What does it really take to turn around a struggling skilled nursing facility? In this virtual episode of Our Purpose Podcast, Hosts James Dieter, Kip Kruger and Chris Light sit down with Sheila Foster, Administrator at Richardson Nursing & Rehab (Richardson, TX), to unpack the real-world playbook behind winning managed care contracts, building census, and creating a culture that keeps staff—even in a 1-star building.

Sheila shares the leadership mindset that separates “desk administrators” from true operators: rounding, answering call lights, building trust, and training AITs with a reality check (yes…starting in housekeeping and the kitchen). Plus, she explains how she identifies hospital discharge bottlenecks, takes on higher-acuity populations (like bariatric and trach), and still controls expenses—without relying on agency.

In this episode, you’ll learn:
 • How Sheila finds “stuck” hospital patients and turns that into contracts & census
 • Why culture beats “$1 more per hour” for retention (and how she built a loyal team)
 • The staffing model shift: stop staffing by headcount—staff by acuity
 • PDPM/Medicaid realities and why reimbursement hasn’t kept up with acuity
 • Cost-saving modernization: Wi-Fi + smart TVs to eliminate cable expenses
 • How skilled nursing is evolving into a mini-hospital (and what’s next)

🎧 Listen, subscribe, and share this with an administrator who needs a turnaround blueprint.