{
  "schema_version": "1.0",
  "audit_pack": {
    "dataset_slug": "home-health-quality",
    "display_name": "Home-Health Quality by State (CMS Care Compare)",
    "one_liner": "State-level rollups of CMS Care Compare home-health agency ratings.",
    "source_families": [
      "CMS Care Compare datasets (public)"
    ],
    "spatial_resolution": "Facility (point) + state rollups.",
    "temporal_coverage": "CMS quarterly Care Compare release (current snapshot 2026-04-01).",
    "refresh_cadence": "Quarterly (matches CMS Care Compare release cadence).",
    "current_version": "v2026.05.0",
    "version_history": [
      {
        "version": "v2026.05.0",
        "released_at": "2026-05-06",
        "changes_summary": "Initial Audit Pack release. Methodology, provenance map, reproducibility statement, and limitations stack baselined."
      }
    ],
    "provenance_map": [
      {
        "name": "agency_ccn",
        "description": "CMS Certification Number for the home-health agency.",
        "source": "CMS Care Compare — Home Health Compare",
        "source_url": "https://data.cms.gov/provider-data/dataset/6jpm-sxkc",
        "refresh_cadence": "Quarterly",
        "confidence": 1
      },
      {
        "name": "state",
        "description": "Agency state (USPS code).",
        "source": "CMS Care Compare — Home Health Compare",
        "source_url": "https://data.cms.gov/provider-data/dataset/6jpm-sxkc",
        "refresh_cadence": "Quarterly",
        "confidence": 1
      },
      {
        "name": "quality_of_patient_care_star",
        "description": "CMS published Quality of Patient Care star rating (1-5).",
        "source": "CMS Care Compare — Home Health Compare",
        "source_url": "https://data.cms.gov/provider-data/dataset/6jpm-sxkc",
        "refresh_cadence": "Quarterly",
        "confidence": 1
      }
    ],
    "reproducibility_statement": "1. Pull the CMS Care Compare Home Health Compare dataset from data.cms.gov/provider-data/dataset/6jpm-sxkc.\n2. Filter to active agencies with non-null Quality-of-Patient-Care star rating.\n3. Bucket by state.\n4. Compute per-state count + rating distribution.",
    "limitations": [
      "Each CMS measure carries its own published limitations; readers should review the CMS dataset documentation linked in the methodology for measure-specific caveats. We do not modify CMS's published measure values, only re-aggregate to state-level rollups.",
      "Sampling-based measures (e.g. patient-experience surveys) carry confidence bands CMS publishes alongside the values. State-level rollups average across facilities and do not preserve those bands; for facility-specific decisions, reference the original CMS Care Compare record.",
      "Date alignment: state rollups are computed from the CMS file's published reporting period, not the file release date. The reporting period typically lags the release date by 6-12 months per CMS convention."
    ],
    "compliance_qa": [
      {
        "question": "What is the source of these facility-quality measures?",
        "answer": "CMS Care Compare datasets, published quarterly at data.cms.gov/provider-data/. CMS itself publishes the measure definitions, sampling methodology, and known limitations; Fonteum Research re-aggregates state-level rollups without altering the underlying measure values.",
        "link": "https://data.cms.gov/provider-data/"
      },
      {
        "question": "When was this dataset last updated?",
        "answer": "Snapshot date is published per dataset and aligns with the most recent CMS Care Compare release we have ingested. CMS publishes new files quarterly; our cadence matches.",
        "link": "https://fonteum.com/corrections-log"
      },
      {
        "question": "Are CMS's own published limitations preserved?",
        "answer": "Yes. Every limitation CMS calls out in the dataset documentation appears in our Limitations section verbatim or paraphrased with a link to the CMS source. We do not silently strip caveats.",
        "link": "https://fonteum.com/methodology#limitations"
      },
      {
        "question": "Can I reproduce these counts independently?",
        "answer": "Yes — the reproducibility statement above lists the exact CMS dataset(s) ingested and the per-state aggregation logic. A buyer can rerun the methodology against the same Care Compare release and reconcile counts.",
        "link": "https://fonteum.com/corrections-log"
      },
      {
        "question": "What is the licensing scope of this data?",
        "answer": "CMS Care Compare data is public-domain federal information. Fonteum's aggregated rollups are licensed under our editorial-policy terms.",
        "link": "https://fonteum.com/terms"
      }
    ],
    "links": {
      "research_url": "https://fonteum.com/research/home-health-quality-by-state-2026",
      "methodology_url": "https://fonteum.com/methodology/home-health-quality",
      "limitations_url": "https://fonteum.com/methodology/home-health-quality#limitations",
      "csv_url": "https://fonteum.com/research/data/home-health-quality-by-state-2026.csv",
      "json_url": "https://fonteum.com/research/data/home-health-quality-by-state-2026.json"
    },
    "scope": {
      "record_count": 11500,
      "record_unit": "agencies",
      "coverage_states": 51,
      "last_snapshot_date": "2026-04-01"
    },
    "generated_at": "2026-05-09T17:26:09.542Z"
  },
  "reproducibility_steps": [
    {
      "step": 1,
      "description": "Pull the CMS Care Compare Home Health Compare dataset from data.cms.gov/provider-data/dataset/6jpm-sxkc."
    },
    {
      "step": 2,
      "description": "Filter to active agencies with non-null Quality-of-Patient-Care star rating."
    },
    {
      "step": 3,
      "description": "Bucket by state."
    },
    {
      "step": 4,
      "description": "Compute per-state count + rating distribution."
    }
  ],
  "fields": [
    {
      "name": "agency_ccn",
      "description": "CMS Certification Number for the home-health agency.",
      "source": "CMS Care Compare — Home Health Compare",
      "source_url": "https://data.cms.gov/provider-data/dataset/6jpm-sxkc",
      "refresh_cadence": "Quarterly",
      "confidence": 1
    },
    {
      "name": "state",
      "description": "Agency state (USPS code).",
      "source": "CMS Care Compare — Home Health Compare",
      "source_url": "https://data.cms.gov/provider-data/dataset/6jpm-sxkc",
      "refresh_cadence": "Quarterly",
      "confidence": 1
    },
    {
      "name": "quality_of_patient_care_star",
      "description": "CMS published Quality of Patient Care star rating (1-5).",
      "source": "CMS Care Compare — Home Health Compare",
      "source_url": "https://data.cms.gov/provider-data/dataset/6jpm-sxkc",
      "refresh_cadence": "Quarterly",
      "confidence": 1
    }
  ]
}