.09	%	Leasing of medical equipment and technical service
Guangzhou Concord Medical Technology Innovation Center Co., Ltd. (“GCMTIC”) **	April 22, 2021	China	42.09	%	Technical service

* On March 26, 2018, July 10, 2018 and on April 7, 2020, the Group entered into agreements with CICC Capital Management Company Limited (“CICC Capital”), a wholly-owned subsidiary of China International Capital Corporation Limited (“CICC”), together with six other investors (“Other Investors”) and CITIC Industrial Investment Group Limited (“CITIC Industrial”). Pursuant to the agreements, CICC Capital, Other Investors and CITIC Industrial make a strategic investment and subscribe new issued 60,000,000, 40,000,000 and 38,888,888 shares of the Group’s subsidiary Concord Healthcare, with total consideration of RMB1,500,000 and RMB700,000.

In April 2021, the Group entered into an investment agreement with five legal entities and one natural individual (“2021 Investors”). Pursuant to which, these investors subscribed new issued 18,805,826 shares of the Group’s subsidiary Concord Healthcare with total consideration of RMB400,000.

Pursuant to these agreements, CCIC Capital, Other Investors, CITIC Industrial and 2021 Investors can request the Group to redeem their interests in Concord Healthcare upon the occurrence of certain events (i.e. failure to complete a qualified IPO by June 30, 2024). The same right is also given to the existing noncontrolling interest shareholder. Given these events are not solely within the control of Concord Healthcare, the noncontrolling interests of CCIC Capital, Other Investors, CITIC Industrial and 2021 Investors are contingently redeemable noncontrolling interests and are classified as mezzanine equity. The noncontrolling interests of other existing noncontrolling interests’ holders are also reclassified from permanent equity to mezzanine equity as contingently redeemable noncontrolling interests. Upon submission of Concord Healthcare’s prospectus to Hong Kong Stock Exchange (“qualified IPO”) on May 30, 2022, the rights of the Investors to request the Company to repurchase the interests held by the Investors no longer exists, according to the agreement signed on May 19, 2022 among shareholders of Concord Healthcare. The existing carrying amount of the equity instrument should be reclassified to permanent equity at the date of the event that caused the reclassification. Therefore, contingently redeemable noncontrolling interests was nil as of December 31, 2022 and 2023.

In March 2022, the Group, established Shanghai Xinhe Enterprise Management Center (Limited Partnership) (“Shanghai Xinhe”) with Shanghai Xinfu Enterprise Management Center (Limited Partnership), and acted as a limited partner. The Group obtained 99.99% shares of Shanghai Xinhe in the consideration of 2.05% shares in Concord Healthcare.

After the completion of all transactions mentioned above, the Group’s equity shares in Concord Healthcare had been diluted from 49.44% to 46.56% as of December 31, 2021 and 43.90% as of December 31, 2022 respectively. In June 2023, the Group and several of its subsidiaries signed a Capital Increase and Share Purchase Agreement with CSPC NBP Pharmaceutical Co., Limited (“NBP”). Pursuant to the agreement, NBP purchased 4.17% shares of Concord Healthcare with the consideration of RMB300,000 (US$42,254). After the transaction, the shares of Concord Healthcare held by the Group was diluted from 43.90% to 42.09% as of December 31, 2023.

On December 1, 2020, the Group obtained declaration from one of the noncontrolling shareholder of Concord Healthcare, pursuant to which the noncontrolling shareholder delegates its 2.36% voting rights in the general meeting of shareholders of Concord Healthcare to the Group irrevocably during the period it owns the share interest in Concord Healthcare, which was diluted to 2.12% after the transaction mentioned above in April 2021 and June 2023. In April 2021, April 2022 and June 2023, the Group successively obtained declaration from another four of the noncontrolling shareholders of Concord Healthcare, pursuant to which the noncontrolling shareholder delegates its totally 5.28% and voting rights, respectively, in the general meeting of shareholders of Concord Healthcare to the Group irrevocably during the period it owns the share interest in Concord Healthcare, after the transaction mentioned above in June 2023. The Group remained control of Concord Healthcare since it is entitled to 50.23% and 50.08% of the voting right of Concord Healthcare as of December 31, 2022 and 2023.

** Aohua Technology, Yundu, Guangzhou Concord Cancer Hospital, SHC, DTMZ, Beijing Century Friendship, CMCC, SH MZJH, YCIH, GCHM, GCMTIC, GCMC and Healthingkon are subsidiaries of Concord Healthcare.

The Group accounts for the changes in accretion to the redemption value in accordance with ASC Topic 480, Distinguishing Liabilities from Equity. The Group elects to use the effective interest method to account for the changes of redemption value over the period from the date of issuance to the earliest redemption date of the noncontrolling interest.

(b)

Establishment of Onshore Fund and Offshore Fund

Establishment of onshore fund

In January 2016, the Group and Zhongrong Guofu Investment Management Company Limited (“ZR Guofu”) established an onshore fund, namely Guofu Huimei (Tianjin) Investment Management Partnership Firm (LP) (“Guofu Huimei”). The registered capital of Guofu Huimei is RMB1,009,000, of which RMB746,001and RMB262,999 were subscribed by ZR Guofu and the Group, for 73.93% and 26.07% equity interest, respectively. General partners of the Guofu Huimei are Shanghai Medstar and ZR Guofu.

Further in April 2017, the Group and ZR Guofu entered into a supplemental contract to the framework agreement, pursuant to which, Guofu Huimei will be used as the platform to invest and provide loans to some domestic entities engaging in hospital business. During 2017, Guofu Huimei acquired 78.31% equity interest of Beijing Century Friendship which holds 55% equity interest of BPMC at consideration of RMB388,500, 54.8% equity interest of CMCC at consideration of RMB182,100, 28.77% equity interest of Tianjin Jiatai Entity Management Limited Partnership (“Tianjin Jiatai”) at consideration of RMB106,500 and established Shanghai Rongchi Medical Management Limited (“SH Rongchi”) with share capital of RMB695,305 with Tianjin Jiatai. The profit or loss of these domestic entities engaging in hospital business is shared proportionally among investors based on the percentage of their respective subscribed share capital. In addition, the Group’s share in Beijing Century Friendship, certain construction in progress and certain prepaid land lease payments are pledged to secure the capital contribution from ZR Guofu at that time.

Establishment of offshore fund

In November 2016, the Company entered into a framework agreement with ZR Guofu to establish an offshore fund Zhongrong International Growth Fund SPC-ZR Concord Healthcare Investment Fund SP (“SP”), for the purpose of acquiring several hospital businesses of the Group, including 100% shares of CHS through China Medstar, 70% shares of Guangzhou Concord Cancer Hospital through CMS Holdings and 59.51% shares of PTC-Houston Management, LP (“PTC”) through Proton (BVI), collectively the “CCM Hospital Businesses”. ZR Guofu will provide management and consultation services on the funds and the Group will continue to manage the CCM Hospital Businesses. ZR Guofu subscribes Class A shares of SP with a consideration of RMB521,396, while the Group subscribes Class B shares of the SP using 1) creditor’s rights of RMB166,299 due from CCM Hospital Business and 2) RMB7,500 cash as consideration.

Pursuant to the supplemental contract, the 75% equity interest in SP held by the ZR Guofu is contractually required to be repurchased by the Group at the end of four years from the establishment of SP in November 2016 at a consideration equivalent to the investment cost of RMB521,396. ZR Guofu is also entitled to an annual premium at 15% for its capital contribution of RMB521,396 in SP in the form of interest expense and consultation expense.

The offshore fund SP was determined as a variable interest entity as the cash injection from ZR Guofu of RMB521,396 was not equity at risk. As the Company maintains the power to direct the activities that most significantly affect SP’s economic performances through supplemental contracts agreed terms and absorbs the expected losses of SP, the Company is the primary beneficiary of SP and consolidates SP and its subsidiaries under by ASC 810-10 Consolidation: Overall.

The 75% equity interest held by the ZR Guofu in SP is accounted for as a liability recorded as “Mandatorily redeemable noncontrolling interests” in the Company’s consolidated balance sheets as a result of the mandatory redemption feature and is carried at the redemption value at the end of each reporting date as determined in accordance with the contract terms from the day of on which control is transferred to the Company. The 15% annual premium is accrued as an interest expense and consultation expense during each reporting period.

In November 2017, ZR Guofu transferred its rights to the mandatorily redeemable noncontrolling interest in SP to Tianjin Jiatai. In December 2017, CMS Holdings redeemed the mandatory redeemable noncontrolling interest from ZR Guofu of RMB97,106 to withdraw the CCM Hospital Businesses. On November 29, 2018, the PTC business had been disposed by Proton (BVI). On November 19, 2020, 90% of the interests in CHS had been disposed by China Medstar and the remaining 10% interests in CHS had been disposed subsequently in January 2024.

Repurchase of onshore fund

In June 2018, Concord Healthcare entered into agreements with Guofu Huimei to purchase its 78.31% equity interests in Beijing Century Friendship which holds 55% equity interest of BPMC and 54.8% equity interest in CMCC at a consideration of RMB388,500 and RMB182,100 respectively. Meanwhile, ZR Guofu and Guofu Huimei reached an agreement pursuant to which ZR Guofu will withdraw its original investments in Guofu Huimei, amounting to RMB746,000. Therefore, Concord Healthcare hold 100% equity interest of Beijing Century Friendship, 80% equity interest of BPMC and 90% equity interests of CMCC upon execution and closing of the agreement and the Group became the sole shareholder of Guofu Huimei. After the withdrawal in 2018, ZR Guofu is no longer part of the onshore fund Guofu Huimei and the domestic hospital businesses.

Repurchase of offshore fund

During 2019, Tianjin Jiatai made total capital injections of RMB34,540 (US$5,105) to SH MZJH, leading to an increase in Tianjin Jiatai’s holding interest from 56.77% to 78.34%.On July 22, 2019, Wuxi Concord entered into an agreement with Tianjin Jiatai, to purchase all its 90% equity interests in Wuxi MZJH at a consideration of RMB27,000. After the acquisition, Wuxi MZJH became a wholly owned subsidiary of the Group. On August 23, 2019, Wuxi Concord further injected capital of RMB82,100 to Wuxi MZJH. On November 13, 2019, Guofu Huimei entered into agreements with ZR Guofu, pursuant to which ZR Guofu would withdraw its investment of 77.18% equity interests in Tianjin Jiatai at a consideration of RMB421,730. As a result of ZR Guofu’s withdrawal, the Group became the sole shareholder of Tianjin Jiatai and its subsidiaries, SH MZJH, Heze Meizhong Jiahe Cancer Center Co., Ltd., SH Rongchi and Oriental Light Group Limited (“Oriental”), including Wuxi MZJH (collectively, the “Tianjin Jiatai Group”). The transaction is accounted for as a business acquisition of Tianjin Jiatai Group by the Group.

Immediately prior to the acquisition of Tianjin Jiatai Group on November 18, 2019, the mandatory redeemable to noncontrolling interest in SP held by Tianjin Jiatai was amounted to RMB434,216. The mandatorily redeemable noncontrolling interest, being a preexisting relationship between the parties, was settled as a result of the business combination. Upon the completion of the acquisition and the settlement of mandatorily redeemable noncontrolling interest, SP is no longer a VIE. On September 25, 2020, SP terminated all its business and completed its cancellation of business registration. On December 26, 2022, Guofu Huimei and its subsidiaries,mainly including Tianjin Jiatai, SH Rongchi, Oriental, and China Medstar, had been disposed by the Group (note 4).

OTHER NON-CURRENT ASSETS (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
OTHER NON-CURRENT ASSETS
Deposit-long-term	¥ 3,760	$ 530	¥ 6,249
Advance to hospitals-noncurrent	1,325	187	1,002
Others	6,341	892	7,842
Other non-current assets	¥ 11,426	$ 1,609	¥ 15,093

PROPERTY, PLANT AND EQUIPMENT, NET - Schedule of Property, Plant and Equipment Net (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2023 USD ($)
PROPERTY, PLANT AND EQUIPMENT, NET
Property and equipment, gross	¥ 3,940,925		¥ 3,583,503	$ 555,068
Less: accumulated depreciation	(385,042)		(308,210)	(54,232)
Impairment charges	¥ (9,010)	$ (1,269)	¥ (16,148)
Impairment, Long-Lived Asset, Held-for-Use, Statement of Income or Comprehensive Income [Extensible Enumeration]	Asset Impairment Charges	Asset Impairment Charges	Asset Impairment Charges
Property, plant and equipment after impairment	¥ 3,546,873		¥ 3,259,145	499,567
Buildings
PROPERTY, PLANT AND EQUIPMENT, NET
Property and equipment, gross	807,737		782,560	113,767
Medical equipment
PROPERTY, PLANT AND EQUIPMENT, NET
Property and equipment, gross	522,385		532,165	73,576
Electronic and office equipment
PROPERTY, PLANT AND EQUIPMENT, NET
Property and equipment, gross	58,999		58,038	8,310
Motor vehicles
PROPERTY, PLANT AND EQUIPMENT, NET
Property and equipment, gross	3,718		3,717	524
Leasehold improvement and building improvement
PROPERTY, PLANT AND EQUIPMENT, NET
Property and equipment, gross	81,766		75,032	11,517
Construction in Progress
PROPERTY, PLANT AND EQUIPMENT, NET
Property and equipment, gross	¥ 2,466,320		¥ 2,131,991	$ 347,374

TAXATION - Loss before income taxes consists (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
TAXATION
Non - PRC	¥ 20,824	$ 2,933	¥ 45,211	¥ 5,451
PRC	(576,418)	(81,189)	(885,107)	(534,688)
Loss before income tax	¥ (555,594)	$ (78,256)	¥ (839,896)	¥ (529,237)

LEASE - Additional Information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2023 USD ($)
LEASE
Lease receivables	¥ 2,175		¥ 2,175		$ 306
Lease receivables with carrying value	1,759		340		248
Derecognition of underlying assets	40,066	$ 5,643	47,409
Failed sale-leaseback transactions as seller-lessee
Sale leaseback liability current	¥ 301,681				$ 42,491
Effective interest rate	4.50%				4.50%
Interest expenses	¥ 74,024	10,426	47,049	¥ 39,876
Sale leaseback liability non current	202,178				$ 28,476
Short term lease cost	41	6
Prepaid land lease amortization expenses	397,859	56,037	407,486
Right-of-use asset amortization expenses	9,627	1,356	9,627	¥ 9,621
Secured debt, other	386,614		¥ 395,973		$ 54,453
Cost of revenue
Failed sale-leaseback transactions as seller-lessee
Short term lease cost	19,834	2,794
General and administrative expense
Failed sale-leaseback transactions as seller-lessee
Short term lease cost	¥ 21,365	$ 3,009
Minimum
Failed sale-leaseback transactions as seller-lessee
Effective interest rate	2.08%				2.08%
Maximum
Failed sale-leaseback transactions as seller-lessee
Effective interest rate	11.70%				11.70%

LEASE - Schedule of Prepaid Land Lease Payments (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
LEASE
Land use rights	¥ 464,209	$ 65,382	¥ 464,209
Less: accumulated amortization	(66,350)	(9,345)	(56,723)
Net carrying value	¥ 397,859	$ 56,037	¥ 407,486

SHAREHOLDERS' EQUITY (Details) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended	12 Months Ended
	Aug. 10, 2015	Jan. 27, 2015	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2018	Dec. 31, 2016	Dec. 31, 2015
SHAREHOLDERS' EQUITY
Consideration to repurchase shares							$ 4,542	$ 3,111
Shares repurchased							967,408	614,033
Amount of dividend paid			$ 0	$ 0	$ 0
Ordinary shares
SHAREHOLDERS' EQUITY
Shares repurchased							2,902,224	1,842,099
ADS
SHAREHOLDERS' EQUITY
Consideration to repurchase shares	$ 20,000
Shares repurchased			0	0	0
ADS \| Maximum
SHAREHOLDERS' EQUITY
Price per share	$ 7.99
Common Class A
SHAREHOLDERS' EQUITY
Conversion of stock, shares converted		45,787,948				45,787,948
Ordinary shares, shares outstanding			84,463,737	84,463,737
Common Class B
SHAREHOLDERS' EQUITY
Conversion of stock, shares issued		45,787,948
Ordinary shares, shares outstanding			45,787,948	45,787,948

INVENTORIES

12 Months Ended

Dec. 31, 2023

INVENTORIES

INVENTORIES

8.INVENTORIES


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Medicine	9,896	4,036	568
Medical material	72,971	36,037	5,076
Low-value consumables	2,575	849	120
	85,442	40,922	5,764

Less: inventory provision	(607)	(575)	(81)

	84,835	40,347	5,683

FAIR VALUE MEASUREMENTS - Additional Information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
FAIR VALUE MEASUREMENTS
Impairment charge, long-lived assets	¥ 9,010	$ 1,269	¥ 16,148
Nonrecurring
FAIR VALUE MEASUREMENTS
Impairment charge, long-lived assets	¥ 0		¥ 0
Significant unobservable inputs (Level 3) \| Measurement Input, Discount Rate \| Minimum
FAIR VALUE MEASUREMENTS
Long lived assets measurement input	15.8	15.8
Significant unobservable inputs (Level 3) \| Measurement Input, Discount Rate \| Maximum
FAIR VALUE MEASUREMENTS
Long lived assets measurement input	19.6	19.6

GOODWILL - Additional Information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2020 CNY (¥)	Dec. 31, 2019 CNY (¥)	Dec. 31, 2018 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Jan. 31, 2021 CNY (¥)	Jan. 31, 2021 USD ($)
GOODWILL
Goodwill, Acquired during period	¥ 0	$ 0		¥ 368,221	¥ 3,213	¥ 45,272	¥ 165,171
Goodwill	575,427		¥ 575,427	581,877				$ 81,047	$ 81,047	¥ 368,221	$ 57,782
Goodwill impairment charges	0	0	0	¥ 0
Decrease of goodwill from disposal	0	$ 0	6,450
GFMH, CMCC, SJYH, BPMC
GOODWILL
Goodwill	¥ 575,427		¥ 575,427					$ 81,047

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

LOSS PER SHARE - Schedule of Basic and Diluted Income Per Share (Details) ¥ / shares in Units, $ / shares in Units, ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥) ¥ / shares shares	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 CNY (¥) ¥ / shares shares	Dec. 31, 2021 CNY (¥) ¥ / shares shares
Numerator
Net loss attributable to Concord Medical Services Holdings Limited	¥ (297,658)	$ (41,927)	¥ (489,661)	¥ (271,427)
Accretion of contingently redeemable noncontrolling interests	0	0	0	(549,194)
Net loss attributable to ordinary shareholders used in calculating loss per ordinary share - basic	¥ (297,658)	$ (41,927)	¥ (489,661)	¥ (820,621)
Denominator:
Weighted average number of ordinary shares outstanding used in calculating loss per share - basic	131,053,858	131,053,858	131,053,858	131,053,858
Weighted average number of ordinary shares outstanding used in calculating loss per share - diluted	131,053,858	131,053,858	131,053,858	131,053,858
Loss per share - basic \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)
Loss per share - diluted \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)
Class A ordinary shares
Numerator
Net loss attributable to ordinary shareholders used in calculating loss per ordinary share - basic	¥ (193,661)	$ (27,279)	¥ (318,582)	¥ (533,909)
Net loss attributable to ordinary shareholders used in calculating loss per ordinary share - diluted	¥ (193,661)	$ (27,279)	¥ (318,582)	¥ (533,909)
Denominator:
Weighted average number of ordinary shares outstanding used in calculating loss per share - basic	85,265,910	85,265,910	85,265,910	85,265,910
Weighted average number of ordinary shares outstanding used in calculating loss per share - diluted	85,265,910	85,265,910	85,265,910	85,265,910
Loss per share - basic \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)
Loss per share - diluted \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)
Class B ordinary shares
Numerator
Net loss attributable to ordinary shareholders used in calculating loss per ordinary share - basic	¥ (103,997)	$ (14,648)	¥ (171,079)	¥ (286,712)
Net loss attributable to ordinary shareholders used in calculating loss per ordinary share - diluted	¥ (103,997)	$ (14,648)	¥ (171,079)	¥ (286,712)
Denominator:
Weighted average number of ordinary shares outstanding used in calculating loss per share - basic	45,787,948	45,787,948	45,787,948	45,787,948
Weighted average number of ordinary shares outstanding used in calculating loss per share - diluted	45,787,948	45,787,948	45,787,948	45,787,948
Loss per share - basic \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)
Loss per share - diluted \| (per share)	¥ (2.27)	$ (0.32)	¥ (3.74)	¥ (6.26)

OTHER NON-CURRENT ASSETS

12 Months Ended

Dec. 31, 2023

OTHER NON-CURRENT ASSETS

OTHER NON-CURRENT ASSETS

Other non-current assets consist of the following:


		As at December 31,
	Notes	2022	2023	2023
		RMB	RMB	US$
Deposit-long-term	i)	6,249	3,760	530
Advance to hospitals-noncurrent	ii)	1,002	1,325	187
Others	iii)	7,842	6,341	892
		15,093	11,426	1,609

Impairment losses of RMB2 and RMB28 (US$4) were reversed for the balances as at December 31, 2022 and 2023.

ii)

Impairment losses of RMB102 were provided for the balances as at December 31, 2022, and RMB324 (US$46) were reversed for the balances as at December 31, 2023.

iii)

Impairment losses of RMB797 and nil was provided for the balances as at December 31, 2022 and 2023.

