Antibiotic stewardship software for nursing homes compared by F881 coverage, antibiogram and price
F881 asks every nursing home for antibiotic use protocols, a system to monitor use and resistance reports, antibiogram included. Here is what each software option covers, which part almost none of them build, and what the choice costs.
8 min read
Antibiotic stewardship software for nursing homes falls into three groups. Infection tracking modules inside the resident record, such as PointClickCare Infection Prevention and Control and MatrixCare's Infection Tracker, log infections against McGeer or Loeb criteria and track antibiotic starts. Standalone tools such as HealthConnex IPAC and StewardshAPP do the same outside the EHR. The third piece, the facility antibiogram that F881 lists among its example resistance reports, is built by almost none of them.
None of these vendors publishes a price. This comparison is written for an administrator, director of nursing, infection preventionist or consultant pharmacist at a US skilled nursing facility who wants the stewardship program to survive the next survey without another spreadsheet. Antimicrobe builds the antibiogram part only, and the article says where that fits.
What F881 actually asks your software to do
The regulation is short. 42 CFR 483.80(a)(3) requires an antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use. The interpretive guidance at tag F881 in Appendix PP of the State Operations Manual fills in the detail: protocols reviewed at least annually, assessment with standardized criteria such as Loeb minimum criteria or an SBAR tool for suspected UTI, orders that state indication, dose and duration, and a review of laboratory results to decide whether an antibiotic is still needed.
The same guidance says the protocols should contain a system of reports on antibiotic use and resistance data. It gives three examples: use measures such as new starts or days of therapy per 1,000 resident days, a summary of antibiotic resistance (the antibiogram) based on laboratory data from, for example, the last 18 months, and outcome tracking for C. difficile, MRSA or CRE. Surveyors are told to look for both antibiotic use reports and antibiotic resistance reports.
The CDC Core Elements of Antibiotic Stewardship for Nursing Homes say the same in practical terms. Tracking and reporting are two of the seven elements, and the CDC self-assessment checklist asks whether the facility has a report of its antibiotic susceptibility patterns from within the last 18 months.
The options side by side
| Option | What it covers | Facility antibiogram | Price |
|---|---|---|---|
| PointClickCare IPC | Infection log, McGeer and Loeb checks, antibiotic timeout, stewardship dashboard | Not described | Add-on, not published |
| MatrixCare Infection Tracker | Infection tracking with MyAnalytics reporting | Not described | Not published |
| HealthConnex IPAC | Standalone infection log, McGeer automation, days of therapy | Not described | Not published |
| StewardshAPP | On-demand stewardship program, prescribing profiles, leadership reports | Listed in its app store description | Not published |
| LTC pharmacy provider program | Policies, protocols, consultant review, education | Depends on the provider | Part of the pharmacy contract |
| AHRQ Nursing Home Guide | Free toolkits, including an Excel antibiogram workbook | Yes, built by hand | Free, paid in staff time |
| Antimicrobe | Facility antibiogram from your lab file, pooled and suppressed per M39 | Yes, the whole product | $249 a month |
What each option does
PointClickCare Infection Prevention and Control is the default for facilities already on PointClickCare, which says more than 60% of skilled nursing providers use its software. The module correlates infection symptoms against McGeer and Loeb criteria, runs an antibiotic timeout workflow and shows a daily dashboard that PointClickCare aligns with the CDC stewardship elements. It covers the use side of F881 well. Its public pages do not describe building a facility antibiogram.
MatrixCare describes an Infection Tracker and MyAnalytics tools for skilled nursing infection tracking. We could not find a MatrixCare page that describes stewardship dashboards or an antibiogram, so ask for both on a demo rather than assuming.
HealthConnex IPAC is the best-known standalone tracker. It says it is trusted by more than 1,000 facilities across North America and lists McGeer criteria automation and days of therapy calculations. It suits operators on an EHR without a strong infection module, or groups that want one tracker across buildings on different EHRs.
StewardshAPP, from Syracuse, New York, sells an on-demand antibiotic stewardship program for nursing homes. Its app store listing mentions creating a facility antibiogram alongside monthly prescribing profiles and leadership reports, which makes it the closest product to an all-in-one. Its website does not detail how the antibiogram is calculated, so ask how it handles duplicate isolates and small counts.
Your long-term care pharmacy provider is the option most facilities already pay for. PharMerica, for example, publishes a model nursing facility antibiotic stewardship program for its client facilities, with protocols, guides and education. That is policy material and consultant time, not a reporting system, and it does not replace the facility's own resistance report.
