I’ve talked to a lot of hospice operators who hit 80 census and immediately start thinking about who to hire. The logic is understandable: you’re growing, things are getting complicated, and you need someone in the building who owns operations. So you post a job for a VP of Operations, budget $120,000 to $160,000 in base salary, and start interviewing.
Here’s what usually happens: the hire takes three to four months. The person you bring on is good, but they spend the first ninety days learning your specific operation before they can make any real changes. You’ve spent close to $50,000 in salary before you’ve seen a single meaningful improvement. And if it doesn’t work out — if the fit is wrong or the person doesn’t have the specific hospice experience you actually needed — you’re back to square one, nine months and a lot of money later.
Fractional operations works differently. Instead of betting on one person who may or may not have the exact expertise your operation needs right now, you get a team that’s already been through the problems you’re facing. We’ve managed survey prep at twenty agencies. We’ve rebuilt referral systems from scratch. We’ve worked through billing audits, leadership transitions, and accreditation cycles. That experience doesn’t take ninety days to access — it’s available from day one.
What Fractional Actually Looks Like
The misconception about fractional work is that you get someone part-time who’s distracted by other clients. That’s not how we operate at Solvr. When we embed with an agency, we’re running specific initiatives — not just advising from a distance.
Practically speaking, that means we’re in your systems. We’re attending your IDT meetings, reviewing your cost reports, rebuilding your intake process. The work gets done. You’re not paying for strategy sessions that leave you with a slide deck and no execution.
For a 100-census agency, a fractional engagement typically runs a fraction of what a full-time hire would cost — with no benefits, no employer taxes, no hiring risk, and no ramp time. And when the specific initiative is complete, you’re not carrying a fixed salary through a slow quarter.
When It Makes Sense to Hire
I want to be honest here. Fractional operations isn’t the answer for every situation. If you’re at 300-plus census and need someone in the building forty hours a week with institutional knowledge that compounds over years, a full-time hire starts to make more sense.
But most independent hospice agencies in the 30 to 200 census range aren’t there yet. They need senior operational capability they can afford, focused on the problems that actually matter right now — not a generalist who’s learning the business on your dime.
The agencies I’ve seen use fractional ops most effectively treat it like what it is: a targeted tool. They bring in fractional support to solve a specific problem, build the infrastructure, and then either hand it off to existing staff or decide at that point whether the growth trajectory justifies a full-time hire.
That’s a much better way to grow than hoping your next hire is the right one.