Skilled Nursing Software: What Multi-Facility Operators Actually Need

Skilled nursing software is any technology system used to manage the clinical, financial, and operational functions of a skilled nursing facility. The category includes electronic health record (EHR) systems, billing and claims management platforms, payroll and HR software, and analytics tools.

For operators running a single building, the challenge is finding tools that do each job well. For multi-facility operators running 5, 10, or 25 buildings, the challenge is fundamentally different: getting all of those tools to communicate, and turning the combined data into something leadership can actually act on.

That second challenge: the multi-facility data problem: is where most skilled nursing software stacks fall short.

The Software Reality for Most Multi-Facility Skilled Nursing Operators

A typical multi-facility skilled nursing organization is running some combination of:

• PointClickCare or MatrixCare (EHR/clinical documentation)
• Paylocity, Paychex, or ADP (payroll and HR)
• Waystar or Change Healthcare (billing clearinghouse)
• Microsoft Excel (everything that doesn't fit elsewhere)

Each system does its job reasonably well in isolation. PointClickCare captures clinical documentation.

Paylocity processes payroll. The clearinghouse scrubs and submits claims.

The problem emerges when someone at the corporate or regional level needs to answer a question that crosses system boundaries:

"Are our buildings with the highest agency hours also the ones where census is fluctuating the most?"

"Which of our facilities has the best PDPM case mix index, and what are they doing differently?"

"We have a building that's been denying a lot of Medicare claims this month. Which clinicians are documenting in a way that's driving the most denials?"

None of these questions can be answered from within a single system. They require data from at least two sources: and usually three or four: that were never designed to talk to each other.

The result, in most organizations, is that the regional director or VP of Operations spends hours pulling data from each system, building a spreadsheet that is already outdated by the time it is finished, and presenting it in a monthly review meeting where the most useful action has already become impossible to take.

"There were also a lot of disparate software out there that were helping you in different areas, but they didn't connect or communicate. So you're still spending your time trying to really manage your specific buckets you're responsible for utilizing all different softwares. And that was just a nightmare."

Renee Pruzansky, VP of Strategy and Business Development, Infinite Care

Categories of Skilled Nursing Software and What Each Does

To make smart software decisions, it helps to understand what each category is designed to do: and what it is not designed to do.

The EHR is not an analytics platform. The payroll system is not a staffing management tool.

The billing clearinghouse is not a revenue cycle analytics tool. Each system has a defined scope, and the multi-facility operator who expects any one of them to provide enterprise-wide visibility will be disappointed.

What fills the gap is an analytics layer: a platform purpose-built to pull data from all of these systems, normalize it, and surface the cross-domain insights that drive operational decisions.

See how Megadata's long-term care analytics platform connects your entire software stack into one real-time view.

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What Multi-Facility Skilled Nursing Operators Actually Need from Software

When operators of 5+ buildings describe the software capability they are missing, four themes emerge consistently:

1. Real-Time Visibility Across All Buildings

Multi-facility operators cannot be in every building. The alternative to physical presence is data: but only if the data is current, accessible, and presented in a form that drives decisions rather than requiring additional analysis.

Daily census, staffing levels, HPPD, overtime hours, clinical quality indicators, and financial performance metrics need to be visible at the building level and rolled up to the portfolio level in one view. Not after the month closes.

Today.

2. Labor and Census Integration

The most expensive operational decision in skilled nursing is how many staff to schedule per shift. That decision should be made in relation to today's census and projected admissions: not based on a fixed schedule built around last month's average.

Real-time integration between census data and labor models is the capability that separates reactive labor management (discovering you were overstaffed after the payroll runs) from proactive labor management (adjusting schedules before the shift starts based on where census is heading).

3. Reimbursement and Clinical Linkage

PDPM ties Medicare reimbursement to case mix. CMI accuracy depends on MDS completion timelines and assessment quality.

Most operators know their average CMI in general terms. What they often lack is visibility into which specific buildings, units, or therapy providers are driving CMI above or below their potential: and which assessment timing gaps are costing revenue before the billing window closes.

Connecting reimbursement data to clinical data in real time allows operators to identify and correct CMI accuracy problems before they become permanent revenue losses.

4. Role-Specific Dashboards

A CEO needs a different view than a director of nursing, who needs a different view than a regional director of operations. Systems that require everyone to run the same canned report: or worse, to request custom reports from an IT department: create information bottlenecks that slow decision-making.

