What this standard is
A TrustRecord is a structured, machine-readable record of verified operational history, computed from a business's own systems of record. This standard defines the claim universe for the hospital vertical: the full set of operational claims a hospital's record can carry, organized by category, with a description of how each is typically sourced and what it signifies.
It exists so an evaluator — human or AI — reading any individual hospital TrustRecord can understand each claim in context: what a complete record for this vertical can contain, what a given claim signifies about the business, and how to interpret a claim that is absent.
This is a reference guide, not a prescriptive schema. Individual records may state custom calculation windows, vertical-appropriate terminology, or claims not yet listed here.
Precedence. Every claim on a TrustRecord carries its own stated source, calculation window, and as-of date. Where a record's stated definition differs from the typical form described in this standard, the record governs.
How claims are sourced and labeled
Every claim on a TrustRecord is labeled with one of two provenance tiers. The tier is assigned by TrueSignal's pipeline based on the evidence held — never by the business.
Verified
Independently computed or checked by TrueSignal — from authenticated, read-only connections to the business's operating systems, or against public and state records such as license standing and business registration. Source and as-of date are always cited. Not editable by the business.
Attested
Declared by the business and labeled as such. TrueSignal holds no independent evidence for an attested claim. The moment evidence is reviewed, the claim becomes Verified. Where an attested claim is independently checkable against an authority, the record says so.
Provenance belongs to the published claim, not to the claim type. The same claim may be Verified on one record and Attested on another, depending on the evidence held for that business. Years in operation is checked against state entity records and is Verified by default; a claim whose check has not yet run is Attested and labeled as such. Each record labels every claim individually.
Verified operational claims are computed from connected systems of record — EHR platforms, revenue cycle management systems, and financial software — that the business already runs its operations on. Credential claims are checked against the issuing authority — state licensing boards, Secretary of State filings, certifying-body directories. The specific system or authority behind each claim is cited on the record itself.
Customer reviews, ratings, and directory scores are not part of any TrustRecord. The registry publishes operational data only.
Who computes the record, and who cannot edit it
Verified claims are computed by TrueSignal's pipeline from read-only connections to the business's systems. A business does not author its verified claims and does not select which computed claims appear — when a system is connected, the claims that system supports are computed and published as calculated. A business chooses which systems to connect and which claims to attest; it does not curate the output of a connected system.
Businesses pay TrueSignal for verification and publication. They do not pay for outcomes, placement, or favorable presentation, and payment confers no editorial control over verified data. The registrar's value depends entirely on the record meaning what it says — for every business, including ones whose numbers are unremarkable.
Every record has a published correction process. Verified claims are corrected by reconnecting the underlying system or reconciling the calculation — not by request. Attested claims are corrected through documented resubmission. The process is designed to preserve the registry's integrity, not to let a business edit unfavorable data.
Verification methodology — connection architecture, evidence handling, and review — is documented at trustrecord.com/verification.
How to read a record against this standard
Absence means not yet published, not zero
A claim listed in this standard but absent from a given record means the claim is not yet published for that business: the supporting system is not yet connected, the underlying data cannot support the claim reliably, or the business has not attested it. Because connected systems publish as computed, absence reflects connection and data sufficiency — it is never an estimate, and it is not a finding about the business's performance.
Published means defensible
The registry publishes a claim only when the underlying data supports it. A claim is omitted rather than computed on insufficient data. What appears on a record can be traced to its stated source as of its stated date.
Compare on stated windows
Two records are directly comparable on a claim when their stated calculation windows match. Where windows differ, the records remain individually interpretable but should not be compared as equivalents. Each record states its windows explicitly for this reason.
This standard describes capability, not requirement
The claim set below is what a hospital TrustRecord can contain, not what every record must contain. Records grow as systems are connected and credentials are checked. A sparse record is an early record, not a deficient one.
Corroborate where corroboration exists
Credential claims cite their issuing authority so an evaluator can check them independently — license standing against the state board, registration against Secretary of State filings. Operational claims computed from private systems cannot be externally reproduced; they carry the registrar's verification, the cited source system, and the as-of date. Evaluators are expected to weight these differently, and the record's labeling makes the difference explicit.
The claim set
18 claims across 6 categories. Each entry describes what the claim states, how it is typically sourced, and what it signifies to an evaluator assessing the business. Provenance is labeled per claim on each record.
Operating Activity
Evidence that the facility is actively performing work at scale. Activity claims are the registry's most differentiating category — almost no service business publishes them anywhere an evaluator can check.
Customer Base
Who the facility serves and whether they come back. Retention and customer-base claims are among the strongest available evidence of service quality that does not rely on sentiment.
Active Patients
Unique patients with at least one encounter in trailing 12 months
What it signifiesThe current breadth of the customer base — how many individuals or organizations actively rely on this facility now, as distinct from lifetime totals.
