Referral Queue
Rodriguez, Maria T.
47m SLA
MRN: KC-2026-00344
→ Valley Skilled Care · Monterey Park
SENTBACKUP ACTIVEMedicare Part ADRG 193
Kim, David S.
2h 15m
MRN: KC-2026-00343
→ Eastside Rehab · Boyle Heights
ESCALATEDMedicare AdvantageDRG 871
Johnson, Patricia A.
18h 30m
MRN: KC-2026-00342
→ Sunrise SNF · East Los Angeles
REVIEWINGMedi-CalDRG 470
Martinez, Rosa L.
✓ Placed
MRN: KC-2026-00341
✓ Sunrise SNF · East Los Angeles
ACCEPTEDMedicare Part ADRG 871
Thompson, Robert W.
6h 20m
MRN: KC-2026-00340
→ Pacific Home Health · Silver Lake
SENTCommercial
Okafor, Emmanuel C.
✓ Resolved
MRN: KC-2026-00339
✕ Valley Care · No Medi-Cal bed
DECLINEDBACKUP SENTMedi-Cal
Rodriguez, Maria T.
MRN: KC-2026-00344 · Case: CMP-44C2-901A · DRG 193 · Simple Pneumonia w/ MCC
47m
SLA Remaining
Discharge Type
Skilled Nursing Facility
Payer
Medicare Part A
LOS
6 days (DRG baseline: 5.1)
Case Manager
J. Chen, RN CCM
Discharge Date
Apr 6, 2026 · 2:00 PM
Home ZIP
90022 · East Los Angeles
Family ZIP
90022 · Same area
Language
Spanish / English
Payer & Insurance Verification
✓ Real-Time Verified
Plan Type
Medicare Part A
Traditional FFS
SNF Benefit
100 Days
Day 1–20: $0 copay
Prior Auth
Not Required
FFS exempt
3-Day Rule
Met ✓
6 inpatient days
Valley Skilled
Accepts ✓
Medicare certified
Backup: Eastside
Accepts ✓
Medicare certified
Medi-Cal Secondary
Not Active
No secondary plan
Verified At
08:02 AM
Auto-verified on intake
Social Vulnerability Screening · 5-Domain Assessment
Requested by Tom Bates, Chief Quality Officer
Domain 01
Social Isolation
High Risk
Lives alone · Limited social network
Domain 02
Economic Insecurity
Moderate
Fixed income · Medicare only
Domain 03
Limited Health Access
Low Risk
Established PCP · Local access
Domain 04
Caregiver Stress
High Risk
Daughter primary caregiver · Working full-time
Domain 05
Elder Abuse Risk
Low Risk
No indicators identified
Facility Match Results · 5-Signal Ranked
5 evaluated · 4 qualified · 1 blocked (payer mismatch)
| Facility | Match | CMS Stars | HEI Equity | Payer | Distance | Status | Action |
|---|---|---|---|---|---|---|---|
PRIMARYValley Skilled Care Monterey Park · Respiratory unit |
96 |
★★★★★ 5.0 overall |
🏳️🌈 Leader | ✓ | 2.1 mi | AWAITING | |
BACKUPEastside Rehab & Care Boyle Heights · Backup active |
88 |
★★★★½ 4.5 overall |
High Performer | ✓ | 3.8 mi | BACKUP SENT | |
Sunrise SNF East Los Angeles |
84 |
★★★★½ 4.5 overall |
🏳️🌈 Leader | ✓ | 4.2 mi | Available | |
Pacific Gardens SNF Alhambra |
79 |
★★★★ 4.0 overall |
Participant | ✓ | 6.1 mi | Available | |
Valley Care Center El Monte · No Medi-Cal beds |
72 |
★★★★ 4.0 overall |
Participant | ⚠; | 7.3 mi | Payer mismatch |
30-Day Readmission Risk Monitor
4
Available Now
14
Occupied
2
Reserved
1
Maintenance
Bed Map · Sunrise SNF · Wings A & B
Available (4)
Occupied (14)
Reserved (2)
Maintenance (1)
IMPACT Act Audit Trail · Discharge Coordination Documentation
Every placement decision timestamped, SHA-256 verified, and immutable. CMS-ready export available on demand.
