The accountability layer for skilled nursing

Every handoff,
ranked and owned.

Signals reads your chart, your roster, and ten public federal datasets in one query. It finds the dollar-valued work sitting between your clinical, billing, and staffing teams, and routes each item to the one person who can close it.

Deploy in
14 days
SOC 2 + HIPAA
Ready on day one
Read-only on your EHR
No write-back required
hive.app / intelligence
Open findings
0items
+14 since 6am
Dollars in play
$1.24M
Annualized, open only
NTA threshold proximity
Mrs. R. PattersonMR# 80214

One point below NC tier. A missed diagnosis in the chart would tip her over.

Urgent
Recoverable
$0
Expires
47 days
Lab
ESBL+
Klebsiella 3/14
Order
IV abx
Ceftazidime active
MDS
Sec I gap
ARD 3/11
OwnerMDS Coordinator
4 sources
One resident, one Tuesday

A resident starts IV antibiotics on a Tuesday. The clinical team does everything right. The facility loses $5,000 to $10,000 over the next three weeks.

The clinical team and the billing team don't share a chart. They don't share a meeting. They barely share a hallway. The dollar-valued handoff never happens.

The chart is right.

Orders, eMAR, MDS, diagnoses. The clinical team is doing its job. Every dose is logged.

The money is wrong.

The same resident is being billed at $260/day Medicaid when the IV antibiotic qualifies them for $500+ Part A.

Nobody owns the handoff.

Clinical sees the chart. Billing sees the claims. Neither sees the other. The $5,000 leaves the building quietly.

That handoff has an owner somewhere. Signals scores the owner, routes the ticket, and verifies the fix. Every handoff, every day.

The live environment, right now

The network Signals already runs on.

Numbers refresh every engine run. Data is synthetic, modeled on real SNF operations. Nothing here belongs to a real resident.

Detectors in production
184
Live across the network
Dollars in play
$130.00M
Open, ranked, and owned
Facilities live
62
Across seven chains
Autonomous share
68%
Closed without human escalation
How the engine works

A rules engine that proposes and retires its own rules.

Five steps, on repeat, without anyone asking. Every step is auditable. Every finding traces back to the rows that triggered it.

Capped at 40 per facility

A real operator works 20 to 40 items at a time. Show them 400 and the feature doesn't work.

Round-robin admission

Every pattern gets a turn. One big compliance finding can't saturate the queue.

  1. Ingest
    01

    Residents, orders, MDS, eMAR, labs, staffing, claims.

  2. Detect
    02

    The catalog runs against every row, every night.

  3. Rank
    03

    Dollar value, urgency, and round-robin balance.

  4. Route
    04

    Into one person's queue, with a draft action attached.

  5. Learn
    05

    The engine grades itself and tunes what fires next.

The miner

The engine proposes new detection patterns on its own.

Four statistical passes run against your operational graph every night. When one spots something, a proposer drafts a new detection pattern and ships it as data. No code deploy.

Mode A
Anomaly

A facility's number on a metric is far enough from the chain median to be suspicious. Robust outlier math, not a trigger-happy z-score.

Hilltop North's antibiotic start rate is 3.1x the network median.
Mode B
Correlation

Residents with feature pattern X have adverse event Y happen at materially higher rates than the base population.

Residents on 3+ sedating meds fall at 2x the facility baseline.
Mode C
Temporal

Event A tends to be followed by event B inside a bounded window. Lead indicator, not coincidence.

Antibiotic start, fall within 14 days, 1.8x likelihood.
Mode D
Peer drift

A facility's own metric diverges from its recent history and the chain trend. Something changed here, and only here.

Adams Court agency hours up 240%, while the network is flat.
The flywheel

At deployment you get the full catalog. Six months later the engine has retired patterns that didn't perform on your data, and accreted twenty or thirty new ones specific to your chain.

shadow
canary
active
warning
quarantine
retired
See it on your own portfolio

Thirty minutes. Your employees. Your vendors.

We walk your actual staff roster and vendor list, show what HQ would look like across your portfolio, and let you drill into the evidence behind any score. You'll know by the end whether this fits your chain. No slide deck.