What Cura offers.
Every engagement runs on the same contract family — a Master Services Agreement, a Business Associate Agreement, and a Statement of Work that names its own deliverables, exclusions, and acceptance criteria. Scope is written down before work starts.
Foundation
Surveillance and reporting build.
A bounded engagement that stands up your infection surveillance and NHSN reporting infrastructure and hands it to your team documented. Nine defined deliverables, each with its own written acceptance criteria:
- Baseline assessment — current state and gaps against NHSN Long-term Care Facility Component requirements and California reporting obligations. Every gap carries one of three recommendations with a stated basis: client-remediable, separate engagement indicated, or no action warranted.
- NHSN onboarding and validation — configuration and validation of the respiratory pathogens and vaccination module required under 42 C.F.R. § 483.80(g), plus any LTCF Component modules you elect, healthcare personnel vaccination reporting, and the annual facility survey.
- Data ingestion pipeline — documented scheduled exports from your EHR, reference lab, and pharmacy, with a runbook.
- Data cleaning recipes — LabID deduplication, onset categorization, denominator capture, and organism normalization, written down and reusable.
- Surveillance dashboard — census, device utilization, infection events by onset category, antibiotic use where pharmacy data permits, respiratory case counts, and trend presentation matched to your event frequency.
- Reporting calendar — every cadence, deadline, and responsible party, including the California-specific ones.
- How-to documentation — one-pagers for the IP delegate or DON covering each recurring task.
- Workflow training — a live 90-minute session for your surveillance team, recorded.
- Continuation recommendation — see below.
Right for facilities transitioning IP coverage, recovering from a failed submission cycle, or starting to formalize what used to live in a binder.
Engagements are remote by default. On-site visits are available and billed separately. The engagement assumes a single facility, a single EHR, a single NHSN OrgID, and an existing NHSN enrollment; anything else is scoped as a change before it starts, not discovered halfway through.
Foundation builds the system and stops there — it does not include ongoing monthly submission or review, which is what Managed Surveillance is for. It is a fixed fee, quoted once the scope is settled on the discovery call.
I will tell you in writing if you don’t need me.
Foundation closes with a written continuation recommendation assessed against stated self-sufficiency criteria — IP staffing and certification, modules elected, survey history, facility complexity, and whether your team completed two monthly reporting cycles without my involvement. If you meet all of them, I issue a self-sufficiency statement and don’t propose ongoing services. It is delivered at no additional charge, and because it requires watching you run the workflow unassisted, it usually arrives after the engagement has closed and been paid.
Beta Pilot
The Foundation build, early.
Cura is a new practice, and the first handful of Foundation engagements are offered as Beta Pilots at materially reduced founder’s pricing. The work is real and contracted, and the deliverable set is the standard Foundation set — same nine deliverables, same acceptance criteria.
What is different, stated in the SOW: the timeline is deliberately longer to allow for methodology iteration, and the cadence may be fits-and-starts as I refine the toolkit in cooperation with you. I can change how I do the work mid-engagement; I cannot reduce what gets delivered or move the acceptance criteria without your agreement.
What I ask in return for the discount: a written testimonial you approve, cooperation on a case study you can redact or decline outright, and a reasonable number of reference calls. Every one of those is subject to your consent, in your sole discretion — nothing about the engagement gets published that you have not approved in writing.
Pilot slots are limited and eligibility is at my discretion. If pilot pricing is gone by the time we talk, I will say so on the call rather than quietly quoting you standard rates.
Managed Surveillance
Ongoing infrastructure support.
An ongoing engagement covering the monthly data pull and cleaning, NHSN submissions, dashboard refresh, California reporting calendar upkeep, recurring check-ins with your DON or IP delegate, and a quarterly trend review. Outbreak coaching is included at every tier, on surveillance data only.
Three tiers, calibrated to facility size, complexity, and how much steady-state support the program needs. Each tier defines its own reporting turnaround SLA, outbreak response window, included-hours soft cap, and communication channel — I share the specific numbers on the call and they are written into the SOW before you sign.
Terms worth knowing before the call: the initial term is twelve months and renews automatically unless either of us gives notice, but either party can terminate for convenience on sixty days’ notice at any tier. Missed service levels earn service credits automatically. Persistent misses let you terminate for cause without penalty. Hours over the tier cap are billed at a stated hourly rate, and I won’t run more than a few overflow hours in a month without your written approval.
A Foundation engagement is the usual starting point but is not required — where you already have a working program, we document the existing environment, modules, data sources, tooling, and open gaps as an equivalent baseline and start from there.
Essential
Standard
Premium
Multi-facility discounts apply at every tier.
Add-Ons
Indicated, not upsold.
Add-Ons attach to a Foundation or Managed engagement. Each one is a separate Statement of Work with its own scope, deliverables, and exclusions — and each is indicated by a specific finding in the Foundation baseline assessment. Where the baseline finds a competent IP, the mandatory reporting stream only, a clean survey history, and demonstrated internal capacity, the indicated outcome is a self-sufficiency statement and no engagement at all.
