Senior living facilities should structure a 90-day onboarding plan for executives in three focused phases: learning, planning, and executing.

• Days 1–30: Learn and observe — meet department heads, review compliance protocols, understand culture, and assess facility operations.
• Days 31–60: Plan and contribute — set short-term goals, identify key metrics, find quick wins, and align strategies with staff and resident needs.
• Days 61–90: Execute and lead — implement initiatives, track progress, report early results, and take full ownership of leadership duties.

Effective onboarding also integrates compliance training, cultural immersion, and clear performance metrics to ensure stability and success. Facilities that follow this structure improve executive retention, strengthen compliance, and maintain continuity in resident care.

When executives step in on their first day at a senior care facility, a figurative stopwatch turns on. Within a small window of time, executives must not only master the facility’s operational complexity, but they must also pave a path forward for the facility to improve. 

Because of the pressure involved, it’s crucial to set executives up for success by creating a seamless onboarding process. The more efficient it is, the faster executives will be able to grasp regulatory nuances, staff dynamics, and resident care priorities, driving meaningful results. If you’re about to hire a new executive for your senior living facility executive team, there is no better time than to revamp your onboarding process. Use this guide to find out why the onboarding process is so vital, and what a high-grade onboarding program looks like.

The High Stakes of Executive Transitions in Senior Care

Because so many stakeholders rely on senior living facilities — from staff members and residents to family members — executives have the potential to impact its vast ecosystem. When a new executive steps in, they need to meet compliance requirements, make operational decisions, and maintain staff morale. For residents and families, any disruption in leadership due to improper onboarding can translate into changes in communication, quality of care, and overall satisfaction.

To minimize any disruptions in leadership or operations during the onboarding process, senior care organizations may want to first seek out an interim solution and focus on creating a structured onboarding process that empowers incoming executives to hit the ground running. This entails clearly defining expectations, facilitating access to key stakeholders, and transferring institutional knowledge efficiently. Without these supports, even the most experienced leaders can struggle to adapt to the complex regulatory environment and cultural nuances unique to senior care.

When these facilities onboard correctly, they shorten the learning curve, allowing executives to improve facilities for the better by implementing their own positive changes to the organization. 

How To Structure a 90-Day Executive Onboarding Plan

The first 90 days in a senior care leadership role often determine an executive’s long-term success. This period sets the tone for how well they integrate into the organization, build trust with staff, and begin driving measurable improvements. An onboarding program structured around this timeframe can give executives the roadmap they need to meet milestones, stay accountable, and foster momentum from day one. 

In essence, we can break down a 90-day executive onboarding plan into three different phases: orientation and relationship-building, strategic alignment, and implementation and accountability.

Phase 1: Days 1-30 — Learning and Observing

Facilities should devote the first month of onboarding to immersion. During this phase, the executive’s primary focus is on listening, observing, and learning the rhythms of the organization. This may include:

-Meeting department heads;
-Reviewing compliance documents;
-Familiarizing themselves with different departments’ operations;
-Touring communities / facilities.

This is also the time to understand the mission, values, and culture that guide every decision in senior care. By emphasizing understanding over action, leaders gain the context they need to make thoughtful, lasting improvements.

Phase 2: Days 31-60 — Planning and Contributing

Once executives have a basic understanding of the facility, they can start actively participating and contributing to their work.  The executive should begin setting short-term goals and identifying operational priorities while continuing to build relationships across teams. Shadowing clinical and administrative processes can uncover both challenges and opportunities, allowing leaders to pinpoint “quick wins” that inspire confidence across the organization. By the end of this phase, a new executive should have a clear strategic plan for their next 30 days and beyond.

Phase 3: Days 61-90 — Executing and Leading

The final phase is where observation and planning give way to action. The executive begins implementing early initiatives, tracking progress, and assessing outcomes against established goals. This is also the time to present an early impact report to the board or leadership team, demonstrating both momentum and alignment with the organization’s long-term objectives. By day 90, an effective leader will have moved from orientation to ownership, positioning the organization for stronger performance and continued stability.

The Key Elements of Executive Onboarding

Each onboarding program may differ. After all, each senior care organization has its individual differences, and so should every executive’s responsibilities. However, all executive onboarding programs should complete the following objectives:

Align New Executives with Compliance and Regulatory Requirements

Senior care executives operate in one of the most tightly regulated industries in the country. From state-level health codes to federal oversight by CMS, OSHA, and HIPAA, the compliance landscape can be complex and constantly evolving. A misstep early on can result in penalties, reputational harm, or compromised resident care.

