EP 19 - How a 1-Star Facility Won Contracts, Census & Culture—Sheila Foster

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.