CALIFORNIA
NURSING OBSERVATORY

How CNO checks the records.

CNO matches public hospital records, checks reporting dates and definitions, and compares staffing, capacity, and demand. The workbook contains the source records and calculations.

27workbook worksheets
739workbook formulas
Download the public review workbook →

Match the hospital, period, and measure.

We match records from different agencies to the same hospital and check what each number actually covers. We show the source and year, keep unlike groups and time periods separate, and explain what the available records cannot tell us. The workbook documents the detailed checks for readers who want to inspect them.

Each measure shows its source, reporting period, and what it covers.

Which agencies oversee a service closure?

These guides identify the records to seek, the notice and oversight requirements to check, and the questions about continued patient access.

CNO Hospital Service Loss Investigation Workflow
Hospital Service Loss Investigation WorkflowHow CNO identifies, defines, verifies, and assesses a possible loss of clinical capability.
Chain of Responsibility for California hospital service-loss events
Chain of ResponsibilityOne service-loss event can implicate more than one authority. Licensing, notice, enforcement, designation, and local oversight may all apply at the same time.

Records, calculations, and checks

Collect and organize public evidence

Hospital financial and utilization extracts, longitudinal measures, source manifests, interpretation rules, and facility comparisons remain available for inspection.

Resolve reporting identity and scope

Stable facility IDs, licenses, campus records, consolidated filings, ownership, and bed totals are checked before numbers are presented as belonging to one hospital.

Compare staffing, demand, and capacity

Nursing labor, contract reliance, available capacity, and operational context can be examined together while preserving reporting periods, denominators, and data limitations.

Separate evidence from interpretation

Missing values stay unknown. Related staffing measures are not treated as independent confirmation, and a facility does not receive a state classification without adequate independently audited evidence.

Test the comparison itself

Peer groups require enough facilities in the same reporting category and match ownership and size when possible. A benchmark is withheld when the comparison would be artificial.

Invite verification and correction

Readers can inspect the workbook, consult the reviewer guide, compare public records, and contact the Observatory when additional evidence or corrections are warranted.

Public reporting does not establish real-time bedside staffing, patient safety, causation, or a statewide trend. The original five-hospital pilot is exploratory and is not used for statistical inference.

Download the pilot workbook and guide.

Pilot V1.0 is a fixed copy of the original review workbook. It contains the formulas, sources, and checks used for the pilot; it does not update with the live site.

Questions about the evidence, permission, or a possible collaboration? Contact the Observatory →