90-Day Diagnostic

The instrument that delivers what
no existing tool can.

The 90-Day Diagnostic is a structured engagement designed to determine whether earlier visibility into middle-layer organizational health creates a meaningful intervention window — before costs are locked in.

Zero workflow disruption
No PHI. No individual scoring.
Fully reversible
Workforce cost context: AHA reports hospitals spent more than $1 trillion on workforce in 2025, with costs rising 5.6%. Average bedside RN turnover costs $60,090–$61,110. Each 1% change in RN turnover moves annual cost by approximately $289,000.
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Why we start with a diagnostic

The structured entry engagement for both sides to evaluate fit.

The 90-Day Diagnostic is how health systems begin with SenterME. It gives both sides a bounded period to test fit, evaluate the signal, and determine whether a longer-term partnership makes sense.

Bounded entry, not open-ended commitment
Mutual fit testing for both teams
Clear path to a longer-term partnership if the value is real

What This Diagnostic Answers

Two questions this diagnostic
helps leadership resolve.

Operational Question
Where is organizational strain building, how is it behaving over time, and where is intervention still possible before the costs compound?
Oversight Question
Can a 90-day structural diagnostic give leadership a more credible basis for staffing review, workforce governance, and executive decision-making?

Signal Validity

We have already proven
people show up.

A critical assumption underlying the Diagnostic is that middle-layer participants will sustain voluntary self-reporting over a 90-day observation window. SenterME has direct behavioral evidence validating this assumption — before a single institutional deployment was run.

Prior to institutional deployment, SenterME's signal capture platform was validated in a consumer context targeting high-performance individuals managing burnout risk. That cohort sustained voluntary check-in rates exceeding twice per week throughout the observation period — without push notifications, reminders, or incentives.

2x+
Signal validity
Weekly voluntary check-in frequency sustained across the validation cohort — without notifications, reminders, or incentives of any kind.
>70%
Signal participation stability threshold — already demonstrated in practice, not theoretical
90
Days of continuous observation — the full window required to produce validated structural intelligence

Investment

Choose the diagnostic scope that matches
your leadership question.

Starting at $25,000. Most health systems choose the expanded diagnostic because it gives leadership enough scope to compare variation across units, facilities, or service lines rather than relying on a single contained snapshot.

Diagnostic 100
Contained Diagnostic
Up to 300 participants · Single site or focused division
Best for one hospital, one focused division, or a limited multi-unit deployment. Designed to establish signal reliability, create a structural baseline, and give leadership an initial view of where middle-layer strain may be concentrating inside a contained scope.
✓
Signal integrity validation
✓
Structural Health Baseline
✓
Unit-level middle-layer strain analysis
✓
30-day & 60-day leadership snapshots
✓
90-day executive readout
✓
Leadership documentation support
Most Health Systems Choose This
Diagnostic 200
Expanded Diagnostic
Up to 1,000 participants · Multi-hospital or system-level
Best for multi-unit, multi-site, or system-level deployments where leadership needs to compare where strain is concentrating, how it varies across sites, and which areas warrant deeper follow-up first.
✓
Everything in Diagnostic 100
✓
Cross-site strain comparison
✓
Multi-unit risk concentration mapping
✓
Site-level middle-layer analysis
✓
Executive workshop
✓
Expansion roadmap
✓
Optional compliance alignment brief
Diagnostic 300
Enterprise Diagnostic
1,000+ participants · Custom scope & reporting
Best for enterprise-scale deployments spanning multiple hospitals, service lines, or leadership groups where the organization needs custom comparison cuts, executive touchpoints, and board-ready reporting.
✓
Everything in Diagnostic 200
✓
Custom participant scope and groupings
✓
Board-level reporting format
✓
Multi-service-line comparison
✓
Custom success-criteria design
✓
Executive touchpoints throughout
✓
Enterprise reporting package
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Important: SenterME is designed to strengthen staffing oversight, leadership review, and organizational visibility in areas that matter to Joint Commission, Magnet, and broader workforce governance. It is not represented as a substitute for legal, accreditation, or regulatory determination.

What You Receive

Four sequenced deliverables.
Each builds on the last.

The Diagnostic produces four outputs across the 90-day observation window. Each deliverable is designed to keep executive and operational leadership oriented as patterns emerge — without requiring action before evidence is sufficient.

