Skilled nursing & assisted living support for the Black Hills
Better care for our residents.
Stronger numbers for your building.
Clinical resource support — delivered as a hybrid partnership built around your building's outcomes: cleaner admissions, fewer avoidable hospital trips, and a monthly read on the metrics that drive your survey, your star rating, and your reimbursement.
Every outcome we work toward will deliver a better quality-of-care your residents will feel first. But, they're also the levers that move your survey, star rating, census, and your bottom line.
Why this area
This is the work I was made for, in a place I love.
I love the Black Hills — the ponderosa pines, the granite hills, the wide skies, and the way people still wave when they pass you on a gravel road. There is a deep respect for country and community here that you feel in the streets, the shops, and the parks.
Rapid City is growing fast — and the senior population is growing faster than both the state and national averages. That is not a statistic to me; it is a call to action. I have dedicated my career to caring for our nation's seniors, and this is one of the best places in the country to do that work.
Source: U.S. Census Bureau population estimates.
Your residents are not numbers. They are the people who built this town, raised their families here, and many who defended this country. I want to help your building care for them the way they deserve.
— JayLee McGary, RN, BSN, DNP Student
Three outcomes I work toward
What we measure, and why it matters:
Cleaner admissions and transfers in
Care
Tight handoff with the sending hospital or community, paperwork that follows the resident, and a receiving team set up to succeed from day one.
Bottom line
Shorter time-to-stable, fewer early returns to the ED, protected PDPM / Medicaid case-mix accuracy from day one.
Fewer avoidable hospital trips
Care
Early-warning rounds, medication reconciliation, condition-specific monitoring (CHF, COPD, sepsis, UTI), and residents kept in your building when it's safe to keep them.
Bottom line
30-day return-to-hospital rate drives your survey, star rating, payer contracts, and referral position. For AL: judged by appropriate vs avoidable escalation within licensed-nurse scope.
Transparent quality-measures tracking
Care
A monthly dashboard your leadership team actually uses — falls, pressure injuries, antipsychotic use, infection trends, return-to-hospital, star-rating trajectory (SNF) or state-survey leading indicators (AL).
Bottom line
Catch trends before the survey does, defend the metrics that drive reimbursement, and show referral sources a real number instead of a story.
The RENEW™ Method
The framework we'll follow:
Every partnership runs on RENEW™ — my proprietary five-phase framework.
Comprehensive assessment for clarity — observe all angles to understand the current state and identify areas for improvement.
Unified team collaboration — build strong connections with the team to foster alignment and drive success.
Strategic direction and priorities — set the course so the team knows what matters most.
Effective implementation — put plans into action efficiently, empowering people and driving meaningful results.
Measure what matters — sustain momentum and keep the facility on track for long-term success.
How I help
6 areas of clinical focus:
State Preparedness
Walk into survey week ready — not reactive.
- ·Mock survey & gap analysis
- ·Tag-by-tag remediation plans
- ·Staff drills and binder readiness
Star Rating Improvement
A measurable plan to move the needle on CMS metrics.
- ·Quality measure deep-dive
- ·Staffing & survey domain strategy
- ·Quarterly improvement roadmap
In-Servicing & Training
Evidence-based education built for the realities of long-term care.
- ·Geriatric physiology
- ·Skin, falls, infection control
- ·Customized curriculum
QAPI / QA Review
QAPI programs that actually move outcomes — not just paperwork.
- ·Committee structure & cadence
- ·PIP design & tracking
- ·Root-cause coaching
Policy & Procedure
Creation and revision of clinical policy that holds up under scrutiny.
- ·New policy authoring
- ·Annual revision cycles
- ·Regulatory alignment
DON / DNS Support
Experienced backup for the hardest seat in the building.
- ·New-leader mentorship
- ·Interim coverage
- ·Executive clinical advisory
Most Black Hills partnerships pull from several of these. We scope which ones matter most for your building during the discovery call.
Who this is for
Built for 2 kinds of buildings:
Skilled nursing facilities
For Admins and DONs
You want a seasoned clinical partner working the metrics every week — not every quarter — without putting someone new in the DON chair.
Assisted living communities
For Executive Directors & HWDs
You want a nurse leader for process decisions, staff training, and the state-specific regs that catch buildings off-guard.
Scope flexes to your acuity, your survey window, and the outcomes you most want to move.
How the partnership runs each month
On-site. On-call. On-track.
01
1 full on-site day per month
I'm in your building once a month — chart spot-checks, floor walk, leadership working session.
