As an operator grows from one facility to three, then to six, the back office tends to grow in a messy way. Each location has its own billing habits, its own hiring paperwork and its own IT workarounds. Eventually someone asks whether it would be better to move these functions to a central hub, often called a shared services model.
Centralization can bring real benefits. It can also create problems that surprise leaders who treated it purely as a cost exercise. Here are the tradeoffs to weigh before you start.
In a shared services model, certain functions that were handled at each location are performed by a central team that serves all of them. Common candidates include:
Billing and accounts receivable: claims, invoicing, collections and payment posting
Accounts payable: vendor invoices and purchasing
Human resources: recruiting, onboarding, benefits administration and records
IT: helpdesk, procurement, security and account management
The facility keeps the work that must happen on site, such as direct care, admissions relationships and day-to-day management.
One process, applied the same way everywhere, makes reporting more reliable and audits easier. Comparing facilities is meaningful when they record things the same way.
A central team can include people with deep skill in billing rules, employment law or security, which a single facility could not afford to employ alone.
Software licenses, training and supervision are purchased once rather than repeated at every site.
When a business office manager is out sick, a central team can cover. At a single location, that absence can halt billing.
Separating duties, such as who enters invoices and who approves payment, is easier with a larger team. This reduces fraud risk and error.
A central biller may not know that a resident's payer changed last week. A central HR person may not understand why a unit is short-staffed. If communication is weak, the facility feels ignored.
Standard processes mean fewer exceptions. Some exceptions matter, particularly for residents and staff who need a human touch.
Moving functions during a busy period can disrupt cash flow or payroll. Mistakes in these areas are highly visible and damaging to trust.
When many facilities depend on one team and one set of systems, an outage or a departure has a larger effect. Documentation and backup staffing become essential.
A central hub holds data for many facilities. That increases the value of the target. The hub needs stronger controls, including multi-factor authentication, access limited by role, encrypted devices and tested backups.
Facility staff may feel that "corporate" is taking over. Frame the change around support, not control.
A common approach:
Start with functions that are transactional and rule-driven, such as accounts payable and payroll.
Move billing next, once processes are documented.
Keep functions that depend on local knowledge, such as recruiting for care roles, partly local, with the hub providing tools and compliance.
Treat IT as shared early, since standardization saves the most trouble.
Document current processes before moving them.
Define service levels, such as how quickly the hub responds to a facility request.
Create clear escalation paths so a problem at a facility reaches a person who can solve it.
Build a single system of record, so everyone sees the same data.
Pilot with one or two facilities before rolling out broadly.
Measure outcomes, including days in accounts receivable, time to hire, ticket response times and facility satisfaction.
Hold regular check-ins between hub leaders and facility administrators.
A hub model depends on reliable connectivity, standard devices, secure remote access, and shared systems. If each facility still runs a different network and different software, centralization becomes painful. Many operators therefore standardize IT first. Confirm that your network can support remote teams safely and that your HIPAA risk analysis covers the new data flows.
What problem are we solving, and how will we know it worked?
Which functions truly benefit from scale?
Do we have the people and systems to run a hub well?
How will facility leaders retain accountability for results?
UnityCare IT helps multi-site healthcare operators standardize networks, devices and security so shared services have a stable base. If you are considering a hub, we can help you map the technology it will need.
An outsourced IT department with proactive maintenance and one number to call.
Call or text: 405-285-3845
New customers: start@unitycareit.com
Existing customers: support@unitycareit.com
Address: UnityCare Technologies, 2524 N Broadway Ste 554, PMB 947974, Edmond, Oklahoma 73034-4172