Post-Acute & Senior Living
Skilled nursing, home health and senior living operate under the tightest regulatory scrutiny and the thinnest margins in healthcare. We work survey readiness, clinical quality and staffing economics as one problem, because in this setting they are one problem.
Three pressures, one operating model
mean annual nursing staff turnover across US nursing homes
Industry figure, not an Adelo Consulting result. Source: Gandhi, Yu & Grabowski, Health Affairs 2021 (payroll data from approx. 15,600 facilities).
In post-acute and senior living, a staffing decision is a survey decision, a survey finding is a census decision, and a census decision is a margin decision. Treating them as separate workstreams is why improvement in one so often shows up as deterioration in another.
We work them together, with leaders who have run these buildings and reviewed the litigation that follows when they are run badly.
The setting where regulatory risk and margin meet.
Capabilities in post-acute & senior living.
Survey readiness and remediation
State and federal survey preparation, plan of correction, immediate jeopardy response and Special Focus Facility recovery.
Clinical quality in post-acute
Falls, pressure injuries, weight loss and dehydration, medication management, and the documentation that evidences care delivered.
Staffing model and PBJ
Staffing model design, Payroll-Based Journal accuracy, agency reduction and the staffing standard that survives a survey.
Star rating and quality measures
Five-Star improvement across survey, staffing and quality measure domains, sequenced by achievable impact.
Census, referral and length of stay
Hospital referral relationships, admission criteria, managed care negotiation and length-of-stay management.
Risk and litigation readiness
Pre-litigation clinical review, documentation improvement, and the systems evidence that resolves or defends a claim.
Outcomes we scope engagements against.
These are the results we design toward and measure. We commit to targets in writing at the start of an engagement, and we report against them honestly — including when we miss.
We do not publish client results we cannot substantiate or attribute. Targets on this page describe engagement design, not guaranteed outcomes.
- Survey findings cleared and readiness sustained
- Star rating improvement across the domains you can move
- Staffing that meets standard without agency dependence
- Census and payer mix improved through referral relationships
- Clinical documentation that holds up in a claim
Three ways to start.
Diagnostic2–4 weeks
A focused assessment with a written finding and a ranked set of actions. Fixed fee, defined scope. Most relationships start here because it is a low-risk way to find out whether we are useful.
Sprint8–16 weeks
A defined improvement engagement against a named target — throughput, denials, turnover, survey readiness. We work alongside your team rather than around them, and we transfer the method as we go.
Embedded6–18 months
Interim leadership or sustained transformation support. Our leader carries real accountability in your operating structure, with a written mandate and measurable commitments.
Frequently engaged by
Engagements rarely stay in one service line.
Talk to us about post-acute & senior living.
Start with a short diagnostic. Fixed fee, a written finding, and a ranked set of actions you own whether or not you work with us again.