{
  "schemaVersion": 1,
  "records": {
    "106500852": {
      "checkedOn": "2026-10-17",
      "acuteRnTurnover": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No DMC-specific acute-hospital RN turnover rate with a defined reporting period and denominator was found in the reviewed sources. The 2022 union departure count is historical; Tenet corporate disclosures do not supply a DMC rate.",
        "sources": [
          {
            "label": "CNA/NNU · historical RN departures · April 22, 2022",
            "url": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals"
          },
          {
            "label": "CNA/NNU · DMC staffing statement · July 2024",
            "url": "https://www.nationalnursesunited.org/press/modesto-nurses-to-picket-for-safe-patient-care"
          },
          {
            "label": "CNA/NNU · contract ratification · March 27, 2026",
            "url": "https://www.nationalnursesunited.org/press/3000-registered-nurses-from-six-california-tenet-hospitals-ratify-new-three-year-contract"
          },
          {
            "label": "Tenet 2025 Form 10-K · Nurse Staffing · printed page 7",
            "url": "https://www.sec.gov/Archives/edgar/data/70318/000119312526159132/d935030dars.pdf"
          },
          {
            "label": "Leapfrog · DMC nursing reporting entries · checked October 17, 2026",
            "url": "https://ratings.leapfroggroup.org/facility/details/05-0464/doctors-medical-center-of-modesto-modesto-ca"
          }
        ]
      },
      "rnVacancies": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No dated DMC-specific count or rate of unfilled budgeted acute-hospital RN positions was found in the reviewed sources. Recruitment advertisements were not converted into vacancy counts.",
        "sources": [
          {
            "label": "CNA/NNU · historical RN departures · April 22, 2022",
            "url": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals"
          },
          {
            "label": "CNA/NNU · DMC staffing statement · July 2024",
            "url": "https://www.nationalnursesunited.org/press/modesto-nurses-to-picket-for-safe-patient-care"
          },
          {
            "label": "CNA/NNU · contract ratification · March 27, 2026",
            "url": "https://www.nationalnursesunited.org/press/3000-registered-nurses-from-six-california-tenet-hospitals-ratify-new-three-year-contract"
          },
          {
            "label": "Tenet 2025 Form 10-K · Nurse Staffing · printed page 7",
            "url": "https://www.sec.gov/Archives/edgar/data/70318/000119312526159132/d935030dars.pdf"
          },
          {
            "label": "Leapfrog · DMC nursing reporting entries · checked October 17, 2026",
            "url": "https://ratings.leapfroggroup.org/facility/details/05-0464/doctors-medical-center-of-modesto-modesto-ca"
          }
        ]
      },
      "context": [
        {
          "label": "Historical RN departures reported by the union",
          "value": "160",
          "period": "Pandemic start through April 22, 2022 · start date not defined",
          "scope": "Doctors Medical Center, Modesto",
          "definition": "Union-reported departure count. This is not an annual turnover percentage or a current vacancy count.",
          "source": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals"
        }
      ],
      "nextStep": "Request the existing DMC RN turnover, retention, and budgeted-vacancy reports with dates, definitions, numerators, denominators, and acute/behavioral campus scope. A request template is prepared; no request has been sent. Inaccessible employer material remains a documented access gap.",
      "publicSourceReview": {
        "completedOn": "2026-10-17",
        "scope": "Targeted public-source review of DMC acute-hospital RN turnover and vacancies; not a review of every working-condition field.",
        "checks": [
          {
            "label": "2022 union departure statement",
            "url": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals",
            "result": "160 RN departures attributed to DMC since the pandemic began; no precise starting date, average RN headcount, or annual turnover denominator."
          },
          {
            "label": "July 2024 DMC union statement",
            "url": "https://www.nationalnursesunited.org/press/modesto-nurses-to-picket-for-safe-patient-care",
            "result": "Union describes staffing concerns and ADO submissions; no numeric acute-hospital RN turnover rate or budgeted vacancy count."
          },
          {
            "label": "March 2026 contract ratification",
            "url": "https://www.nationalnursesunited.org/press/3000-registered-nurses-from-six-california-tenet-hospitals-ratify-new-three-year-contract",
            "result": "DMC is named; rapid-response and orientation provisions reported. No facility turnover rate, vacancy count, executed local clauses, or shift-level implementation records supplied."
          },
          {
            "label": "Tenet 2025 Form 10-K",
            "url": "https://www.sec.gov/Archives/edgar/data/70318/000119312526159132/d935030dars.pdf",
            "result": "Nurse Staffing section states that turnover and vacancy data inform staffing assessments. Corporate scope; no DMC-specific numeric turnover or vacancy result identified in this review."