Requested by Tom Bates, Chief Quality Officer · Shannon Bradley, Head of Health Equity
Requested by Tom Bates, Chief Quality Officer · Shannon Bradley, Head of Health Equity
✓ 100% Coverage · All Cases Documented
47
Cases Documented This Month
100%
IMPACT Act Coverage Rate
0
Documentation Gaps
SHA-256
Immutable Hash Standard
Timestamp
Event
SHA-256 Hash
Status
Apr 6 · 08:02 AM
Rodriguez, Maria T. · Payer verified: Medicare Part A · SNF benefit confirmed · 3-day rule met
a3f8c2d1e9b4...
✓ Verified
Apr 6 · 08:04 AM
Rodriguez, Maria T. · 5 facilities evaluated · 5-signal match completed · Valley Skilled Care scored 96/100
f7e2a5c8d3b1...
✓ Verified
Apr 6 · 08:06 AM
Rodriguez, Maria T. · Social vulnerability screening completed · 5 domains assessed · High risk: isolation, caregiver stress
c9b3e7f1a6d4...
✓ Verified
Apr 6 · 08:08 AM
Rodriguez, Maria T. · HEI equity score applied: Valley Skilled Care = Leader, Eastside Rehab = High Performer
d4c1f8b2e5a7...
✓ Verified
Apr 6 · 08:09 AM
Rodriguez, Maria T. · Family proximity: patient ZIP 90022 · family ZIP 90022 · 2.1 mi to primary facility
e6a9d3c2b8f1...
✓ Verified
Apr 6 · 08:14 AM
Rodriguez, Maria T. · Primary referral sent to Valley Skilled Care · Backup activated: Eastside Rehab
b2f7a4e9c1d6...
✓ Verified
Apr 6 · 08:52 AM
Rodriguez, Maria T. · SLA monitoring active · 47 minutes remaining · Auto-escalate at 00:00
f1c8b5a2d9e3...
⏳ Active
Apr 5 · 11:58 AM
Martinez, Rosa L. · Placement confirmed · Sunrise SNF · Bed 214-B · Medicare Part A verified
a7d2c9f4b1e8...
✓ Verified
Apr 5 · 08:16 AM
Martinez, Rosa L. · 5-signal match · Sunrise SNF scored 96/100 · HEI Leader · 2.1 mi from family ZIP
c3e8f1d6a9b2...
✓ Verified
Equity & Family Proximity Intelligence
HRC Healthcare Equality Index scoring applied to every placement decision as a primary signal — not a filter bolted on afterward. Family geographic proximity captured at patient ZIP and family ZIP level.
Designed for Shannon Bradley, Head of Health Equity · Keck Medicine of USC
Designed for Shannon Bradley, Head of Health Equity · Keck Medicine of USC
HEI
Leader Standard
Family Geographic Proximity · Rodriguez, Maria T.
90022
Patient Home ZIP
90022
Family ZIP (Daughter)
2.1 mi
Distance to Primary Facility
East LA
Community Anchor
Spanish
Language Match
TransLatin@
Community Partner
HEI Score Breakdown · Matched Facilities
98
Valley Skilled Care
🏳️🌈 HEI Leader
91
Eastside Rehab & Care
High Performer
94
Sunrise SNF
🏳️🌈 HEI Leader
72
Pacific Gardens SNF
Participant
AI Explainability Statement
Shannon Bradley · Transparency RequiredHow COMPASS Ranks Facilities
COMPASS applies a 5-signal weighted algorithm: (1) Clinical acuity match, (2) Insurance verification, (3) CMS quality stars, (4) HEI equity score, (5) Geographic proximity. No facility pays for a higher ranking. The equity signal is weighted equally to clinical match — not as a secondary filter.
What COMPASS Will Never Do
✕ Rank a facility higher because it paid a fee
✕ Remove the equity signal to simplify results
✕ Override a placement without a documented reason
✕ Share patient data without documented consent
✕ Allow a payer-mismatched facility to receive a referral
✕ Remove the equity signal to simplify results
✕ Override a placement without a documented reason
✕ Share patient data without documented consent
✕ Allow a payer-mismatched facility to receive a referral