This is why compliance training is such an essential asset in an onboarding program. Facilities can integrate it with several different strategies, including guided reviews of state inspection protocols, documentation standards, and quality-of-care regulations. Facilities can also pair new executives with compliance officers during their first weeks, which can help contextualize policies and demonstrate how regulatory standards are applied day-to-day.

Ongoing reinforcement is equally essential. Schedule regular check-ins with compliance personnel, and participate in at least one internal audit during the first quarter to help new executives foster a proactive approach to maintaining compliance.

Integrate Executives into the Organizational Culture

Senior living communities thrive on relationships — between staff, residents, and families — and leaders who immerse themselves in that environment.

To promote cultural integration, onboarding should include opportunities for connection. Schedule department-wide introductions, encourage participation in leadership retreats, and prioritize visibility on the floor. When executives spend time interacting with residents, staff, and families, they gain a deeper understanding of the community’s values and needs.

Set Clear Early Performance Metrics 

The best way to increase transparency between executives and HR departments during onboarding is to establish what metrics they will be measuring. These performance metrics should encompass operational, financial, and cultural goals that reflect both short-term priorities and long-term vision. For example, some concrete metrics could include:

• Staff turnover rates;
• Compliance audit scores;
• Occupancy growth
• Resident and staff satisfaction surveys.

Evaluating these metrics during the first 90 days and regularly thereafter can help keep executives accountable while providing a space for constructive growth. Whenever HR teams start the onboarding process, they should be transparent with executives about these metrics so executives have something to strive toward. 

The Benefits of Effective Executive Onboarding

When senior care organizations prioritize creating a smooth onboarding process that includes the aforementioned objectives, the results go beyond the first 90 days. Soon enough, they might find that staff turnover decreases. New executives may also be more likely to feel less burnt out, which is a continual problem in a high-demand, emotionally driven field like senior care. As a result, HR teams won’t have to go through the cycle of hiring and re-hiring executives continually. 

Start Successful Onboarding with the Right Hiring Team

The best way to make these transitions seamless begins long before day one — it starts with hiring the right executive. Thankfully, with an executive search firm like MedBest, you can do just that. Our team evaluates each candidate for their qualifications and skills so they fit with your facility’s culture, mission, and demands. We also remain even after a successful hire to ensure that candidates are transitioning and onboarding seamlessly. 

With MedBest’s help and putting extra thought into onboarding, executives can stay longer, leading to lasting organizational success. Set your organization up for a bright future by contacting MedBest today!

FAQs About Executive Onboarding in Senior Care

What Is Executive Onboarding in Senior Care?

Executive onboarding in senior care is the structured process of integrating new leaders into a healthcare or senior living organization. It involves orienting them to compliance requirements, company culture, and performance expectations. This process helps executives quickly build relationships, make informed decisions, and lead confidently from their first few weeks on the job.

Why Is Executive Onboarding Important in the Senior Care Industry?

The senior care industry operates under strict regulations and high emotional stakes. When a new executive joins without proper onboarding, it can disrupt compliance, staff morale, and resident satisfaction. A thoughtful onboarding plan ensures that new leaders understand organizational priorities, adapt to the culture, and maintain continuity in care and compliance standards.

What Should a 90-Day Onboarding Plan for Senior Care Executives Include?

A 90-day plan should include clear milestones for learning, relationship-building, and performance. The first month often focuses on orientation and compliance, the second on strategic alignment, and the third on measurable impact. By the end of the 90 days, the executive should have a firm grasp of operational goals and be ready to lead effectively with confidence and clarity.

H3: How Can Organizations Align New Executives With Compliance Standards?

Senior care organizations should integrate compliance training into onboarding from day one. This means reviewing state regulations, Medicare and Medicaid requirements, and company-specific policies early in the process. Regular check-ins with compliance officers and participation in internal audits during the first quarter help ensure that new leaders remain aligned and accountable.

How Does Onboarding Affect Executive Retention Rates?

Structured onboarding significantly improves executive retention by reducing early-stage frustration and role confusion. When leaders feel supported, informed, and equipped with clear goals, they’re more likely to stay and grow within the organization. Effective onboarding fosters loyalty, job satisfaction, and stronger leadership stability across the organization.

What Role Does Company Culture Play in Executive Onboarding?

Cultural integration is one of the most critical components of executive onboarding. Leaders who understand and embody the organization’s mission, values, and communication style are more effective at building trust with staff and residents. Activities like team introductions, shadowing department heads, and participating in community events can help new executives connect meaningfully with the culture.

How Can Senior Care Organizations Measure the Success of Executive Onboarding?

HR teams can measure the success of onboarding through key performance indicators such as staff retention, compliance audit results, operational efficiency, and satisfaction scores from both employees and residents. Regular feedback sessions and performance check-ins during the first six months also help track progress and ensure the executive’s long-term success.