STFE Systems delivers the only CMS-defensible, SHA-256 auditable admission decision engine built exclusively for Skilled Nursing Facilities and Critical Access Hospitals. Not a recommendation. A calculation.
STFE (Spatio Temporal Facility Engine) is a deterministic clinical decision engine that evaluates every SNF and CAH admission against a multi-domain constraint matrix — clinical safety, CMS regulatory compliance, operational capacity, and financial viability — in under 2 seconds.
Unlike AI-based recommendation tools, STFE produces a cryptographically signed, reproducible calculation. When CMS audits your facility, "the AI recommended it" is not defensible. A SHA-256 signed constraint evaluation is.
PDF, EHR push, SMART on FHIR, CDS Hooks, or direct API
Comprehensive FHIR clinical data mapping → patient state: vitals, diagnoses, payer, procedures
38+ domains evaluated: clinical, CMS, capacity, financial, psych, wound, anticoag
Comprehensive transformation pathways resolve conflicts: care coordination, logistics, specialist consults
SHA-256 POI hash, DON NPI sign-off, immutable CMS-defensible record
SNFs and CAHs face a perfect storm of clinical, regulatory, and financial pressure. STFE was built to solve each of these head-on.
Facilities admit patients based on "clinical judgment" with no reproducible documentation. When CMS opens an ADR, there's no defensible record — just a physician's memory.
AI recommendation tools output probabilities. CMS requires certainty. "The AI said 78% likely safe" is not an audit defense. Deterministic calculation is the only acceptable standard.
Hospital discharge planners wait hours or days for SNF admission decisions. The average SNF takes 4–6 hours to respond to a referral — often losing the patient to a faster competitor.
High-cost IV antibiotics, specialty medications, and anticoagulants eat SNF margins invisibly. Without pre-admission pharmacy analysis, facilities discover the loss after the patient is already admitted.
Cardiology, pulmonary, orthopedic, psych safety, wound care — each domain is evaluated by a different specialist. No integrated system connects all constraints into one decision.
1,381 Critical Access Hospitals have unique swing bed rules, 101% cost-based reimbursement, and 72-hour admission constraints. Every major competitor is SNF-first. CAHs use spreadsheets.
Unlike general clinical decision support tools, STFE was designed from the ground up for post-acute care facilities — with domain-specific rules, CMS guardrails, and admission logic baked in.
STFE evaluates every SNF referral across clinical, regulatory, operational, and financial dimensions simultaneously — in under 2 seconds.
STFE is the only enterprise admission system with CAH-specific rules. We cover swing bed regulations, 101% cost-based reimbursement, and 72-hour constraints that no competitor addresses.
One unified platform spanning clinical intelligence, EHR integration, compliance automation, and financial analytics.
38+ clinical domains evaluated deterministically in under 2 seconds. Every decision is reproducible, auditable, and defensible. No black boxes.
SMART on FHIR launch from Epic, Cerner, and PointClickCare. CDS Hooks for passive real-time alerts. FHIR R4 adapter maps comprehensive clinical data to the patient state vector automatically.
Upload hospital discharge summaries and referral packets. AI extracts clinical fields and pre-populates the intake form. DON reviews and executes the deterministic engine.
Upload a CSV of up to 500 historical patients. STFE re-evaluates every case against current clinical rules and generates a risk-stratified PDF report. No PHI transmitted to audit vendors.
Directors of Nursing configure clinical thresholds — TUG limits, INR ceilings, O2 saturation floors — without code deployment. NPI-signed rule changes take effect within 60 seconds.
Every case creates an SHA-256 signed, immutable audit record — patient state, facility thresholds, rule set version, and DON signature — all frozen at the moment of evaluation.
The entire admission workflow — from referral receipt to CMS-defensible documentation — in under 3 minutes.
PDF fax, EHR push via SMART on FHIR, CDS Hook, or direct API. Nurse marks received — response clock starts.
AI extracts from PDF or FHIR pulls complete clinical data. Patient state built: vitals, diagnoses, payer, procedures, medications.
38+ constraint domains checked against DON-configured facility thresholds. Engine identifies transformation pathways to resolve conflicts.
Intake nurse or DON records Accept / Reject / Override. Override requires 15+ character clinical justification for HIPAA audit trail.
SHA-256 POI hash created. DON NPI attached. MDS 3.0 pre-populated. Hospital discharge planner receives Status Portal link.
How STFE compares to AI recommendation tools, legacy admission systems, and doing nothing.
Upload a de-identified CSV of your historical admissions. STFE evaluates every case against current CMS rules and returns a risk-stratified report — showing which patients should have been held, which modifications were missed, and the estimated financial impact.
Most facilities are surprised by what a shadow audit reveals. In our pilots, a meaningful portion of historical admissions contain clinical constraint violations that create audit exposure — and were never flagged at intake.
We're a deliberately small team building deterministic clinical decision infrastructure for a 1,381-CAH and 15,000-SNF segment that nobody else takes seriously. If you've ever shipped a system where a wrong answer means a real audit, you'll fit here.
No "the model said so" answers. Every output is a calculation a regulator can re-derive.
Our customers run admission decisions through STFE before signing them. Bugs hurt people.
SHA-256 audit chains, type-safe constraint registry, full HIPAA boundary discipline.
Plainsboro, NJ + Hyderabad, India. Async-first. Evidence over presence.
We are a deep-tech startup pioneering the future of healthcare interoperability and deterministic AI. At the core of our technology is the Spatio-Temporal Feasibility Engine (STFE) — a proprietary, rules-based engine designed to eliminate "physical hallucinations" in AI by validating complex, multidimensional constraints. We build secure, SMART on FHIR-compliant systems that integrate seamlessly with major EHR platforms. If you want to work on bleeding-edge neuro-symbolic AI and build deterministic systems that healthcare providers can trust, join us.
Lead the technical design and scaling of the STFE platform. You will be the technical backbone, ensuring our Python/FastAPI backend and React frontend communicate flawlessly, perform at scale, and maintain strict deterministic data integrity.
STFE Systems requires a robust, secure, and highly available infrastructure. Own our AWS cloud environment, ensuring zero-downtime deployments, strict security compliance for healthcare data, and seamless scaling.
Build the core modules of the STFE platform. You will translate complex deterministic rules into highly efficient, scalable code, working closely with the Architect to bring the multidimensional state vector engine to life.
Build responsive, intuitive, and highly secure user interfaces using React and Tailwind CSS that real clinicians and DONs use every day to make admission decisions. Strong attention to UX detail and accessibility required.
In deterministic healthcare systems, bugs are not an option. Build our testing infrastructure from the ground up, ensuring that every constraint and transformation node in the STFE functions with 100% mathematical accuracy before deployment.
We are expanding our core team to accelerate the development of the STFE platform. Work alongside our senior engineers to build features, write tests, and ensure our systems are production-ready.
We are expanding our core team to accelerate the development of the STFE platform. Work alongside our senior engineers to build features, write tests, and ensure our systems are production-ready.
Clinical informatics, customer success, sales engineering, compliance — if you've built things that real hospitals depended on, we want to hear from you.
Apply by email — careers@stfe.io — with resume, portfolio or GitHub, and a brief note on a system you've shipped where correctness mattered. We read every email.
STFE Systems operates a dual-hub model — clinical strategy and customer success in the United States, engineering and product development in India.
See the engine evaluate a real patient case in under 90 seconds. We'll also run a complimentary shadow audit on your historical data.
Our clinical team will reach out within 24 hours to schedule your personalized demo and shadow audit.