Skilled Nursing Operations

Skilled-nursing operations — census, staffing, shifts, care tasks, incidents, and compliance in one backend.

Keep the facility staffed, residents cared for, and surveys survivable — schedulers fill shifts against staffing targets, nurses work a rounds screen of today's rooms, compliance runs checklists that flag themselves when overdue, and families see updates on their resident without calling the front desk.

Built for skilled nursing facilities juggling census, staffing ratios, and compliance — where the answer to "are we covered tonight?" shouldn't live in anyone's head.

Your DON and administrators can

• See live census, staffing, and open shifts across every unit at a glance
• Track incidents from report to resolution
• Keep staff credentials current before a survey finds the gap

Your schedulers can

• Fill shifts against per-unit staffing targets and spot gaps before they become call-outs

Your nurses can

• Work a mobile rounds screen of today's rooms and care tasks — and check them off as they go

Your compliance officer can

• Run compliance checks and checklists, with overdue items swept up and flagged automatically

Families can

• Log in and see updates on their resident — read-only, and only their resident

While the building runs, scheduled sweeps flag overdue checklists, reminders go out on time, and every action lands in the audit log. Row-level security keeps Admin, DON, Nurse, Scheduler, Compliance Officer, and Family each in their own lane.

What's included

• 7 user roles: Admin, DON, Nurse, Scheduler, Compliance Officer, Family, Public (referral form)
• 17 data tables: Residents, Census, Shifts, Care Tasks, Incidents, Compliance Checks, Credentials, Family Updates
• 24 workflows: Missed-task escalation, credential expiry ladder, reportability deadline watch, coverage-gap alerts
• 13 email templates: Admission, shift, incident, credential, compliance and family notices
• 9 AI agents: Incident Intake, Daily Staffing Brief, Survey-Prep Auditor, Family Update Drafter + 5 role assistants
• Sample data: Demo users for every role + seeded residents, shifts and tasks — optional at install
• Security: Facility- and unit-level row-level security on every table

Data tables (17)

• Facilities — The facility itself — name, address and the contact emails that alerts go to — and the anchor every unit, staff member, resident and log entry is scoped to.
• Units — The nursing units inside each facility, giving census, shifts, staffing targets and rounds their per-unit view of the building.
• Staffing Targets — Per-unit, per-shift staffing targets that the shift board is filled against, so a coverage gap shows up as soon as a unit falls short.
• Residents — The resident roster every other screen hangs off: who is in which room, their status and care level, and the family contacts and updates that belong to them.
• Census — A running head-count by unit so the DON and administrator can answer "how full are we tonight?" without walking the floors.
• Staff — The staff roster for each facility — role, default unit and linked login — that shifts are assigned to and credentials are tracked against.
• Shifts — The shift board schedulers fill against each unit's staffing target, with call-offs, no-shows and coverage gaps visible at a glance.
• Task Schedules — Each resident's recurring care routine, the schedule the daily sweep turns into that day's care tasks on the nurse rounds screen.
• Care Tasks — Today's care tasks for every room, generated from the resident's schedule and worked off the nurse rounds screen.
• Incidents — Incident reports from first write-up through DON sign-off and state-reportability, with the filing clock tracked on each one.
• Checklist Templates — Reusable checklist definitions for each facility, with a default assignee, from which the recurring compliance checks are generated.
• Compliance Checks — Daily compliance checklists spun up from templates, ticked off by the compliance officer and flagged automatically when they slip past due.
• Credentials — Licenses and certifications for every staff member, so an expiring credential is caught before it puts someone on the schedule.
• Family Contacts — Relatives and responsible parties for each resident, linked to a portal login so they see updates on their resident and nothing else.
• Family Updates — Warm, PHI-free updates written by staff and published to the family portal so relatives stay informed without calling the front desk.
• Audit Log — Append-only record of who changed what and when on resident records across the facility, kept for survey and compliance review and never edited by hand.
• Referral Inquiries — Admission inquiries submitted through the public referral form, tracked by status so the admissions team can follow up on each prospective resident.

User roles (7)

• Admin — Runs the building: sets up units, staffing targets, checklist templates and users, and oversees census, incidents and compliance for their own facility.
• DON — Clinical lead who reviews incidents, decides what is state-reportable, and keeps an eye on care tasks and compliance across every unit.
• Nurse — Floor staff working a rounds screen of today's rooms and tasks, filing incidents and quick census updates for their own unit only.
• Scheduler — Builds the schedule, fills open shifts against staffing targets and watches coverage and hours-per-resident-day, without seeing clinical detail.
• Compliance Officer — Owns the checklists, credentials and audit trail that a survey will ask about, with read-only visibility into clinical records.
• Family — A responsible party's read-only portal showing their resident's status and the updates staff have published, and nothing else.
• Public (referral form) — Lets prospective families submit a bed-availability inquiry from the public site without a login and without seeing any resident data.

