Fractional CTO + build team · nursing home operators
Software is built for the 80%. Your buildings run at 100.
Manoa is a fractional CTO and a build team for nursing home operators. Bring the wishlist. We scope every item and give you an honest call: build it with us, coach your own person through it, or go buy it.
Build or buy
Buy the EHR. Build what runs on top of it.
Every vendor ships the version that fits most operators. The part that does not fit is where your month-end goes sideways. That layer is worth building, and AI has made it far cheaper to build than it was two years ago. It has not made it easier to build right.
Your EHR
PointClickCare or MatrixCare is the system of record. Nobody should build that. We build on its exports.
Payroll and scheduling
Commodity systems for commodity needs. Buy them, connect them, move on.
Month-end and the census pack
Every operator reviews buildings differently. The pack your regionals read on Monday is yours to shape.
Labor and agency reporting
The report depends on how your buildings staff. That is exactly the part a vendor averages away.
Workflows between systems
The hand-off from MDS to billing, from the staffing vendor to payroll. Vendors stop at their own edge.
The questions administrators ask
Which building, which payer, which shift. Ask it of your own data instead of a dashboard built for everyone.
What we build
The layer between your EHR and your Monday meeting.
Six things most operators are running on spreadsheets and goodwill. We build them on the data you already have and keep them running.
Month-end and census
The census, occupancy and payer-mix pack, built from PCC exports, in the format your regionals already review. When month-end breaks, we fix the pipeline rather than the spreadsheet.
pcc.export → warehouse.censusLabor and agency, by building, by shift
Agency hours and overtime every morning, pulled from payroll and the staffing vendor. Your administrators see it before the invoice does.
payroll · staffing → ops.dailyPDPM, MDS and AR
Rate checks before claims go out, MDS due dates that live in a system instead of someone's head, and AR days by payer every Friday.
mds → billing.pdpm · ar.agingConnections between what you already bought
PointClickCare, payroll, staffing and billing talk to each other because someone built the connection and keeps it working.
pcc · payroll · staffing · billingAnswers from your own data
Summaries, alerts and the questions your administrators ask every week, answered from your records rather than a vendor's demo.
your.data → answersA CTO who tells you which
Every item on the list gets a call. Some deserve a build. Some need your developer and a plan. Some are one vendor demo away, and we will sit in on it with you.
fractional cto · monthlyHow it works
What an engagement looks like
There is no discovery phase to pay for and no SOW to negotiate. We start by listening, build the first thing, then settle into a cadence.
List and scope
We sit in your meetings, read your reports and map every system in the operation. By the end of the month your wishlist is scoped item by item: build, coach or buy.
Build the first one
Usually it is month-end or labor. We ship it, hand your operator a report they trust, and move down the list.
Cadence
A standing seat in your ops meeting, a Slack channel that gets answered, and a monthly review of what shipped and what is next. One flat monthly fee covers it. Stop with thirty days' notice.
Who's in the room
Aryeh Hoffman
Founder and fractional CTO
Twelve years building software for nursing home operators, most recently as CTO of Megadata, the long-term care analytics platform now running in 1,900+ facilities. Aryeh has sat on the vendor side of enough demos to know exactly where a product stops fitting an operation.
He runs every Manoa engagement himself: the scoping, the ops meeting, and the call when something breaks.
Talk to us
Thirty minutes. Bring the wishlist.
Bring the list of things you wish your software did. We will tell you which ones are worth building, which need a coach, which you should buy, and what a monthly engagement would look like for your buildings. No deck, and no proposal unless you ask for one.