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For emergency medicine groups

KEEP builds the group's case from its own data.

Contract terms watched every month. Excess walkouts split into the group's share and the hospital's, in dollars. A signed pack both sides read.

Watch the filmnarrated · 1 min 41 s
Synthetic

How it works

Threshold MonitorSynthetic
Delta Crossing Regional Medical CenterLA-01 · August 2026 · 7 terms held · C-0001
Boarding hours
Threshold≤ 1,400.0 hcontractual · sum
Month1,987.6 h744 / 744 · 744
Distance+587.6 hsixth month
StandingBreached

1The contract's terms, watched month by month.

Attribution Engine · LA-01Synthetic
Coverage or treated loadours
105.9walkouts
Boarding elevatedthe hospital's
35.3walkouts
Both elevatednot apportioned
48.3walkouts
$14,644 forgone professional revenue · at most

2Excess walkouts split into the group's share and the hospital's, in dollars.

Record held · 12 of 12 months · 4 months not yet arrived, September to December 2026
Delta Crossing Regional Medical Center · August 2026

Two of seven contract terms breached. Boarding hours, for the sixth month running.

3A signed pack the hospital reads on the same page.

Declined

Where a figure cannot be stated honestly, the engine declines it and prints its reason.

See the refusal
1The gap

Two parties make the numbers. The contract holds one to account.

Boarding is the hospital's, walkouts count against the group, and a patient who leaves a boarded department left because of both.

Contract scorecard · LA-01 · August 2026Synthetic
Terms against thresholdvalue · present / qualifying · period
Boarding hoursbreach · ≤1,400.0 · sum · contractual · sixth consecutive month
1,987.6hours744/744 · 744
Left without being seenmet · ≤3.00% · proportion · internal target
2.61%744/744 · 744
2027voluntary

From 2027 hospitals can report Medicare's emergency timeliness measure; from 2028 they must. Walkouts and boarding over four hours are two of its four components.

read from the product · engine 20260923180000 · extract through 2026-08-31 23:00
2Monitoring and arguing

Monitoring describes. KEEP argues.

Your platform tells both parties what happened. KEEP builds the group's own case from the same data, in a document the hospital can cross-examine.

The comparisonSynthetic
An analytics platformKEEP
PurposeDescribe what happenedBuild an argument
StanceNeutral, shared with the hospitalGroup-owned, adversarially prepared
OutputDashboards, drill-downs, alertsA signed document with a thesis
Time horizonThis monthThe whole contract term
AttributionReports the metricDecomposes excess walkouts by whose quantity was elevated; forgone professional revenue, at most
the marks are drawn as the product draws them for LA-01 · engine 20260923180000
3Attribution

Excess walkouts, split by whose quantity was elevated. The group's share first.

At Delta Crossing, 189.6 excess walkouts apportion to 105.9 ours, 35.3 the hospital's and 48.3 both at once — reported, never apportioned.

Attribution Engine · LA-01 · twelve months to August 2026Synthetic
930 walkouts this year · 564 in hours the method can decompose · 366 in hours it cannot · 189.6 excess over baseline · four strata
Coverage or treated loadours · 2.202% of 15,213
105.9excess walkouts
Boarding elevatedthe hospital's · 5.189% of 925
35.3excess walkouts
Both elevatednot apportioned · 5.840% of 1,113
48.3excess walkouts
Delta Crossing Regional Medical Center
LA-01 · 37,987 arrivals in scope · the subject
83.7expected walkouts
attributable to boarding · at most · of 189.6 excess walkouts in total · range 35.3–83.7
$14,644 forgone professional revenue
Two Rivers General Hospital
LA-02 · 24,003 arrivals in scope · the comparator
6.9expected walkouts
attributable to boarding · at most · of 52.3 excess walkouts in total · range 0.1–6.9
$1,212 forgone professional revenue
Boarding-attributable loss runs 12.1× higher — compared at each site’s upper bound. Our share of the excess: 55.9% lower · 81.4% upper, and the pack leads with the upper.
read from the product · engine 20260923180000 · extract through 2026-08-31 23:00 · revenue per visit unsourced
4The pack

Not a dashboard. A signed document with a thesis.

The cover states its own shape, so an abridged pack cannot pass as a complete one; a signed version is never changed, only succeeded.

Record held · 12 of 12 months · 4 months not yet arrived, September to December 2026
Evidence pack · Standard · 12 of 14 exhibits
Delta Crossing Regional Medical Center · August 2026

Two of seven contract terms breached. Boarding hours, for the sixth month running.

