Incident Score: Analysis & Impact (PEAFLOCRM1776443473)
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Rankiteo Score Impact Analysis
Key Highlights From The Incident Analysis
- Timeline of Cookeville Regional Medical Center's Ransomware and lateral movement inside company's environment.
- Overview of affected data sets, including SSNs and PHI, and why they materially increase incident severity.
- How Rankiteo’s incident engine converts technical details into a normalized incident score.
- How this cyber incident impacts Cookeville Regional Medical Center Rankiteo cyber scoring and cyber rating.
- Rankiteo’s MITRE ATT&CK correlation analysis for this incident, with associated confidence level.
Full Incident Analysis Transcript
In this Rankiteo incident briefing, we review the Cookeville Regional Medical Center breach identified under incident ID PEAFLOCRM1776443473.
The analysis begins with a detailed overview of Cookeville Regional Medical Center's information like the linkedin page: https://www.linkedin.com/company/crmc, the number of followers: 5607, the industry type: Hospitals and Health Care and the number of employees: 2416 employees
After the initial compromise, the video explains how Rankiteo's incident engine converts technical details into a normalized incident score. The incident score before the incident was 496 and after the incident was 267 with a difference of -229 which is could be a good indicator of the severity and impact of the incident.
In the next step of the video, we will analyze in more details the incident and the impact it had on Cookeville Regional Medical Center and their customers.
On 14 April 2026, Cookeville Regional Medical Center (CRMC) disclosed Ransomware issues under the banner "Cookeville Regional Medical Center Hit by Rhysida Ransomware Attack".
Cookeville Regional Medical Center (CRMC), a 309-bed hospital serving 14 counties in Tennessee’s Upper Cumberland region, has notified 337,917 patients that their personal and medical data was compromised in a July 2025 ransomware attack.
The disruption is felt across the environment, and exposing 337,917 records, with nearly 337,917 records at risk.
In response, and began remediation that includes Additional security measures implemented, and stakeholders are being briefed through Breach notification letters mailed on April 14, 2026.
The case underscores how Completed (forensic analysis), teams are taking away lessons such as Delayed or vague breach notifications can increase risks of identity theft and phishing for affected individuals. The extended investigation timeline reflects the complexity of forensic analysis following hospital ransomware attacks, with advisories going out to stakeholders covering 12 months of free identity theft protection through Experian offered to affected individuals.
Finally, we try to match the incident with the MITRE ATT&CK framework to see if there is any correlation between the incident and the MITRE ATT&CK framework.
The MITRE ATT&CK framework is a knowledge base of techniques and sub-techniques that are used to describe the tactics and procedures of cyber adversaries. It is a powerful tool for understanding the threat landscape and for developing effective defense strategies.
MITRE ATT&CK® Correlation Analysis
Rankiteo's analysis has identified several MITRE ATT&CK tactics and techniques associated with this incident, each with varying levels of confidence based on available evidence. Under the Initial Access tactic, the analysis identified Exploit Public-Facing Application (T1190) with moderate confidence (50%), supported by evidence indicating attack occurred between July 11 and July 14, 2025 and Valid Accounts (T1078) with moderate confidence (60%), supported by evidence indicating rhysida ransomware-as-a-service group attributed to attack. Under the Execution tactic, the analysis identified User Execution: Malicious File (T1204.002) with moderate to high confidence (70%), supported by evidence indicating rhysida ransomware-as-a-service group responsible for attack. Under the Credential Access tactic, the analysis identified Unsecured Credentials: Credentials In Files (T1552.001) with moderate confidence (60%), supported by evidence indicating personal and medical data compromised, including financial details and OS Credential Dumping (T1003) with moderate confidence (50%), supported by evidence indicating 337,917 records exposed, including SSNs and drivers license numbers. Under the Discovery tactic, the analysis identified File and Directory Discovery (T1083) with moderate to high confidence (70%), supported by evidence indicating medical record numbers, treatment information, and health insurance data exposed. Under the Collection tactic, the analysis identified Data from Local System (T1005) with moderate to high confidence (80%), supported by evidence indicating 337,917 patients personal and medical data compromised. Under the Exfiltration tactic, the analysis identified Exfiltration Over C2 Channel (T1041) with high confidence (90%), supported by evidence indicating sample files published on dark web leak site; 10 Bitcoin ransom demanded. Under the Impact tactic, the analysis identified Data Encrypted for Impact (T1486) with high confidence (90%), supported by evidence indicating data encryption confirmed; ransomware strain identified as Rhysida and Defacement: Internal Defacement (T1491.001) with moderate confidence (60%), supported by evidence indicating prolonged downtime, canceled appointments, and patient diversions reported. Under the Defense Evasion tactic, the analysis identified Obfuscated Files or Information (T1027) with moderate to high confidence (70%), supported by evidence indicating rhysida ransomware-as-a-service group attributed to attack and Impair Defenses: Disable or Modify Tools (T1562.001) with moderate confidence (60%), supported by evidence indicating extended investigation timeline reflects complexity of forensic analysis. These correlations help security teams understand the attack chain and develop appropriate defensive measures based on the observed tactics and techniques.
Sources & References
- Cookeville Regional Medical Center Rankiteo Cyber Incident Details: https://www.rankiteo.com/company/crmc/incident/PEAFLOCRM1776443473
- Cookeville Regional Medical Center CyberSecurity Rating page: https://www.rankiteo.com/company/crmc
- Cookeville Regional Medical Center Rankiteo Cyber Incident Blog Article: https://blog.rankiteo.com/peaflocrm1776443473-cookeville-regional-medical-center-florida-lung-asthma-sleep-specialists-heart-south-cardiovascular-group-ransomware-april-2026/
- Cookeville Regional Medical Center CyberSecurity Score History: https://www.rankiteo.com/company/crmc/history
- Cookeville Regional Medical Center CyberSecurity Incident Source: https://www.infosecurity-magazine.com/news/cookeville-medical-center-data/
- Rankiteo A.I CyberSecurity Rating methodology: https://www.rankiteo.com/Images/rankiteo_algo.pdf
- Rankiteo TPRM Scoring methodology: https://static.rankiteo.com/model/rankiteo_tprm_methodology.pdf