Joshua Hoes

Healthcare Operations leader currently seeking an opportunity in the Knoxville Tennessee Region. Servant-minded healthcare executive with leadership experience spanning skilled nursing, assisted living, memory care, and Life Plan communities. Passionate about building cultures centered on accountability, compassion, operational excellence, and resident-centered care.

Proven history of improving CMS ratings, increasing occupancy, enhancing clinical quality, and leading teams through complex operational challenges. Brings a hands-on leadership style, strong regulatory knowledge, and a commitment to developing people, systems, and sustainable organizational success.

Executive Director/Administrator (NHA) at Diversicare of Oak Ridge SNF (2026-07 – Present)

• Executive Leadership responsibility for a SNF licensed for 120 beds
• Manage over 60 staff
• In two months, increased ADC from 84 overall and 18 Skilled Mix to ADC 92 overall and 24 Skilled Mix
• Increased Quality Measures from 3 star to 4 star
• Successfully led the team through their first Recertification Survey in three years resulting in an over 50% decrease in tags

Interim Health Services Administrator- Contract at Ventana By Buckner, CCRC (2026-03 – 2026-06)

• Direct operations of Assisted Living and a Skilled Nursing Facility in a Life Plan Community
• Oversaw License Recertification survey with Zero Tag Life Safety and only 3 Minor Health Survey citations
• Oversaw coordination and transition of new therapy management company
• Ventana SNF achieved Best in America Nursing Home in both News Week Magazine and US News publication
• Improved occupancy from 84% to 98% overall in Skilled Nursing
• Increased daily occupancy in Skilled Nursing by 10%

Executive Director/Administrator (NHA) at San Remo- Cantex Continuing Care Network (2025-09 – 2026-03)

• Executive Leadership responsibility for a SNF licensed for 112 beds
• Manage over 90 staff
• Increased in 4 months ADC from 83 overall and 23 Skilled Mix in Sept 2025 to ADC 102 overall and 42 Skilled Mix by Feb 2026
• Initiated New Contracts with new ACO due to increase Overall CMS rating
• Enhanced CMS rating from Three Star to Four Star overall in first 4 months, and achieved Five Star QM rating by April 2026
• Added new Pulmonary, Cardiology and Renal programs to increase Acuity capabilities

Executive Director at Autumn Leaves- Life Care Services, CCRC (2023-09 – 2025-09)

• Direct operations of Independent Living, Assisted Living and a Skilled Nursing Facility in a Life Plan Community
• Improved Quality Measures from a Four Star to a Five Star and overall rating from a Two star to a Five Star CMS rating.
• Achieved Best in America Nursing Home in both News Week Magazine and US News publication
• Achieved Best In Senior Living in News Week Magazine and US News publication for our Independent and Assisted Living
• Improved occupancy from 86% to 98% overall in both Independent and Assistant Living
• Increased daily occupancy in Skilled Nursing by 35%

Executive Director (NHA) at Le Reve Rehabilitation and Memory Care (2022-07 – 2023-07)

• Direct operations for senior living community comprised of 108 SNF beds and 40 MC Assisted Living units
• Increased monthly revenue from $220K to $500K in first 12 months
• Increased SNF occupancy from 26 to 53 in 12 months for new facility opened during peak COVID
• Increased skilled census from 7 ADC to 16 ADC, including managed care and Medicare
• Hired new internal Admissions Director
• Recruited and hired Director of Nursing with transitional care (TCU) background
• Improved Quality Measure score from Three Star to Four Star
• Reduced agency cost from average $15K monthly to $0 in first three months; revamped hiring process
• Partnered with pulmonary, nephrology, and cardio specialists to execute medical rounds
• Reduced internal pressure ulcers and psychotropic med utilization
• Achieved zero Nursing tags on annual survey and two life safety tags (without Maintenance support)
• Initiated Assisted Living program opening and regulatory approval
• Manage Human Resources function, executed Maintenance duties due to hiring limitations

Administrator (NHA), Christian Care Center at Christian Care Communities, CCRC Mesquite (2019-07 – 2022-06)

• Executive Leadership responsibility for a SNF licensed for 180 beds, operating 120
• Manage over 120 staff
• Increased ADC from 75 patients in Jul 2019 to 95 prior to COVID outbreak in Nov 2020
• Initiated 30-bed COVID unit, increased census to high of 105 (87.5%)
• Maintained ADC between 85 and 105 during pandemic
• Enhanced CMS rating from Two Star to Four Star in first 6 months, achieved Five Star QM rating
• Achieved deficiency-free Infection Control surveys throughout three-year tenure
• Reduced monthly agency cost by 50% between July 2019 and August 2021 despite COVID challenges
• Laid off following acquisition of CCC parent company by Boncrest Resource Group in May 2022

Administrator (NHA) at Stockdale Nursing & Rehab (2018-03 – 2019-07)

• Served as operations leader for 67-bed rural, privately-owned SNF. Since closed
• Adjusted budget to produce average monthly savings of $25K
• Increased occupancy from ADC of 22 to 27
• Managed staff of 30 associates
• Executed all Business Office functions including A/R, A/P, trust fund management, and Medicaid submissions
• Managed patient admissions and records
• Directed kitchen for six months covering vacant department head position

Administrator-in-Training, Trinity Terrace, CCRC, Fort Worth, TX at Pacific Retirement Services (2017-05 – 2017-11)

• Completed 1,000-hour training in Life Plan community’s 52-bed healthcare center
• Implemented new, profitable Central Supply system
• Evaluated, analyzed, and implemented new hire policies to boost morale and reduce turnover
• Conducted daily rounds
• Contributed to state survey preparation, provided documentation and wrote plan of correction
• Participated in management discussion during new build of MC, Assisted Living and rehab/SNF addition

College & Youth Ministry Leader at DFW Church (2011 – 2016)

• Ministered to youth and their families through weekly devotionals and other programs
• Recruited, trained and nurtured Youth Ministry volunteer teams

Assistant Service Manager at H-E-B | Central Market (1999 – 2011)

• Coached, developed, and trained Partners while role modeling superior customer service
• Managed Partner HR decisions

Nursing Home Administration – Tarrant County College (2017-05)

Bachelors in Agribusiness – Texas A&M, College Station (2005-05)