ACCRUED EXPENSES AND OTHER LIABILITIES (Tables)

12 Months Ended

Dec. 31, 2023

ACCRUED EXPENSES AND OTHER LIABILITIES

Schedule of accrued expenses and other liabilities


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Accrued expenses*	75,010	387,040	54,513
Salaries and welfare payable	73,803	98,599	13,887
Business and other taxes payable	27,961	15,619	2,200
Contractual liabilities	100,802	59,408	8,367
Other payables	142,305	171,127	24,103
	419,881	731,793	103,070

As of December 31, 2022 and 2023, accrued expenses mainly consisted of payables for property, plant and equipment, accrued interest expense for bank and other borrowings and other accrued expenses. The addition in 2023 was mainly due to the increase in payables for hospital construction and related plants.

ORGANIZATION AND BASIS OF PRESENTATION - Schedule of subsidiaries (Details)	12 Months Ended
	Dec. 31, 2023
ORGANIZATION AND BASIS OF PRESENTATION
Entity incorporation, State or Country code	E9
Ascendium Group Limited ("Ascendium")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Sep. 10, 2007
Percentage of ownership by the Company	100.00%
Principal activities	Investment holding
China Medical Services Holdings Limited ("CMS Holdings")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jul. 18, 2008
Percentage of ownership by the Company	100.00%
Principal activities	Investment holding
Shenzhen Aohua Medical Technology Development Co., Ltd. ("Aohua Technology ")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Feb. 21, 2008
Percentage of ownership by the Company	42.09%
Principal activities	Leasing of medical equipment and provision of management services
Shanghai Medstar Financial Leasing Company Limited ("Shanghai Medstar")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Mar. 21, 2003
Percentage of ownership by the Company	98.19%
Principal activities	Leasing of medical equipment and provision of management services
Meizhong Jiahe Medical Technology Development Group Co., Ltd. ("MHM")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jul. 23, 2008
Percentage of ownership by the Company	42.09%
Principal activities	Provision of management services
Beijing Yundu Internet Technology Co., Ltd. ("Yundu")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jul. 26, 2007
Percentage of ownership by the Company	42.09%
Principal activities	Provision of management services
Tianjin Concord Medical Technology Limited ("Tianjin Concord Medical")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Apr. 22, 2010
Percentage of ownership by the Company	98.19%
Principal activities	Leasing of medical equipment and provision of management services
Guangzhou Concord Cancer Center Co., Ltd ("Guangzhou Concord Cancer Hospital")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jun. 29, 2011
Percentage of ownership by the Company	33.67%
Principal activities	Medical treatment and service business
CCM (Hong Kong) Medical Investments Limited ("CCM (HK)")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jun. 03, 2013
Percentage of ownership by the Company	85.71%
Principal activities	Investment holding
Shanghai Concord Cancer Center Co., Ltd ("SHC")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Mar. 17, 2014
Percentage of ownership by the Company	44.10%
Principal activities	Medical treatment and service business
Datong Meizhong Jiahe Cancer Center ("DTMZ")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Oct. 23, 2014
Percentage of ownership by the Company	42.09%
Principal activities	Medical treatment and service business
Wuxi Concord Medical Development Ltd. ("Wuxi Concord")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Dec. 29, 2015
Percentage of ownership by the Company	100.00%
Principal activities	Provision of management services
Beijing Concord Medical Technology Ltd.("BJCMT")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jan. 04, 2016
Percentage of ownership by the Company	100.00%
Principal activities	Provision of management services
Beijing Century Friendship Science & Technology Development Co., Ltd ("Beijing Century Friendship")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Oct. 08, 2018
Percentage of ownership by the Company	98.19%
Principal activities	Provision of management services and investment holding
Beijing Proton Medical Center Co., Ltd ("BPMC")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Oct. 08, 2018
Percentage of ownership by the Company	54.01%
Principal activities	Medical treatment and service business
Shanghai Meizhong Jiahe Cancer Center Co., Ltd. ("CMCC")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Oct. 08, 2018
Percentage of ownership by the Company	39.94%
Principal activities	Medical treatment and service business
Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. ("SH MZJH")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Nov. 18, 2019
Percentage of ownership by the Company	18.70%
Principal activities	Medical treatment and service business
Wuxi Meizhongjiahe Cancer Center ("Wuxi MZJH")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Nov. 18, 2019
Percentage of ownership by the Company	98.45%
Principal activities	Medical treatment and service business
Yinchuan Meizhong Jiahe Internet Hospital Ltd. ("YCIH")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Oct. 18, 2020
Percentage of ownership by the Company	42.09%
Principal activities	Medical treatment and service business
US Proton Therapy Holdings Limited ("Proton BVI")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jun. 29, 2011
Percentage of ownership by the Company	100.00%
Principal activities	Investment holding
US Proton Therapy Holdings Limited ("US Proton")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	May 16, 2011
Percentage of ownership by the Company	100.00%
Principal activities	Investment holding
Guangzhou Concord Hospital Management Co., Ltd. ("GCHM") (formerly known as Guangzhou New Spring Hospital Management Ltd.)
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Apr. 21, 2020
Percentage of ownership by the Company	29.46%
Principal activities	Medical treatment and service business
Guangzhou Concord Medical Cancer Ltd. ("GCMC") (formerly known as Guangzhou New Spring Medical Cancer Ltd)
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Apr. 21, 2020
Percentage of ownership by the Company	29.46%
Principal activities	Investment holding
Beijing Healthingkon Technology Co Ltd ("Healthingkon")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Jan. 04, 2021
Percentage of ownership by the Company	11.09%
Principal activities	Leasing of medical equipment and technical service
Guangzhou Concord Medical Technology Innovation Center Co., Ltd ("GCMTIC")
ORGANIZATION AND BASIS OF PRESENTATION
Date of establishment/acquisition	Apr. 22, 2021
Percentage of ownership by the Company	42.09%
Principal activities	Technical service

BANK AND OTHER BORROWINGS (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
BANK AND OTHER BORROWINGS
Total bank and other borrowings	¥ 3,036,202	$ 427,640	¥ 2,984,010
Short-term	319,625	45,018	168,601
Long-term, current portion	722,563	101,771	343,982
Total	1,042,188	146,789	512,583
Long-term, non-current portion	¥ 1,994,014	$ 280,851	¥ 2,471,427

RESTRICTED CASH (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
RESTRICTED CASH
Restricted cash current	¥ 32,280	$ 4,547	¥ 1,060

ACQUISITIONS AND DISPOSALS

12 Months Ended

Dec. 31, 2023

ACQUISITIONS AND DISPOSALS

ACQUISITIONS AND DISPOSALS

4.ACQUISITIONS AND DISPOSALS

For the year ended December 31, 2021

Acquisition of Healthingkon

In November, December 2020 and January 2021, several subsidiaries of the Group entered into a series of restructuring framework agreements and capital increase agreements with a third party, Beijing Healthingkon Technology Co., Ltd. (“Healthingkon”) and Healthingkon’s shareholders to obtain 26.34% shares of Healthingkon with the total consideration of 89% shares of SH MZJH and RMB21,500. The acquisition date was on January 4, 2021, when the Group actually obtained the shareholder rights on Healthingkon. On the same day, a subsidiary of the Group entered into a concerted action agreement with two other shareholders of Healthingkon, pursuant to which the two shareholders agreed to be coordinated actors on the matters related to shareholders’ rights of Healthingkon. After the agreement, the Group obtained majority control over Healthingkon. And SH MZJH was under the control and consolidation of the Group before and after the transaction. The fair value of the gross assets acquired during the acquisition is not concentrated in a single identifiable asset or a group of similar identifiable assets and it meets the definition of a business and was accounted for as business acquisition under ASC 805.

The purchase price allocation was as follows:


		RMB
Cash consideration		21,500
Fair value of the share consideration		98,338
Total		119,838

The Group, with the assistance of an independent third-party valuation firm, assessed the fair values of the acquired identifiable assets and liabilities assumed. The following table summarizes the purchase consideration and fair values of the assets acquired and liabilities assumed as of the acquisition date:


		RMB
Current assets		16,567
Property, plant and equipment, net		1,421
Intangible assets		133,183
Goodwill		368,221
Current liabilities		(44,564)
Deferred tax liabilities		(19,829)
Non-controlling interest		(335,161)
Total		119,838

The acquired amortizable intangible assets primarily include the AI technology of Healthingkon with the estimated remaining amortization periods of 10 years. The Group recognized RMB368,221 (US$57,782) in goodwill arising from this acquisition, primarily represents the expected synergies from combining the Healthingkon’s resources and experiences in the AI with the Group’s current business, and the further development of internet hospital business and cloud system solution business. The goodwill recognized is not deductible for income tax purposes.

Pro forma results of operations for Healthingkon acquisition have not been presented because it was not material to the consolidated financial statements.

For the year ended December 31, 2022

Disposal of Guofu Huimei and its subsidiaries

In the fiscal year of 2022, the Group, Shanghai Epu Supply Chain Technology Co. Ltd. (“Shanghai Epu”) and Shanghai Rongsheng Medical Management Co., Ltd. (“Shanghai Rongsheng”) entered into a shares transfer agreement. Pursuant to Agreement, the Group would sell all the shares it held in Guofu Huimei and its subsidiaries (“GFHM disposal group”) to Shanghai Epu and Shanghai Rongsheng with the consideration of RMB190,000(US$27,547). The disposal transaction was completed on December 26, 2022 and the net book value of the net asset is approximately RMB189,402 (US$27,460). There was no noncontrolling interest in Guofu Huimei and its subsidiaries before the transaction.

The disposal of GFHM group represents the disposal of a portion of the hospital business reporting unit, the Company assigned RMB6,450 (US$935) of goodwill to the GFHM group on a relative fair value basis when the disposal transaction has completed. For the goodwill remaining in the hospital business reporting unit, the Company did not record any impairment loss for the years ended December 31, 2022 as the fair value of the reporting unit is in excess of its carrying value(Note 11).

This disposal does not represent a strategic shift on the Group’s major business and have no major effect on the Company’s results of operations, the disposal of the entity does not qualify as discontinued operation.

On December 26, 2022, the Company calculated a loss regarding the deconsolidation of the Guofu Huimei and its subsidiaries as follows:


	RMB	US$
Cash proceeds	190,000	27,547
Disposition of net assets	(189,402)	(27,460)
Goodwill	(6,450)	(935)
Accumulated other comprehensive loss	(55,694)	(8,075)
Loss on disposal of Guofu Huimei and its subsidiaries	(61,546)	(8,923)

The following table summarizes the carrying amounts of the major classes of assets and liabilities of the disposed subsidiaries as of December 26, 2022:


	RMB	US$
Current assets	199,727	28,957
Current liabilities	(10,325)	(1,497)
Net assets disposed	189,402	27,460

For the year ended December 31, 2023

Disposals of King Cheers and partial shareholding of BPMC

On December 27, 2023, the Group entered into an equity transfer agreement with a third party, Sallekey Capital Management Limited. Pursuant to agreement, the Group would sell all the shares it held in King Cheers Holdings Limited (“King Cheers”) and 25% shares in BPMC held by King Cheers with a nominal consideration of HK$1. The disposal transaction was completed on December 27, 2023. The Group recognized a total loss of RMB709 (US$100). After the sale of 25% shares in BPMC, the Group still maintained an 54.01% interest and the change in ownership interests that did not result in a change of control. Therefore, the Group considered the transfer of shares in BPMC an equity transaction, and directly recorded the difference between the carrying value of ownership interests sold and the nominal consideration in equity attribute to the Group.

In addition, On March 1, 2023, the Group dissolved Datong Meizhong Jiahe Traditional Chinese Medicine Clinic (“Datong Meizhongjiahe”), and the Group recognized a total gain of RMB71 (US$10).

This dissolution or disposal of subsidiary did not represent a strategic shift on the Group’s major business and have no major effect on the Company’s results of operations, the disposal of the entity does not qualify as discontinued operation.

ACQUISITIONS AND DISPOSALS (Tables)

12 Months Ended

Dec. 31, 2023

Guofu Huimei and its subsidiaries

ACQUISITIONS AND DISPOSALS

Schedule of gain on disposal of assets


	RMB	US$
Cash proceeds	190,000	27,547
Disposition of net assets	(189,402)	(27,460)
Goodwill	(6,450)	(935)
Accumulated other comprehensive loss	(55,694)	(8,075)
Loss on disposal of Guofu Huimei and its subsidiaries	(61,546)	(8,923)

Schedule of fair values of the assets acquired and liabilities assumed


	RMB	US$
Current assets	199,727	28,957
Current liabilities	(10,325)	(1,497)
Net assets disposed	189,402	27,460

HealthingKon

ACQUISITIONS AND DISPOSALS

Schedule of fair values of the assets acquired and liabilities assumed


		RMB
Current assets		16,567
Property, plant and equipment, net		1,421
Intangible assets		133,183
Goodwill		368,221
Current liabilities		(44,564)
Deferred tax liabilities		(19,829)
Non-controlling interest		(335,161)
Total		119,838

Schedule of reconciliation of total purchase consideration


		RMB
Cash consideration		21,500
Fair value of the share consideration		98,338
Total		119,838

BANK AND OTHER BORROWINGS (Tables)

12 Months Ended

Dec. 31, 2023

Derivative liability

Schedule of Bank and Other Borrowings


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Total bank and other borrowings	2,984,010	3,036,202	427,640
Comprised of:
Short-term	168,601	319,625	45,018
Long-term, current portion	343,982	722,563	101,771
	512,583	1,042,188	146,789
Long-term, non-current portion	2,471,427	1,994,014	280,851
	2,984,010	3,036,202	427,640

Long-term Bank and Other Borrowings [Member]

Derivative liability

Schedule of Maturities of Long-Term and Other Debt


	RMB	US$
Within one year	722,563	101,771
Between one and two years	434,783	61,238
Between two and three years	401,895	56,606
Between three and four years	629,389	88,648
Above four years	527,947	74,359
	2,716,577	382,622

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 835
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482900/835-30-50-1

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(f))
-Publisher FASB
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+ Details

Other long-term liabilities (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
Other long-term liabilities
Accrued unrecognized tax benefits & surcharge	¥ 44,470	$ 6,263	¥ 60,299
Lease deposit received from hospital	2,000	282	2,000
Convertible Note	20,000	2,818	20,000
Others	2,533	357	1,785
Other long-term liabilities	¥ 69,003	$ 9,719	¥ 84,084

