COO, Skilled Nursing Operations Leader

Legacy Healthcare; Oklahoma City (OK); On-site; USD 150,000 - 230,000; Full time

Job summary

Legacy Healthcare seeks a hands-on Chief Operating Officer (COO) to lead seven skilled nursing facilities. The role combines operations, clinical performance, and financial stewardship to drive census growth, quality, and profitability.

The COO will partner with Administrators, DONs, and leadership teams, setting clear standards, monitoring performance, and implementing turnaround plans where needed. A strong healthcare operations background and willingness to spend time on-site are essential.

Qualifications

• Significant experience in skilled nursing, post-acute care, long-term care, or a closely related healthcare environment.
• Demonstrated experience managing multiple facilities, departments, or complex healthcare operations.
• Strong understanding of SNF operations, staffing, census, reimbursement, quality, and regulatory requirements.
• Strong financial and analytical skills with the ability to understand and manage facility-level P&Ls.
• Proven ability to improve operational and financial performance.
• Strong leadership and communication skills.
• Ability to hold senior leaders accountable while developing and supporting them.
• Willingness to spend meaningful time in the facilities rather than managing exclusively from a corporate office.

Responsibilities

• Provide leadership and accountability for all seven facilities.
• Partner with and hold Administrators, DONs, and facility leadership teams accountable for results.
• Establish clear operating standards and consistent expectations across the portfolio.
• Monitor facility performance through regular operational and financial reviews.
• Drive census growth, occupancy, admissions, and referral development.
• Manage labor costs, staffing levels, overtime, agency utilization, and productivity.
• Review facility P&Ls and identify opportunities to improve revenue, margins, and operating performance.
• Monitor key financial and operational metrics and translate data into action.
• Identify underperforming facilities and develop specific turnaround plans.
• Ensure facilities maintain strong clinical, quality, and regulatory performance.
• Maintain survey readiness and ensure deficiencies are addressed quickly and effectively.
• Monitor rehospitalizations, quality measures, Five-Star performance, and other key clinical indicators.
• Support recruitment and retention of strong Administrators, DONs, nursing leaders, and other key personnel.
• Develop facility leaders and build a strong management pipeline.
• Work closely with ownership on budgets, forecasts, capital needs, strategic initiatives, and growth opportunities.
• Identify opportunities to improve systems, processes, purchasing, vendor relationships, and overall efficiency.
• Ensure accountability through regular facility visits, meetings, dashboards, and performance reviews.
• Create a culture of ownership, accountability, urgency, and continuous improvement.

Skills

Hands-on

Analytical

Accountable

Commercially minded

Operationally strong

Education

Bachelor's degree preferred

Advanced degree in healthcare administration/finance

LNHA license preferred

Job description

Legacy Healthcare seeks a hands-on Chief Operating Officer (COO) to lead seven skilled nursing facilities. The role combines operations, clinical performance, and financial stewardship to drive census growth, quality, and profitability.

The COO will partner with Administrators, DONs, and leadership teams, setting clear standards, monitoring performance, and implementing turnaround plans where needed. A strong healthcare operations background and willingness to spend time on-site are essential.