          },
          {
            "label": "Leapfrog DMC facility page",
            "url": "https://ratings.leapfroggroup.org/facility/details/05-0464/doctors-medical-center-of-modesto-modesto-ca",
            "result": "Nursing and Bedside Care and Nursing Care entries display Declined to Report. This is a Leapfrog disclosure status, not a measured staffing result. Survey year not established from the retrieved page."
          },
          {
            "label": "HCAI official facility record",
            "url": "https://hcai.ca.gov/facility/doctors-medical-center/",
            "result": "Identity matched to 1441 Florida Avenue, HCAI 106500852. Financial and utilization measures do not establish RN departures or budgeted vacancies."
          },
          {
            "label": "DMC employer health-equity page",
            "url": "https://www.dmc-modesto.com/health-equity",
            "result": "Page opened; linked acute-hospital equity report could not be retrieved. Its contents were not assessed."
          }
        ],
        "accessGaps": [
          "DMC health-professionals page returned 403; teams and news pages could not be retrieved.",
          "The linked hospital equity report could not be retrieved. No absence of workforce data is inferred from inaccessible material."
        ],
        "remainingRecords": "DMC and unit-level RN separation counts, monthly headcounts, turnover definitions, first-year retention, budgeted and filled RN FTEs, and dated vacancy reports.",
        "requestStatus": "Prepared only; not sent.",
        "requestTemplate": "/downloads/workforce/dmc-workforce-records-request.txt"
      }
    },
    "106500939": {
      "checkedOn": "2026-10-17",
      "acuteRnTurnover": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN turnover rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "Sutter Memorial nursing recruitment listing",
            "url": "https://jobs.sutterhealth.org/us/en/job/R-142461/Registered-Nurse-II-Telemetry"
          }
        ]
      },
      "rnVacancies": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN budgeted vacancy count or rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "Sutter Memorial nursing recruitment listing",
            "url": "https://jobs.sutterhealth.org/us/en/job/R-142461/Registered-Nurse-II-Telemetry"
          }
        ]
      },
      "context": [],
      "nextStep": "Obtain the existing facility workforce reports and resolve the documented access/scope gaps. A request template is prepared; no request has been sent.",
      "publicSourceReview": {
        "completedOn": "2026-10-17",
        "scope": "Targeted review of accessible and retained public sources for acute-hospital RN turnover and vacancies. Blocked and unresolved sources remain identified below.",
        "checks": [
          {
            "label": "Official campus identity",
            "url": "https://hcai.ca.gov/facility/memorial-medical-center-modesto/",
            "result": "Memorial Medical Center, Modesto, 1700 Coffee Road; HCAI 106500939."
          },
          {
            "label": "Sutter Memorial nursing recruitment listing",
            "url": "https://jobs.sutterhealth.org/us/en/job/R-142461/Registered-Nurse-II-Telemetry",
            "result": "Facility-specific recruitment description; no defined facility RN turnover rate or budgeted vacancy total."
          }
        ],
        "accessGaps": [
          "Targeted Sutter/Memorial turnover and vacancy searches found no qualifying facility-specific numeric result. The attempted Sutter hospital-about page could not be accessed."
        ],
        "remainingRecords": "Dated acute-hospital RN separations and denominator, first-year retention, budgeted/filled/unfilled RN FTEs, and unit-level coverage definitions.",
        "requestStatus": "Prepared only; not sent.",
        "requestTemplate": "/downloads/workforce/106500939-workforce-records-request.txt"
      }
    },
    "106500867": {
      "checkedOn": "2026-10-17",
      "acuteRnTurnover": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN turnover rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "2022 union departure statement",
            "url": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals"
          },
          {
            "label": "March 2026 contract ratification",
            "url": "https://www.nationalnursesunited.org/press/3000-registered-nurses-from-six-california-tenet-hospitals-ratify-new-three-year-contract"
          },
          {
            "label": "Tenet 2025 Form 10-K",
            "url": "https://www.sec.gov/Archives/edgar/data/70318/000119312526159132/d935030dars.pdf"
          }
        ]
      },
      "rnVacancies": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN budgeted vacancy count or rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "2022 union departure statement",
            "url": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals"
          },
          {
            "label": "March 2026 contract ratification",
            "url": "https://www.nationalnursesunited.org/press/3000-registered-nurses-from-six-california-tenet-hospitals-ratify-new-three-year-contract"
          },
          {
            "label": "Tenet 2025 Form 10-K",
            "url": "https://www.sec.gov/Archives/edgar/data/70318/000119312526159132/d935030dars.pdf"
          }
        ]
      },
      "context": [
        {
          "label": "Historical RN departures reported by the union",
          "value": "nearly 100",
          "period": "Pandemic start through April 22, 2022 · start date not defined",
          "scope": "Emanuel Medical Center, Turlock",
          "definition": "Union-reported departure count. This is not an annual turnover percentage or a current vacancy count.",
          "source": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals"
        }
      ],
      "nextStep": "Obtain the existing facility workforce reports and resolve the documented access/scope gaps. A request template is prepared; no request has been sent.",
      "publicSourceReview": {
        "completedOn": "2026-10-17",
        "scope": "Targeted review of accessible and retained public sources for acute-hospital RN turnover and vacancies. Blocked and unresolved sources remain identified below.",
        "checks": [
          {
            "label": "Official campus identity",
            "url": "https://hcai.ca.gov/facility/emanuel-medical-center/",
            "result": "Emanuel Medical Center, Turlock, 825 Delbon Avenue; HCAI 106500867."
