diff --git a/docs/DECISIONS.md b/docs/DECISIONS.md
index 3568487..6388f35 100644
--- a/docs/DECISIONS.md
+++ b/docs/DECISIONS.md
@@ -12,6 +12,23 @@
   - Clear seam for post-MVP split: package boundaries remain explicit so services can be carved out later if load or ownership requires it.
   - Keeps risk focus on measure correctness, run determinism, and case idempotency rather than distributed-systems overhead.
 
+## ADR-003: Single all-encompassing TWH instance (consolidation from three-instance model)
+
+- **Date:** 2026-05-21
+- **Status:** Accepted
+- **Stakeholder:** Doug (confirmed direction 2026-05-21)
+- **Context:** During the sprint build-out (May 2–17), three separate deployment instances were created to isolate concerns during development: `workwell` (base skeleton), `ecqm` (CMS eCQM catalog seeding), and `twh` (Total Worker Health — OSHA safety measures). Each had its own workflow, frontend image, and partially-seeded database. Doug's May 21 review surfaced that these were not separate products — they were a development stepping stone. From the JOURNAL 2026-05-21 entry:
+  > "Doug clarified the product direction: TWH (Total Worker Health) is all-encompassing. OSHA occupational safety compliance and clinical quality (eCQMs, HEDIS wellness) are not separate products — they are two sides of the same coin and belong in one platform. The three-instance deployment model (workwell, ecqm, twh) was a development stepping stone, not the product architecture. One TWH instance covers everything."
+  >
+  > "NIOSH's TWH framework is the conceptual foundation: worker health is shaped by both workplace hazards (OSHA safety programs) and general health promotion (chronic disease, preventive care). WorkWell is the platform that manages both in one system with a shared measure catalog, shared case workflow, shared audit trail, and shared CQL evaluation engine."
+- **Decision:** Consolidate to a single TWH deployment. Delete the `deploy-os-mieweb.yml` (workwell instance) and `deploy-ecqm-mieweb.yml` (eCQM instance) workflows. The sole active workflow is `deploy-twh-mieweb.yml`, which builds the backend (`ghcr.io/taleef7/workwell-api`) and TWH-branded frontend (`ghcr.io/taleef7/workwell-twh-frontend`) and sets `WORKWELL_INSTANCE=twh` to seed all three measure categories on startup: OSHA safety (4 active CQL + 3 catalog-only), HEDIS wellness (4 active CQL), and CMS eCQM catalog (49 Draft entries). The old `workwell` and `workwell-api` MIE containers were deleted from the manager UI. Fly.io `workwell-measure-studio-api` was destroyed (stale secondary stack from the Fly era). The production URLs are `https://twh.os.mieweb.org` (frontend) and `https://twh-api.os.mieweb.org` (backend).
+- **Consequences:**
+  - `ecqm.os.mieweb.org` and `workwell.os.mieweb.org` are intentionally offline. The workwell hostname currently returns a 404; a 301 redirect to `twh.os.mieweb.org` is the documented follow-up (see infra/redirect/).
+  - The eCQM seeding path (`ensureCmsEcqmCatalogSeed()`), the `workwell-ecqm-frontend` image build config, and the `*_ECQM` GitHub secrets are retained as a restore-later capability in case a separate eCQM-only instance is needed in future.
+  - Every push to `main` deploys the single TWH environment, giving a clear signal that `main` is always production.
+  - The platform can expand its catalog (more OSHA measures, more HEDIS measures, more CMS eCQMs) without any infrastructure change — it is all one seeded database with one shared catalog, case workflow, and audit trail.
+  - Cost: reduced — one container pair instead of three.
+
 ## ADR-002: evidence_json shape and define-level traceability
 
 - **Date:** 2026-05-01
diff --git a/docs/JOURNAL.md b/docs/JOURNAL.md
index bfb8dbd..e50425b 100644
--- a/docs/JOURNAL.md
+++ b/docs/JOURNAL.md
@@ -1,5 +1,17 @@
 # Journal
 
+## 2026-06-08 — docs(decisions): ADR-003 TWH single-instance consolidation
+
+### What changed
+
+- **ADR-003:** Captured the 2026-05-21 TWH single-instance consolidation decision in `docs/DECISIONS.md` as a numbered ADR. Quoted the JOURNAL rationale verbatim; documented that the eCQM seeding path and `*_ECQM` secrets are retained as restore-later capability; noted the `workwell.os` redirect as a follow-up (see `infra/redirect/`).
+
+### Verification
+
+- Docs-only PR; no backend or frontend changes.
+
+---
+
 ## 2026-06-08 — Documentation sync: truth-up across the living docs
 
 ### What changed