Floor operations for skilled nursing
Fix it before it becomes a grievance.
Most grievances start with something small that nobody wrote down: a hearing aid, a sweater, a bed that won't lower. Auden runs that floor work from the phones staff already carry, so fewer concerns ever get raised. When one still comes in, it's on a clock and answered the way F585 requires.
Built by a licensed nursing home administrator, for the people who sit across from the surveyor.
Live example. Five things that won't turn into a phone call from a family, and one concern with its clock running.
On the floor
What Auden runs, so it never becomes a concern
A hearing aid that came in at admission and can't be found. A sweater that went to laundry and didn't come back. A bed nobody fixed. A resident moved rooms and the walker stayed behind. Each of these is a record in Auden, with a name and a time on it, so the answer is on file before anyone has to ask.
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Belongings
Inventory at admission
Staff photograph or write each item as it comes in: glasses, dentures, hearing aids, clothing, valuables. The resident or family signs on the screen, and the signed list can't be edited. Items brought in later are added with their own date, and a discharge check goes item by item.
R.W. · 201A
16 items · 12 photos
Signed with the resident's daughter -
Room changes
Moved, and received
When a resident changes rooms, the move is logged with the reason and a note that the resident was told first. The receiving unit signs that the belongings arrived, checks off any rental equipment, and reports anything missing on the spot.
119A → 417A
14 items arrived
Received on the new unit, signed -
Laundry
Pickup to closet
Each pickup gets a bag tag and an item count. The bag moves through washing, ready, and delivered, where the aide signs, and the housekeeping supervisor signs off. If fewer items come back than went out, staff report what's missing before the bag is delivered.
LB-1008-03
7 out · 7 back · 9h 20m
Signed off by the supervisor -
Housekeeping
Room status, hall by hall
Every room shows To clean, Cleaning, Clean, or Inspected. Staff work from a checklist for daily, discharge, and isolation cleans, and only the supervisor marks a room inspected. Empty rooms that pass inspection show as ready for admission.
Room 306
Discharge clean · inspected
Ready for admission -
Repairs
Work orders on a clock
Anyone puts in a work order from their phone, with a photo: a bed that won't lower, a missing remote, a leak. Maintenance works it against a target set by how urgent it is, a broken room stays off the ready list, and the person who reported it confirms the fix. Recurring building checks show when each one is next due.
WO-1008-04 · Room 204
Bed won't lower · today
Fixed in 3h 10m, confirmed -
Rental equipment
Every unit has a place
BiPAPs, CPAPs, concentrators, specialty beds and mattresses are checked in by asset and serial number, assigned to a resident or the equipment room, and seen on rounds. A unit comes off the count only when the vendor's driver signs for it.
Asset 519556 · CPAP
Waiting for vendor pickup
Not seen in 2 days flags on rounds
Floor tools are a working prototype with sample residents, shown as initials and room only.
Rental equipment
Stop paying for equipment that walked out at discharge
The vendor's walk-through report tells you a unit is missing months after it left. By then nobody remembers where it went, and the buyout is on your invoice.
- Discharge can't finish until every rental with that resident has a place: the equipment room, another resident, or going home with a named approver.
- Rounds catch it in days. A unit that hasn't been seen in 48 hours turns red, so the search starts while people still remember.
- Load the vendor's report and Auden lines it up with your records by asset number, so you can dispute a buyout with a signed pickup in hand.
In the equipment room, waiting for pickup. Tell the vendor before a buyout is billed.
Auden has the driver's signed pickup, ticket PU-88213.
Missing in Auden too, since the resident in 208 was discharged. Search or decide on a buyout.
Recognition
Staff earn stars for doing it right
Every signed inventory, on-time delivery, confirmed repair and finished round earns stars. Staff trade them for perks your facility picks, like a jeans day, a free meal from the kitchen, or first pick of shifts.
- The moment lands. A star pops on the screen the second the work is signed, and unlocking a reward gets a real celebration.
- Process, never outcome. Stars go to finishing work the right way. Reporting a problem never earns or costs a thing, so nobody has a reason to hide one.
- Hard to fake. Most stars land at the second signature, daily limits stop tapping for stars, and a supervisor can reverse anything that wasn't real.
J. Ames · Laundry aide
Steady hand
3 more for a free meal from the kitchen
- 25Jeans day passredeemed
- 50Free meal from the kitchen3 to go
- 100Preferred parking for a week53 to go
When a concern still comes in
A concern is a clock, not a note in a binder
Auden timestamps it the moment it's raised, routes it to every department that has to answer, holds each one to its own acknowledgement window, and builds the written decision F585 requires.
Someone raises it
A resident, a family member, or a staff member files in under a minute: at the desk, on a phone, or anonymously. The received timestamp is set once and never moves.
It goes to the right desks
Assign every department that has to answer, not just one. Each gets its own acknowledgement window and its own response box. Re-route later without losing the original clock.
Departments answer in writing
Each department head records what they found and what they did about it. Nothing is closed on a verbal "handled it" that nobody can produce six months later.
You issue the decision
The administrator writes the decision with a live check against all seven required elements, then prints it for the resident's file and the grievance log.
42 CFR §483.10(j) · F585
Seven things the written decision has to say
A decision missing any one of them is a finding, no matter how well the concern itself was handled. Auden checks each element as it's written and won't mark a decision complete until all seven are there.
Residents can file anonymously. Auden accepts an anonymous concern without a name attached and still runs the same clocks against it, because obstructing that right is separately citable under F550.
- 01The date the grievance was received
- 02A summary of the grievance as it was stated
- 03The steps taken to investigate it
- 04A summary of the pertinent findings
- 05Whether the grievance was confirmed
- 06Any corrective action taken, or to be taken
- 07The date the written decision was issued
§483.12(c)
Abuse allegations don't wait in a queue
A concern that alleges abuse, neglect, or misappropriation isn't a grievance with a shorter clock. It's a different track, and Auden treats it that way from the first keystroke.
Reportable incident track
Separate route, separate deadlines, no scoring
Flagging a concern as reportable pulls it out of the normal queue immediately and puts the statutory deadlines in front of whoever is holding it. Nobody earns stars on a reportable incident. That's hard-coded, not a setting, so nothing in the system can ever create a reason to under-report.
When a belonging is reported missing and anyone thinks it was taken, Auden says so plainly and offers the reportable track. Staff make the call; Auden makes sure they see the question.
Why it's built this way
Written by someone who has run the survey
Stars for process, never outcome
Staff earn stars for finishing work the right way, never for what they found, what they concluded, or how fast they closed something. Rewarding speed to closure is how facilities teach people to close things quietly.
Signatures where things change hands
Admission, delivery, room change, vendor pickup. Each handoff is signed on the screen by the person taking responsibility, because that's the moment that gets argued about later.
One building, one record
Concerns, belongings, laundry, rooms, repairs and the equipment at the bedside, in one place instead of three binders, a clipboard, and somebody's memory.
Now recruiting pilot facilities
See it on your own floor
Auden is in pilot with a small number of skilled nursing facilities. Tell us a little about your building and we'll walk your actual workflow through it: concerns, belongings, laundry, rooms, repairs and rental equipment.
Pilot facilities aren't charged. We'll ask you to use initials and room numbers rather than resident names, so nothing protected goes into the system while we're still testing.