name = "Atlas Commons research objects — hospital quality surface for North Carolina (2026)"
description = "North Carolina's hospital quality data from CMS Care Compare, with each figure's epistemic status labeled so a consuming agent can weight it correctly: measured hospital/subtype/ownership counts; the CMS Overall Star Rating distribution (a model CMS computes, not a direct measurement); the atlas-computed state mean HCAHPS star and median measure comparisons (in-house aggregations CMS does not publish); and the interpretive boundary (these are state aggregates, not a verdict on any one hospital). Source: CMS Care Compare. CC0."
license = "CC0-1.0"
jsonld = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc.jsonld"

[[claims]]
id = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc/hospital-census"
warrant = "RECORDED"
name = "120 hospitals are listed in North Carolina on CMS Care Compare (2026)"
text = "CMS Care Compare lists 120 hospitals in North Carolina for 2026; 90 carry an Overall Star Rating and 30 do not. A census of listed hospitals."
source = "CMS Care Compare (2026)"
sourceUrl = "https://www.medicare.gov/care-compare/"
falsifier = "A RECORD of measured/reported events (occurred=true) from CMS Care Compare (2026); superseded when CMS Care Compare (2026) publishes its next release."

[[claims]]
id = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc/subtype-distribution"
warrant = "RECORDED"
name = "Hospital counts by CMS facility type in North Carolina (2026): Acute Care Hospitals 80, Critical Access Hospitals 20, Psychiatric 14, Acute Care - Veterans Administration 4"
text = "Counts of the 120 hospitals by CMS facility type: Acute Care Hospitals 80, Critical Access Hospitals 20, Psychiatric 14, Acute Care - Veterans Administration 4, Acute Care - Department of Defense 2. A count of listed facilities per CMS type."
source = "CMS Care Compare (2026)"
sourceUrl = "https://www.medicare.gov/care-compare/"
falsifier = "A RECORD of measured/reported events (occurred=true) from CMS Care Compare (2026); superseded when CMS Care Compare (2026) publishes its next release."

[[claims]]
id = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc/ownership-distribution"
warrant = "RECORDED"
name = "Hospital counts by ownership in North Carolina (2026): Voluntary non-profit - Private 54, Proprietary 18, Government - Hospital District or Authority 15, Government - Local 11"
text = "Counts of the 120 hospitals by CMS ownership category: Voluntary non-profit - Private 54, Proprietary 18, Government - Hospital District or Authority 15, Government - Local 11, Voluntary non-profit - Other 7, Government - State 6, Veterans Health Administration 4, Department of Defense 2, Government - Federal 2, Voluntary non-profit - Church 1. A count of listed facilities per ownership type."
source = "CMS Care Compare (2026)"
sourceUrl = "https://www.medicare.gov/care-compare/"
falsifier = "A RECORD of measured/reported events (occurred=true) from CMS Care Compare (2026); superseded when CMS Care Compare (2026) publishes its next release."

[[claims]]
id = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc/star-distribution"
warrant = "MODELED"
name = "CMS Overall Star Rating distribution for North Carolina hospitals (2026): 5★ 12, 4★ 28, 3★ 29, 2★ 17, 1★ 4"
text = "Counts of the 90 rated hospitals by CMS Overall Star Rating: 5★ 12, 4★ 28, 3★ 29, 2★ 17, 1★ 4. The Overall Star Rating is a LATENT-VARIABLE STATISTICAL MODEL CMS computes by combining measure-group scores — it is NOT a direct measurement; the count by star is mechanical over CMS's published per-hospital ratings."
source = "CMS Care Compare (2026)"
sourceUrl = "https://www.medicare.gov/care-compare/"
falsifier = "occurred=FALSE: a MODELED figure — an authority's computed quantity ESTIMATING an independent/latent value (an index or annualized expectation), REPRODUCIBLE from its disclosed inputs, NOT a record of an event. adjudged=TRUE because CMS Care Compare (2026) (an external authority) computes and publishes it. The grounding promises \"reproduce this from the inputs\" — so a categorical authority VERDICT that is NOT reproducible (a star rating, a risk class) is a 'determination', not 'modeled'. Superseded by the next release."

[[claims]]
id = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc/avg-hcahps-star"
warrant = "DERIVED"
name = "State mean HCAHPS patient-experience star for North Carolina is 3.36 (a computed average, 2026)"
text = "The mean of the CMS HCAHPS summary star (patient experience) across rated North Carolina hospitals is 3.36. Each HCAHPS star is a CMS survey-based composite; this STATE MEAN is an in-house aggregation (the atlas computed it), not a CMS-published figure."
source = "CMS Care Compare (2026) — atlas-computed state mean of CMS HCAHPS stars"
sourceUrl = "https://www.medicare.gov/care-compare/"
falsifier = "occurred=FALSE (a calculation, not an event) and adjudged=FALSE (a transparent in-house formula, not an authority's verdict — no external adjudicator). Reproduce it from its named inputs; falsified if the formula or inputs are wrong. Lower warrant than the adjudged figures above."

