MatrixCare antibiogram software for skilled nursing facilities that already track infections in MatrixCare

The one F881 report that is missing

Under 42 CFR 483.80(a)(3), surveyed as F881, a nursing home has to run an antibiotic stewardship program that monitors antibiotic use and resistance. Infection rates and anti-infective counts tell you how much your residents get. They do not tell the nurse practitioner on call whether nitrofurantoin or cephalexin is the better empiric bet for a urinary tract infection in your building.

That answer comes from a cumulative antibiogram: every urine, wound and respiratory isolate from your residents over a year or more, one isolate per resident per organism, and the share still susceptible to each drug. We could not find a MatrixCare product page, podcast or release that describes building one. So the report is usually an old hospital antibiogram, a spreadsheet the consultant pharmacist rebuilds each spring, or a blank page in the stewardship binder.

• In MatrixCare: infection cases, antibiotic orders, symptoms, tests, precautions, infection rates, residents on anti-infectives
• Not described by MatrixCare: percent susceptible by organism and drug, first isolate per resident, the 30 isolate rule, pooled years
• In Antimicrobe: the facility antibiogram with counts printed, urine first, plus a pooled report across your buildings

Where the data for a MatrixCare building really comes from

You do not need to pull anything out of MatrixCare. Culture results land in the resident chart one at a time, which is right for care and wrong for statistics. The lab that ran the cultures holds the same results as rows, and most reference labs that serve nursing homes can send a client line list on request.

Ask for every culture with a susceptibility result for your facility over the last one to three years, with these columns: resident identifier (a hashed or lab accession ID is fine), collection date, specimen source, organism, antibiotic and the S, I or R the lab reported. Save it as CSV. That file is the whole interface.

A sample request you can send the lab, column by column, is on nursing home antibiogram software.

1. 1

   Your reference lab

   A client line list of cultures with susceptibilities, one to three years

2. 2

   CSV file

   Resident ID, date, source, organism, drug and S, I or R

3. 3

   Antimicrobe

   First isolate per resident, cells under 30 flagged, years pooled and labeled

4. 4

   Facility antibiogram

   Printed for the stewardship binder and the QAPI meeting

Can a single MatrixCare facility report an antibiogram on its own?

For E. coli, often yes. For most other organisms, not in one year. In a study of urine cultures from 231 Georgia skilled nursing facilities (Fridkin and colleagues, Infection Control and Hospital Epidemiology, 2019, PMID 31133088), 49% of facilities had enough E. coli isolates in a single year to meet the 30 isolate guideline, and only about 1 in 10 did for Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis or Pseudomonas aeruginosa.

There are two honest fixes, and the software has to do both without hiding anything. Pool two or three years for the thin organisms and label the years on the report. Or, if you run several buildings in one area, pool across buildings, which is the approach the Georgia authors found statistically sound. Antimicrobe prints the count behind every percentage, so a reviewer can see which cells rest on 34 isolates and which on 140.

The CLSI M39 rules behind those choices, including what to do with a cell under 30, are on CLSI M39 antibiogram software.

MatrixCare, a consultant spreadsheet and Antimicrobe side by side

If you are still choosing an infection tracker rather than adding an antibiogram, MatrixCare, PointClickCare IPC, HealthConnex and StewardshAPP are compared in antibiotic stewardship software for nursing homes. Sister buildings on PointClickCare follow the same route, described on PointClickCare antibiogram software.

Who buys this, and on which plan

A single MatrixCare facility buys the Lab plan: $249 a month for one facility, 25,000 isolates a year and two seats, which is enough for the director of nursing and the consultant pharmacist. It is paid by card with no implementation fee, and annual billing is half the monthly price.

Operators with several buildings get more out of it, because pooling across buildings is how the thin organisms become reportable. Stewardship, $749 a month, covers up to three facilities and adds unit and source cuts, quarterly trends and MDRO watch. Network, $2,400 a month, covers up to twelve facilities with cross-facility comparison and scheduled ingest of a lab export, so the regional clinical director sees every building on the same breakpoints.

How operators with many buildings set up one report per facility plus a regional one is covered in antibiogram software for multi-facility nursing home operators, and every plan limit is on the pricing page.

• Directors of nursing who need the antibiogram in the binder before the next survey window
• Infection preventionists who already live in the MatrixCare Infection Tracker and want the resistance half beside it
• Consultant pharmacists who rebuild a spreadsheet for every client building each year
• Regional clinical directors at operators with 3 to 12 buildings on MatrixCare
• Life plan communities whose skilled nursing wing sends cultures to a single reference lab

What this does not do

• It does not connect to MatrixCare or read the resident chart. It reads the CSV line list your lab exports
• It does not log infection cases, apply McGeer or Loeb criteria or run antibiotic timeouts. Keep the Infection Tracker for that
• It does not count antibiotic starts, days of therapy or residents on anti-infectives. MyAnalytics covers that
• It does not change the S, I or R your lab reported on the Lab plan
• It does not report to NHSN