Antibiogram software for multi-facility nursing home operators that need one report per building and one for the region
An operator with a dozen skilled nursing facilities owes a dozen F881 antibiograms, and most single buildings cannot fill one. Here is how operators pool data across buildings, which routes they use today, and what software costs at 3, 12 and 30 facilities.
8 min read
Antibiogram software for a multi-facility nursing home operator has to do three things a spreadsheet does badly: read culture line lists from several labs into one set of rules, print a facility antibiogram for every building with the counts shown, and pool buildings in the same region so the thin organisms become reportable. Antimicrobe does this from CSV uploads, at $749 a month for up to three buildings and $2,400 a month for up to twelve.
This is written for the regional or corporate clinical director, the corporate infection preventionist, or the VP of clinical services at an operator that runs several skilled nursing facilities and wants one consistent stewardship report across them before the next round of surveys.
Who owns the antibiogram when you run twelve buildings
Every certified building has its own F881 obligation under 42 CFR 483.80(a)(3), so every building needs a way to show it monitors resistance. In a single-site home that falls on the director of nursing and the consultant pharmacist. In an operator it usually drifts upward, to a corporate infection preventionist or a regional clinical director, because nobody at the building level has the time or the data skills, and because the operator wants the same answer in every binder.
That shift changes the buying question. A director of nursing asks how to get one report. A regional director asks how to get twelve that use the same rules, the same breakpoints and the same layout, and how to update them every year without twelve spreadsheets maintained by twelve different people.
Why one building rarely has enough isolates
The numbers are the reason operators have an advantage here. Fridkin and colleagues looked at urine cultures from 231 CMS-certified skilled nursing facilities in Georgia sent to a single regional referral lab in 2016 and 2017 (Infection Control and Hospital Epidemiology, 2019, PMID 31133088). In one year, 49% of facilities had enough E. coli isolates to meet the 30 isolate guideline. For Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Pseudomonas aeruginosa it was about 1 in 10.
The authors concluded that aggregating across nursing homes in a region is a statistically sound way around the shortage. A standalone home can only pool years. An operator can pool buildings, which gives prescribers a current report instead of one that averages three years of a changing resistance picture.
Three ways operators build antibiograms today
Most operators we talk to are on one of three routes, often a mix of them across regions. Each has a real cost, and only one of them scales past a handful of buildings without adding headcount.
The borrowed hospital antibiogram deserves a word. It describes inpatients at the hospital, not your long-stay residents, and the organisms and susceptibilities differ. It is better than nothing, and a pooled report from your own buildings is better than it. The single-building version of this decision is laid out on nursing home antibiogram software.
| Route | Per-building report | Pooled regional report | Same rules every building | Cost |
|---|---|---|---|---|
| Reference lab client antibiogram | If the lab offers it | Only if every building uses the same lab | Lab's rules, not yours | Often bundled, varies by lab |
| Hospital antibiogram borrowed | No, hospital data | No | Not your residents | Free |
| Consultant spreadsheet per building | Yes, by hand | Manual merge | Depends on each consultant | Consultant hours |
| AHRQ antibiogram toolkit | Yes, guided by hand | Manual | Yes, if everyone follows it | Free, paid in staff time |
| Antimicrobe | Yes, from the lab CSV | Yes, labeled on the report | Yes, one rule set per account | $749 for 3, $2,400 for 12 a month |
How do you build one antibiogram for several nursing homes?
Get one culture line list per building, or one file with a facility column, covering the same period. Apply the same rules to all of it: final results only, the first isolate per resident per organism, the same breakpoint version, and a flag on any cell under 30 isolates. Then print each building's report and a pooled report for the region, with the facilities and years named on the page.
The hard part is the input, not the arithmetic. Buildings in one operator often use two or three different reference labs, and each lab spells organisms and drugs a little differently. Antimicrobe maps each lab's columns once and keeps the mapping, so next year's run is an upload, not a cleanup project.
- Resident identifier, hashed if your policy requires it
- Facility name or code
- Collection date
- Specimen source, so urine can be reported on its own
- Organism, antibiotic and the S, I or R the lab reported
Operators on PointClickCare and MatrixCare
Most operators already run their infection tracking inside the EHR. PointClickCare Infection Prevention and Control and the MatrixCare Infection Tracker both log infection cases and antibiotic orders, and both offer analytics across buildings. Neither describes building a cumulative antibiogram in its public material, so the resistance half of F881 still needs its own report.
You do not need an interface to either EHR for that. The culture results come from the labs, and the labs can export them. Keep the EHR for the use side and add the antibiogram beside it.
The EHR-specific details are on PointClickCare antibiogram software and MatrixCare antibiogram software.
How much does antibiogram software cost for a nursing home chain?
Antimicrobe publishes every price, and plans are sized by facility count. Annual billing is half the monthly price on every plan, and there is no implementation fee.
Spread across buildings, Network works out to $200 per facility a month at twelve, less than a few consultant hours per building. The full limits are on the pricing page. If a long-term care pharmacy builds the reports for you instead, the options on that side are in antibiogram software for long-term care pharmacy providers.
| Buildings | Plan | Monthly price | What changes |
|---|---|---|---|
| 1 | Lab | $249 | One facility, 25,000 isolates a year, 2 seats |
| 2 to 3 | Stewardship | $749 | Unit and source cuts, quarterly trends, MDRO watch, 8 seats |
| 4 to 12 | Network | $2,400 | Cross-facility comparison, scheduled lab export ingest, 25 seats |
| 13 or more | Enterprise | $3,990 | Unlimited facilities, isolates and seats |
Getting the report in front of prescribers
An antibiogram in a survey binder satisfies nobody. The point is that the nurse practitioner or attending choosing an empiric antibiotic for a suspected UTI sees the urine column first. Operators that get value from it print a one-page urine antibiogram for each nurse station and the prescriber workroom, and review it at the quarterly QAPI meeting alongside antibiotic starts and infection rates from the EHR.
Some operators already run screens at nurse stations for staffing boards and huddle notes, and a digital signage system for the screens you already own can keep the current urine antibiogram on them instead of a printout that goes stale. The CLSI M39 rules that decide what goes on that page are on CLSI M39 antibiogram software.
Questions to ask before you choose
- Can it read files from every reference lab our buildings use, and keep each lab's column mapping?
- Does it print a report for each building and a pooled regional one, with the pooled facilities named?
- Is the first isolate rule applied per resident, and are cells under 30 isolates flagged rather than printed?
- Can the corporate team see every building while each director of nursing sees only their own?
- What does it cost at our building count, and is that price published?
- Do we need an EHR interface, or can we start from a lab export this month?
Related on this site: nursing home antibiogram software, MatrixCare antibiogram software, PointClickCare antibiogram software, antibiotic stewardship software for nursing homes, Antimicrobe pricing.