ORGANIZATION AND BASIS OF PRESENTATION - Additional information (Details) ¥ in Thousands, $ in Thousands								1 Months Ended								12 Months Ended
	Dec. 01, 2020	Apr. 07, 2020 CNY (¥) shares	Nov. 13, 2019 CNY (¥)	Aug. 23, 2019 CNY (¥)	Jul. 22, 2019 CNY (¥)	Jul. 10, 2018 CNY (¥) shares	Mar. 26, 2018 shares	Jun. 30, 2023 CNY (¥)	Jun. 30, 2023 USD ($)	Mar. 31, 2022	Apr. 30, 2021 CNY (¥) shares	Jun. 30, 2018 CNY (¥)	Nov. 30, 2017 CNY (¥)	Nov. 30, 2016 CNY (¥)	Jan. 31, 2016 CNY (¥)	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2020	Dec. 31, 2017 CNY (¥)	Dec. 31, 2016 shares	Dec. 31, 2015 shares	Dec. 31, 2023 USD ($)	Nov. 19, 2020	Dec. 31, 2019 CNY (¥)	Dec. 31, 2019 USD ($)	Nov. 18, 2019 CNY (¥)
ORGANIZATION AND BASIS OF PRESENTATION
Capital injected amount																			¥ 400,000
Shares repurchased \| shares																						967,408	614,033
Investment in equity method investees																		¥ (2,300)	¥ (61,159)
Equity method investments																¥ 324,163		336,254						$ 45,657
Common unit value authorized															¥ 1,009,000
Accounts receivable, allowance																¥ 30,486		¥ 7,764						$ 4,294
Shanghai Xinhe Enterprise Management Center (Limited Partnership) ("Shanghai Xinhe")
ORGANIZATION AND BASIS OF PRESENTATION
Equity interest in equity method investment										99.99%						72.73%		99.99%						72.73%
Percentage of shares as consideration										2.05%
Guofu Huimei Investment Management Limited Partnership
ORGANIZATION AND BASIS OF PRESENTATION
Equity method investments												¥ 746,000
ZR Group
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of ownership in equity interest to be repurchased														75.00%
Consideration to be made on acquisition of equity interest														¥ 521,396
ZR Group \| ZR ConcordHealthcare Investment Fund SP ("SP") [Member]
ORGANIZATION AND BASIS OF PRESENTATION
Creditor's rights settled for acquisition of equity interest														166,299
Business combination, consideration transferred														¥ 7,500
ZR Guofu
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interest withdrawn			77.18%
Consideration			¥ 421,730
Period of equity interest repurchased														4 years
Creditor's rights settled for acquisition of equity interest													¥ 97,106
Consideration for repurchase of equity interest														¥ 521,396
Annual premium percentage to be paid														15.00%
Partners' capital account, contributions															¥ 746,001
Percentage of interest in partnership															73.93%
ZR Guofu \| ZR ConcordHealthcare Investment Fund SP ("SP") [Member]
ORGANIZATION AND BASIS OF PRESENTATION
Consideration to be made on acquisition of equity interest														¥ 521,396
Shanghai Rongchi Medical Management Limited
ORGANIZATION AND BASIS OF PRESENTATION
Common unit value authorized																					¥ 695,305
The Group
ORGANIZATION AND BASIS OF PRESENTATION
Partners' capital account, contributions															¥ 262,999
Percentage of interest in partnership															26.07%
Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. ("SH MZJH")
ORGANIZATION AND BASIS OF PRESENTATION
Capital contributed																										¥ 34,540
Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. ("SH MZJH") \| ZR ConcordHealthcare Investment Fund SP ("SP") [Member]
ORGANIZATION AND BASIS OF PRESENTATION
Creditor's rights settled for acquisition of equity interest				¥ 82,100
Beijing Century Friendship Science and Technology Development Co., Ltd.
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interest sold												100
Business combination, consideration transferred																					388,500
Shanghai Meizhongjiahe ProMed Cancer Centers Co., Ltd
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interest sold												90
Business combination, consideration transferred																					182,100
Tianjin Jiatai Entity Management limited Partnership
ORGANIZATION AND BASIS OF PRESENTATION
Business combination, consideration transferred																					¥ 106,500
Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. ("SH MZJH")
ORGANIZATION AND BASIS OF PRESENTATION
Capital contributed \| $																											$ 5,105
Percentage of equity interest sold																78.34		56.77						78.34
Business combination, consideration transferred					¥ 27,000
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM")
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of interest held after disposal	2.12%
Shanghai Medstar Financial Leasing Company Limited ("Shanghai Medstar")
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interests acquired																98.19%								98.19%
Beijing Proton Medical Center Co., Ltd ("BPMC")
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interests acquired																54.01%								54.01%
Percentage of equity interest sold												80
Tianjin Jiatai Group
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interest sold					90
Redeemable noncontrolling interest, equity, common, carrying amount																												¥ 434,216
Tianjin Concord Medical Technology Limited ("Tianjin Concord Medical")
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interests acquired																98.19%								98.19%
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM")
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interests acquired																		43.90%	46.56%
Noncontrolling interest, ownership percentage by noncontrolling owners	2.36%										5.28%
Percentage of interest held after disposal																				49.44%
Guangzhou Concord Medical Cancer Hospital Co Ltd \| ZR Guofu
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of shares acquire for business														70.00%
PTC Houston Management \| ZR Guofu
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of shares acquire for business														59.51%
CCM Hospital Business \| ZR Guofu
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of shares acquire for business														100.00%
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM")
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interest sold																50.08		50.23						50.08
Business acquisition, equity interest issued or issuable, number of shares \| shares		38,888,888				40,000,000	60,000,000
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM") \| CITIC Industrial
ORGANIZATION AND BASIS OF PRESENTATION
Business combination, consideration transferred		¥ 700,000
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM") \| Beijing Century Friendship Science and Technology Development Co., Ltd.
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of interest in partnership												78.31%
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM") \| Shanghai Meizhongjiahe ProMed Cancer Centers Co., Ltd
ORGANIZATION AND BASIS OF PRESENTATION
Business combination, consideration transferred												¥ 182,100
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM") \| CCIC Capital and Other Investor
ORGANIZATION AND BASIS OF PRESENTATION
Business combination, consideration transferred						¥ 1,500,000
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM") \| Beijing Proton Medical Center Co., Ltd ("BPMC")
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interests acquired												55.00%
Business combination, consideration transferred												¥ 388,500
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM") \| Shanghai Meizhong Jiahe Cancer Center Co Ltd
ORGANIZATION AND BASIS OF PRESENTATION
Percentage of equity interests acquired												54.80%
Beijing Century Friendship Science and Technology Development Co., Ltd.
ORGANIZATION AND BASIS OF PRESENTATION
Voting interest acquired																					78.31%
Beijing Proton Medical Center Co., Ltd ("BPMC")
ORGANIZATION AND BASIS OF PRESENTATION
Voting interest acquired																					55.00%
Shanghai Meizhongjiahe ProMed Cancer Centers Co., Ltd
ORGANIZATION AND BASIS OF PRESENTATION
Voting interest acquired																					54.80%
Tianjin Jiatai Entity Management limited Partnership
ORGANIZATION AND BASIS OF PRESENTATION
Voting interest acquired																					28.77%
Investors 2021
ORGANIZATION AND BASIS OF PRESENTATION
Business combination, consideration transferred											¥ 400,000
Business acquisition, equity interest issued or issuable, number of shares \| shares											18,805,826
CHS [Member]
ORGANIZATION AND BASIS OF PRESENTATION
Percentage interest shares																									90.00%
Percentage of remaining interest disposed subsequently																									10.00%
Percentage of interest held after disposal																				90.00%
Business combination, consideration transferred																¥ 26,909	$ 3,790
Concord Healthcare
ORGANIZATION AND BASIS OF PRESENTATION
Percentage interest shares								4.17%	4.17%
Percentage of interest held after disposal																42.09%	42.09%	43.90%
Business combination, consideration transferred								¥ 300,000,000	$ 42,254

PREPAYMENTS AND OTHER CURRENT ASSETS - Additional Information (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
PREPAYMENTS AND OTHER CURRENT ASSETS
Reserve for prepayments and other current assets	¥ 59,603	$ 8,395	¥ 17,290
Financing Receivable, Allowance for Credit Loss	20,496	2,887	3,011
JYADK
PREPAYMENTS AND OTHER CURRENT ASSETS
Reserve for prepayments and other current assets	33,985	4,787	9,017
Third Party
PREPAYMENTS AND OTHER CURRENT ASSETS
Amounts receivable from third parties	126,570	17,827	115,677
Suppliers
PREPAYMENTS AND OTHER CURRENT ASSETS
Reserve for prepayments and other current assets	0		0
Related party
PREPAYMENTS AND OTHER CURRENT ASSETS
Amounts due to subsidiaries	151,481	21,335	169,453
Subsidiaries
PREPAYMENTS AND OTHER CURRENT ASSETS
Amounts due to subsidiaries	¥ 185,466	$ 26,122	¥ 178,453

LONG-TERM INVESTMENTS - Equity method investments (Details) - CNY (¥) ¥ in Thousands	Dec. 31, 2023	Dec. 28, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
LONG-TERM INVESTMENTS
Equity investments with readily determinable fair value	¥ 51,624		¥ 51,524
Xi'an JiangyuanAndike Ltd. ("JYADK")
LONG-TERM INVESTMENTS
Equity interest in equity method investment	29.70%		29.70%
Equity investments with readily determinable fair value	¥ 14,925		¥ 10,496
Suzhou Shengshan Huiying Venture Capital Investment LLP. ("Suzhou Shengshan")
LONG-TERM INVESTMENTS
Equity interest in equity method investment	5.15%		5.15%		5.15%	5.15%	5.41%	8.13%
Equity investments with readily determinable fair value	¥ 9,413		¥ 12,939
Zhejiang Marine Leasing Ltd
LONG-TERM INVESTMENTS
Equity interest in equity method investment	20.00%		20.00%
Equity investments with readily determinable fair value	¥ 189,676		¥ 179,231
Guangdong Hengjian Proton Medical Industry Co., Ltd ("Guangdong Hengjian")
LONG-TERM INVESTMENTS
Equity interest in equity method investment	14.20%		14.20%
Equity investments with readily determinable fair value	¥ 86,185		¥ 86,315
Beijing Proton Medical Center Co Ltd [Member]
LONG-TERM INVESTMENTS
Equity interest in equity method investment		54.01%
Shanghai Xinhe Enterprise Management Center (Limited Partnership) ("Shanghai Xinhe")
LONG-TERM INVESTMENTS
Equity interest in equity method investment	72.73%		99.99%	99.99%
Equity investments with readily determinable fair value	¥ 22,448		¥ 45,005
Shanghai Changshengshu Management Co. LTD("Shanghai Changshengshu")
LONG-TERM INVESTMENTS
Equity interest in equity method investment	20.00%		20.00%
Equity investments with readily determinable fair value	¥ 1,216		¥ 1,968
Guangzhou Yicheng Biological Immune Technology Co. LTD("Guangzhou Yicheng")
LONG-TERM INVESTMENTS
Equity interest in equity method investment	30.00%		30.00%
Equity investments with readily determinable fair value	¥ 300		¥ 300
Equity interest owned by the group
LONG-TERM INVESTMENTS
Equity investments with readily determinable fair value	¥ 324,163		¥ 336,254

FAIR VALUE MEASUREMENTS

12 Months Ended

Dec. 31, 2023

FAIR VALUE MEASUREMENTS

FAIR VALUE MEASUREMENTS

30.FAIR VALUE MEASUREMENTS

The Group applies ASC Topic 820, Fair Value Measurements and Disclosures (“ASC 820”), which defines fair value, establishes a framework for measuring fair value and expands disclosures about fair value measurements.

ASC 820 establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows:

Level 1 - Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active markets.

Level 2 - Include other inputs that are directly or indirectly observable in the market place.

Level 3 - Unobservable inputs which are supported by little or no market activity.

ASC 820 describes three main approaches to measuring the fair value of assets and liabilities: (1) market approach; (2) income approach and (3) cost approach. The market approach uses prices and other relevant information generated from market transactions involving identical or comparable assets or liabilities. The income approach uses valuation techniques to convert future amounts to a single present value amount. The measurement is based on the value indicated by current market expectations about those future amounts. The cost approach is based on the amount that would currently be required to replace an asset.

The Group apply fair value accounting for all financial assets and liabilities that are recognized or disclosed at fair value in the financial statements on a recurring basis. Goodwill, intangible assets, and other long-lived assets are measured at fair value on a nonrecurring basis, only if impairment is indicated.

Certain equipment and long-lived assets related to the Group’s low-performance centers were impaired to their fair value on a nonrecurring basis. As of December 31, 2022 and 2023, the resulting impairment charge of nil and nil was recorded in “impairment of long-lived assets” in the consolidated statements of comprehensive loss. The Group calculated the fair value of long-lived assets based on estimated future discounted cash flows based on the discount rate between 15.8% and 19.6% and expected remaining useful life of such assets and classified the fair value as a Level 3 measurement due to the significance of unobservable inputs.

The inputs used to measure the estimated fair value of goodwill are classified as Level 3 in the fair value hierarchy due to the significance of unobservable inputs using company-specific information.

The Company measured the fair value of its derivative liability on a recurring basis using significant unobservable (Level 3) inputs as of December 31, 2023.


	Fair Value Measurement at the End of the Reporting Period Using
		Quoted Prices in
		Active	Significance
		Markets for	Other	Significant
	As of	Identical	Observable	Unobservable
	December 31,	Assets	Inputs	Inputs
	2023	(Level 1)	(Level 2)	(Level 3)
	RMB	RMB	RMB	RMB
Liability Items

Derivative liability:	163			163

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

PREPAYMENTS AND OTHER CURRENT ASSETS (Tables)

12 Months Ended

Dec. 31, 2023

PREPAYMENTS AND OTHER CURRENT ASSETS

Schedule of prepayments and other current assets


		As at December 31,
	Notes	2022	2023	2023
		RMB	RMB	US$
Due from suppliers	i)	31,660	66,893	9,422
Loan receivables	ii)	294,130	312,036	43,949
Advances to employees		2,601	2,213	312
Dividend receivable		1,643	-	-
Deductible value-added tax		44,268	43,355	6,106
Tax refund		234	241	34
Due from hospital		1,138	1,087	153
Deferred expenses		200	317	45
Others		26,767	46,407	6,536
		402,641	472,549	66,557

Allowance for credit losses		(17,290)	(59,603)	(8,395)

		385,351	412,946	58,162

The Group records allowance for doubtful debts in “general and administrative expenses” in the consolidated statements of comprehensive loss.

ii)

Derivative liability

12 Months Ended

Dec. 31, 2023

Derivative liability

Derivative liability

21. Derivative liability

In August 2021, Ascendium Group Limited (“Ascendium”), a subsidiary of the Company, entered into debt contracts with Great Lion Global Limited (“Great Lion Debt”) and Vantage Chance Limited (“Vantage Debt”) for the borrowings with the principal amount of US$5,000 and US$10,000 respectively with the terms of two years. The issuance date was August 10, 2021 and November 10, 2021 respectively with no issuance cost. The basic interest rate per annum were both 4.5%. 11% and 22% shares of Concord Hospital Management Group Ltd. (HK) that held by Ascendium were pledged for the two debts respectively. In 2023, the two debts were extended for one year respectively.

According to the contracts, there are additional payment terms that depends on the occurrence of a qualified IPO, which are as follow: if the Concord Healthcare successfully complete a qualified IPO during the borrowing period, the Group need to pay the lender a excess return, which was not a fixed amount and varied with the future stock price of Concord Healthcare; if failed, the Group need to pay the additional interest with an interest rate of 5.5% per annum.

The Group evaluated the borrowings and determined the additional payment terms as the embedded component of the debt contracts, which qualified as derivatives to be separately accounted for in accordance with ASC 815, “Derivatives and Hedging”. The Group engaged an appraiser to perform fair value measurement of the embedded derivative. According to the appraisal report, the fair value of the embedded derivatives, which was recorded as derivative liability in the financial statements, as of December 31, 2022 and 2023, was RMB1,793 and RMB57 (US$8) respectively for Great Lion Debt, and RMB3,497 and RMB106 (US$15) respectively for Vantage Debt. Because of the fair value change of the embedded derivative liability, the Group recognized a gain from fair value change totaling RMB5,207 (US$733) in the financial statements.

The Group has accounted the debt host as long-term bank and other borrowings, current portion. The net proceeds the Group received from the issuance of the debt was RMB35,500 (US$5,000) and RMB70,999 (US$10,000) respectively. Because the fair value of derivative liability on the issue date should be recorded as an adjustment of the carrying amount of the debt, the totaling carrying amount of the two debts was RMB98,168 and RMB106,499 (US$15,000) as of December 31,2022 and 2023, respectively.

LEASE - Other operating leases (Details) - 12 months ended Dec. 31, 2023 ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
LEASE
Operating lease cost	¥ 41,158	$ 5,797
Short term lease cost	41	6
Total	¥ 41,199	$ 5,803

ACCRUED EXPENSES AND OTHER LIABILITIES

12 Months Ended

Dec. 31, 2023

ACCRUED EXPENSES AND OTHER LIABILITIES

ACCRUED EXPENSES AND OTHER LIABILITIES

16.ACCRUED EXPENSES AND OTHER LIABILITIES

The components of accrued expenses and other liabilities are as follows:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Accrued expenses*	75,010	387,040	54,513
Salaries and welfare payable	73,803	98,599	13,887
Business and other taxes payable	27,961	15,619	2,200
Contractual liabilities	100,802	59,408	8,367
Other payables	142,305	171,127	24,103
	419,881	731,793	103,070

DEPOSITS FOR NON-CURRENT ASSETS

12 Months Ended

Dec. 31, 2023

DEPOSITS FOR NON-CURRENT ASSETS

DEPOSITS FOR NON-CURRENT ASSETS

13.DEPOSITS FOR NON-CURRENT ASSETS

Deposits for non-current assets consist of the following:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Deposits for purchases of property, plant and equipment*	8,932	4,646	654
	8,932	4,646	654

As at December 31, 2022 and 2023, certain of the Group’s deposits for non-current assets with a total net book value of nil and nil were pledged for other borrowings of nil and nil, respectively.

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION - Condensed statements of cash flows (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Net cash (used in) generated from operating activities	¥ (276,471)	$ (38,944)	¥ (216,694)	¥ (359,313)
Net cash (used in) generated from investing activities	(47,681)	(6,715)	(118,792)	(565,981)
Net cash (used in) generated from financing activities	257,653	36,290	383,088	642,449
Exchange rate effect on cash	(2,425)	(338)	(47,170)	(4,639)
Net (decrease) increase in cash	(68,924)	(9,707)	432	(287,484)
Cash at beginning of the year	158,283
Cash at end of the year	58,139	8,189	158,283
Parent Company
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Net cash (used in) generated from operating activities	(1,258)	(177)	(2,047)	(9,301)
Net cash (used in) generated from investing activities	15,655	2,205	(29,335)	(88,546)
Net cash (used in) generated from financing activities	1,590	224	16,591	110,876
Exchange rate effect on cash	(31)	(5)	1,243	(50)
Net (decrease) increase in cash	15,956	2,247	(13,548)	12,979
Cash at beginning of the year	1,510	213	15,058	2,079
Cash at end of the year	¥ 17,466	$ 2,460	¥ 1,510	¥ 15,058

- Definition

Amount of currency on hand as well as demand deposits with banks or financial institutions. Includes other kinds of accounts that have the general characteristics of demand deposits. Excludes cash and cash equivalents within disposal group and discontinued operation.

+ References + Details

LOSS PER SHARE (Tables)

12 Months Ended

Dec. 31, 2023

LOSS PER SHARE

Schedule of computation of basic and diluted loss per share


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$

Net loss attributable to Concord Medical Services Holdings Limited	(271,427)	(489,661)	(297,658)	(41,927)
Accretion of contingently redeemable noncontrolling interests	(549,194)	—	—	—
Numerator for EPS computation	(820,621)	(489,661)	(297,658)	(41,927)


	For the Years Ended December 31
	2021		2022		2023		2023
	Class A	Class B	Class A	Class B	Class A	Class A	Class B	Class B
	RMB	RMB	RMB	RMB	RMB	USD	RMB	USD
Numerator
Net loss attributable to ordinary shareholders used in calculating loss per ordinary share – basic and diluted	(533,909)	(286,712)	(318,582)	(171,079)	(193,661)	(27,279)	(103,997)	(14,648)
Denominator:
Weighted average number of ordinary shares outstanding used in calculating loss per share – basic and diluted	85,265,910	45,787,948	85,265,910	45,787,948	85,265,910	85,265,910	45,787,948	45,787,948
Loss per share – basic and diluted	(6.26)	(6.26)	(3.74)	(3.74)	(2.27)	(0.32)	(2.27)	(0.32)

RESTRICTED CASH

12 Months Ended

Dec. 31, 2023

RESTRICTED CASH

RESTRICTED CASH

5.RESTRICTED CASH

Restricted cash mainly represented cash deposits pledged as security for the proceeds from specialized bank borrowings for hospital construction and commercial acceptance bill. Balance of restricted cash was RMB1,060 and RMB32,280 (US$4,547) as of December 31, 2022 and 2023, respectively.

