{
  "version": 1,
  "generatedAt": "2026-09-07T04:32:07.308636+00:00",
  "data": {
    "sourcePopulation": "CMS Acute Care Hospitals",
    "nationalHospitals": 3107,
    "californiaHospitals": 276,
    "nationalRated": 2663,
    "californiaRated": 257,
    "nationalDistribution": [
      {
        "rating": 1,
        "count": 175
      },
      {
        "rating": 2,
        "count": 572
      },
      {
        "rating": 3,
        "count": 846
      },
      {
        "rating": 4,
        "count": 780
      },
      {
        "rating": 5,
        "count": 290
      }
    ],
    "californiaDistribution": [
      {
        "rating": 1,
        "count": 29
      },
      {
        "rating": 2,
        "count": 57
      },
      {
        "rating": 3,
        "count": 66
      },
      {
        "rating": 4,
        "count": 80
      },
      {
        "rating": 5,
        "count": 25
      }
    ],
    "nationalMean": 3.16,
    "californiaMean": 3.06,
    "nationalEmergencyServices": 2825,
    "californiaEmergencyServices": 224,
    "nationalEmergencyServicesPercent": 0.9092,
    "californiaEmergencyServicesPercent": 0.8116,
    "coreCohortRated": 236,
    "coreCohortDistribution": [
      {
        "rating": 1,
        "count": 28
      },
      {
        "rating": 2,
        "count": 55
      },
      {
        "rating": 3,
        "count": 63
      },
      {
        "rating": 4,
        "count": 65
      },
      {
        "rating": 5,
        "count": 25
      }
    ],
    "coreCohortMean": 3.02,
    "hcahpsCaliforniaVsNational": {
      "measureId": "H_RECMND_DY",
      "measureName": "Patients who definitely recommend the hospital",
      "exactDefinitionAndPeriodMatch": true,
      "aggregationMatch": true,
      "population": "CMS Acute Care Hospitals reporting a numeric H_RECMND_DY result",
      "californiaHospitalCount": 262,
      "nationalHospitalCount": 2904,
      "californiaUnweightedMeanPercent": 67.76,
      "nationalPercent": 69.01,
      "officialNationalPercentContextOnly": 71.0,
      "period": {
        "startDate": "10/01/2024",
        "endDate": "09/30/2025"
      },
      "method": "Both California and U.S. results are unweighted means of hospital-level H_RECMND_DY percentages, restricted to CMS Acute Care Hospitals, with the identical reporting period and numeric-result eligibility. U.S. includes California.",
      "limitation": "Describes the average reporting hospital, not the average patient. Suppressed/unavailable results are excluded. The published CMS national statistic is retained separately for context and is not used as the comparator. No case-mix or sampling uncertainty comparison is inferred."
    },
    "californiaVsUnitedStates": [
      {
        "id": "cmsOverallRatingMean",
        "domain": "quality",
        "measure": "CMS hospital overall rating",
        "unit": "stars, unweighted mean among rated acute-care hospitals",
        "california": 3.06,
        "unitedStates": 3.16,
        "californiaCount": 257,
        "unitedStatesCount": 2663,
        "period": "Current CMS Provider Data release",
        "direction": "Higher is better; descriptive only",
        "source": "CMS Hospital General Information",
        "method": "Same CMS acute-care population and rating definition; unweighted means exclude unrated hospitals.",
        "limitation": "The U.S. value includes California. Ratings are composites with CMS suppression and eligibility rules, not risk-free rankings."
      },
      {
        "id": "cmsEmergencyServicesPercent",
        "domain": "access_capacity",
        "measure": "Acute-care hospitals reporting emergency services",
        "unit": "share of acute-care hospitals",
        "california": 0.8116,
        "unitedStates": 0.9092,
        "californiaCount": 276,
        "unitedStatesCount": 3107,
        "period": "Current CMS Provider Data release",
        "direction": "No performance direction assigned",
        "source": "CMS Hospital General Information",
        "method": "Hospitals with Emergency Services = Yes divided by all CMS acute-care hospitals in the geography.",
        "limitation": "Presence of an emergency service does not measure service level, capacity, travel time, access, or outcomes."
      },
      {
        "id": "hcahpsDefinitelyRecommend",
        "domain": "patient_experience",
        "measure": "Patients who definitely recommend the hospital",
        "unit": "percent",
        "california": 67.76,
        "unitedStates": 69.01,
        "californiaCount": 262,
        "unitedStatesCount": 2904,
        "period": {
          "startDate": "10/01/2024",
          "endDate": "09/30/2025"
        },
        "direction": "Higher is better",
        "source": "CMS HCAHPS Hospital; CMS Hospital General Information eligibility",
        "method": "Both California and U.S. results are unweighted means of hospital-level H_RECMND_DY percentages, restricted to CMS Acute Care Hospitals, with the identical reporting period and numeric-result eligibility. U.S. includes California.",
        "limitation": "Describes the average reporting hospital, not the average patient. Suppressed/unavailable results are excluded. The published CMS national statistic is retained separately for context and is not used as the comparator. No case-mix or sampling uncertainty comparison is inferred."
      },
      {
        "id": "cmsSep1Mean",
        "domain": "quality_timeliness",
        "measure": "Appropriate care for severe sepsis and septic shock",
        "unit": "percent, unweighted mean among reporting acute-care hospitals",
        "california": 68.76,
        "unitedStates": 63.59,
        "californiaCount": 260,
        "unitedStatesCount": 2750,
        "period": {
          "startDate": "10/01/2024",
          "endDate": "09/30/2025"
        },
        "direction": "Higher is better",
        "source": "CMS Timely and Effective Care - Hospital",
        "method": "Same CMS measure, acute-care population, and reporting period in both geographies; suppressed/non-numeric results are excluded.",
        "limitation": "Unweighted hospital summaries do not adjust for hospital volume, case mix, or missingness. The U.S. value includes California."
      },
      {
        "id": "cmsEdMedianMinutes",
        "domain": "quality_timeliness",
        "measure": "ED median minutes before leaving, excluding transfers and psychiatric/mental-health patients",
        "unit": "minutes, median across reporting acute-care hospitals",
        "california": 183.0,
        "unitedStates": 170.0,
        "californiaCount": 225,
        "unitedStatesCount": 2797,
        "period": {
          "startDate": "10/01/2024",
          "endDate": "09/30/2025"
        },
        "direction": "Lower is better",
        "source": "CMS Timely and Effective Care - Hospital",
        "method": "Same CMS measure, acute-care population, and reporting period in both geographies; suppressed/non-numeric results are excluded.",
        "limitation": "Unweighted hospital summaries do not adjust for hospital volume, case mix, or missingness. The U.S. value includes California."
      }
    ]
  }
}