[[claims]]
id = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc/measures-median"
warrant = "DERIVED"
name = "Median North Carolina hospital's measures vs national (2026): 0 better, 13 no different, 0 worse"
text = "For the median North Carolina hospital, the count of quality measures rated better than / no different from / worse than the national rate is 0 / 13 / 0. The better/worse determination is CMS's risk-adjusted comparison (modeled); the MEDIAN across hospitals is an in-house aggregation, not a CMS-published figure."
source = "CMS Care Compare (2026) — atlas-computed state median of CMS risk-adjusted measure comparisons"
sourceUrl = "https://www.medicare.gov/care-compare/"
falsifier = "occurred=FALSE (a calculation, not an event) and adjudged=FALSE (a transparent in-house formula, not an authority's verdict — no external adjudicator). Reproduce it from its named inputs; falsified if the formula or inputs are wrong. Lower warrant than the adjudged figures above."

[[claims]]
id = "https://care-atlas.ryanjhunter.workers.dev/care/states/nc/boundary"
warrant = "INTERPRETATION"
name = "What these care figures are — and are NOT — for North Carolina (the epistemic boundary)"
text = "Every figure above is a STATE-LEVEL aggregate over CMS Care Compare: counts of listed hospitals (recorded), the distribution of CMS's MODELED Overall Star Rating (modeled), and atlas-computed state means/medians (derived). They are NOT a verdict on any individual hospital, a measure of outcomes you will personally experience, or a substitute for CMS Care Compare's per-hospital detail. For a specific hospital, use CMS Care Compare directly."
source = "Care Atlas framing (over the CMS Care Compare facts above)"
sourceUrl = "https://care-atlas.ryanjhunter.workers.dev/"
falsifier = "occurred=FALSE (a framing, not an event) and adjudged=FALSE (the atlas's reading, not a CMS verdict) — the LOWEST-warrant claim here. The figures above span recorded counts, CMS modeled star ratings, and atlas-derived aggregates; the four-status labels each, and this is the only interpretation."

[[careIndicators]]
indicator = "Hospitals listed"
value = 120
warrant = "RECORDED"
source = "CMS Care Compare (2026)"

[[careIndicators]]
indicator = "Hospitals with an Overall Star Rating"
value = 90
warrant = "RECORDED"
source = "CMS Care Compare (2026)"

[[careIndicators]]
indicator = "Hospitals without an Overall Star Rating"
value = 30
warrant = "RECORDED"
source = "CMS Care Compare (2026)"

[[careIndicators]]
indicator = "State mean HCAHPS patient-experience star"
value = 3.36
warrant = "DERIVED"
source = "CMS Care Compare (2026) — atlas-computed state mean"

[[careIndicators]]
indicator = "Median hospital — measures better than national"
value = 0
warrant = "DERIVED"
source = "CMS Care Compare (2026) — atlas-computed state median"

[[careIndicators]]
indicator = "Median hospital — measures no different from national"
value = 13
warrant = "DERIVED"
source = "CMS Care Compare (2026) — atlas-computed state median"

[[careIndicators]]
indicator = "Median hospital — measures worse than national"
value = 0
warrant = "DERIVED"
source = "CMS Care Compare (2026) — atlas-computed state median"

[[careIndicators]]
indicator = "Data year"
value = 2026
warrant = "RECORDED"
source = "CMS Care Compare (2026)"

[[careIndicators]]
indicator = "CMS source dataset"
value = "care_gold.hospital_quality_serving_surface"
warrant = "—"
source = "CMS Care Compare (2026)"

[[careIndicators]]
indicator = "CMS source id"
value = "src:cms:care-compare:2026"
warrant = "—"
source = "CMS Care Compare (2026)"

[[careIndicators]]
indicator = "Content hash"
value = "9411feb416b3ec30"
warrant = "—"
source = "CMS Care Compare (2026)"

[[careIndicators]]
indicator = "Generated at"
value = "2026-06-20T03:42:08.398414+00:00"
warrant = "—"
source = "CMS Care Compare (2026)"

[[starDistribution]]
stars = 5
hospitals = 12

[[starDistribution]]
stars = 4
hospitals = 28

[[starDistribution]]
stars = 3
hospitals = 29

[[starDistribution]]
stars = 2
hospitals = 17

[[starDistribution]]
stars = 1
hospitals = 4

[[subtypeDistribution]]
facility_type = "Acute Care Hospitals"
hospitals = 80

[[subtypeDistribution]]
facility_type = "Critical Access Hospitals"
hospitals = 20

[[subtypeDistribution]]
facility_type = "Psychiatric"
hospitals = 14

[[subtypeDistribution]]
facility_type = "Acute Care - Veterans Administration"
hospitals = 4

[[subtypeDistribution]]
facility_type = "Acute Care - Department of Defense"
hospitals = 2

[[ownershipDistribution]]
ownership = "Voluntary non-profit - Private"
hospitals = 54

[[ownershipDistribution]]
ownership = "Proprietary"
hospitals = 18

[[ownershipDistribution]]
ownership = "Government - Hospital District or Authority"
hospitals = 15

[[ownershipDistribution]]
ownership = "Government - Local"
hospitals = 11

[[ownershipDistribution]]
ownership = "Voluntary non-profit - Other"
hospitals = 7

[[ownershipDistribution]]
ownership = "Government - State"
hospitals = 6

[[ownershipDistribution]]
ownership = "Veterans Health Administration"
hospitals = 4

[[ownershipDistribution]]
ownership = "Department of Defense"
hospitals = 2

[[ownershipDistribution]]
ownership = "Government - Federal"
hospitals = 2

[[ownershipDistribution]]
ownership = "Voluntary non-profit - Church"
hospitals = 1