ACQUISITIONS AND DISPOSALS - Disposal of Guofu Huimei and its subsidiaries loss regarding the deconsolidation (Details) - Dec. 26, 2022 - Guofu Huimei and its subsidiaries ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
ACQUISITIONS AND DISPOSALS
Cash proceeds	¥ 190,000	$ 27,547
Disposition of net assets	(189,402)	(27,460)
Goodwill	(6,450)	(935)
Accumulated other comprehensive loss	(55,694)	(8,075)
Loss on disposal of CHS	¥ (61,546)	$ (8,923)

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Schedule of Information Relating to Property, Plant and Equipment (Details)	Dec. 31, 2023
Buildings \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	20 years
Buildings \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	50 years
Medical equipment \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	5 years
Medical equipment \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	20 years
Electronic and office equipment \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	3 years
Electronic and office equipment \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	5 years
Motor vehicles
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	5 years
Leasehold improvement and building improvement \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Estimated useful life	5 years

CONCENTRATION OF RISKS (Details)	12 Months Ended
CONCENTRATION OF RISKS (Details)	Dec. 31, 2023 customer issuer	Dec. 31, 2022 customer issuer	Dec. 31, 2021 customer issuer
Foreign currency exchange rate risk
Depreciation (appreciation) of the RMB against US dollar (as a percent)	2.90%	8.20%	(2.30%)
Customer concentration risk \| Sales revenue
CONCENTRATION OF RISKS
Number of customers \| customer	5	5	5
Concentration risk percentage	28.39%	29.20%	30.95%
Supplier concentration risk \| Cost of goods
CONCENTRATION OF RISKS
Concentration risk percentage	96.00%	93.00%	94.00%
Number of suppliers \| issuer	5	5	5

ORGANIZATION AND BASIS OF PRESENTATION (Tables)

12 Months Ended

Dec. 31, 2023

ORGANIZATION AND BASIS OF PRESENTATION

Schedule of subsidiaries


			Percentage of
	Date of	Place of	ownership by
Entities	establishment/acquisition	establishment	the Company		Principal activities
Subsidiaries
Ascendium Group Limited (“Ascendium”)	September 10, 2007	British Virgin Islands (“BVI”)	100	%	Investment holding
China Medical Services Holdings Limited (“CMS Holdings”)	July 18, 2008	Hong Kong	100	%	Investment holding
Shenzhen Aohua Medical Technology Development Co., Ltd. (“Aohua Technology ”) **	February 21, 2008	PRC	42.09	%	Leasing of medical equipment and provision of management services
Shanghai Medstar Financial Leasing Company Limited (“Shanghai Medstar”)	March 21, 2003	PRC	98.19	%	Leasing of medical equipment and provision of management services
Concord Healthcare Group Co., Ltd. (“Concord Healthcare”) (formerly known as Meizhong Jiahe Medical Technology Development Group Co., Ltd.) *	July 23, 2008	PRC	42.09	%	Provision of management services
Beijing Yundu Internet Technology Co., Ltd. (“Yundu”) **	July 26, 2007	PRC	42.09	%	Provision of management services
Tianjin Concord Medical Technology Limited (“Tianjin Concord Medical”)	April 22, 2010	PRC	98.19	%	Leasing of medical equipment and provision of management services
Guangzhou Concord Cancer Center Co., Ltd. (“Guangzhou Concord Cancer Hospital”) **	June 29, 2011	PRC	33.67	%	Medical treatment and service business
CCM (Hong Kong) Medical Investments Limited (“CCM (HK)”)	June 03, 2013	Hong Kong	85.71	%	Investment holding
Shanghai Concord Cancer Center Co., Ltd. (“SHC”) **	March 17, 2014	PRC	44.10	%	Medical treatment and service business
Datong Meizhong Jiahe Cancer Center (“DTMZ”) **	October 23, 2014	PRC	42.09	%	Medical treatment and service business
Wuxi Concord Medical Development Ltd. (“Wuxi Concord”)	December 29, 2015	PRC	100	%	Provision of management services


			Percentage of
	Date of	Place of	ownership by
Entities	establishment/acquisition	establishment	the Company		Principal activities
Beijing Concord Medical Technology Ltd.(“BJCMT”)	January 4, 2016	PRC	100	%	Provision of management services
Beijing Century Friendship Science & Technology Development Co., Ltd. (“Beijing Century Friendship”)**	October 8, 2018	PRC	98.19	%	Provision of management services and investment holding
Beijing Proton Medical Center Co., Ltd. (“BPMC”)	October 8, 2018	PRC	54.01	%	Medical treatment and service business
Shanghai Meizhong Jiahe Cancer Center Co., Ltd. (“CMCC”)**	October 8, 2018	PRC	39.94	%	Medical treatment and service business
Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. (“SH MZJH”) **	November 18,2019	PRC	18.70	%	Medical treatment and service business
Wuxi Meizhong Jiahe Cancer Center Co., Ltd. (“Wuxi MZJH”)	November 18,2019	PRC	98.45	%	Medical treatment and service business
Yinchuan Meizhong Jiahe Internet Hospital Ltd. (“YCIH”) **	October 18, 2020	PRC	42.09	%	Medical treatment and service business
US Proton Therapy Holdings Limited (“Proton BVI”)	May 16, 2011	BVI	100	%	Investment holding
US Proton Therapy Holdings Limited (“US Proton”)	June 29, 2011	United States of America	100	%	Investment holding
Guangzhou Concord Hospital Management Co., Ltd. (“GCHM”) (formerly known as Guangzhou New Spring Hospital Management Ltd.) (note 4) **	April 21, 2020	China	29.46	%	Investment holding
Guangzhou Concord Medical Cancer Ltd. (“GCMC”) (formerly known as Guangzhou New Spring Medical Cancer Ltd) (note 4) **	April 21, 2020	China	29.46	%	Medical treatment and service business
Beijing Healthingkon Technology Co., Ltd. (“Healthingkon”) (note 4) **	January 4, 2021	China	11.09	%	Leasing of medical equipment and technical service
Guangzhou Concord Medical Technology Innovation Center Co., Ltd. (“GCMTIC”) **	April 22, 2021	China	42.09	%	Technical service

** Aohua Technology, Yundu, Guangzhou Concord Cancer Hospital, SHC, DTMZ, Beijing Century Friendship, CMCC, SH MZJH, YCIH, GCHM, GCMTIC, GCMC and Healthingkon are subsidiaries of Concord Healthcare.

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION - Condensed statements of comprehensive loss (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Total Revenues	¥ 537,402	$ 75,691	¥ 472,085	¥ 485,633
Cost of revenues	(614,010)	(86,481)	(624,494)	(542,530)
General and administrative expenses	(330,078)	(46,491)	(311,160)	(347,746)
Selling expenses	(56,299)	(7,930)	(61,479)	(53,675)
Operating loss	(462,985)	(65,211)	(525,048)	(458,318)
Interest income	10,832	1,526	10,021	5,894
Interest expense	(165,669)	(23,334)	(120,357)	(73,789)
Other income, net	(10,839)	(1,527)	(216,607)	(1,223)
Foreign exchange gain(loss)	10,149	1,429	54,982	(19,925)
Net loss attributable to Concord Medical Services Holdings Limited	(297,658)	(41,927)	(489,661)	(271,427)
Foreign currency translation, net tax of nil	(6,480)	(913)	(53,964)	14,821
Unrealized losses on available-for-sale securities, net	(31,173)	(4,391)
Total other comprehensive income (loss), net of tax	(37,653)	(5,304)	(53,964)	14,821
Comprehensive loss attributable to Concord Medical Services Holdings Limited	(335,311)	(47,231)	(543,625)	(256,606)
Parent Company
PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION
Total Revenues	0	0	0	0
Cost of revenues	0	0	0	0
General and administrative expenses	(2,414)	(340)	5,242	(14,428)
Selling expenses	0	0	(524)	(2,090)
Operating loss	(2,414)	(340)	4,718	(16,518)
Equity in loss of subsidiaries	(314,122)	(44,246)	(605,175)	(793,117)
Interest income	14	2	0	0
Interest expense	(9,926)	(1,398)	(10,394)	(1,459)
Changes in fair value of derivatives	5,282	744	1,055	0
Other income, net	(1,008)	(142)	96,609	0
Foreign exchange gain(loss)	24,516	3,453	23,526	(9,527)
Net loss attributable to Concord Medical Services Holdings Limited	(297,658)	(41,927)	(489,661)	(820,621)
Foreign currency translation, net tax of nil	(6,480)	(913)	(53,964)	14,821
Unrealized losses on available-for-sale securities, net	(31,173)	(4,391)	0	0
Total other comprehensive income (loss), net of tax	(37,653)	(5,304)	(53,964)	14,821
Comprehensive loss attributable to Concord Medical Services Holdings Limited	¥ (335,311)	$ (47,231)	¥ (543,625)	¥ (805,800)

Derivative liability (Details) ¥ in Thousands, $ in Thousands	1 Months Ended	12 Months Ended
	Aug. 31, 2021 USD ($)	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2023 USD ($)
Derivative liability
Debt instrument term	2 years
Basic interest rate		4.50%				4.50%
Additional interest rate		5.50%	5.50%
Change in fair value of derivative liability		¥ 5,207	$ 733	¥ 1,015	¥ (39)
Net proceeds from issuance of debt		110,000	15,493	422,765	¥ 386,635
Great Lion Debt
Derivative liability
Principal amount	$ 5,000
Basic interest rate	11.00%
Fair value of embedded derivative		57		1,793		$ 8
Net proceeds from issuance of debt		35,500	5,000
Debt instrument, Carrying amount \| ¥		98,168
Vantage Debt
Derivative liability
Principal amount	$ 10,000
Basic interest rate	22.00%
Fair value of embedded derivative		106		¥ 3,497		15
Net proceeds from issuance of debt		70,999	$ 10,000
Debt instrument, Carrying amount		¥ 106,499				$ 15,000

BANK AND OTHER BORROWINGS (Schedule of Maturities of Long-Term and Other Debt) (Details) ¥ in Thousands, $ in Thousands		1 Months Ended	12 Months Ended
	Dec. 07, 2021 CNY (¥)	Aug. 31, 2021	Dec. 31, 2021 CNY (¥)	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)
Derivative liability
Proceeds from convertible note	¥ 20,000		¥ 20,000
Convertible debt term		2 years
Conversion ratio			4.75
Long-term bank and other borrowings
Derivative liability
Within one year				¥ 722,563	$ 101,771
Between one and two years				434,783	61,238
Between two and three years				401,895	56,606
Between three and four years				629,389	88,648
Above four years				527,947	74,359
Total				¥ 2,716,577	$ 382,622

SHARE-BASED AWARDS (Narrative) (Details) - USD ($)		12 Months Ended
SHARE-BASED AWARDS (Narrative) (Details) - USD ($)	Feb. 18, 2014	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SHARE-BASED AWARDS
Ordinary shares that may be issued		13,218,000
Options granted	3,479,604	0	0	0
Options granted, exercise price	$ 2.04
Unrecognized share-based compensation cost		$ 0	$ 0	$ 0
Exercisable share outstanding options granted to employees		0	0
Restricted shares [Member]
SHARE-BASED AWARDS
Unrecognized share-based compensation cost		$ 0
Shares vesting description		The Restricted Shares have a service condition where the grantees can remove restriction on 25% of total number of restricted shares on annual basis over a four-year period ending the fourth anniversary of the grant date.

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

DEPOSITS FOR NON-CURRENT ASSETS - Schedule of Deposits for Non-Current Assets (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
DEPOSITS FOR NON-CURRENT ASSETS
Deposits for purchases of property, plant and equipment	¥ 4,646	$ 654	¥ 8,932
Deposits	¥ 4,646	$ 654	¥ 8,932

RELATED PARTY TRANSACTIONS

12 Months Ended

Dec. 31, 2023

RELATED PARTY TRANSACTIONS

RELATED PARTY TRANSACTIONS

25.RELATED PARTY TRANSACTIONS

Related parties^#


Name of Related Parties		Relationship with the Group
JYADK		Equity investee of the Group
Zhejiang Marine Leasing Ltd.		Equity investee of the Group
Cherrylane Investments Limited		An entity controlled by a director of the Company
Guangdong Proton International Hospital Management Co., Ltd.		A wholly owned subsidiary of an equity investee of the Group
Morgancreek investment Holdings Limited		An entity controlled by the CEO of the Company

# These are the related parties that have engaged in significant transactions with the Company for the years ended December 31, 2021, 2022 and 2023.

b) The Group had the following related party transactions for the years ended December 31, 2021, 2022 and 2023.


	For the Years ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Loan to:
Guangdong Proton International Hospital Management Co., Ltd.	142,895	16,800	200	28
	142,895	16,800	200	28
Interest income from:
JYADK	650	—	—	—
Guangdong Proton International Hospital Management Co., Ltd.	2,797	6,961	6,813	960
	3,447	6,961	6,813	960

Loan from:
Cherrylane Investments Limited	15,932	—	—	—
Zhejiang Marine Leasing Ltd	8,500	220,369	4,400	620
Morgancreek investment Holdings Limited	—	—	17,750	2,500
	24,432	220,369	22,150	3,120
Interest expense to:
Cherrylane Investments Limited	554	1,334	423	60
Zhejiang Marine Leasing Ltd	12,978	15,456	13,683	1,927
Morgancreek investment Holdings Limited	—	—	202	28
	13,532	16,790	14,308	2,015
Repayment to:
Cherrylane Investments Limited	3,824	—	19,710	2,776
Zhejiang Marine Leasing Ltd.	77,062	82,915	32,127	4,525
Morgancreek investment Holdings Limited	—	—	9,940	1,400
	80,886	82,915	61,777	8,701
Repayment from:
JYADK	2,430	—	—	—
	2,430	—	—	—

(c)

The balances between the Group and its related parties as of December 31, 2022 and 2023 are listed below.


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Due from related parties, current:
Guangdong Proton International Hospital Management Co., Ltd.	169,453	151,481	21,335
	169,453	151,481	21,335

Due to related parties, current:
Cherrylane Investments Limited	13,105	1,659	234
Morgancreek investment Holdings Limited	—	8,012	1,128
	13,105	9,671	1,362

Due to related parties, non-current
Zhejiang Marine Leasing Ltd.	122,579	69,182	9,744
	122,579	69,182	9,744
Due to related parties, non-current, due within 1 year
Zhejiang Marine Leasing Ltd	123,855	163,208	22,987
Cherrylane Investments Limited	10,001	4,075	574
	133,856	167,283	23,561

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

+ Details

ACQUISITIONS AND DISPOSALS - Additional Information (Details) ¥ in Thousands, $ in Thousands						1 Months Ended	3 Months Ended	12 Months Ended
	Dec. 27, 2023 HKD ($)	Dec. 27, 2023 CNY (¥)	Dec. 27, 2023 USD ($)	Mar. 01, 2023 CNY (¥)	Mar. 01, 2023 USD ($)	Jan. 31, 2021 CNY (¥)	Jan. 31, 2021 CNY (¥)	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2020	Dec. 31, 2023 USD ($)	Dec. 28, 2023	Dec. 31, 2022 USD ($)	Dec. 31, 2021 CNY (¥)	Apr. 30, 2021	Jan. 31, 2021 USD ($)	Dec. 01, 2020
ACQUISITIONS AND DISPOSALS
Goodwill						¥ 368,221	¥ 368,221	¥ 575,427		¥ 575,427		$ 81,047		$ 81,047	¥ 581,877		$ 57,782
Beijing Proton Medical Center Co., Ltd ("BPMC")
ACQUISITIONS AND DISPOSALS
Equity interest in equity method investment													54.01%
Beijing MeizhongJiahe Hospital Management Co., Ltd. ("MHM")
ACQUISITIONS AND DISPOSALS
Noncontrolling Interest, Ownership Percentage by Parent										43.90%				43.90%	46.56%
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners																5.28%		2.36%
Percentage of interest held after disposal											49.44%
Beijing Proton Medical Center
ACQUISITIONS AND DISPOSALS
Business combination, consideration transferred \| $	$ 1
Loss recognized		¥ 709	$ 100
Percentage of share consideration	25.00%	25.00%	25.00%
CHS
ACQUISITIONS AND DISPOSALS
Percentage of interest held after disposal										8.73%	10.00%
Datong Meizhongjiahe
ACQUISITIONS AND DISPOSALS
Gain recognized on disposal				¥ 71	$ 10
CHS
ACQUISITIONS AND DISPOSALS
Business combination, consideration transferred								¥ 26,909	$ 3,790
Percentage of interest held after disposal											90.00%
HealthingKon
ACQUISITIONS AND DISPOSALS
Voting interest acquired						26.34%	26.34%										26.34%
Business combination, consideration transferred						¥ 119,838
Cash consideration						¥ 21,500	¥ 21,500
Estimated amortization periods						10 years
Goodwill						¥ 368,221	¥ 368,221
HealthingKon \| Shanghai Meizhong Jiahe Imaging Diagnostic Center Co., Ltd. ("SH MZJH")
ACQUISITIONS AND DISPOSALS
Percentage of share consideration						89.00%	89.00%										89.00%

CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (DEFICIT) (Parenthetical)	Dec. 31, 2021
CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (DEFICIT)
Percentage of equity redeemed to reduce minority shareholders equity	15

CONCENTRATION OF RISKS

12 Months Ended

Dec. 31, 2023

CONCENTRATION OF RISKS

CONCENTRATION OF RISKS

3.CONCENTRATION OF RISKS

Concentration of credit risk

Assets that potentially subject the Group to significant concentration of credit risk primarily consist of cash, restricted cash, accounts receivable, due from suppliers, loans receivables, advance made to and receivables form disposal of medical equipment from hospital customers. The maximum exposure of such assets to credit risk is their carrying amounts as of the balance sheet dates.

As of December 31, 2023, substantially all of the Group’s cash and restricted cash were deposited in financial institutions located in the PRC, Hong Kong, United States of America, which management believes are of high credit quality.

Accounts receivable are typically unsecured and are derived from network revenue earned from hospitals in PRC, as well as hospital revenue earned from patients in PRC. The risk with respect to accounts receivable is mitigated by credit evaluations the Group performs on its customers and its ongoing monitoring of outstanding balances.

Due from suppliers are typically unsecured and arise from deposits paid in advance for future purchases of medical equipment. Due to the Group’s concentration of advances made to a limited number of suppliers and the significant prepayments that are made to them, any negative events or deterioration in financial strength with respect to the Group’s suppliers may cause material loss to the Group and have a material adverse effect on the Group’s financial condition and results of operations. The risk with respect to advances made to suppliers is mitigated by credit evaluations that the Group performs on its suppliers prior to making any advances and the ongoing monitoring of its suppliers’ performance.

