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Fold the ledger state, liveness verdict, plan and scope gaps and the provider reauth flag into ok / limited / degraded / action_required with a reason code, the one action, the unavailable types and redacted diagnostics. Keep the last ten sync attempts per connection for those diagnostics, publish the state on the integrations envelope, every per-provider status route and the Apple Health config read, and page the operator once per failure streak instead of once a day.