For CMS GUIDE Programs
Working care-navigation operations plus a proposed evidence layer for programs that need to know whether intended care was actually delivered.
Design-partner validation · not a live product claim
Start with one care pathway and one costly evidence question.
We propose linking versioned pathway rules to source records, surfacing supported, missing, contradictory, and indeterminate components, and requiring qualified human review. The compiler will be built only if programs validate the problem and a clinical-methodology partner approves the measurement approach.
Nine Required Domains
The CMS GUIDE Model requires nine care delivery domains. GentleNext tracks workflows across all nine today. Maturity labels below are honest about what ships versus what still needs partner validation.
Comprehensive Assessment
In productBuilt-in caregiver-burden (ZBI) and dementia-staging (CDR/FAST) assessments, plus guided intake flows.
Care Planning
In productPerson-centered plans with 'Next Step' family views after navigator publish.
24/7 Access
In productHuman-staffed helpline routing and escalation. Programs attest the helpline is human-staffed; AI does not resolve urgent contacts.
Ongoing Monitoring
In productTier-based cadence tracking, overdue flags, and home-visit status on the caseload.
Care Coordination
In productSecure messaging and task management between navigator and family.
Respite
In productTracks respite utilization against the annual benefit cap and records G-codes on utilization.
Medication Management
In productFlags high-risk medication names from a curated token list and supports visit-level reconciliation. Not a full Beers-criteria engine.
Caregiver Education
In productNavigator-delivered support and training-domain coverage in navigator CE / training records.
Social Needs
In productStandardized HRSN screening with community resource referral, including semantic resource search.
Built to validate before scaling
The first engagement should be an 8–12 week paid design-partner pilot, not a platform replacement. Our tenant-scoped architecture can support later expansion, but PHI work remains blocked until required agreements, controls, and partner approvals are complete.
Interoperability
SMART-on-FHIR import/export is scaffolded in the platform and ready for partner sandbox validation. Initial pilots can operate standalone or with CSV-based data import. Bulk reporting export for CMS is available from the navigator reports surface.