02
Weekly leadership call
A standing call with your leadership team (Admin/DON/ADON for SNF; ED/HWD for AL). We work the metrics and don't let anything quietly drift.
03
Email access through the business day
Every day a DON or wellness director would be working — questions, document review, escalation, second opinions.
04
Monthly outcomes report
Tied to the three outcomes above, with both clinical and financial-impact framing — so the whole leadership team sees the same picture.
Not an interim DON / not your wellness director
Here's what this is — and what it isn't:
You get experienced clinical leadership on the same questions a DON would face — at a fraction of the cost of a full interim seat.
This isn't a seat on your org chart. It's a standing clinical partner your leadership team can pull on the same days a DON would be working — for the same questions, documents, and escalation calls — while the work, the seat, and the credit stay with your team.
Why local matters
Local means in your building, not on a screen.
Real on-site presence — your monthly day is actually on the floor, no travel padding on your invoice, and the ability to flex up to an on-site intensive during a survey week without waiting on flights. Based in the Black Hills, in your building when it matters.
Travel radius
Rapid City & the surrounding hills.
Rapid City, Spearfish, Sturgis, Hot Springs, Custer, and the surrounding communities. A bit further out? Ask — if the fit is right, I'll travel for it.
Built around your building
Scoped together, priced per facility, 6-month initial term billed monthly.
- →SNF, AL, or memory care — scope flexes to your acuity and your pain points.
- →Pricing is per-facility. I send a clear monthly proposal after our scoping call.
- →6-month initial term to give the work room to land, then a 12-month renewal — billed monthly throughout.
About me
JayLee McGary, RN, BSN, DNP Student.
Clinical and Operational Leadership in Skilled Nursing, Based in the Black Hills
FAQ
Quick answers.
Which outcomes can you actually move, and how fast?
The fastest wins usually come from admissions process and early-warning rounds — you can see a shift in return-to-hospital and time-to-stable inside the first 60–90 days. QAPI maturity and star-rating trajectory are 6–12 month moves. I'll be honest on the discovery call about what's realistic for your building.
Do better quality measures really change our reimbursement?
Yes — directly and indirectly. 5-star drives your payer contracts and your network position with the hospitals upstream. Avoided citations protect you from F-tags that gate certain admissions. Lower return-to-hospital rates make you the preferred discharge partner. Clean admissions protect your PDPM / Medicaid case-mix from day one.
Can you take the lead on a POC submission?
Yes — when I've been involved in the building and the facts. I'll write a POC that's accurate, accepted on first submission, and actually doable by your team. I'll also stay involved long enough to confirm it's implemented, not just filed.
Will you run a full mock survey?
Yes — a one-day single department mock survey visit fits inside the hybrid partnership one day on-site visit. If your building needs a deeper multi-day mock survey (2–4 days), that becomes a separate on-site intensive engagement so we can give it the full scope it deserves.
Do you work with assisted living too, or just skilled nursing?
Both. The scope shifts — for AL it's process review and decisions, staff training, and state-specific regs — but the partnership shape is the same.
Are you our DON or our wellness director?
No. I'm available the same days they would be — for the same questions, documents, escalation calls — but the work, the seat, and the credit stay with your team. If your building actually needs an interim or a new hire, I'll help in the interview process.
How is this different from hiring an interim DON?
An interim sits in the chair every day and carries the full cost and risk of the role. I operate as a standing clinical partner — one on-site day per month, weekly leadership calls, and email access through the business day — so your team keeps the seat and the credit while still getting experienced clinical leadership at a fraction of the cost.
Do you actually live in the Black Hills?
Yes. For years, I've traveled throughout the country but always return to Rapid City. Now I'm setting up shop here. That means your monthly on-site day is real, windshield time isn't built into your invoice, and I can bump you up to a true on-site intensive during a survey week without flying in.
How far do you travel?
Rapid City, Spearfish, Sturgis, Hot Springs, Custer, and surrounding communities. If you're a bit further out, ask — if the fit is right, I'll travel for it.
Will you sign an NDA before we share building info?
Yes. Before any real facility detail changes hands.
What does the commitment look like?
A 6-month initial term to give the work room to land, then a 12-month renewal. Billed monthly throughout — no annual prepay.
Let's talk
Let's see if this is the right fit.
Tell me what's going on in your building and what you're hoping to move. I'll read it personally and reach out to schedule a real conversation to see if this makes sense for your team.
Inquire about the hybrid partnership
Tell me about your facility.
I personally review every request and will respond as soon as I can. The more specific you can be, the faster I can help.