{
  "benchmarks": [
    {
      "benchmark_id": "national-rn-icu-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 2,
      "notes": "Direct-care RN maximum.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "icu"
    },
    {
      "benchmark_id": "national-rn-icu-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 2,
      "notes": "Mapped to intensive care.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "ccu"
    },
    {
      "benchmark_id": "national-rn-icu-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 2,
      "notes": "Mapped to intensive care.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "burn_icu"
    },
    {
      "benchmark_id": "national-rn-pediatric-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 2,
      "notes": "Pediatric critical-care comparison.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "picu"
    },
    {
      "benchmark_id": "national-rn-nicu-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 2,
      "notes": "Neonatal critical-care comparison.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "nicu"
    },
    {
      "benchmark_id": "national-rn-med-surg-v2",
      "effective_end": null,
      "effective_start": "2026-07-01",
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 4,
      "notes": "Current direct-care RN maximum; changed from five to four effective July 1, 2026.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "med_surg"
    },
    {
      "benchmark_id": "national-rn-telemetry-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 4,
      "notes": "",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "telemetry"
    },
    {
      "benchmark_id": "national-rn-intermediate-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 3,
      "notes": "",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "intermediate"
    },
    {
      "benchmark_id": "national-rn-oncology-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 4,
      "notes": "",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "oncology"
    },
    {
      "benchmark_id": "national-rn-pediatrics-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 4,
      "notes": "",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "pediatrics"
    },
    {
      "benchmark_id": "national-rn-labor-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 2,
      "notes": "",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "labor_delivery"
    },
    {
      "benchmark_id": "national-rn-postpartum-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 6,
      "notes": "Mother and baby must each be counted as a separate patient.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "postpartum"
    },
    {
      "benchmark_id": "national-rn-mother-baby-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 8,
      "notes": "Mother and baby must each be counted as a separate patient.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "mother_baby"
    },
    {
      "benchmark_id": "national-rn-or-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 1,
      "notes": "",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "or"
    },
    {
      "benchmark_id": "national-rn-pacu-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 2,
      "notes": "",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "pacu"
    },
    {
      "benchmark_id": "national-rn-ed-v2",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 5,
      "notes": "High-load instantaneous ceiling. Oregon separately requires an average of no more than four patients per direct-care RN over a 12-hour shift; trauma patients require 1:1.",
      "nurse_definition": "direct-care RN",
      "source_id": "oregon_ors_441",
      "source_title": "Oregon ORS 441.765",
      "source_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors441.html",
      "status": "draft",
      "unit_type": "ed"
    },
    {
      "benchmark_id": "national-licensed-nurse-psych-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 6,
      "notes": "Licensed-nurse comparison; licensed vocational nurses and psychiatric technicians may count within limits, so this must not be represented as an RN-only legal rule.",
      "nurse_definition": "licensed nurse",
      "source_id": "california_title22_70217",
      "source_title": "California Title 22 CCR 70217",
      "source_url": "https://www.cdph.ca.gov/Programs/CHCQ/LCP/CDPH%20Document%20Library/GACHRLS_Regulations_with_Survey_Procedures.pdf",
      "status": "draft",
      "unit_type": "psych"
    },
    {
      "benchmark_id": "national-rn-generic-experimental-v1",
      "effective_end": null,
      "effective_start": null,
      "jurisdiction": "national_comparison",
      "max_patients_per_rn": 5,
      "notes": "Experimental placeholder for services without a defensible numeric RN ceiling. The value is not an ANA recommended ratio and must be replaced by validated specialty HPPD benchmarks.",
      "nurse_definition": "direct-care RN",
      "source_id": "ana_staffing_measures",
      "source_title": "Draft national comparison fallback",
      "source_url": "https://anaprodsite2.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-measures/",
      "status": "draft",
      "unit_type": "other_inpatient"
    }
  ],
  "confirmed_data_definition": "A facility is filterable as confirmed when it contains at least one A/B unit. confirmation_scope distinguishes full or partial observed-shift, aggregate, and mixed coverage; unreported services remain C/D.",
  "evidence_grades": {
    "A": "Actual unit/shift census and direct-care RN assignments",
    "B": "Actual unit aggregate or productive-hours data",
    "C": "Payroll/RN paid-hour model with utilization",
    "D": "Financial/capacity proxy model"
  },
  "known_model_limits": [
    "C/D hospitals use one aggregate inpatient service line rather than all actual units.",
    "The paid-hour conversion is calibrated only to the California HCAI/CMS overlap; unit allocation, acuity priors, and peak factors have not met the national validation gates.",
    "AHRQ-only specialty hospitals are retained for coverage, but their current active status is unverified and their D-grade staffing input is a capacity/peer prior.",
    "Massachusetts ICU reports are partial facility evidence; the retained residual service line remains modeled and the hospital keeps its weakest C/D evidence grade until all major services are confirmed.",
    "Oregon investigation reports can establish A-grade evidence only for the specifically documented unit and shift. Other units and periods remain modeled unless separately observed.",
    "Vermont reports provide annual RN HPPD for listed units, not actual high-load shifts or complete hospital service coverage; their peak factor and residual services remain modeled.",
    "Draft comparison benchmarks do not yet have the required clinical reviewer signoff.",
    "A forced Yes/No can remain Low or Experimental confidence and does not establish legal compliance, harm, or causation."
  ],
  "model_version": "national-safe-staffing-v0.14.0-ma-icu-expansion",
  "peak_definition": "Observed empirical P90 or posterior median of modeled peak-ratio draws.",
  "reliability_warning": "C/D results are directional experimental estimates, not validated hospital rankings or definitive clinical/legal safety findings.",
  "system_rollup": "Any known member hospital failure means system No.",
  "verdict_definition": "Estimated to meet the national comparison benchmark during a high-load period."
}