Multi-facility operators need software that delivers role-appropriate views without configuration overhead, accessible both from a desktop and a mobile device for leadership in the field.

"It really allows me to go into one platform and have everything I need to make informed decisions on a daily basis."

Levi Israel, CEO, Extended Care

The Analytics Layer: Filling the Gap in Your Skilled Nursing Software Stack

An analytics platform for skilled nursing is not a replacement for your EHR, payroll system, or billing clearinghouse. It is the layer above those systems that does what none of them can: connect data across all domains and deliver a unified, real-time view of how the organization is performing.

Megadata integrates with 70+ data sources: including PointClickCare, MatrixCare, Paylocity, ADP, Paychex, and most major billing systems: and surfaces that data in role-specific dashboards covering:

• Census and admissions: daily census by building, referral source tracking, discharge trends
• Labor and staffing: real-time HPPD, agency vs. internal hours, overtime tracking, schedule coverage
• Reimbursement. PDPM case mix index, assessment timeline tracking, CMI by unit
• Clinical quality. Five-Star indicators, rehospitalization rates, survey risk flags
• Financial performance: revenue per patient day, EBITDAR by building, department-level expense tracking
• PBJ compliance: real-time staffing data aligned with Payroll-Based Journal reporting requirements

The result is that a regional director can start the morning with a 10-minute review of every building's performance across all of these domains: not a two-hour data-gathering exercise.

For a full overview of how the platform works, see Why Choose Megadata and explore the platform modules.

Questions to Ask When Evaluating Skilled Nursing Software

Before adding any new software to your stack, these questions help clarify whether a tool will actually solve the problem:

1. Does this connect to our existing systems, or does it require manual data entry? Every manual step is a bottleneck and an error source.

2. How current is the data? Real-time matters for operational decisions. Daily is acceptable for some financial reporting. Weekly is too slow for labor management.

3. Is it built for multi-facility operators, or adapted from single-facility tools? Single-building dashboards that aggregate to a portfolio view are rarely as useful as platforms designed for multi-facility visibility from the ground up.

4. Who uses it: and what does each role see? CEO, RDO, DON, and department heads have different information needs. Good software surfaces the right data for each role without requiring configuration.

5. What does implementation look like? Enterprise software implementations in LTC frequently stall. Ask specifically: how many weeks to first meaningful data? Who manages the integration?

Frequently Asked Questions

What software do skilled nursing facilities use most?
PointClickCare is the dominant EHR platform in skilled nursing, followed by MatrixCare. For payroll, ADP, Paylocity, and Paychex are common.

For analytics and multi-facility reporting, purpose-built platforms like Megadata are increasingly replacing homegrown Excel-based reporting.

What is the difference between an EHR and a skilled nursing analytics platform?
An EHR captures and stores clinical data: documentation, assessments, care plans, medication administration. An analytics platform pulls data from the EHR and other systems, normalizes it, and surfaces operational insights across the organization.

The EHR stores the data; the analytics platform tells you what the data means for your operations.

Do skilled nursing analytics platforms replace PointClickCare?
No. Analytics platforms like Megadata integrate with PointClickCare to pull data and surface insights that PointClickCare's native reporting does not provide: particularly across multiple facilities.

They complement rather than replace the EHR.

How does analytics software help with Five-Star ratings?
Analytics platforms surface the real-time data behind Five-Star metrics: staffing hours per patient day, Payroll-Based Journal staffing ratios, rehospitalization rates, and quality measure trends. Operators who see these metrics in real time can address gaps before they affect the Five-Star score: rather than discovering them after the CMS update.

What should I budget for skilled nursing analytics software?
Pricing varies by organization size and platform scope. Analytics platforms are typically priced per facility per month, with enterprise arrangements for large portfolios.

The ROI case for most operators is built on agency cost reduction, PDPM optimization, and staffing efficiency: and typically more than covers the subscription cost within the first year.

The Bottom Line

There is no shortage of software in skilled nursing. The problem for multi-facility operators is not that the tools do not exist: it is that the tools do not talk to each other, and none of them was designed to give leadership the cross-domain visibility they need to run a portfolio.

The organizations that have solved this problem have added an analytics layer to their existing stack: a platform that connects their EHR, payroll, and billing data into a single real-time view of how every building is performing.

See what Megadata looks like across your building portfolio. Book a call with our team.