The situation plays itself out hundreds of times a year in skilled nursing and senior living communities. Organizations struggle to secure leadership to provide local oversight of day-to-day operations and frequently settle for patchwork approaches that fill gaps, but don’t drive sustained positive quality and financial outcomes. Then it happens, the regulatory survey that everyone knew was coming leaves in its wake massive civil monetary penalties and the threat of denial of payment for new admissions. All resources are redirected at implementing a plan of correction with all attention diverted from running an efficient, financially sustainable business. The senior living community is thrust into financial decline. Staffing and non-staffing discretionary spending is not adequately monitored, with the false assumption that the more you throw at the problem, the better your chance of extricating yourself from the situation. Sound familiar?


How HDG Brought Operational Stability and Financial Success to a Client’s Retirement Community

Hope should not be lost in these situations. Health Dimensions Group (HDG) helps organizations experiencing these challenges find harbors of safety and future operational success. Recently, HDG was engaged by a large social services organization that was looking to exit the senior care services sector, but found itself struggling to improve operational and financial performance at one of its senior communities. The solution was securing HDG to provide interim operational and clinical leadership and campus oversight directed at stabilizing the operations and repositioning the business to bring optimal valuation for future divestiture.

Within the first three weeks of HDG’s oversight, the skilled nursing facility of the continuing care retirement community (CCRC) underwent its annual inspection by the state’s Department of Aging and Disability Services. During that period, HDG consultants implemented corrective measures which resulted in survey outcomes of just six low-level citations—fewer than the state’s average. Over a period of six months, HDG made significant strides in improving the financial and nonfinancial aspects of the operation. These successes included a 25 percent increase in the skilled nursing facility’s occupancy and a three-fold increase in Medicare/managed care payor mix, in addition to significant improvements in the accuracy and timeliness of the completion and submission of minimum data set (MDS) records. Subsequent annual surveys in both the skilled nursing and the assisted living facilities were deficiency-free under HDG’s oversight.

Throughout the engagement, HDG was a trusted advisor and operating partner with the campus’s parent organization, resulting in significant operational and financial improvements at the CCRC. Following the operational turnaround completed by HDG, the client sold the real property to a real estate investment trust (REIT), which, in turn, entered into a long-term lease of the campus to an HDG-affiliated organization, with HDG continuing to provide management and oversight.


What Our Client Says

At the conclusion of the engagement, the parent organization’s CEO commented, “We wanted to stabilize the community, to improve census, and to improve our financial results. HDG provided value to all three of those objectives. We saw it in the survey results, in the resident and employee satisfaction surveys, and in the bids that we received for the campus when we subsequently put it back on the market. What we appreciated about HDG was how responsive they were to our needs throughout the whole engagement. We would highly recommend HDG to any organization in need of operational turnaround and to those contemplating whether to engage a management company.”


How HDG Can Help Your Organization

Health Dimensions Group is an experienced partner in operational assessments, performance improvement, and turnaround management. For more information on Health Dimensions Group’s services, check out

Authored by Darrin W. Hull, SVP, Consulting Services, Health Dimensions Group, 763.537.5700,