Dorothy is AI-powered incident documentation for skilled nursing facilities and assisted living communities. Nurses describe what happened and Dorothy creates complete, structured documentation posted directly to PointClickCare.

Does Dorothy integrate with PointClickCare?

Yes. Dorothy integrates with PointClickCare to sync incident documentation. Additional EHR integrations are on the roadmap.

How fast is incident documentation with Dorothy?

Most incidents can be documented in about 30 seconds. Dorothy prompts for any missing details so the final report is complete every time.

What does Dorothy generate?

Dorothy generates content for the incident report, a PointClickCare progress note and document, CMS-aligned follow-up action steps, and family communication templates — all from a short voice or text description of what happened.

Is Dorothy medical advice?

No. Dorothy supports documentation and response planning. Follow your clinical protocols and local policies.

Is Dorothy HIPAA compliant?

Dorothy is HIPAA-aligned and signs Business Associate Agreements with all customer organizations. The platform is designed to minimize PHI exposure in the AI layer.

Do we need to install anything?

No. Dorothy runs in a web browser on any phone, tablet, or desktop. No installation, no IT project required.

How much does Dorothy cost?

Dorothy is $299 per facility per month. Flat rate — no per-user fees, no per-incident fees. Unlimited staff, unlimited incidents.

What Is F-Tag F0689? Documentation Requirements for Skilled Nursing Facilities

If your skilled nursing facility has ever received a citation related to resident falls, accidents, or inadequate supervision, F0689 was likely on the citation. It's one of the most commonly cited F-tags in skilled nursing — and much of what surveyors evaluate under F0689 comes down to documentation.

What F0689 Requires

F0689 — Free from Accident Hazards/Adequate Supervision/Assistive Devices — requires that each resident receives adequate supervision and assistance devices to prevent accidents. The regulation covers two primary obligations:

Environment: The facility must ensure the environment is as free from accident hazards as is possible.
Supervision: Each resident must receive adequate supervision and assistive devices to prevent accidents.

What makes F0689 challenging isn't the standard itself — it's that surveyors evaluate compliance through documentation. They look at your incident records to determine whether your facility identified risks, took appropriate precautions, and responded appropriately when accidents occurred.

What Surveyors Evaluate in Incident Documentation

When a surveyor reviews an incident under F0689, they're looking for a specific documentary record that tells a complete story. That record should include:

Time and circumstances of the incident: When did it happen? What was the resident doing? What were the environmental conditions at the time?
Immediate interventions: What did staff do immediately after the incident? Was the resident assessed for injury? Was a physician notified?
Witness information: Who discovered or witnessed the incident? Was another staff member present?
Resident response: How did the resident respond immediately following the incident? What was their condition?
Follow-up actions: What monitoring was initiated? Was the care plan updated? Was family notified? Was a risk reassessment completed?
Root cause analysis: Was the contributing factors assessed? Were environmental or care plan changes made in response?

A note that says "resident was found on the floor" is not documentation under F0689. Surveyors want to see evidence that the facility responded appropriately, investigated contributing factors, and took steps to prevent recurrence.

Common F0689 Deficiency Patterns

The deficiency patterns that lead to F0689 citations are remarkably consistent across facilities:

Missing environmental assessments

Facilities frequently document that an incident occurred but fail to document the environmental factors at the time — lighting conditions, floor surface, whether assistive devices were in place, whether the call light was within reach. Without this information, surveyors cannot evaluate whether the environment was adequately safe.

Incomplete post-incident follow-up

The incident is noted, but the follow-up record is thin or absent. No monitoring schedule. No documentation of the post-incident assessment. No evidence that the care plan was reviewed or updated. Follow-up documentation is where many facilities get cited with F0689.

Inconsistent documentation between shifts

Day shift incidents receive thorough documentation from experienced staff; night shift incidents get two sentences from a nurse who's managing six other things. Surveyors notice this pattern and it raises questions about the facility's documentation systems and quality oversight.

Delayed documentation

Reports written at the end of a shift — or the next day — are less credible than documentation created right after the incident. Details fade, timing becomes approximate, and the documentary record suggests the incident wasn't treated with the urgency it deserved. Surveyors prefer records that show documentation happened close to the time of the incident.

No documented risk reassessment

After a fall or accident, the resident's fall risk assessment should be reviewed. If it was updated, that update should be in the record. If it wasn't updated, there should be documentation explaining why no change was warranted. A pattern of incidents without subsequent risk reassessment is a clear F0689 deficiency.

Practical Steps to Strengthen F0689 Documentation

Document immediately, not end-of-shift

The single most impactful change most facilities can make is moving incident documentation from end-of-shift to immediately after the incident. Documentation that happens within minutes is more accurate, more complete, and more credible than documentation that happens hours later. This is easier said than done, but tools that let nurses document by voice — while walking away from the incident — make immediate documentation practical.

Use a structured documentation template

Relying on individual staff to remember all required documentation elements leads to variation. A structured approach — whether a form, a prompt list, or an AI tool — ensures every report covers the same elements regardless of who's documenting.

Document follow-up as a discrete step

Treat follow-up documentation as a separate required step, not an optional addition. Every incident should generate a documented monitoring plan, progress note, and care plan review — and those should be in the system before the end of the shift.

Train on specifics, not just compliance

Documentation training often covers what to document in general terms. More effective training walks staff through what surveyors specifically look for — including the environmental factors, the timing requirements, and the follow-up obligations that commonly lead to F0689 citations.

How Dorothy Helps With F0689 Documentation

Dorothy is AI-powered incident documentation software that addresses the common F0689 deficiency patterns structurally, not through additional training. When a nurse describes an incident — by voice or text — Dorothy produces a complete, structured report that includes the elements surveyors look for: environmental conditions, immediate interventions, witness information, resident response, and follow-up actions.

Because documentation happens immediately (not end-of-shift) and produces a consistent output regardless of who's documenting, the inconsistency pattern that underlies many F0689 citations disappears from the record. Documentation posts directly to PointClickCare, so there is no delay.