Success Story · Health
Building a technology innovation lab that actually sticks
How Foundations Health Solutions automated Quality Measures reporting across 60+ skilled nursing facilities — turning a manual data burden into a real-time clinical decision tool, while keeping nurses in control of the work.
Foundations Health Solutions
Skilled Nursing Operator · 60+ Facilities, Ohio · Quality Measures Reporting
60+
Facilities on a single real-time QM platform
3–4 hrs
Per MDS nurse recovered each week from manual reporting
Real-time
Quality Measure visibility at company, region, and facility level
2 phases
QM reporting plus CMS 5-STAR IQIES automation deployed
The Challenge
Foundations Health Solutions is one of Ohio’s premier skilled nursing operators — recognized for clinical leadership and operational excellence across a network of more than 60 facilities. As part of its commitment to improvement, FHS built a technology innovation lab to apply digital tools to the high-volume processes its frontline teams navigate every day.
One of the lab’s earliest priorities was Quality Measures — the metrics that shape CMS Five-Star ratings, drive regulatory compliance, and signal the quality of resident care. The underlying clinical practices were sound. The problem was the process around them. MDS nurses were spending three to four hours every week downloading facility-level QM reports from the state portal, transcribing data into spreadsheets by hand, and building internal tracking reports manually. Visibility was retrospective, early warnings were easy to miss, and that manual work was consuming time that belonged to the patient.
FHS saw a clear opportunity: move from backward-looking reporting to real-time action — and build something their teams would actually use.
The Solution
AXI partnered with FHS and Silvertek Innovation to design and build a centralized QM dashboard and alert system — automating data flows from the CMS IQIES portal, surfacing quality trends in real time, and distributing reports automatically across the organization. But the technology was only part of the work.
The process mattered more. AXI began with in-depth discovery sessions alongside the FHS MDS Director, who had the clearest view of where manual workflows were breaking down across the network. From there, the team worked directly with a pilot group of regional MDS nurses — whose feedback shaped how data was visualized, how alerts were prioritized, and how the system fit into existing weekly quality reviews.
The platform automated the weekly download of facility-level QM reports from MDS 3.0, auto-generated the internal rate tracking report for every region and facility, and surfaced analytics through dashboards accessible to MDS nurses, facility directors, and senior leadership. A second phase extended the same discipline to CMS 5-STAR IQIES reporting — automating the quarterly collection and consolidation of Five-Star ratings across all 60+ facilities, eliminating another layer of entirely manual work.
The Results
With the platform live across the network, the impact showed up where it mattered. Nurses got back the hours previously lost to downloading, transcribing, and formatting — and those hours went back to the floor. Quality performance is now visible in real time at every level of the organization.
3–4 hours per week recovered per MDS nurse — time previously spent on manual QM downloads, spreadsheet transcription, and internal report creation.
Real-time Quality Measure visibility across 60+ facilities — automated dashboards surface performance at company, regional, and facility level as data becomes available.
CMS 5-STAR IQIES tracking automated enterprise-wide — quarterly Five-Star ratings consolidated and distributed to clinical staff without manual processing.
Clinical adoption built in from the start — because frontline nurses co-designed the system, it integrated naturally into existing workflows rather than adding another tool to manage.
What made it work
This is what human-centered automation looks like in practice: a technology-forward provider with a real vision, a clinical team willing to engage deeply in the design, and an automation partner willing to subordinate the technology to the workflow.
FHS didn’t come to AXI looking for a prebuilt product. They came with a blueprint for what their innovation lab could do — and the expectation that the tool would be shaped around the people who would live with it. AXI brought the automation engineering; the MDS Director and regional nurses brought the operational intelligence. The result was something that felt, as Joe Altieri put it, made for the team rather than handed to them.
That dynamic — provider vision, clinical input, automation execution — is what AXI Health is designed to enable across post-acute care.
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