          },
          {
            "label": "2022 union departure statement",
            "url": "https://www.nationalnursesunited.org/press/rns-to-hold-info-pickets-and-public-actions-april-27-tenet-hospitals",
            "result": "Union reports nearly 100 RN departures since the pandemic began; not an annual turnover rate. No exact starting date or denominator."
          },
          {
            "label": "March 2026 contract ratification",
            "url": "https://www.nationalnursesunited.org/press/3000-registered-nurses-from-six-california-tenet-hospitals-ratify-new-three-year-contract",
            "result": "DMC is named; rapid-response and orientation provisions reported. No facility turnover rate, vacancy count, executed local clauses, or shift-level implementation records supplied."
          },
          {
            "label": "Tenet 2025 Form 10-K",
            "url": "https://www.sec.gov/Archives/edgar/data/70318/000119312526159132/d935030dars.pdf",
            "result": "Nurse Staffing section states that turnover and vacancy data inform staffing assessments. Corporate scope; no DMC-specific numeric turnover or vacancy result identified in this review."
          }
        ],
        "accessGaps": [
          "Targeted Emanuel turnover/vacancy searches did not identify qualifying facility-level numeric results. An attempted legacy employer-about URL returned unrelated Carondelet content and was excluded."
        ],
        "remainingRecords": "Dated acute-hospital RN separations and denominator, first-year retention, budgeted/filled/unfilled RN FTEs, and unit-level coverage definitions.",
        "requestStatus": "Prepared only; not sent.",
        "requestTemplate": "/downloads/workforce/106500867-workforce-records-request.txt"
      }
    },
    "106500967": {
      "checkedOn": "2026-10-17",
      "acuteRnTurnover": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN turnover rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "District recruitment page",
            "url": "https://oakvalleyhospital.com/job-openings/"
          },
          {
            "label": "March 5, 2026 district board packet lead",
            "url": "https://oakvalleyhospital.com/wp-content/uploads/2026/03/03.05.2026-District-Board-Packet.pdf"
          },
          {
            "label": "Retained separate-SNF CMS workforce record",
            "url": "/downloads/workforce-conditions.json"
          }
        ]
      },
      "rnVacancies": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN budgeted vacancy count or rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "District recruitment page",
            "url": "https://oakvalleyhospital.com/job-openings/"
          },
          {
            "label": "March 5, 2026 district board packet lead",
            "url": "https://oakvalleyhospital.com/wp-content/uploads/2026/03/03.05.2026-District-Board-Packet.pdf"
          },
          {
            "label": "Retained separate-SNF CMS workforce record",
            "url": "/downloads/workforce-conditions.json"
          }
        ]
      },
      "context": [],
      "nextStep": "Obtain the existing facility workforce reports and resolve the documented access/scope gaps. A request template is prepared; no request has been sent.",
      "publicSourceReview": {
        "completedOn": "2026-10-17",
        "scope": "Targeted review of accessible and retained public sources for acute-hospital RN turnover and vacancies. Blocked and unresolved sources remain identified below.",
        "checks": [
          {
            "label": "Official campus identity",
            "url": "https://hcai.ca.gov/facility/oak-valley-hospital-district/",
            "result": "Oak Valley Hospital, Oakdale, 350 South Oak Street; HCAI 106500967."
          },
          {
            "label": "District recruitment page",
            "url": "https://oakvalleyhospital.com/job-openings/",
            "result": "Hospital, clinics and nursing-home roles are separately listed. Advertisements are not a count of unfilled budgeted hospital RN positions."