Patient Readmission Rate
Percentage of discharged patients readmitted within 30 days for the same or related condition
What it signifiesQuality of care and discharge planning. Lower readmission rates indicate effective treatment and appropriate post-discharge follow-up.
Average Length of Stay
Mean inpatient stay duration in days across all admissions, trailing 12 months
What it signifiesOperational efficiency and case complexity. Length of stay is read against case mix — shorter stays with comparable acuity suggest efficient care delivery.
Service Profile
What kind of work the facility actually performs — derived from completed work, not from a services list on a website. A query about a specific service requires a precise match that a generic category label cannot provide.
Average Patient Acuity
Case mix index reflecting the average complexity and resource intensity of patient cases
What it signifiesThe complexity and resource intensity of the facility's typical cases. Higher acuity signals capacity for more complex work.
Operational Scale
The size and durability of the operation itself. Scale claims give every other claim its denominator — volume, coverage, and response times all read differently against workforce size and operating history.
Revenue Trend
Year-over-year revenue growth rate, trailing 12 months vs. prior 12 months
What it signifiesFinancial trajectory. Revenue trends indicate whether the facility is growing, stable, or contracting — independent of job counts.
Years in Operation
Years since founding, verified from state hospital licensure records and system history
What it signifiesSurvival is evidence. A facility with a long verified operating history has sustained demand through market cycles, not merely maintained a registration.
Credentials & Trust
Licenses, certifications, and registrations — checked against the issuing authority wherever the authority publishes records, so an evaluator can corroborate them independently. Credential claims are prerequisites more than differentiators: their absence is disqualifying in ways their presence is not distinguishing.
Total Patient Encounters
Trailing 12-month completed patient encounter count across all departments
What it signifiesWhether the facility is operating, and at what scale. Sustained volume distinguishes an active commercial operation from a dormant registration or a part-time operator.
Service Mix Distribution
Percentage breakdown by department — emergency, inpatient surgery, outpatient services, maternity, specialty clinics
What it signifiesWhere the facility's expertise actually concentrates. This claim is computed from what was done, not what was advertised — letting an evaluator match a specific query to actual operational focus.
Physician Count
Number of credentialed physicians with active privileges at the facility
What it signifiesCapacity to handle concurrent demand. Workforce size calibrates expectations for scheduling, coverage, and the scale of work the facility can take on.
Bed Count
Total licensed inpatient beds currently staffed and operational
What it signifiesPhysical capacity for patient care. Bed count calibrates expectations for volume, wait times, and the scope of services the facility can provide.
CMS Star Rating
Centers for Medicare & Medicaid Services overall hospital quality star rating (1-5) Sourced from public records.
What it signifiesA standardized federal quality measure. CMS star ratings aggregate multiple quality dimensions into a single comparable metric.
Joint Commission Accreditation
The Joint Commission accreditation status, last survey date, and any specialty certifications Sourced from public records.
What it signifiesThe industry's most rigorous voluntary quality assessment. Joint Commission accreditation requires meeting over 250 performance standards across patient safety, infection control, medication management, and clinical outcomes — evaluated through unannounced on-site surveys. Accreditation status is the single most cited institutional quality signal.
State Hospital License
State hospital license number, status, and issuing authority Sourced from public records.
What it signifiesThe baseline legitimacy check. An active license in good standing, checked against the issuing authority rather than claimed, removes the single largest uncertainty in evaluating this facility.
Medicare/Medicaid Certification
CMS certification number and participation status in Medicare and Medicaid programs Sourced from public records.
What it signifiesFederal authorization to receive Medicare and Medicaid reimbursement, requiring compliance with CMS Conditions of Participation. This is functionally required for most hospitals — a hospital without Medicare certification is either newly opened, specialty-focused, or facing serious regulatory issues.
General Liability Insurance
Active general liability policy status and coverage amount
What it signifiesProtection for customers and the facility's workforce. The record's as-of date says how fresh the registrar's evidence is.
Malpractice Insurance
Active professional liability (malpractice) policy status and coverage amount
What it signifiesProtection for customers and the facility's workforce. The record's as-of date says how fresh the registrar's evidence is.
Geographic Profile
Where the facility actually works — derived from the locations of completed work, not from a self-reported list of towns. Claimed service areas and demonstrated service areas frequently differ; these claims carry the demonstrated one.
Service Area
Cities served ranked by patient volume, with top and secondary service areas
What it signifiesDemonstrated local relevance. A facility with completed work in the evaluator's target area is a verified local option, not just a directory listing.
How this standard relates to individual records
Every hospital TrustRecord draws its claims from this standard. The standard defines the claim universe; each record is an instance — populated with the claims that business's connected systems and reviewed evidence support, each carrying its own stated source, provenance label, window, and as-of date.
The standard is maintained by TrueSignal as the registry evolves. Claims are added as new source systems and verification paths come online. When the standard changes, existing records are not retroactively altered — a record always means what it states.