With respect to advances made to and receivables form disposal of medical equipment from hospital customers hospital customers, the Group conducts periodic credit evaluation of its customers but does not require collateral or other security from its hospital customers.

Concentration of customers

The Group currently generates a substantial portion of its revenue from a limited number of customers. As a percentage of revenues, the top five customers accounted for 30.95%, 29.20% and 28.39% for the years ended December 31, 2021, 2022 and 2023, respectively. The loss of revenue from any of these customers would have a significant negative impact on the Group’s business. However, arrangements with customers are mostly long-term in nature. Due to the Group’s dependence on a limited number of customers and the profit sharing received by the Group depends on the performance of the hospitals that the Group does not control, any negative events with respect to the Group’s customers may cause material fluctuations or declines in the Group’s revenue and have a material adverse effect on the Group’s financial condition and results of operations.

Concentration of suppliers

A significant portion of the Group’s medical equipment and construction is sourced from its five largest suppliers who collectively accounted for 94%, 93% and 96% of total medical equipment and construction purchases of the Group for the years ended December 31, 2021, 2022 and 2023, respectively. Failure to develop or maintain the relationships with these suppliers may cause the Group not able to identify other suppliers timely in order to expand its business with new hospitals. Any disruption in the supply of medical equipment to the Group may adversely affect the Group’s business, financial condition and results of operations.

Current vulnerability due to certain other concentrations

The Group’s operations may be adversely affected by significant political, economic and social uncertainties in the PRC. Although the PRC government has been pursuing economic reform policies for more than 20 years, no assurance can be given that the PRC government will continue to pursue such policies or that such policies may not be significantly altered, especially in the event of a change in leadership, social or political disruption or unforeseen circumstances affecting the PRC’s political, economic and social conditions. There is also no guarantee that the PRC government’s pursuit of economic reforms will be consistent or effective.

The Group transacts most of its business in RMB, which is not freely convertible into foreign currencies. On January 1, 1994, the PRC government abolished the dual rate system and introduced a single rate of exchange as quoted daily by the People’s Bank of China (the “PBOC”). However, the unification of the exchange rates does not imply that the RMB may be readily convertible into United States dollars or other foreign currencies. All foreign exchange transactions continue to take place either through the PBOC or other banks authorized to buy and sell foreign currencies at the exchange rates quoted by the PBOC. Approval of foreign currency payments by the PBOC or other institutions requires submitting a payment application form together with suppliers’ invoices, shipping documents and signed contracts.

Additionally, the value of the RMB is subject to changes in central government policies and international economic and political developments affecting supply and demand in the PRC foreign exchange trading system market.

A medical-related business is subject to significant restrictions under current PRC laws and regulations. Currently, the Group conducts its operations in China through contractual arrangements entered into with hospitals in the PRC. The relevant regulatory authorities may find the current contractual arrangements and businesses to be in violation of any existing or future PRC laws or regulations. If so, the relevant regulatory authorities would have broad discretion in dealing with such violations.

Foreign currency exchange rate risk

The Group’s exposure to foreign currency exchange rate risk primarily relates to cash and restricted cash denominated in the US$. The depreciation (appreciation) of the RMB against US$ was (2.3)%, 8.2% and 2.9% during the years ended December 31, 2021, 2022 and 2023, respectively. In the long term, the RMB may appreciate or depreciate more significantly in value against the U.S. dollar or other foreign currencies, depending on the market supply and demand with reference to a basket of currencies.

CONSOLIDATED STATEMENTS OF CASH FLOWS ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
CASH FLOWS FROM OPERATING ACTIVITIES
Net loss	¥ (531,021)	$ (74,795)	¥ (768,990)	¥ (522,672)
Adjustments to reconcile net loss to net cash generated from operating activities:
Share-based compensation (note 23)			(5,919)	14,680
Depreciation of property, plant and equipment (note 9)	82,124	11,567	88,692	64,288
Amortization of intangible assets (note 12)	36,705	5,170	34,495	30,171
Amortization of land lease payments (note 10)	9,625	1,356	9,627	9,621
Lease expense to reduce operating lease ROU	26,683	3,758	19,322	21,720
Income from equity method investments	(20,789)	(2,928)	(17,647)	(18,163)
Change in fair value of derivative liability (note 21)	(5,207)	(733)	(1,015)	39
(Gain) loss on disposal of long-lived assets	(62)	(9)	3	0
Deferred tax expense (benefit)	(13,039)	(1,837)	(71,848)	11,257
Allowance for doubtful accounts, net	64,712	9,114	5,400	2,555
Interest and consultation expenses	165,669	23,334	120,357	73,789
Loss on disposal of subsidiaries (note 4)	638	90	61,546	0
Gain on sale of partial interests in an equity method investment	(37,498)	(5,281)	0	0
Loss from agreements termination with a cooperative hospital			204,250	0
Changes in operating assets and liabilities net of effects of acquisition and disposals:
Accounts receivable	36,454	5,134	644	(64,450)
Prepayments and other current assets	(149,738)	(21,090)	(130,156)	(30,908)
Inventories	44,489	6,266	(46,750)	(4,352)
Other non-current assets	1,618	228	(15)	(175)
Accounts payable	15,779	2,222	113,743	262,842
Accrued expenses and other liabilities	70,838	9,977	119,055	(2,515)
Deferred revenue	(41,179)	(5,800)	57,168	(193,464)
Income tax payable	705	99	818	(858)
Accrued unrecognized tax benefit	(15,830)	(2,230)	(6,539)	621
Operating lease liabilities	(18,147)	(2,556)	(2,935)	(13,339)
Net cash used in operating activities	(276,471)	(38,944)	(216,694)	(359,313)
CASH FLOWS FROM INVESTING ACTIVITIES
Purchase of land use right			(215)	0
Investment in equity method investees			(2,300)	(61,159)
Investment in equity investments without readily determinable fair value	(100)	(14)	0	(6,439)
Acquisitions of business, net of cash acquired			0	1,569
Acquisitions of property, plant and equipment	(113,003)	(15,916)	(222,980)	(278,977)
Acquisitions of intangible assets	(4,211)	(593)	(818)	(19,712)
Deposits for the purchases of property, plant and equipment	(2,699)	(380)	(160,793)	(481,604)
Proceeds from disposal of property, plant and equipment	310	44	5,635	212,975
Proceed from agreements termination with a cooperative hospital			238,093	0
Proceeds from principal portion of direct financing leases			7,536	31,525
Cash distribution from equity method investments	12,022	1,693	5,101	15,863
Proceeds from disposal of certain percentage of an equity method investment	60,000	8,451	0	0
Redemption of available-for-sale debt securities			11,949	19,978
Net cash used in investing activities	(47,681)	(6,715)	(118,792)	(565,981)
CASH FLOWS FROM FINANCING ACTIVITIES
Proceeds from short-term bank borrowings	337,695	47,563	217,470	126,112
Proceeds from long-term bank and other borrowings	110,000	15,493	422,765	386,635
Proceeds from convertible note (note 22)				20,000
Borrowings from related parties (note 25)	22,150	3,120	220,369	24,432
Repayment to related parties (note 25)	(61,777)	(8,701)	(82,915)	(80,886)
Repayment of short-term bank and other borrowings	(442,858)	(62,375)	(197,598)	(24,706)
Repayment of long-term bank and other borrowings	(7,561)	(1,065)	(197,003)	(206,057)
Purchase of subsidiary shares from noncontrolling interests			0	(4,581)
Capital injection from a noncontrolling interests in a subsidiary	300,004	42,255		1,500
Proceeds from issuance of contingently redeemable noncontrolling interests of a subsidiary				400,000
Net cash generated from financing activities	257,653	36,290	383,088	642,449
Effect of foreign exchange rate changes on cash and cash equivalent and restricted cash	(2,425)	(338)	(47,170)	(4,639)
Net increase (decrease) in cash	(68,924)	(9,707)	432	(287,484)
Cash and cash equivalents and restricted cash at beginning of the year	159,343	22,443	158,911	446,395
Cash and cash equivalents and restricted cash at end of the year	90,419	12,736	159,343	158,911
Reconciliation of cash and cash equivalents and restricted cash to the consolidated balance sheets
Cash and cash equivalents	58,139	8,189	158,283	157,386
Restricted cash, current portion	32,280	4,547	1,060	1,387
Restricted cash, noncurrent portion				138
Total cash and cash equivalents and restricted cash	90,419		159,343	158,911
Supplemental schedule of major cash flows information:
Income tax paid	(898)	(126)	(3,013)	0
Interest paid	(152,359)	(21,459)	(145,257)	(134,180)
Supplemental schedule of major non-cash activities:
Acquisition of property, plant and equipment, construction in progress and other intangible assets through utilization of deposits	5,812	819	257,440	460,078
Acquisition of property, plant and equipment, construction in progress and other intangible assets included in accrued expense and other liabilities	¥ 285,358	$ 40,192	¥ 2,181	¥ 99,406

SEGMENT REPORTING - Total long-lived assets excluding financial instruments, intangible assets, long-term investment and goodwill by country (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
Revenues from External Customers and Long-Lived Assets [Line Items]
Total long-lived assets	¥ 4,132,784	$ 582,090	¥ 3,862,975
PRC
Revenues from External Customers and Long-Lived Assets [Line Items]
Total long-lived assets	¥ 4,132,784	$ 582,090	¥ 3,862,975

INTANGIBLE ASSETS, NET - Schedule of Acquired Intangible Assets (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
Intangible assets, net:
Intangible assets, net, beginning balance	¥ 353,766		¥ 657,837
Addition of software	6,296		3,334
Decrease from cooperation termination with a cooperative hospital			(272,910)
Amortization expenses	(36,705)	$ (5,170)	(34,495)	¥ (30,171)
Intangible assets, cost	493,062
Less: accumulated amortization	(168,812)
Less: intangible asset impairment	(963)
Intangible assets, net, ending balance	323,287	45,534	353,766	657,837
Customer Relationships Intangibles [Member]
Intangible assets, net:
Intangible assets, cost	32,449
Less: accumulated amortization	(31,486)
Less: intangible asset impairment	(963)
Operating Lease Intangibles [Member]
Intangible assets, net:
Intangible assets, cost	418
Less: accumulated amortization	(418)
Operating License Intangibles [Member]
Intangible assets, net:
Intangible assets, net, beginning balance	204,714		490,296
Decrease from cooperation termination with a cooperative hospital			(272,910)
Amortization expenses	(12,672)		(12,672)
Intangible assets, cost	253,440
Less: accumulated amortization	(61,398)
Intangible assets, net, ending balance	192,042	27,049	204,714	490,296
Favorable Lease Intangibles
Intangible assets, net:
Intangible assets, net, beginning balance	14,692		16,256
Amortization expenses	(1,564)		(1,564)
Intangible assets, cost	21,010
Less: accumulated amortization	(7,882)
Intangible assets, net, ending balance	13,128	1,849	14,692	16,256
Technology.
Intangible assets, net:
Intangible assets, net, beginning balance	105,832		118,971
Amortization expenses	(13,219)		(13,139)
Intangible assets, cost	132,190
Less: accumulated amortization	(39,577)
Intangible assets, net, ending balance	92,613	13,044	105,832	118,971
Others
Intangible assets, net:
Intangible assets, net, beginning balance	28,528		32,314
Addition of software	6,226		3,334
Amortization expenses	(9,250)		(7,120)
Intangible assets, cost	53,555
Less: accumulated amortization	(28,051)
Intangible assets, net, ending balance	¥ 25,504	$ 3,592	¥ 28,528	¥ 32,314

LEASE - Schedule of future lease payments (Details) - Dec. 31, 2023 ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
2024	¥ 57,992	$ 8,168
2025	29,134	4,103
2026	24,046	3,387
2027	21,723	3,060
2028	22,097	3,112
Thereafter	167,181	23,547
Total future lease payments	322,173	45,377
Less: Imputed interest	82,674	11,645
Total lease liability balance	¥ 239,499	$ 33,732

BANK AND OTHER BORROWINGS

12 Months Ended

Dec. 31, 2023

BANK AND OTHER BORROWINGS

BANK AND OTHER BORROWINGS

18.BANK AND OTHER BORROWINGS


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Total bank and other borrowings	2,984,010	3,036,202	427,640
Comprised of:
Short-term	168,601	319,625	45,018
Long-term, current portion	343,982	722,563	101,771
	512,583	1,042,188	146,789
Long-term, non-current portion	2,471,427	1,994,014	280,851
	2,984,010	3,036,202	427,640

Certain bank borrowings are secured by equipment with a net carrying value of RMB412,683 and RMB391,056 (US$55,079) (note 9), accounts receivable with a carrying value of RMB11,166 and RMB13,312 (US$1,875) (note 6) (including lease receivables with a carrying value of RMB340 and RMB1,759 (US$248) (note 10)), certain land use rights (which are recorded as “right-of-use assets”) with a carrying value of RMB395,973 and RMB386,614 (US$54,453) (note 10), certain long-term investments with a carrying value of RMB179,231 and RMB189,676 (US$26,715) (note 14), certain construction in progress with a carrying value of RMB1,754,217 and RMB2,027,277 (US$285,536) (note 9), as of December 31, 2022 and 2023, respectively.

The short-term bank and other borrowing bore a weighted average interest of 6.60% and 8.19% per annum, and the long-term bank and other borrowings bore a weighted average interest of 6.48% and 7.42% per annum, respectively, as of December 31, 2022 and 2023.

Bank and other borrowings amounted to RMB151,753 (US$21,374) (2022: RMB156,555) and RMB2,884,449(US$406,266) (2022:RMB2,827,455) were denominated in US$ and RMB, respectively as of December 31, 2023.

The maturity analysis of the long-term bank and other borrowings are as follows:


	RMB	US$
Within one year	722,563	101,771
Between one and two years	434,783	61,238
Between two and three years	401,895	56,606
Between three and four years	629,389	88,648
Above four years	527,947	74,359
	2,716,577	382,622

As of December 31, 2023, the Group had unutilized short-term bank credit lines and unutilized long-term bank credit lines amounted to nil and RMB930,000 (US$130,988), respectively.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

GOODWILL - Carrying amount (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2020 CNY (¥)	Dec. 31, 2019 CNY (¥)	Dec. 31, 2018 CNY (¥)
Goodwill [Roll Forward]
Goodwill, Beginning Balance	¥ 575,427	$ 81,047	¥ 581,877
Addition	0	0		¥ 368,221	¥ 3,213	¥ 45,272	¥ 165,171
Disposal	0	0	(6,450)
Impairment	0	0	0	0
Goodwill, Ending Balance	¥ 575,427	$ 81,047	¥ 575,427	¥ 581,877

- Definition

+ References + Details

RESTRICTED NET ASSETS

12 Months Ended

Dec. 31, 2023

RESTRICTED NET ASSETS

RESTRICTED NET ASSETS

19.RESTRICTED NET ASSETS

The Company’s ability to pay dividends is primarily dependent on the Company receiving distributions of funds from its subsidiaries. Relevant PRC statutory laws and regulations permit payments of dividends by the Group’s PRC subsidiaries only out of their retained earnings, if any, as determined in accordance with PRC accounting standards and regulations. The results of operations reflected in the financial statements prepared in accordance with U.S. GAAP differ from those reflected in the statutory financial statements of the Company’s subsidiaries.

In accordance with the PRC Regulations on Enterprises with Foreign Investment and their articles of association, a foreign invested enterprise established in the PRC is required to provide certain statutory reserves, namely general reserve fund, the enterprise expansion fund and staff welfare and bonus fund which are appropriated from net profit as reported in the enterprise’s PRC statutory accounts. A foreign invested enterprise is required to allocate at least 10% of its annual after-tax profit to the general reserve until such reserve has reached 50% of its respective registered capital based on the enterprise’s PRC statutory accounts. Appropriations to the enterprise expansion fund and staff welfare and bonus fund are at the discretion of the board of directors for all foreign invested enterprises. The aforementioned reserves can only be used for specific purposes and are not distributable as cash dividends. Additionally, in accordance with the company law of the PRC, a domestic enterprise is required to provide at least 10% of its annual after-tax profit to the statutory common reserve until such reserve has reached 50% of its respective registered capital based on the enterprise’s PRC statutory accounts. A domestic enterprise is also required to provide discretionary surplus reserve, at the discretion of the board of directors, from the profits determined in accordance with the enterprise’s PRC statutory accounts.

As a result of these PRC laws and regulations that require annual appropriations of 10% of after-tax income to be set aside prior to payment of dividends as general reserve fund, the Company’s PRC subsidiaries are restricted in their ability to transfer a portion of their net assets to the Company.

In addition, foreign exchange and other regulation in the PRC may further restrict the Company’s PRC subsidiaries from transferring funds to the Company in the form of dividends, loans and advances. The amount of net assets restricted was RMB4,015,583 (US$565,583) as of December 31, 2023.

LEASE - Other information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)
LEASE
Operating cash flows from operating leases	¥ 18,147	$ 2,556
ROU assets obtained in exchange for operating lease liabilities	¥ 15,060	$ 2,121
Weighted-average remaining lease terms (in years)	3 years	3 years
Weighted-average discount rate	5.87%	5.87%

TAXATION (Details) ¥ in Thousands, $ in Thousands	1 Months Ended	12 Months Ended
TAXATION (Details) ¥ in Thousands, $ in Thousands	Apr. 30, 2019	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
TAXATION
Applicable tax rates		25.00%	25.00%	25.00%	25.00%	25.00%	25.00%
Current income tax for federal and state for US Proton		¥ 404	$ 57	¥ 196		¥ 362
Withholding tax rate		10	10
Net operating loss carryforwards		¥ 1,703,345							$ 239,911
Unrecognized tax benefits		63,899		67,172		81,901			9,000	$ 9,461
Unrecognized tax benefits, net deferred tax asset related to tax loss carryforwards		28,712		19,962					4,044
Unrecognized tax benefits which affect the annual effective tax rate		35,421		39,412					4,989
Uncertain tax position, impact on taxes		6,121	$ 862	7,254		¥ 12,918
Accrued interest and penalties		¥ 9,283		¥ 13,091					$ 1,307
Property leasing arrangement
TAXATION
Value added tax	13.00%
Technical service
TAXATION
Value added tax		6.00%	6.00%
United States
TAXATION
Applicable tax rates		21.00%	21.00%	21.00%	21.00%	21.00%	21.00%
Singapore
TAXATION
Income tax profits \| $					$ 0		$ 0	$ 0
Hong Kong
TAXATION
Income tax profits \| ¥		¥ 0

PROPERTY, PLANT AND EQUIPMENT, NET - Additional Information (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2023 USD ($)
PROPERTY, PLANT AND EQUIPMENT, NET
Depreciation of property, plant and equipment	¥ 82,124	$ 11,567	¥ 88,692	¥ 64,288
Tangible asset impairment charges	0		0
Impairment write off	7,138	$ 1,005	0	2,645
Equipment under operating lease, cost	124,894		128,486		$ 17,591
Equipment under operating lease, accumulated depreciation	104,174		100,681		14,673
Property and equipment pledged as collateral for other borrowings	391,056		412,683		55,079
Property and equipment pledged to secure bank and other borrowings	2,027,277		1,754,217		$ 285,536
Hospital
PROPERTY, PLANT AND EQUIPMENT, NET
Impairment of intangible assets (Excluding Goodwill)	0		0	0
Impairment write off	¥ 0		¥ 0	¥ 0

SEGMENT REPORTING

12 Months Ended

Dec. 31, 2023

SEGMENT REPORTING

SEGMENT REPORTING

28.SEGMENT REPORTING

For the years ended December 31, 2021, 2022 and 2023, the Group had two operating segments, including network and hospital. The operating segments also represented the reporting segments. The Group’s CODM assess the performance of the operating segments based on the measures of revenues costs and gross profit (loss) by the network and hospital segment. Other than the information provided below, the CODM do not use any other measures by segments.