Fixed-fee where the scope is bounded; time-and-materials against a cap where it isn’t. No Add-On is priced as a share of your savings, revenue, or reimbursement, and none is tied to a quality measure, star rating, or survey outcome — where any part of my fee varies, it varies with process metrics inside my control.
California Reporting Compliance Layer
An operational inventory of your California reporting workflows — immunization registry submission, Title 17 reportable-condition notification, and local health department pathways. I build the inventory; you and your counsel decide legal applicability, and I make no submission to a state or local agency under this scope.
Indicated when Registry submissions incomplete, or the facility sits in a county whose LHD requirements aren’t yet documented.
NHSN Data Integrity Pack
Reconciliation and validation of historical NHSN submissions that predate my engagement, with a written correction recommendation. I don’t enter, modify, or delete anything in NHSN except at your specific written direction.
Indicated when Prior submissions show categorization or deduplication error, or open NHSN alerts of unknown origin.
Antimicrobial Use & Stewardship Analytics
Antibiotic use measurement — days of therapy, rates per 1,000 resident-days, and a documentation screen — built into your reporting. Internal analytics only; nothing here is submitted to an external agency, and it is not stewardship program leadership or pharmacist services.
Indicated when No antimicrobial use measurement in place, or F881 tracking evidence absent. Requires that your pharmacy will release dispense data.
Antibiogram Feasibility Assessment
An isolate-count feasibility check on whether a facility-specific antibiogram is statistically supportable, and sourcing of a defensible surrogate where it isn’t. Sometimes the honest answer is that no antibiogram should be built — that is a legitimate finding.
Indicated when Facility-specific antibiogram absent or of unknown validity.
Surveillance Survey-Readiness Review
A documentation-only review of your surveillance record against the infection prevention critical element pathway. Internal preparation material. I do not communicate with any survey or enforcement body, and this is not survey representation.
Indicated when Survey history shows an infection-related citation, or the IP is newly in role.
Quality Reporting Program Vaccination Reporting Support
Preparation and validation of healthcare personnel and resident vaccination reporting through the applicable NHSN component, against the deadline CMS/NHSN publishes for the cycle.
Indicated when HCP influenza vaccination reporting missed, late, or of uncertain completeness.
Outbreak Data Support Pack
Line-list and surveillance-data support during an outbreak. Signed dormant at Foundation close with no fee until you activate it, and priced time-and-materials against a cap — the depth of an outbreak can’t honestly be scoped in advance. You remain solely responsible for all public health notifications.
Indicated when Any facility with an active or recurring outbreak history.
What Cura doesn't do.
Cura is specific about scope, because that's how good work happens. Four of these boundaries are written into the Master Services Agreement as reserved exclusions — no Statement of Work, change order, or side request can add them, however it is styled. They change only by a signed amendment to the agreement itself.
- No survey representation. I will not represent, appear for, or act on your behalf in any survey, inspection, or enforcement proceeding.
- No direct or bedside resident care, and no directing changes to the clinical care of any resident.
- No authoring or adopting policies on your behalf. Advisory review of your policies, and recommendations about them, remain in scope.
- No registered-nurse staffing hours, and no serving in a staffing capacity at your facility.
One more boundary is harder still. I cannot be your Infection Preventionist. Cura is an independent contractor providing surveillance and analytics on a project basis; you may not designate me as your IP for purposes of 42 C.F.R. § 483.80(b) or California Health & Safety Code § 1255.9, my hours count toward neither that requirement nor your direct patient care hours, and unlike the exclusions above this one cannot be added back by amendment. Every engagement assumes you employ a qualified full-time IP throughout.
Beyond those, and available by change order or a separate scope where they make sense: clinical outbreak management, antimicrobial stewardship program leadership or pharmacist services, construction and renovation infection risk assessment, employee and occupational health, EHR or vendor selection, and software development past the lightweight scripts the build calls for. Third-party hosting, licensing, and export fees are yours.
And the honest one: I don't warrant outcomes. Not infection rates, not the absence of a citation, not a quality measure. Some of the measures that move your Medicare payment — the healthcare-associated infection measure under SNF Value-Based Purchasing among them — are derived from claims data, not from surveillance data, and no surveillance engagement moves them directly. Anyone telling you otherwise is selling something.
Licensed to you, permanently, for the facility we named.
On payment, you get a perpetual, irrevocable license to use the deliverables for your internal operations at the facilities named in the Statement of Work — including the scripts, recipes, dashboards, and documentation. The license transfers to an acquirer of that facility. It does not extend to sister facilities, a parent, or a management company that isn't named, and I retain my underlying methods and templates. The dashboard is built on my account and transfers to yours whenever you ask, at no charge, whether or not you continue with me — I confirm that in writing before you ever decide about ongoing work.
What an engagement costs.
Foundation is a fixed fee, with reduced founder’s pricing on the remaining pilot slots. Managed Surveillance is a monthly retainer that varies by tier. Add-Ons are quoted per scope. I share specific numbers on the call, once I know what your facility needs.