1,987.6h
boarding hours
ceiling 1,400.0 h
744 / 744 · 744
1.77
patients per provider-hour
floor 1.80
744 / 744 · 744
$14,644
forgone professional revenue
at most · revenue per visit unsourced
see the method exhibit
the current draft's cover, headline and figures as the product prints them · engine 20260923180000Synthetic
5The refusal

When a figure cannot be stated honestly, KEEP says why instead.

At Cane Ridge there is no boarding series, so the attribution declines in its own words, and the empty figure opens to its reason.

Attribution Engine · LA-03Synthetic
The group-controllable sharenot statable at this site — the engine declines in its own words
Declined
The group-controllable share is a fraction of a decomposition whose hospital-side term cannot be estimated at this site: there is no boarding series. The group's own drivers can be counted — coverage shortfall and treated load are both derivable here — but an excess is measured against hours where no driver was elevated, and whether a driver was elevated cannot be known without the boarding series. So neither the group's cost nor its share of the whole is statable at this site.
15,698 arrivals out of scope · every in-extract hour classified boarding-not-derivable
the engine's sentence, whole, as the product prints it · read from the product · engine 20260923180000
Threshold MonitorSynthetic
Cane Ridge Parish HospitalLA-03 · August 2026 · 5 terms held · 2 metrics silent · C-0003
Left without being seen
Threshold≤ 4.00%internal target · proportion
Month1.38%744 / 744 · 744
Distance−2.62 pt
StandingMet
Boarding hours
Threshold—no term in C-0003
Monthnot derivableNo bed-status join available in this EDIS.
Distance—
StandingSilent
Patients per provider-hour
Threshold—no term in C-0003
Month1.33744 / 744 · 744
Distance—
StandingSilent
read from the product · engine 20260923180000 · silence is a state of its own, never a pass

Any tool can draw the chart. This one will not draw it blind — and the figures that do print open the same way.

LA-03 · declined at this site

Lineage
The group's stratum plus the unapportioned both-elevated hours, as a share of all the excess that entered the decomposition — the upper bound.
Cane Ridge Parish Hospital · 12 months
declined at this site · computed
1What this measures
Computed — arithmetic over other figures. No row contains it.
2Where this number comes from
This figure has no source of its own. It is arithmetic, and every number it is made of carries its own — section 3 names them.
3Why this site cannot state it
DECLINED · the engine's sentence, above
4Coverage, and why there is none
This figure is not formed at this site, so it inherits no coverage. The engine's reason is printed with it.
read from the product · engine 20260923180000

LA-01 · a figure that prints

Lineage
Left without being seen
Delta Crossing Regional Medical Center · August 2026 · LA-01
2.61% · 744 / 744 · 744 · met
1What this measures
Left without being seen, over arrivals. Unit of coverage: HOUR. · metric_lwbs_rate_monthly · proportion · never seen by a clinician, AMA excluded (CMS OP-22 population) · the definition, as the database holds it: postgres, verbatim · 81 lines
2Where each number comes from
This figure's four numbers are not all stamped to the same relation. They name 3: d_hour, d_month, ed_hourly. · everything it depends on · 23 relations · 5 steps · reads directly contract_thresholds · d_month · d_site_cohort · d_site_hour · d_site_month_absence
3The rows behind this number
6 encounter rows from Aug 2026 · the engine reads the aggregate, not these
4Coverage, stated with the figure
present / qualifying 744 / 744 out of population 0 in period 744
read from the product · engine 20260923180000
6Institutional memory

Groups lose renewals to amnesia. KEEP keeps the record as it happens.

Every term judged every month against its own threshold, twelve of twelve on record, each signed version kept beside the next.

Term · LA-01 · C-0001 · August 2026Synthetic

Boarding hours

Delta Crossing Regional Medical Center · contract C-0001
Term on record · 12 of 12 months
Threshold
≤ 1,400.0 h · a ceiling on the month's sum · contractual
Aug
1,987.6 h · sum over the month · 744 / 744 · 744 · admit order → ED departure
Distance
+587.6 h · over the ceiling · the sixth month running, breached since March 2026
Months met
6 of 12 judged · 6 breached
Boarding hours, by monthsum · Sep to Aug
threshold · ≤ 1,400.0 h
present / qualifying · period · 744 / 744 · 744 · August 2026 · the hourly feed, 744 of 744 hours

Boarding hours, 1,987.6 h. The ceiling is ≤ 1,400.0 h, contractual. Breached for the sixth month running.

read from the product · engine 20260923180000
7One client

KEEP has exactly one client: the group.

Every adjacent vendor sells to the hospital or the enterprise, or is the party being measured. KEEP is group-side by construction.

One address. No form.
comingsoon@usekeep.health

Nothing here is gated, and nothing is collected. Every figure on this page is synthetic: three fictional hospitals, one fictional group.

The film · narrated · 1 min 41 s