Summarized information by segments for the years ended December 31, 2021, 2022 and 2023 is as follows:


	For the year ended December 31, 2023
	Network	Hospital	Total
	RMB	RMB	RMB	US$
Revenues from external customers	218,343	319,059	537,402	75,691
Cost of sales	(206,527)	(407,483)	(614,010)	(86,481)
Gross profit (loss)	11,816	(88,424)	(76,608)	(10,790)


	For the year ended December 31, 2022
	Network	Hospital	Total
	RMB	RMB	RMB
Revenues from external customers	254,442	217,643	472,085
Cost of sales	(225,245)	(399,249)	(624,494)
Gross profit (loss)	29,197	(181,606)	(152,409)


	For the year ended December 31, 2021
	Network	Hospital	Total
	RMB	RMB	RMB
Revenues from external customers	324,458	161,175	485,633
Cost of sales	(253,826)	(288,704)	(542,530)
Gross profit (loss)	70,632	(127,529)	(56,897)


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Segment assets
Network	2,048,126	1,769,085	249,170
Hospital	3,956,808	4,284,858	603,510
Total segment assets	6,004,934	6,053,943	852,680

Major Customers

For the year ended December 31, 2021, 2022 and 2023, one of the Company’s customers accounted for 11.9%, 12.2% and 12.8% of the Company’s total revenue, respectively.

Geographic Information

Net revenue by country is based upon the sales location that predominately represents the customer location. For the year ended December 31, 2021, 2022 and 2023, all of Group’s revenue was generated from PRC. Total long-lived assets excluding financial instruments, intangible assets, long-term investment and goodwill by country were as follows:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
PRC	3,862,975	4,132,784	582,090
Total long-lived assets	3,862,975	4,132,784	582,090

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-15

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-31

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-42

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-40

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//280/tableOfContent

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 26
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-26

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 34
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-34

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-21

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-21

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

+ Details

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION

12 Months Ended

Dec. 31, 2023

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION

PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION

31.PARENT COMPANY ONLY CONDENSED FINANCIAL INFORMATION

Condensed balance sheets


	As at December 31
	2022	2023	2023
	RMB	RMB	US$
ASSETS
Current assets:
Cash and cash equivalent	1,510	17,466	2,460
Prepayments and other current assets	24,271	24,999	3,521
Total current assets	25,781	42,465	5,981
Total assets	25,781	42,465	5,981

LIABILITIES AND SHAREHOLDERS’ EQUITY
Current liabilities:
Short term loan	32,417	41,179	5,800
Long-term debts due within one year	111,028	110,574	15,574
Accrued expenses and other liabilities	11,649	20,483	2,885
Derivative liability	5,290	163	23
Amounts due to subsidiaries	1,729,363	1,992,011	280,568
Total current liabilities	1,889,747	2,164,410	304,850
Total liabilities	1,889,747	2,164,410	304,850

Shareholders’ equity (deficit):
Class A ordinary shares (par value of US$0.0001per share; authorized shares-500,000,000; issued shares-96,565,584 and 96,565,584 as of December 31, 2022 and 2023; outstanding shares-84,463,737 and 84,463,737 as of December 31, 2022 and 2023, respectively)	68	68	10
Class B ordinary shares (par value of US$0.0001per share; authorized shares‑45,787,948; issued shares-45,787,948 and 45,787,948 as of December 31, 2022 and 2023; outstanding shares- 45,787,948 and 45,787,948 as of December 31, 2022 and 2023, respectively)	37	37	5
Treasury stock (12,101,847 and 12,101,847 shares as of December 31, 2022 and 2023, respectively)	(7)	(7)	(1)
Additional paid-in capital	1,930,633	2,007,965	282,816
Accumulated other comprehensive loss	(27,766)	(65,419)	(9,214)
Accumulated deficit	(3,766,931)	(4,064,589)	(572,485)
Total shareholders’ equity (deficit)	(1,863,966)	(2,121,945)	(298,869)
Total liabilities and shareholders’ equity (deficit)	25,781	42,465	5,981

Condensed statements of comprehensive loss


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Revenues	—	—	—	—
Cost of revenues	—	—	—	—
General and administrative expenses	(14,428)	5,242	(2,414)	(340)
Selling expenses	(2,090)	(524)	—	—
Operating loss	(16,518)	4,718	(2,414)	(340)
Equity in loss of subsidiaries	(793,117)	(605,175)	(314,122)	(44,246)
Interest income	—	—	14	2
Interest expense	(1,459)	(10,394)	(9,926)	(1,398)
Changes in fair value of derivatives	—	1,055	5,282	744
Other income, net	—	96,609	(1,008)	(142)
Foreign exchange gain(loss)	(9,527)	23,526	24,516	3,453
Net loss	(820,621)	(489,661)	(297,658)	(41,927)
Other comprehensive income (loss)
Foreign currency translation, net of tax of nil	14,821	(53,964)	(6,480)	(913)
Unrealized losses on available-for-sale securities, net	—	—	(31,173)	(4,391)
Total other comprehensive (loss) income	14,821	(53,964)	(37,653)	(5,304)
Comprehensive loss	(805,800)	(543,625)	(335,311)	(47,231)

Condensed statements of cash flows


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Net cash (used in) generated from operating activities	(9,301)	(2,047)	(1,258)	(177)
Net cash (used in) generated from investing activities	(88,546)	(29,335)	15,655	2,205
Net cash (used in) generated from financing activities	110,876	16,591	1,590	224

Exchange rate effect on cash	(50)	1,243	(31)	(5)

Net (decrease) increase in cash	12,979	(13,548)	15,956	2,247
Cash at beginning of the year	2,079	15,058	1,510	213

Cash at end of the year	15,058	1,510	17,466	2,460

Basis of presentation

For the presentation of the parent company only condensed financial information, the Company records its investment in subsidiaries under the equity method of accounting as prescribed in ASC 323, Investments - Equity Method and Joint Ventures. Such investment is presented on the balance sheet as “Investment in subsidiaries” and the subsidiaries profit or loss as “Equity in loss of subsidiaries” on the statements of comprehensive income loss. The parent company only financial statements should be read in conjunction with the Company’s consolidated financial statements.

Revenue (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
Revenue (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
REVENUE
ASC 606 revenue	¥ 520,665	$ 73,334	¥ 450,119	¥ 443,149
ASC 842 revenue:
Operating lease income	¥ 13,371	$ 1,883	¥ 18,226	¥ 35,913
Operating Lease, Lease Income, Statement of Income or Comprehensive Income [Extensible Enumeration]	Total Revenues	Total Revenues	Total Revenues	Total Revenues
Sales-type lease income	¥ 3,366	$ 474	¥ 3,326	¥ 5,210
Direct financing lease income			414	1,361
ASC 842 revenue	16,737	2,357	21,966	42,484
Total Revenues	537,402	75,691	472,085	485,633
Management and technical support
REVENUE
ASC 606 revenue	23,164	3,263	53,341	64,599
Medical solution
REVENUE
ASC 606 revenue	178,442	25,133	179,135	217,375
Medical service
REVENUE
ASC 606 revenue	218,595	30,788	131,936	101,854
Medicine income
REVENUE
ASC 606 revenue	100,464	14,150	85,707	59,321
ASC 842 revenue:
Total Revenues	¥ 100,464	$ 14,150	¥ 85,707	¥ 59,321

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Parenthetical) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
Interest expense	¥ 165,669	$ 23,334	¥ 120,357	¥ 73,789
Interest income (including interest income from related party amounting to RMB3,447, RMB6,961 and RMB6,813 (US$960) for the years ended December 31, 2021, 2022 and 2023, respectively)	10,832	1,526	10,021	5,894
Foreign currency translation, net of tax	0		0	0
Related party
Interest expense	14,308	2,015	16,790	13,532
Interest income (including interest income from related party amounting to RMB3,447, RMB6,961 and RMB6,813 (US$960) for the years ended December 31, 2021, 2022 and 2023, respectively)	¥ 6,813	$ 960	¥ 6,961	¥ 3,447

- Definition

Amount of the cost of borrowed funds accounted for as interest expense.

+ References + Details

SHARE-BASED AWARDS

12 Months Ended

Dec. 31, 2023

SHARE-BASED AWARDS

SHARE-BASED AWARDS

23.SHARE-BASED AWARDS

On October 16, 2008, the Board of Directors adopted the 2008 Share Incentive Plan (the “2008 Share Incentive Plan”). The 2008 Share Incentive Plan provides for the granting of options, share appreciation rights, or other share based awards to key employees, directors or consultants, which was subsequently amended on November 17, 2009 and November 26, 2011 to increase the number of ordinary shares available for grant under the plan. The total number of the Company’s ordinary shares that may be issued under the 2008 Share Incentive Plan is up to 13,218,000 ordinary shares.

Share options

On February 18, 2014, the Company granted options to purchase 3,479,604 ordinary shares to its employees at an exercise price of $2.04 per share that have a contractual life of eight years and vest over four equal installments on the first, second, third, and fourth anniversary of the grant date. The Company recognizes the compensation expense on a straight-line basis over the requisite service period for the entire award. The Company calculated the estimated grant date fair value of the share options granted on February 18, 2014, using a Binomial Tree Model, with key assumptions as follows.


	February 18, 2014
Risk-free interest rate	2.33	%
Dividend yield	5	%
Exercise multiple	2.5
Expected volatility range	39.03	%

The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying awards and the fair value of the Company’s shares that would have been received by the option holders if all in-the-money options had been exercised on the issuance date. There were no options granted or exercised for the years ended December 31, 2021, 2022 and 2023. As of December 31, 2023, unrecognized share-based compensation cost related to share options was nil.

For the outstanding hare options granted to employees as at December 31, 2021, all them has lapsed and the exercisable shares at December 31, 2022 and 2023 was nil.

Restricted shares

On February 18, 2014, July 1, 2014 and August 1, 2014, the Company granted 1,370,250, 21,132 and 69,564 restricted shares of the Company (“Restricted Shares”) to the employees of the Company, respectively. The Restricted Shares have a service condition where the grantees can remove restriction on 25% of total number of Restricted Shares on annual basis over a four-year period ending the fourth anniversary of the grant date.

The Group did not grant any Restricted Shares in 2015 and 2016.

On August 7, 2017, August 8, 2017, September 13, 2017 and October 2, 2018, the Company granted 1,453,950, 3,319,200, 45,000 and 5,992,605 Restricted Shares to the employees of the Company, respectively. The Restricted Shares have a service condition where the grantees can remove restriction on 25% of total number of restricted shares on annual basis over a four-year period ending the fourth anniversary of the grant date.


		Fair Value per Share
		at the Grant
Grant Date	Number of Awards	date (US$)
February 18, 2014	1,370,250	1.93
July 1, 2014	21,132	2.35
August 1, 2014	69,564	2.44
August 7, 2017	1,453,950	1.33
August 8, 2017	3,319,200	1.34
September 13, 2017	45,000	1.33
October 2, 2018	5,992,605	1.19


		Weighted
	Numbers	average grant
	of shares	date fair value
	RMB	US$
Outstanding, January 1, 2023	10,785,789	1.31
Granted	—	—
Forfeited	—	—
Exercised	—	—
Outstanding, December 31, 2023	10,785,789	1.31
Exercisable, December 31, 2023	10,785,789	1.31

As of December 31, 2023, unrecognized share-based compensation cost related to Restricted Shares was nil.

The share-based compensation expense of the share options and Restricted Shares granted to employees for the years ended December 31, 2021, 2022 and 2023 is as follows:


	For the Years ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
General and administrative expenses	12,565	(6,424)	—	—
Selling expenses	2,115	505	—	—
	14,680	(5,919)	—	—

All of the share options granted to employees has expired, which led a negative share-based compensation expense for the year ended December 2022.

PROPERTY, PLANT AND EQUIPMENT, NET

12 Months Ended

Dec. 31, 2023

PROPERTY, PLANT AND EQUIPMENT, NET

PROPERTY, PLANT AND EQUIPMENT, NET

9.PROPERTY, PLANT AND EQUIPMENT, NET

Property, plant and equipment consist of the following:


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Buildings	782,560	807,737	113,767
Medical equipment	532,165	522,385	73,576
Electronic and office equipment	58,038	58,999	8,310
Motor vehicles	3,717	3,718	524
Leasehold improvement and building improvements	75,032	81,766	11,517
Construction in progress	2,131,991	2,466,320	347,374
Total	3,583,503	3,940,925	555,068
Less: accumulated depreciation	(308,210)	(385,042)	(54,232)
Impairment charges	(16,148)	(9,010)	(1,269)
	3,259,145	3,546,873	499,567

Depreciation expenses were RMB64,288, RMB 88,692 and RMB82,124 (US$11,567) for the years ended December 31, 2021, 2022 and 2023, respectively. Impairment loss of RMB nil, nil and nil were recognized for network operating segment and impairment loss of nil, nil and nil for hospital operating segment for the years ended December 31, 2021, 2022 and 2023, respectively.

For the years ended December 31, 2021, 2022 and 2023, impairment of RMB2,645, nil and RMB7,138 (US$1,005) was written off for network operating segment upon the disposal of medical equipment and construction project, and impairment of nil, nil and nil was written off for hospital operating segment.

The Group held equipment under operating lease contracts with customers with an original cost of RMB128,486 and RMB124,894 (US$17,591) and accumulated depreciation of RMB100,681 and RMB104,174 (US$14,673), as of December 31, 2022 and 2023, respectively.

The total net book value of the Group’s property, plant and equipment pledged as collateral for other borrowings as of December 31, 2022 and 2023 was RMB412,683 and RMB391,056 (US$55,079) (note 18), respectively.

The total net book value of the Group’s construction in progress pledged to secure bank and other borrowings as of December 31, 2022 and 2023 was RMB1,754,217 and RMB2,027,277 (US$ 285,536) (note 18), respectively.

LONG-TERM INVESTMENTS (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
LONG-TERM INVESTMENTS
Equity investments without readily determinable fair value	¥ 51,624	$ 7,271	¥ 51,524
Equity method investments	324,163	45,657	336,254
Available-for-sale debt securities	18,924	2,665	50,096
Total	¥ 394,711	$ 55,593	¥ 437,874

RELATED PARTY TRANSACTIONS (Tables)

12 Months Ended

Dec. 31, 2023

RELATED PARTY TRANSACTIONS

Schedule of related party transactions

Related parties^#


Name of Related Parties		Relationship with the Group
JYADK		Equity investee of the Group
Zhejiang Marine Leasing Ltd.		Equity investee of the Group
Cherrylane Investments Limited		An entity controlled by a director of the Company
Guangdong Proton International Hospital Management Co., Ltd.		A wholly owned subsidiary of an equity investee of the Group
Morgancreek investment Holdings Limited		An entity controlled by the CEO of the Company

# These are the related parties that have engaged in significant transactions with the Company for the years ended December 31, 2021, 2022 and 2023.

b) The Group had the following related party transactions for the years ended December 31, 2021, 2022 and 2023.


	For the Years ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Loan to:
Guangdong Proton International Hospital Management Co., Ltd.	142,895	16,800	200	28
	142,895	16,800	200	28
Interest income from:
JYADK	650	—	—	—
Guangdong Proton International Hospital Management Co., Ltd.	2,797	6,961	6,813	960
	3,447	6,961	6,813	960

Loan from:
Cherrylane Investments Limited	15,932	—	—	—
Zhejiang Marine Leasing Ltd	8,500	220,369	4,400	620
Morgancreek investment Holdings Limited	—	—	17,750	2,500
	24,432	220,369	22,150	3,120
Interest expense to:
Cherrylane Investments Limited	554	1,334	423	60
Zhejiang Marine Leasing Ltd	12,978	15,456	13,683	1,927
Morgancreek investment Holdings Limited	—	—	202	28
	13,532	16,790	14,308	2,015
Repayment to:
Cherrylane Investments Limited	3,824	—	19,710	2,776
Zhejiang Marine Leasing Ltd.	77,062	82,915	32,127	4,525
Morgancreek investment Holdings Limited	—	—	9,940	1,400
	80,886	82,915	61,777	8,701
Repayment from:
JYADK	2,430	—	—	—
	2,430	—	—	—

Schedule of related party balances

(c)

The balances between the Group and its related parties as of December 31, 2022 and 2023 are listed below.


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Due from related parties, current:
Guangdong Proton International Hospital Management Co., Ltd.	169,453	151,481	21,335
	169,453	151,481	21,335

Due to related parties, current:
Cherrylane Investments Limited	13,105	1,659	234
Morgancreek investment Holdings Limited	—	8,012	1,128
	13,105	9,671	1,362

Due to related parties, non-current
Zhejiang Marine Leasing Ltd.	122,579	69,182	9,744
	122,579	69,182	9,744
Due to related parties, non-current, due within 1 year
Zhejiang Marine Leasing Ltd	123,855	163,208	22,987
Cherrylane Investments Limited	10,001	4,075	574
	133,856	167,283	23,561

Revenue (Tables)

12 Months Ended

Dec. 31, 2023

Revenue

Schedule of Deferred revenue Recognition


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
ASC 606 revenue:
Management and technical support	64,599	53,341	23,164	3,263
Medical solution	217,375	179,135	178,442	25,133
Medical service	101,854	131,936	218,595	30,788
Medicine income	59,321	85,707	100,464	14,150
ASC 606 revenue	443,149	450,119	520,665	73,334
ASC 842 revenue:
Operating lease income*	35,913	18,226	13,371	1,883
Sales-type lease income*	5,210	3,326	3,366	474
Direct financing lease income*	1,361	414	—	—
ASC 842 revenue	42,484	21,966	16,737	2,357
Total revenue	485,633	472,085	537,402	75,691

* Operating lease income, sales-type lease income and direct financing lease income were recognized under ASC 842, Leases.