1
Delivered at diagnostic close · Foundation output
A shared structural baseline
A quantified view of how strain, load, and stabilization are behaving across participating units during the observation period, so leadership is working from a common operating picture rather than fragmented impressions. This is the organizational fingerprint that does not exist anywhere in your current data stack.
System Snapshot · Structural Foundation
2
Primary diagnostic output · Unit-level resolution
A validated view of where middle-layer strain is concentrating
The diagnostic localizes where pressure is building across manager and team-leader roles, shows how that strain behaves over time, and distinguishes between contained strain, cycling strain, and compounding strain — an evidence-backed picture calibrated to your health system's specific operational reality.
Unit-Level Visibility · Role-Differentiated · Trajectory Tracking
3
30-day & 60-day check-ins · Interpretive reports
Interim leadership interpretation at 30 and 60 days
Two structured check-ins help leadership stay oriented as patterns emerge, without forcing premature action before the evidence is mature enough to trust. Each snapshot provides current signal stability, emerging strain patterns, and interpretive context to inform how leadership reads what they are seeing.
Interpretive · Leadership-Oriented · Action-Calibrated
4
90-day close · Decision-ready output
A 90-day executive diagnostic readout
A consolidated, decision-ready view of the structural baseline, middle-layer strain patterns, validated thresholds, and the specific conditions under which an expanded deployment or targeted intervention would make sense — equipping leadership with a clear, internally defensible investment case for continuation or expansion.
Decision-Ready · Investment-Justified · Expansion-Calibrated

What Leadership Knows at Close

At the end of 90 days, leadership should be able
to answer four practical questions.

This diagnostic is designed to build evidence on your system, in your context. It is not a promise of outcomes. It is a bounded test of whether earlier structural visibility changes what leadership can see and govern.

01
Pattern Visibility
Does the diagnostic reveal repeatable strain patterns that are not already obvious through existing workforce, staffing, or exit data?
02
Early Timing
Do those patterns appear early enough to matter — before downstream indicators make the problem visible?
03
Leadership Usefulness
Does the visibility help leadership make earlier, more targeted decisions about staffing review, manager support, workload distribution, or follow-up?
04
Governance Support
Does the diagnostic strengthen leadership's ability to organize staffing oversight, workforce review, and internal documentation in areas already under scrutiny?

Risk Instrument

The exposure this diagnostic
is designed to surface.

Healthcare buyers are operating under heavy labor and margin pressure. The diagnostic investment is small relative to the financial exposure attached to workforce instability — and a fraction of what a single preventable attrition event costs.

$1T+
Hospital workforce spend in 2025 — AHA reports costs rose 5.6% that year, making workforce the single largest expense category
$60K+
Average cost per bedside RN turnover event — at $289,000 per 1% change in annual RN turnover rate
$5.6B+
Annual preventable workforce exposure across U.S. hospitals — because the coordination layer where strain first forms remains invisible in real time
Four frameworks. One gap.
The industry has already decided
what's required.
These frameworks create accountability pressure. SenterME can strengthen how hospitals monitor, document, and govern the workforce conditions those frameworks care about.
Highest urgency · Effective Jan 2026
Joint Commission NPG 12
Requires a nurse staffing plan directed by the nurse executive, with staffing adequacy evaluated through performance-improvement activities and documented review at least annually.
At stake
Medicare deemed status · Accreditation · CMS reimbursement
SenterME strengthens staffing-plan oversight by giving leaders earlier visibility into organizational strain that can inform staffing adequacy review and performance-improvement analysis.
High financial impact
CMS Value-Based Purchasing / HCAHPS
Nurse work environment is strongly associated with HCAHPS performance. Under Hospital Value-Based Purchasing, participating hospitals have up to 2% of Medicare payments withheld and redistributed based on performance scores.
At stake
Millions in annual reimbursement · Public ratings · Competitive positioning
Santi gives leaders earlier visibility into nurse work environment strain associated with HCAHPS risk, before patient-experience scores make that deterioration obvious.
Strategic differentiator
ANCC Magnet Recognition Program
Evaluates transformational leadership, structural empowerment, and empirical outcomes through qualitative and quantitative documentation. Organizations must demonstrate measurable workforce and patient outcomes.
At stake
Magnet designation · Recruitment yield · Patient volume premium
SenterME can strengthen Magnet-related leadership, empowerment, and outcomes documentation by adding a longitudinal view of workforce conditions over time.
Foundational compliance
CMS Conditions of Participation §482.23
Requires hospitals to maintain organized nursing services with adequate staff to provide care to all patients as needed. Nursing services must be directed by a qualified nurse executive with documented staffing oversight.
At stake
Medicare and Medicaid participation · CMS survey standing
SenterME can support nursing-services oversight under §482.23 by giving leaders a more structured view of workforce conditions relevant to staffing review and governance.

Start with a conversation.
Not a commitment.

We'll walk through how the diagnostic works, which scope fits your health system, and what the evidence would look like for your specific structural context. No pitch deck. Just a real conversation.

Book a Demo →

Zero workflow disruption · No PHI · No individual scoring · Fully reversible · NPG 12 compliance evidence included