The AHRQ Nursing Home Antimicrobial Stewardship Guide is free and CMS cites it in F881. Its antibiogram toolkit includes a sample data request for your lab, antibiogram specifications and an Excel workbook. It works if someone on staff has the hours to clean the file, remove duplicates and decide what to suppress every year.
Do nursing homes need antibiotic stewardship software?
No regulation requires software. CMS requires a program, protocols and a system to monitor use and resistance, and many homes meet that on paper. The case for software is the tracking and reporting work. When CDC researchers reviewed F881 citations from September 2018 to July 2019 (Gouin and colleagues, IDWeek 2021 abstract), 631 nursing homes had been cited, and 40% of those had tracking and reporting deficiencies, mostly missing or incomplete antibiotic or infection surveillance logs.
The prescribing problem is real too. The CDC Core Elements cite studies in which up to 70% of residents receive at least one course of systemic antibiotics over a year and 40 to 75% of nursing home antibiotics may be unnecessary or inappropriate. A meta-analysis of 18 studies (Wu and colleagues, Journal of the American Geriatrics Society, 2019) found stewardship programs in long-term care reduced overall antimicrobial use by 14%. Published evidence for any specific software product is thin and comes from vendors.
Why the antibiogram is the part most homes miss
Infection logs are built into the daily workflow. The antibiogram is a once-a-year statistics job, and the numbers work against a single building. In a study of 231 Georgia long-term care facilities (Fridkin and colleagues, Infection Control and Hospital Epidemiology, 2019), 49% had enough Escherichia coli isolates for the CLSI M39 threshold of 30, but only about 1 in 10 had enough Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis or Pseudomonas aeruginosa.
Borrowing the referring hospital's antibiogram is the usual shortcut, and it is a weak one. A 2020 study of VA nursing homes and their medical centers, reported by AMDA, found that about 20% of organism and antibiotic comparisons disagreed on average, with the nursing homes more often showing higher resistance. A facility report built from your own residents, pooled over two or three years where the counts are small, is what the 18-month language in F881 points to.
How to make a small denominator honest, from pooling windows to what to suppress, is covered on nursing home antibiogram software. If your reference lab already produces client reports, the routes are in antibiogram software for reference labs.
How much does antibiotic stewardship software for nursing homes cost?
No vendor in this market publishes a price. PointClickCare IPC is an add-on to an existing PointClickCare contract and is usually priced inside it. Standalone trackers quote per facility. The pharmacy provider's program is bundled into the dispensing contract, and the AHRQ toolkits cost nothing but staff hours.
Antimicrobe's Lab plan is $249 a month for one facility, bought by card with no implementation fee. Operators with several buildings use Stewardship at $749 a month for up to three facilities, or Network at $2,400 a month to pool small facilities into a regional antibiogram.
Every limit is on the pricing page. Pooling across sister facilities is described in regional antibiogram software for health systems.
Where Antimicrobe fits
Antimicrobe builds the facility antibiogram from the culture results file your lab sends. It keeps the first isolate per resident, pools years when a species is under 30 isolates, marks what it suppressed, cuts urine from everything else, and prints the rules and the pooling window on the report so a surveyor and a prescriber can see what the numbers mean.
It does not log infections, check McGeer or Loeb criteria, track antibiotic starts or days of therapy, or connect to PointClickCare or MatrixCare. Most homes run it beside whichever tracker they already have, so the use side and the resistance side of F881 both have a report.
Finding one hour a quarter when the medical director, the consultant pharmacist and the director of nursing can all review those reports is its own problem, and a shared meeting scheduling tool takes the email chain out of it. Long-term acute care hospitals, which sit between the hospital and the nursing home, are covered on LTACH antibiogram software.
Questions to ask before you buy
- Which F881 reports does this produce out of the box: antibiotic starts, days of therapy per 1,000 resident days, resistance, C. difficile and MDRO outcomes?
- Does it build a facility antibiogram, and how does it handle duplicate cultures and species under 30 isolates?
- Does it read our lab results electronically, or does staff type them in?
- Which McGeer and Loeb criteria versions does it apply, and can our medical director change them?
- Can the consultant pharmacist and medical director log in, and what does each extra seat cost?
- What is the price per facility per month, and what is the total for every building we operate?
Related on this site: nursing home antibiogram software, LTACH antibiogram software, antibiogram software for reference labs, regional antibiogram software for health systems, Antimicrobe pricing.