RELATED PARTY TRANSACTIONS - Related party balances (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
RELATED PARTY TRANSACTIONS
Due to related parties, current:	¥ 171,127	$ 24,103	¥ 142,305
Other long-term liabilities	69,003	9,719	84,084
Related party
RELATED PARTY TRANSACTIONS
Due from related parties, current:	151,481	21,335	169,453
Due to related parties, current:	9,671	1,362	13,105
Other long-term liabilities	69,182	9,744	122,579
Due to related parties, non-current, due within 1 year	167,283	23,561	133,856
Related party \| Guangdong Proton International Hospital Management Co., Ltd
RELATED PARTY TRANSACTIONS
Due from related parties, current:	151,481	21,335	169,453
Related party \| Cherrylane Investment Limited
RELATED PARTY TRANSACTIONS
Due to related parties, current:	1,659	234	13,105
Due to related parties, non-current, due within 1 year	4,075	574	10,001
Related party \| Zhejiang Marine Leasing Ltd
RELATED PARTY TRANSACTIONS
Other long-term liabilities	69,182	9,744	122,579
Due to related parties, non-current, due within 1 year	163,208	22,987	123,855
Related party \| Morgancreek investment Holdings Limited
RELATED PARTY TRANSACTIONS
Due to related parties, current:	¥ 8,012	$ 1,128	¥ 0

ACQUISITIONS AND DISPOSALS - Disposal of Guofu Huimei and its subsidiaries classes of assets and liabilities (Details) - Dec. 26, 2022 - Guofu Huimei and its subsidiaries ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
ACQUISITIONS AND DISPOSALS
Current assets	¥ 199,727	$ 28,957
Current liabilities	(10,325)	(1,497)
Net assets disposed	¥ 189,402	$ 27,460

- Definition

Amount classified as liabilities attributable to disposal group held for sale or disposed of, expected to be disposed of within one year or the normal operating cycle, if longer.

+ References + Details

ACQUISITIONS AND DISPOSALS - Acquisition of Healthingkon Assets and Liabilities (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 CNY (¥)	Jan. 31, 2021 CNY (¥)	Jan. 31, 2021 USD ($)
ACQUISITIONS AND DISPOSALS
Goodwill	¥ 575,427	$ 81,047	¥ 575,427	$ 81,047	¥ 581,877	¥ 368,221	$ 57,782
HealthingKon
ACQUISITIONS AND DISPOSALS
Current assets						16,567
Property, plant and equipment, net						1,421
Intangible assets						133,183
Goodwill						368,221
Current liabilities						(44,564)
Deferred tax liabilities						(19,829)
Non-controlling interest						(335,161)
Total						¥ 119,838

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)

12 Months Ended

Dec. 31, 2023

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Schedule of property, plant and equipment estimated useful


		Estimated
		residual
Category	Estimated useful life	value
Buildings	20‑50 years	—
Medical equipment*	5‑20 years	—
Electronic and office equipment	3‑5 years	—
Motor vehicles	5 years	—
Leasehold improvement and building improvement	shorter of lease term or 5 years	—

Schedule of estimated useful life for the intangible assets


		Estimated
		useful life
Operating license		20 years
Favorable leases		12-17 years
Customer relationship		5‑16 years
Operating leases		9‑16 years
Software		3‑5 years
Technology		10 years

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

12 Months Ended

Dec. 31, 2023

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

2.SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Basis of presentation

The accompanying consolidated financial statements have been prepared in accordance with United States generally accepted accounting principles (“U.S. GAAP”).

Going Concern

Use of estimates

Principles of consolidation

Foreign currency translation and transactions

Accumulated other comprehensive loss represents the cumulative foreign currency translation adjustments at each balance sheet date.

Convenience translation

Business combination and noncontrolling interests

Cash and cash equivalents

Restricted cash

Long-term investments

The Group’s long-term investments consist of equity investments without readily determinable fair value, equity method investments and available-for-sale debt securities.

Goodwill

Accounts receivable and credit losses for doubtful accounts

The receivable balances are written off when they are deemed uncollectible. The Group generally does not require collateral from its customers.

Inventories

Inventories, consisting of medicine, medical supplies and low-value consumables, are accounted for using the individual pricing method, and are valued at the lower of cost or market.

Loan receivables

Leases

Lessee Accounting

a. The lease transfers ownership of the underlying asset to the lessee by the end of the lease term.

b. The lease grants the lessee an option to purchase the underlying asset that the lessee is reasonably certain to exercise.

c. The lease term is for a major part of the remaining economic life of the underlying asset.

e. The underlying asset is of such a specialized nature that it is expected to have no alternative use to the lessor at the end of the lease term.

The Group classifies a lease as an operating lease when it does not meet any one of these criteria.

Lessor Accounting

A general description of the Group’s lease income for each type of lease arrangement was as follows:

i.Sales-type lease income

ii.Operating lease income

iii.Direct financing lease income

Property, plant and equipment, net

Property, plant and equipment are stated at cost and are depreciated using the straight-line method over the estimated useful lives of the assets, as follows:


		Estimated
		residual
Category	Estimated useful life	value
Buildings	20‑50 years	—
Medical equipment*	5‑20 years	—
Electronic and office equipment	3‑5 years	—
Motor vehicles	5 years	—
Leasehold improvement and building improvement	shorter of lease term or 5 years	—

Intangible assets, net


		Estimated
		useful life
Operating license		20 years
Favorable leases		12-17 years
Customer relationship		5‑16 years
Operating leases		9‑16 years
Software		3‑5 years
Technology		10 years

Impairment of long-lived assets

Impairment loss on long-lived assets of nil, nil and nil was recognized for the years ended December 31, 2021, 2022 and 2023, respectively.

Derivative liability

Treasury stock

Fair value of financial instruments

Revenue recognition

ASC 606 revenue

i.Management and Technical Support

ii.Medical solution

iii.Medical service

iv.Medicine income

Cost of revenue

A.Network costs

(1) Costs of lease and management service arrangements

(2) Cost of sales-type lease

Cost of sales-type lease as a lessor is recorded as the carrying value of the underlying asset at lease commencement.

(3) Cost of management and technical support

Cost of management and technical support mainly include labor costs, and, where applicable, medical consumables and maintenance expenses which are expensed as incurred.

(4) Cost of medical solution

B.Hospital costs

Income taxes

Share-based compensation

Share-based awards and restricted shares granted to employees are accounted for under ASC 718, Compensation-Stock Compensation (“ASC 718”).

Loss per share

Comprehensive loss

Segment reporting

Recently adopted accounting pronouncements

Recent accounting pronouncement pending adoption

LONG-TERM INVESTMENTS - Available-for-sale debt securities (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
LONG-TERM INVESTMENTS
Available-for-sale debt securities - Fair Value	¥ 18,924	$ 2,665	¥ 50,096
Private equity funds
LONG-TERM INVESTMENTS
Available-for-sale debt securities - Fair Value	¥ 18,924
Available-for-sale debt securities - Redemption frequency	Annually
Minimum \| Private equity funds
LONG-TERM INVESTMENTS
Available-for-sale debt securities - Redemption Notice Period	5 days
Maximum \| Private equity funds
LONG-TERM INVESTMENTS
Available-for-sale debt securities - Redemption Notice Period	9 days

SHAREHOLDERS' EQUITY

12 Months Ended

Dec. 31, 2023

SHAREHOLDERS' EQUITY

SHAREHOLDERS' EQUITY

17.SHAREHOLDERS’ EQUITY

Ordinary Shares

The Company’s ordinary shares are divided into Class A ordinary shares and Class B ordinary shares. The rights of the holders of Class A and Class B ordinary shares are identical, except with respect to voting and conversion rights. On January 27, 2015, the directors of the Company had resolved, subject to the adoption of the Amended M&A, to issue 45,787,948 Class B Ordinary Shares to Morgancreek Investment Holdings Limited (“Morgancreek”), in exchange of 45,787,948 Class A Ordinary Shares held by Morgancreek. During the year ended December 31, 2018, the 45,787,948 Class A ordinary shares of Morgancreek were converted to Class B ordinary shares.

As of December 31, 2023, there were 84,463,737 Class A and 45,787,948 Class B ordinary shares outstanding.

Share repurchase program

On August 10, 2015, the Board of Director approved a share repurchase program pursuant to which, the Company is authorized to repurchase up to US$20,000 of its outstanding ADSs at a price not exceeding US$7.99 per ADS. During the year ended December 31, 2015 and 2016, the Company repurchased 614,033 and 967,408 ADSs, representing 1,842,099 and 2,902,224 ordinary shares, with a total consideration of US$3,111 and US$4,542 respectively. No ADS was repurchased in 2021, 2022 and 2023.

Special dividend

No special dividend or other dividend was declared in 2021, 2022 and 2023.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 505
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481004/946-505-50-6

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480237/815-40-50-6

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480008/505-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//505/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 16
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-16

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-18

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-18

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-18

+ Details

Document and Entity Information	12 Months Ended
Document and Entity Information	Dec. 31, 2023 shares
Document Information [Line Items]
Document Type	20-F
Amendment Flag	false
Document Registration Statement	false
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Document Transition Report	false
Document Shell Company Report	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Entity Registrant Name	Concord Medical Services Holdings Ltd
Entity Central Index Key	0001472072
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Shell Company	false
Entity Emerging Growth Company	false
Document Accounting Standard	U.S. GAAP
ICFR Auditor Attestation Flag	false
Entity File Number	001-34563
Entity Incorporation, State or Country Code	E9
Entity Address, Address Line One	Room A1-A5 26/F, East Zone, Hanwei Plaza
Entity Address, Address Line Two	No. 7 Guanghua Road, Chaoyang District
Entity Address, City or Town	Beijing
Entity Address, Postal Zip Code	100020
Entity Address, Country	CN
Auditor Name	Shandong Haoxin Certified Public Accountants Co., Ltd.
Auditor Firm ID	5035
Auditor Location	Weifang, People’s Republic of China
Document Financial Statement Error Correction [Flag]	false
Business Contact [Member]
Document Information [Line Items]
Contact Personnel Name	Mr. Boxun Zhang
Entity Address, Address Line One	Room A1-A5 26/F, East Zone, Hanwei Plaza
Entity Address, Address Line Two	No. 7 Guanghua Road, Chaoyang District,
Entity Address, City or Town	Beijing
Entity Address, Postal Zip Code	100020
Entity Address, Country	CN
Local Phone Number	5903 6688
Contact Personnel Fax Number	5957-5252
City Area Code	86 10
Ordinary shares [Member]
Document Information [Line Items]
Entity Common Stock, Shares Outstanding	130,251,685
American Depositary Shares [Member]
Document Information [Line Items]
Trading Symbol	CCM
Title of 12(b) Security	American depositary shares, each representing three Class A ordinary shares, par value US$0.0001 per share
Security Exchange Name	NYSE
Common Class A
Document Information [Line Items]
Entity Common Stock, Shares Outstanding	84,463,737
Title of 12(b) Security	Class A ordinary shares, par value US$0.0001 per share*
Security Exchange Name	NYSE
No Trading Symbol Flag	true
Common Class B
Document Information [Line Items]
Entity Common Stock, Shares Outstanding	45,787,948

LEASE (Tables)

12 Months Ended

Dec. 31, 2023

LEASE

Schedule of component lease receivables


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Current
Account receivable - Operating lease	14,230	14,683	2,068
Account receivable - Sales-type lease	906	1,515	213

Total	15,136	16,198	2,281

Schedule of component sales-type and direct financing leases


	For the Year Ended December 31, 2023
			Direct financing
	Sales-type leases		leases		Operating leases
	RMB	US$	RMB	US$	RMB	US$
Selling loss recognized at the commencement date	—	—	—	—	—	—

Interest income on net investment in the lease	3,366	474	—	—	—	—
Including: Income relating to variable lease payments not included in the measurement of the net investment in a lease	3,366	474	—	—	—	—

Lease income relating to lease payments					13,371	1,883
Including: Income relating to variable lease payments not included in the measurement of lease receivable	—	—	—	—	13,371	1,883


	For the Year Ended December 31, 2022
			Direct financing
	Sales-type leases		leases		Operating leases
	RMB	US$	RMB	US$	RMB	US$

Selling loss recognized at the commencement date	—	—	—	—	—	—

Interest income on net investment in the lease	3,326	482	414	60	—	—
Including: Income relating to variable lease payments not included in the measurement of the net investment in a lease	3,326	482	—	—	—	—

Lease income relating to lease payments					18,226	2,643
Including: Income relating to variable lease payments not included in the measurement of lease receivable	—	—	—	—	18,226	2,643

Schedule of Future Minimum Lease Payments Under Non-Cancellable Operating Leases


	Future minimum
	operating lease payments
	RMB	US$
2024	1,396	197
2025	1,396	197
2026	931	131
2027	—	—
2028	—	—
Above 5 years	—	—

Schedule of components of lease cost


	For the year ended December 31, 2023
	RMB	US$
Operating lease cost	41,158	5,797
Short term lease cost	41	6

Total	41,199	5,803

Schedule of cash flow and other information operating leases


	For the year
	ended December 31, 2023
	RMB		US$
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	18,147		2,556
ROU assets obtained in exchange for operating lease liabilities*	15,060		2,121
Weighted-average remaining lease terms (in years)	3		3
Weighted-average discount rate	5.87	%	5.87	%

* Includes new leases entered into during the year ended December 31, 2023. Changes in the ROU asset and liability are presented net within operating activities.

Summary of future minimum lease payments


	Minimum Lease Payments
	RMB	US$
Year ending December 31,
2024	57,992	8,168
2025	29,134	4,103
2026	24,046	3,387
2027	21,723	3,060
2028	22,097	3,112
Thereafter	167,181	23,547
Total future lease payments	322,173	45,377
Less: Imputed interest	82,674	11,645
Total lease liability balance	239,499	33,732

Schedule of prepaid land lease payments


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
	Right-of-use	Right-of-use	Right-of-use
	Asset	asset	asset

Land use rights	464,209	464,209	65,382
Less: accumulated amortization	(56,723)	(66,350)	(9,345)
Net carrying value	407,486	397,859	56,037

Schedule of estimated annual amortization expenses


	Amortization
	RMB	US$
2024	9,627	1,356
2025	9,627	1,356
2026	9,627	1,356
2027	9,627	1,356
2028	9,627	1,356

LEASE - Lease income (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2022 USD ($)
Sales-type leases
LEASE
Interest income on net investment in the lease	¥ 3,366	$ 474	¥ 3,326	$ 482
Including: Income relating to variable lease payments not included in the measurement of the net investment in a lease	3,366	474	3,326	482
Direct financing leases
LEASE
Interest income on net investment in the lease			414	60
Operating leases
LEASE
Lease income relating to lease payments	13,371	1,883	18,226	2,643
Including: Income relating to variable lease payments not included in the measurement of lease receivable	¥ 13,371	$ 1,883	¥ 18,226	$ 2,643

PREPAYMENTS AND OTHER CURRENT ASSETS - Schedule of Prepayments and Other Current Assets (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
PREPAYMENTS AND OTHER CURRENT ASSETS
Due from suppliers	¥ 66,893	$ 9,422	¥ 31,660
Loan receivables	312,036	43,949	294,130
Advances to employees	2,213	312	2,601
Dividend receivable			1,643
Deductible value-added tax	43,355	6,106	44,268
Tax refund	241	34	234
Due from hospital	1,087	153	1,138
Deferred expenses	317	45	200
Others	46,407	6,536	26,767
Prepayments and other current assets, gross	472,549	66,557	402,641
Allowance for credit losses	(59,603)	(8,395)	(17,290)
Prepayments and other current assets	¥ 412,946	$ 58,162	¥ 385,351

ACQUISITIONS AND DISPOSALS - Acquisition of Healthingkon (Details) - HealthingKon - CNY (¥) ¥ in Thousands	1 Months Ended	3 Months Ended
	Jan. 31, 2021	Jan. 31, 2021
ACQUISITIONS AND DISPOSALS
Cash consideration	¥ 21,500	¥ 21,500
Fair value of the share consideration	98,338
Total	¥ 119,838

ACCOUNTS RECEIVABLE - Schedule of Accounts Receivable (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)	Dec. 31, 2023 USD ($)
ACCOUNTS RECEIVABLE
Accounts receivable	¥ 103,982		¥ 138,035		$ 14,646
Allowance for credit losses	(30,486)		(7,764)		(4,294)
Accounts receivable, net	73,496		130,271		$ 10,352
The rollforward in the allowance for credit losses were as follows:
Balance at the beginning of the year	7,764	$ 1,094	4,932	¥ 6,473
Provisions for the year	22,752	3,204	2,832	1,463
Reversal of provisions from prior periods due to subsequent cash collection during the year	(30)	(4)		(983)
Amounts written off during the year				(2,021)
Balance at the end of the year	¥ 30,486	$ 4,294	¥ 7,764	¥ 4,932

GOODWILL (Tables)

12 Months Ended

Dec. 31, 2023

GOODWILL.