Workflows (24)

• W1 Staff user provisioning — Gives a new staff member a working login scoped to their facility and unit the moment their staff record is saved.
• W2 Family portal linking — Connects a family contact's portal login to their resident so they see only what belongs to them.
• W3 Admission — Opens the first census entry and sends the welcome email the moment a new resident is admitted.
• W3a Credential denormalization — Stamps the staff member's facility onto each new credential so it lands in the right facility's expiry ladder and reports.
• W4 Census denormalization — Fills in facility, unit and room on every new census movement from the resident so the head-count rolls up by unit without re-entry.
• W5 Care Task denormalization — Tags each new care task with the resident's facility and unit so it shows on the right rounds screen and unit reports.
• W5a Task Schedule denormalization — Tags each new task schedule with the resident's facility and unit so daily task generation stays scoped to the right building and floor.
• W5b Task completion stamp — Records who closed out a care task and when, the moment it is marked completed or refused on the rounds screen.
• W6 Incident intake — Routes every new incident to the DON for review and raises an immediate alert when it is major or sentinel.
• W6b DON sign-off stamp — Stamps the DON's sign-off on an incident the moment its status flips to signed, giving surveyors a clean timestamp on every review.
• W7 Reportability clock — Starts the state filing clock the moment the DON marks an incident reportable, so the deadline is never guessed at.
• W8 Reportability deadline watch — Checks every hour for reportable incidents and follow-up investigations that have not been filed and chases the people responsible before the deadline.
• W9 Daily task generation — Builds each morning's care task list for every resident from their recurring schedule so nurses start the shift with rounds ready to go.
• W10 Missed task escalation — Flags care tasks that slip past their scheduled time and escalates them to the unit so nothing is quietly missed.
• W11 Shift assignment and credential gate — Warns the scheduler when an assigned staff member has an expiring or expired credential and confirms the shift to the staff member by email.
• W12 Coverage gap — Turns a call-off or no-show into an open-shift alert so the scheduler can cover the gap before the shift starts.
• W13 Credential expiry ladder — Warns staff and the compliance officer as credentials approach expiry and marks them expired the day they lapse.
• W14 Compliance generation — Creates today's compliance checks from the active checklist templates so the compliance officer never has to set them up by hand.
• W15 Compliance overdue — Sweeps for compliance checks past their due date, marks them overdue and escalates them before a surveyor finds the gap.
• W16 Staffing target denormalization — Copies the unit's facility onto each new staffing target so the shift board compares coverage against the right building's numbers.

Email templates (13)

• E1 Admission welcome
• E2 Shift assignment
• E3 Incident filed - DON review
• E4 Major or sentinel incident alert
• E5 State-reportability deadline
• E6 Missed task escalation
• E7 Credential warning on scheduled staff
• E8 Coverage gap
• E9 Credential expiry tier
• E10 Overdue checklists
• E11 Staffing below target
• E12 Resident status change
• E13 Referral inquiry received

AI agents (9)

• A1 Incident Intake and Reportability — Turns a nurse's rough incident narrative into a structured report and recommends whether the state-reportability clock should start.
• A2 Daily Staffing Brief — Gives the DON and scheduler a morning brief on coverage, hours per resident day and any credential risk on today's schedule.
• A3 Survey-Prep Auditor — Runs a mock survey against your records and hands back a punch list grouped by F-tag so you fix gaps before the real one.
• A4 Family Update Drafter — Drafts warm, PHI-free portal updates for families from a few notes, ready for a nurse to review and publish.
• Facility Ops Assistant — Answers the administrator's questions about census, staffing and open incidents across the facility without opening a report.
• Rounds Companion — A nurse's pocket assistant for today's rounds: which rooms are due, what is flagged and what still needs doing.
• Staffing Assistant — Helps the scheduler see coverage, open shifts and staffing ratios by unit and shift in plain language.
• Compliance Assistant — Walks the compliance officer through open incidents, reportability deadlines and overdue checks.
• Family Companion — Lets a family member ask about their loved one and get answers drawn only from the updates published for their resident.

Categories: Operations, Healthcare, Compliance