          },
          {
            "label": "March 5, 2026 district board packet lead",
            "url": "https://oakvalleyhospital.com/wp-content/uploads/2026/03/03.05.2026-District-Board-Packet.pdf",
            "result": "Search index identifies an HR statistics report. PDF retrieval failed; no numerical finding taken from the inaccessible packet."
          },
          {
            "label": "Retained separate-SNF CMS workforce record",
            "url": "/downloads/workforce-conditions.json",
            "result": "Oakdale SNF RN turnover remains separate; not substituted for acute-hospital RN turnover."
          }
        ],
        "accessGaps": [
          "March 2026 board packet could not be retrieved. The referenced HR statistics report still requires inspection and workforce-scope verification."
        ],
        "remainingRecords": "Dated acute-hospital RN separations and denominator, first-year retention, budgeted/filled/unfilled RN FTEs, and unit-level coverage definitions.",
        "requestStatus": "Prepared only; not sent.",
        "requestTemplate": "/downloads/workforce/106500967-workforce-records-request.txt"
      }
    },
    "106504042": {
      "checkedOn": "2026-10-17",
      "acuteRnTurnover": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN turnover rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "2024 Central Valley employer nursing report",
            "url": "https://nursingncal.kaiserpermanente.org/annual-report/2024-report/medical-centers/central-valley/"
          },
          {
            "label": "2025 Modesto employer nursing report",
            "url": "https://nursingncal.kaiserpermanente.org/annual-report-2025/medical-centers/modesto/"
          }
        ]
      },
      "rnVacancies": {
        "value": null,
        "status": "not_found_in_reviewed_sources",
        "period": null,
        "scope": "Acute hospital RNs",
        "definition": null,
        "detail": "No qualifying acute-hospital RN budgeted vacancy count or rate was found in the accessible sources reviewed. Remaining access and scope questions are listed in the public-source review.",
        "sources": [
          {
            "label": "2024 Central Valley employer nursing report",
            "url": "https://nursingncal.kaiserpermanente.org/annual-report/2024-report/medical-centers/central-valley/"
          },
          {
            "label": "2025 Modesto employer nursing report",
            "url": "https://nursingncal.kaiserpermanente.org/annual-report-2025/medical-centers/modesto/"
          }
        ]
      },
      "context": [
        {
          "label": "Employer-reported nursing turnover · regional context",
          "value": "5.9%",
          "period": "2025",
          "scope": "Kaiser Permanente Northern California · region-wide",
          "definition": "Regional employer statement; hospital-only scope, denominator and calculation are not supplied in the reviewed text. Not a Modesto hospital rate.",
          "source": "https://nursingncal.kaiserpermanente.org/annual-report-2025/"
        }
      ],
      "nextStep": "Obtain the existing facility workforce reports and resolve the documented access/scope gaps. A request template is prepared; no request has been sent.",
      "publicSourceReview": {
        "completedOn": "2026-10-17",
        "scope": "Targeted review of accessible and retained public sources for acute-hospital RN turnover and vacancies. Blocked and unresolved sources remain identified below.",
        "checks": [
          {
            "label": "Official campus identity",
            "url": "https://hcai.ca.gov/facility/kaiser-foundation-hospital-modesto/",
            "result": "Kaiser Permanente Modesto Medical Center, 4601 Dale Road; HCAI 106504042."
          },
          {
            "label": "2024 Central Valley employer nursing report",
            "url": "https://nursingncal.kaiserpermanente.org/annual-report/2024-report/medical-centers/central-valley/",
            "result": "Retained 10.2% turnover context spans Modesto and Manteca; not adopted as an acute Modesto RN rate."
          },
          {
            "label": "2025 Modesto employer nursing report",
            "url": "https://nursingncal.kaiserpermanente.org/annual-report-2025/medical-centers/modesto/",
            "result": "Report page opened. Retrieved text contains dashboard numbers without complete metric labels/definitions and discusses ambulatory nursing. The 5.10% value was not adopted as a verified acute-hospital RN turnover rate."
          }
        ],
        "accessGaps": [
          "Original employer HTML retrieval returned 403; extracted page text did not resolve dashboard label, RN denominator, or inpatient versus ambulatory scope."
        ],
        "remainingRecords": "Dated acute-hospital RN separations and denominator, first-year retention, budgeted/filled/unfilled RN FTEs, and unit-level coverage definitions.",
        "requestStatus": "Prepared only; not sent.",
        "requestTemplate": "/downloads/workforce/106504042-workforce-records-request.txt"
      }
    }
  }
}