Schedule of goodwill


	For the years ended December 31,
	2022	2023
	RMB	RMB	US$
Balance as of January 1	581,877	575,427	81,047
Addition	—	—	—
Disposal	(6,450)	—	—
Impairment	—	—	—
Balance as of December 31	575,427	575,427	81,047

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 24
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482548/350-20-55-24

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1A
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1A

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-2

+ Details

ACCOUNTS RECEIVABLE - Additional Information (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
Accounts receivable \| Asset pledged as collateral without right
ACCOUNTS RECEIVABLE
Other assets	¥ 13,312	$ 1,875	¥ 11,166

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

SHARE-BASED AWARDS (Summary of Restricted Shares) (Details) - Restricted shares [Member] - $ / shares								12 Months Ended
	Oct. 02, 2018	Sep. 13, 2017	Aug. 08, 2017	Aug. 07, 2017	Aug. 01, 2014	Jul. 01, 2014	Feb. 18, 2014	Dec. 31, 2023
SHARE-BASED AWARDS
Numbers of shares, Beginning balance								10,785,789
Numbers of shares, Granted	5,992,605	45,000	3,319,200	1,453,950	69,564	21,132	1,370,250
Numbers of shares, Ending balance								10,785,789
Numbers of shares, Exercisable								10,785,789
Weighted average grant date fair value, Beginning balance								$ 1.31
Weighted average grant date fair value, Ending balance								1.31
Weighted average grant date fair value, Exercisable								$ 1.31
February 18, 2014 [Member]
SHARE-BASED AWARDS
Numbers of shares, Granted								1,370,250
Weighted average grant date fair value, Granted								$ 1.93
July 1, 2014 [Member]
SHARE-BASED AWARDS
Numbers of shares, Granted								21,132
Weighted average grant date fair value, Granted								$ 2.35
August 1, 2014 [Member]
SHARE-BASED AWARDS
Numbers of shares, Granted								69,564
Weighted average grant date fair value, Granted								$ 2.44
August 7, 2017 [Member]
SHARE-BASED AWARDS
Numbers of shares, Granted								1,453,950
Weighted average grant date fair value, Granted								$ 1.33
August 8, 2017 [Member]
SHARE-BASED AWARDS
Numbers of shares, Granted								3,319,200
Weighted average grant date fair value, Granted								$ 1.34
September 13, 2017 [Member]
SHARE-BASED AWARDS
Numbers of shares, Granted								45,000
Weighted average grant date fair value, Granted								$ 1.33
October 2, 2018 [Member]
SHARE-BASED AWARDS
Numbers of shares, Granted								5,992,605
Weighted average grant date fair value, Granted								$ 1.19

LEASE - Lease receivables (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
Current
Account receivable - Operating lease	¥ 14,683	$ 2,068	¥ 14,230
Account receivable - Sales-type lease	1,515	213	906
Total	¥ 16,198	$ 2,281	¥ 15,136

LONG-TERM INVESTMENTS (Tables)

12 Months Ended

Dec. 31, 2023

LONG-TERM INVESTMENTS

Schedule of long-term investments


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Equity investments without readily determinable fair value	51,524	51,624	7,271
Equity method investments	336,254	324,163	45,657
Available-for-sale debt securities	50,096	18,924	2,665
Less: Impairment loss	—	—	—
Total	437,874	394,711	55,593

Schedule of equity investments without readily determinable fair value


		Equity interest owned by the
		Group
		As at December 31,
	Note	2022			2023
		RMB			RMB
Allcure Information	i)	22,160	9.6	%	22,160	9.6	%
Concord Healthcare Singapore Pte. Ltd.	ii)	22,925	8.73	%	22,925	8.73	%
Legion Healthcare Partners LLC	iii)	6,439	5.83	%	6,439	5.83	%
Beijing He Xu elderly Care Service Co., Ltd.	iv)	—	—	%	100	4.00	%
Total		51,524			51,624

ii)

iii)

iv)

Schedule of equity method investments


		Equity interest owned by the
		Group
		as at December 31,
	Notes	2022			2023
		RMB			RMB
Xi’an JiangyuanAndike Ltd. (“JYADK”)		10,496	29.70	%	14,925	29.70	%
Suzhou Shengshan Huiying Venture Capital Investment LLP. (“Suzhou Shengshan”)	i)	12,939	5.15	%	9,413	5.15	%
Zhejiang Marine Leasing Ltd.	ii)	179,231	20.00	%	189,676	20.00	%
Guangdong Hengjian Proton Medical Industry Co., Ltd. (“Guangdong Hengjian”)	iii)	86,315	14.20	%	86,185	14.20	%
Shanghai Xinhe Enterprise Management Center (Limited Partnership) (“Shanghai Xinhe”)	iv)	45,005	99.99	%	22,448	72.73	%
Shanghai Changshengshu Management Co. Ltd. (“Shanghai Changshengshu”)	v)	1,968	20.00	%	1,216	20.00	%
Guangzhou Yicheng Biological Immune Technology Co. Ltd. (“Guangzhou Yicheng”)	vi)	300	30.00	%	300	30.00	%
Total		336,254			324,163

ii)

iii)

iv)

vi)

Schedule of available-for-sale debt securities


	As at December 31, 2023
		Redemption	Redemption Notice
	Fair value	Frequency	Period
	RMB
Private equity funds	18,924	Annually	5-9 days
	18,924

- Definition

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aaa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

+ Details

Other long-term liabilities - Convertible Note (Details) - CNY (¥) ¥ in Thousands		1 Months Ended	12 Months Ended
	Dec. 07, 2021	Aug. 31, 2021	Dec. 31, 2021	Dec. 31, 2023
Other long-term liabilities
Proceeds from convertible note	¥ 20,000		¥ 20,000
Basic interest rate				4.50%
Debt instrument term		2 years
Unpaid interest			4.75
If holder choose to convert in first three years
Other long-term liabilities
Basic interest rate			2.50%
Debt instrument term			3 years
If holder choose to convert In fourth or fifth year
Other long-term liabilities
Proceeds from convertible note			¥ 20,000
Percentage of proceeds from convertible note			80.00%
Convertible debt
Other long-term liabilities
Principal amount			¥ 20,000
Basic interest rate			4.75%
Debt instrument term			5 years

PROPERTY, PLANT AND EQUIPMENT, NET (Tables)

12 Months Ended

Dec. 31, 2023

PROPERTY, PLANT AND EQUIPMENT, NET

Schedule of property, plant and equipment, net


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Buildings	782,560	807,737	113,767
Medical equipment	532,165	522,385	73,576
Electronic and office equipment	58,038	58,999	8,310
Motor vehicles	3,717	3,718	524
Leasehold improvement and building improvements	75,032	81,766	11,517
Construction in progress	2,131,991	2,466,320	347,374
Total	3,583,503	3,940,925	555,068
Less: accumulated depreciation	(308,210)	(385,042)	(54,232)
Impairment charges	(16,148)	(9,010)	(1,269)
	3,259,145	3,546,873	499,567

LEASE - Schedule of non-cancellable operating lease payment (Details) - Dec. 31, 2023 ¥ in Thousands, $ in Thousands	CNY (¥)	USD ($)
LEASE
2023	¥ 1,396	$ 197
2024	1,396	197
2025	¥ 931	$ 131

SUBSEQUENT EVENTS (Details) $ / shares in Units, ¥ in Thousands, $ in Thousands, $ in Thousands				1 Months Ended				12 Months Ended
	Jan. 09, 2024 HKD ($) $ / shares	Jan. 09, 2024 CNY (¥)	Jan. 09, 2024 USD ($)	Dec. 31, 2024 CNY (¥)	Mar. 31, 2024 CNY (¥)	Mar. 31, 2024 USD ($)	Feb. 29, 2024 CNY (¥) loan	Dec. 31, 2023 HKD ($)	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2024 USD ($)	Mar. 31, 2024 USD ($)	Feb. 29, 2024 USD ($)	Jan. 19, 2024 CNY (¥)	Jan. 19, 2024 USD ($)
SUBSEQUENT EVENTS
Gross proceeds from the initial public offering								$ 554,914		$ 71,044
Amount of loan contract									¥ 89,980	$ 12,672
Subsequent Event
SUBSEQUENT EVENTS
Gross proceeds from the initial public offering	$ 554,914		$ 71,044
Payments for repurchase of initial public offering		¥ 200,000	28,169
Subsequent Event \| CHS
SUBSEQUENT EVENTS
Price per share \| $ / shares	$ 14.28
Gross proceeds from the initial public offering	$ 562,900		$ 72,200
Subsequent Event \| Hebei CSPC Concord Hospital Management Co., LTD ("HCCH")
SUBSEQUENT EVENTS
Capital injection amount														¥ 102,000	$ 14,366
Subsequent Event \| Shanghai Meizhong Jiahe Cancer Center Co., Ltd. ("CMCC") \| Xiamen International Bank Co., Ltd
SUBSEQUENT EVENTS
Granted maximum loan credit				¥ 10,000							$ 1,408
Working capital loan				¥ 10,000							$ 1,408
Interest rate				5.50%
Subsequent Event \| Shanghai Meizhong Jiahe Cancer Center Co., Ltd. ("CMCC") \| Bank of Shanghai
SUBSEQUENT EVENTS
Interest rate					4.20%	4.20%
Principal amount					¥ 10,000							$ 1,408
Subsequent Event \| Shanghai Medstar Financial Leasing Company Limited ("Shanghai Medstar") \| Inner Mongolia Hongxin Yubang Supply Chain Co., Ltd
SUBSEQUENT EVENTS
Interest rate							6.00%
Principal amount							¥ 50,000						$ 7,042
Subsequent Event \| Shanghai Medstar Financial Leasing Company Limited ("Shanghai Medstar") \| Shanghai Linen International Trading Co.Ltd
SUBSEQUENT EVENTS
Interest rate							15.00%
Principal amount							¥ 10,000						$ 1,408
Number of loans settled in one lump sum at maturity \| loan							2
Subsequent Event \| SH MZJH \| Bank of Shanghai
SUBSEQUENT EVENTS
Interest rate					4.50%	4.50%
Amount of loan contract					¥ 9,980	$ 1,406
Subsequent Event \| Minimum \| Shanghai Meizhong Jiahe Cancer Center Co., Ltd. ("CMCC") \| Xiamen International Bank Co., Ltd
SUBSEQUENT EVENTS
Period of loan				Jan. 03, 2024
Subsequent Event \| Maximum \| Shanghai Meizhong Jiahe Cancer Center Co., Ltd. ("CMCC") \| Xiamen International Bank Co., Ltd
SUBSEQUENT EVENTS
Period of loan				Jul. 03, 2024

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Additional information (Details) $ / shares in Units, ¥ in Thousands, $ in Thousands, $ in Thousands		12 Months Ended
	Dec. 29, 2023 $ / shares	Dec. 31, 2023 HKD ($) loan	Dec. 31, 2023 CNY (¥) loan item	Dec. 31, 2023 USD ($) loan	Dec. 31, 2022 CNY (¥) item	Dec. 31, 2021 CNY (¥) item	Dec. 31, 2023 USD ($) item	Dec. 31, 2020 item	Jan. 01, 2018 CNY (¥)
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Net loss from continuing operations			¥ 531,021	$ (74,795)	¥ 768,990	¥ 522,672
Net cash (used in) generated from operating activities			(276,471)	$ (38,944)	(216,694)	(359,313)
Cash and cash equivalents			58,139		158,283		$ 8,189
Working capital			1,334,186				187,914
Accumulated deficit			¥ (4,064,589)		¥ (3,766,931)		$ (572,485)
Number of loan contracts \| loan		5	5	5
Amount of loan contract			¥ 89,980	$ 12,672
Noon buying rate	7.0999
Conversion from noon buying rate to per share value \| $ / shares	$ 1.00
Description of liquid investments maturity term		90 days	90 days	90 days
Number of reporting units after disposal of the GFHM \| item			2		2		2
Interest costs incurred			¥ 223,936	$ 31,541	¥ 180,847	139,873
Interest and other costs relating to construction capitalized			58,267	8,207	60,490	66,084
Impairment on long-lived assets \| ¥			¥ 0		¥ 0	¥ 0
Gross proceeds from the initial public offering		$ 554,914		$ 71,044
CHS [Member]
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Number of reporting units after disposal of the GFHM \| item						2		2
Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Lessor, sales-type lease, term of contract			5 years				5 years
Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Lessor, sales-type lease, term of contract			20 years				20 years
Offices and facility under leases \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Lessee, finance lease, term of contract			1 year				1 year
Lessee, operating lease, term of contract			1 year				1 year
Offices and facility under leases \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Lessee, finance lease, term of contract			20 years				20 years
Land use rights under leases
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Lessee, finance lease, term of contract			50 years				50 years
Lessee, operating lease, term of contract			50 years				50 years
Equipment leased to others \| Minimum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Lessor, sales-type lease, term of contract			5 years				5 years
Equipment leased to others \| Maximum
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Lessor, sales-type lease, term of contract			20 years				20 years
Cumulative effect, period of adoption, adjusted balance
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Accumulated deficit \| ¥									¥ 5,632

TAXATION - Current and deferred components of the income tax expense (benefit) (Details) ¥ in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)	Dec. 31, 2021 CNY (¥)
TAXATION
Current tax expense (benefit)	¥ (7,014)	$ (988)	¥ (8,765)	¥ 4,115
Deferred tax benefit	(17,559)	(2,473)	(62,141)	(10,680)
Income tax expense	¥ (24,573)	$ (3,461)	¥ (70,906)	¥ (6,565)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

ACCOUNTS RECEIVABLE (Tables)

12 Months Ended

Dec. 31, 2023

ACCOUNTS RECEIVABLE

Schedule of accounts receivable


	As at December 31,
	2022	2023	2023
	RMB	RMB	US$
Accounts receivable	138,035	103,982	14,646
Allowance for credit losses	(7,764)	(30,486)	(4,294)
Accounts receivable, net	130,271	73,496	10,352

The roll forward in the allowance for credit losses were as follows:


	For the Years Ended December 31,
	2021	2022	2023	2023
	RMB	RMB	RMB	US$
Balance at the beginning of the year	6,473	4,932	7,764	1,094
Provisions for the year	1,463	2,832	22,752	3,204
Reversal of provisions from prior periods due to subsequent cash collection during the year	(983)	—	(30)	(4)
Amounts written off during the year	(2,021)	—	—	—
Balance at the end of the year	4,932	7,764	30,486	4,294

COMMITMENTS AND CONTINGENCIES

12 Months Ended

Dec. 31, 2023

COMMITMENTS AND CONTINGENCIES.

COMMITMENTS AND CONTINGENCIES

27.COMMITMENTS AND CONTINGENCIES

Purchase commitments

The Group has commitments to purchase certain medical equipment of RMB220,972 and RMB271,876 (US$38,293) at December 31, 2022 and 2023, respectively, which are scheduled to be paid within following years.

Income taxes

As of December 31, 2023, the Group has recognized approximately RMB44,470 (US$6,263) as an accrual for unrecognized tax positions. The final outcome of the tax uncertainty is dependent upon various matters including tax examinations, interpretation of tax laws or expiration of status of limitation. However, due to the uncertainties associated with the status of examinations, including the protocols of finalizing audits by the relevant tax authorities, there is a high degree of uncertainty regarding the future cash outflows associated with these tax uncertainties.

INTANGIBLE ASSETS, NET (Tables)

12 Months Ended

Dec. 31, 2023

INTANGIBLE ASSETS, NET

Schedule of acquired intangible assets


	Customer	Operating	Operating	Favorable
	relationship	lease	license	lease
	intangibles	intangibles	intangibles	intangibles	Technology	Others	Total
	RMB	RMB	RMB	RMB	RMB	RMB	RMB
Intangible assets, net at January 1, 2022	—	—	490,296	16,256	118,971	32,314	657,837
Addition of software	—	—	—	—	—	3,334	3,334
Decrease from cooperation termination with a cooperative hospital	—	—	(272,910)				(272,910)
Foreign Exchange Gain	—	—	—	—	—	—	—
Amortization expenses	—	—	(12,672)	(1,564)	(13,139)	(7,120)	(34,495)
Intangible Asset impairment	—	—	—	—	—	—	—
Intangible assets, net at December 31, 2022	—	—	204,714	14,692	105,832	28,528	353,766

Addition of software	—	—	—	—	—	6,226	6,296
Amortization expenses	—	—	(12,672)	(1,564)	(13,219)	(9,250)	(36,705)
Intangible assets, net at December 31, 2023	—	—	192,042	13,128	92,613	25,504	323,287
Intangible assets, net at December 31, 2023, in US$	—	—	27,049	1,849	13,044	3,592	45,534


At December 31, 2023
Intangible assets, cost	32,449	418	253,440	21,010	132,190	53,555	493,062
Less: accumulated amortization	(31,486)	(418)	(61,398)	(7,882)	(39,577)	(28,051)	(168,812)
Less: intangible asset impairment	(963)	—	—	—	—	—	(963)
Intangible assets, net at December 31, 2023	—	—	192,042	13,128	92,613	25,504	323,287

Schedule of estimated annual amortization expenses


	Amortization
	RMB	US$
2024	40,759	5,741
2025	35,767	5,038
2026	34,064	4,798
2027	29,142	4,105
2028	183,555	25,852

CONSOLIDATED BALANCE SHEETS ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
Current assets:
Cash and cash equivalents	¥ 58,139	$ 8,189	¥ 158,283
Restricted cash	32,280	4,547	1,060
Accounts receivable (net of allowance of RMB7,764 and RMB30,486 (US$4,294) as of December 31, 2022 and 2023, respectively)	73,496	10,352	130,271
Prepayments and other current assets (net of reserve of RMB17,290 and RMB59,603 (US$8,395) and including amounts due from related parties amounting to RMB169,436 and RMB151,481 (US$21,335) as of December 31, 2022 and 2023, respectively)	412,946	58,162	385,351
Inventories	40,347	5,683	84,835
Total current assets	617,208	86,933	759,800
Non-current assets:
Property, plant and equipment, net	3,546,873	499,567	3,259,145
Right-of-use assets, net	580,365	81,743	594,897
Goodwill	575,427	81,047	575,427
Intangible assets, net	323,287	45,534	353,766
Deposits for non-current assets	4,646	654	8,932
Long-term investments	394,711	55,593	437,874
Other non-current assets	11,426	1,609	15,093
Total non-current assets	5,436,735	765,747	5,245,134
Total assets	6,053,943	852,680	6,004,934
Current liabilities:
Accounts payable	129,236	18,203	146,748
Accrued expenses and other liabilities	731,793	103,070	419,881
Income tax payable	1,522	214	818
Operating lease liabilities, current	46,492	6,548	35,916
Short-term bank and other borrowings (including loan from related party of RMB13,105 and RMB7,810 (US$1,100) as of December 31, 2022 and 2023, respectively)	319,625	45,018	168,601
Long-term bank and other borrowings, current portion (including loan from related party of RMB133,856 and RMB167,283 (US$23,561) as of December 31, 2022 and 2023, respectively)	722,563	101,771	343,982
Derivative liability	163	23	5,290
Total current liabilities	1,951,394	274,847	1,121,236
Non-current liabilities:
Long-term bank and other borrowings, non-current portion (including loan from related party of RMB122,579 and RMB69,182 (US$9,744) as of December 31, 2022 and 2023, respectively)	1,994,014	280,851	2,471,427
Deferred tax liabilities	99,538	14,020	112,577
Operating lease liabilities, non-current	193,007	27,184	199,953
Other long-term liabilities	69,003	9,719	84,084
Total non-current liabilities	2,355,562	331,774	2,868,041
Total liabilities	4,306,956	606,621	3,989,277
Commitments and contingencies
Equity:
Treasury stock (12,101,847 and 12,101,847 shares as of December 31, 2022 and 2023, respectively)	(7)	(1)	(7)
Additional paid-in capital	2,007,965	282,816	1,930,633
Accumulated other comprehensive loss	(65,419)	(9,214)	(27,766)
Accumulated deficit	(4,064,589)	(572,485)	(3,766,931)
Total Concord Medical Services Holdings Limited shareholders' deficit	(2,121,945)	(298,869)	(1,863,966)
Noncontrolling interests	3,868,932	544,928	3,879,623
Total equity	1,746,987	246,059	2,015,657
Total liabilities and equity	6,053,943	852,680	6,004,934
Class A ordinary shares
Equity:
Ordinary shares	68	10	68
Class B ordinary shares
Equity:
Ordinary shares	¥ 37	$ 5	¥ 37

ACCRUED EXPENSES AND OTHER LIABILITIES - Schedule of Accrued Expenses and Other Liabilities (Details) ¥ in Thousands, $ in Thousands	Dec. 31, 2023 CNY (¥)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 CNY (¥)
ACCRUED EXPENSES AND OTHER LIABILITIES
Accrued expenses	¥ 387,040	$ 54,513	¥ 75,010
Salaries and welfare payable	98,599	13,887	73,803
Business and other taxes payable	15,619	2,200	27,961
Contractual liabilities	59,408	8,367	100,802
Other payables	171,127	24,103	142,305
Total	¥ 731,793	$ 103,070	¥ 419,881