The tier contract

It answers regulatory questions. It does not practice medicine.

Every question an operator asks lands in one of three tiers, and the tier decides what jubalMED will do — an output constraint built into the product, not a disclaimer under it.

Why a line at all

Because the stakes are different on each side of it.

What a regulation requires is a research question — it has a citable answer. Whether a particular patient qualifies for the benefit is a clinical determination with legal weight, made by your medical director under authority no software holds. A tool that blurs those two does its user no favor.

So jubalMED draws the line where the regulations draw it, and holds that line the same way it handles citations: by construction. Tier discipline is part of the product’s tested behavior — the release gate includes cases that verify a tier-3 question gets a decline and a cited process, not an opinion.

Tier 1

No patient involved

“Are we required to provide personal care when our patient resides in a nursing facility?”

Answers fully: the controlling statute, regulation, and survey guidance, quoted verbatim, dated, with provenance. This is the bulk of compliance work — disputes, documentation duties, survey preparation, policy questions.

Tier 2

Patient facts as context

“Given a patient receiving continuous home care, what must we document for each nursing shift?”

Answers the regulatory question inside the situation — what is required, permitted, or must be documented — always as the generic requirement that applies. It never renders a judgment about the particular patient, and it never needs patient identifiers to do its job.

Tier 3

Patient as the subject

“Does this patient still qualify for hospice? Should we recertify?”

Declines — by construction. Eligibility, prognosis, and recertification are clinical determinations that belong to your medical director and interdisciplinary team. What jubalMED offers instead: the process, timing, and documentation requirements that govern that determination, fully cited.

Patient information

Built to work without identifiers.

Because tier 1 and tier 2 questions are answered as generic regulatory requirements, jubalMED does not need patient identifiers to be useful — and asks you to keep them out of your questions. The regulatory answer is the same for every patient in the situation; that is precisely what makes it a regulation.

As document workflows expand, they arrive under the same posture: the minimum information the research requires, and nothing that identifies a patient.

Bring your hardest surveyor question.

Invite-only, with founding rates for early members. When someone tells you what the rules say, jubalMED shows you what the rules actually require.