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Insights

Operating notes from inside the building.

Short, practical pieces on the situations we are called into — survey findings, staffing ratings, leadership gaps, census and margin. Written by people who have had to fix them, not summarized from a trade publication.

Survey · October 28, 2026 · 7 min read

Immediate jeopardy: what has to happen in the first 72 hours

An immediate jeopardy citation starts a clock measured in days, not weeks. The sequence that removes the finding fastest, and the mistakes that extend it.

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CMS · October 22, 2026 · 8 min read

What actually moves your Five-Star staffing rating

The staffing domain is driven by payroll data you already submit. Why the raw hours-per-resident-day number is not the rating, and the handful of levers that change it.

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Census · October 15, 2026 · 7 min read

Census recovery is an operations problem before it is a marketing problem

When occupancy slides, most operators buy leads. The inquiry-to-move-in path usually breaks in the building, not in the ad budget.

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Survey · July 21, 2026 · 5 min read

Writing a plan of correction that holds

What makes a plan of correction accepted, and what makes it survive the revisit.

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Leadership · July 21, 2026 · 5 min read

The real cost of an executive director vacancy

What an open ED seat costs a community each month it stays open.

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Finance · July 21, 2026 · 5 min read

Where assisted living margin actually erodes

Margin rarely disappears in one line. Where it leaks, and how to find it.

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