stack/docs/superpowers/plans/2026-08-20-palliative-finish-p43.md

Palliative RFI Finishing Pass — Run Record (2026-08-20)

Not a forward plan — the run record of the "full analysis and full documentation" pass that closed out P42/P43's open analysis items. Forward work remaining for P44 is listed at the end.

Goal: Every open analysis input for the P44 comment (due 2026-09-12, docket closes 2026-09-14) either done or running to completion; documentation current (notebook, tracker, spec, memory).

What was done

• Stage-3 PRISMA eligibility + extraction launched (rig 4090, qwen2.5:14b-ctx32k created via Ollama /api/create; stack prisma eligible palliative-rfi --max-chars 60000; chained extract). Two fixes en route: --max-chars cap so bounded-context models keep the criteria in window, and a deterministic uncertain / unavailable-fulltext path for items with no retrieved full text (they also tripped the qwen/Ollama empty-response quirk; the eligibility prompt got the same one-sentence-system restructure that fixed screening). Log: .state/prisma-stage3.log.
• #649 closed — § II.E close read; pincite analysis in docs/spec/2026-08-20-cy2027-iie-crossread-palliative-rfi.md, condensed as notebook Section 6. Headline: II.E proposes nothing; the only operative text is II.D's G2211 changes; three CMS concessions anchor part (d).
• #648 closed — claims utilization methodology exhibit (notebook Section 5) over the synthetic Tuva CCLF (962 beneficiaries, 2016-2018): ACP/CCM/TCM/Home-E/M sparse but concentrated in serious illness (75-91% of users), CCM reaching ~1/7 of the 611 seriously-ill; PCM/APCM structurally absent (post-window codes). Scope-disclosed as methodology, not empirics.
• #644 closed — sixth cited source captured: MLN909188 (June 2025) CCM/PCM/APCM coding booklet, bib PV8APQ4A, synced to Zotero (--tag source:rfi-cited).
• #645 closed — sibling rules: FY2027 Hospice NPRM is 2026-06604 at 91 FR 17338 (the rule's "90 FR 17360" cite is a volume typo), ESRD is 2026-12925 at 91 FR 38784. Both created as bib rule items (KUZC5FN2, IGXTEJU3), fr-grabbed (322 ¶/42 pp; 887 ¶/87 pp), fr-jump verified.
• #663 implemented — stack comments extract-ocr (RapidOCR ONNX, pip-only; PDFs rasterized via PyMuPDF), TDD'd, smoke-verified; full run over 2,738 queued comments launched, chained with a palliative re-sweep. Log: .state/comments/ocr.log.
• Notebook updated: Sections 5 (claims) and 6 (II.E) added, Provenance → Section 7 with today's pipeline lines, stage-3 methods disclosure current. Headless nb_integration: pass.

Still open / running when this record was written

• Stage-3 eligibility+extraction run (hours; queue-driven and idempotent — re-run stack prisma eligible palliative-rfi --max-chars 60000 to sweep any stragglers, then stack prisma extract palliative-rfi).
• OCR run over 2,738 comments (hours) → auto re-sweep updates topic:palliative.
• Europe PMC tier armed but EBI unreachable two days running — when it recovers, stack prisma fetch palliative-rfi -w 8 for ~400 author manuscripts, then re-run eligibility for newly-fetched texts.
• #652 stays open by design: PCM-1/2/3 descriptors await human review; CBE 3665 reporting-condition decision; time thresholds.
• #615 (post-close re-farm of CMS-2026-2377) after 2026-09-14.
• P44: #650 draft (target 2026-09-12), #651 submit + archive receipt.