National healthcare advisory

He fixes hard buildings — on quality as well as finance.

Operator-led consulting for senior living, post-acute care, and healthcare organizations navigating growth, change, performance pressure, or complex decisions.

Available for engagements across the United States

Roger began his healthcare career in 1993, scrubbing pots and pans in a nursing home kitchen. From that humble, ground-level start, he built a career leading complex healthcare and senior-care operations.

His experience spans skilled nursing, assisted and independent living, home health, personal services, physician clinics, supply chain, capacity management, accreditation, and organizational transitions. He is also a real estate executive and the founder of R&A Davis Real Estate LLC.

Faith and family are central to Roger’s life. He shares life in Rayland with his wife, Amy, and is the proud father of two successful daughters. His small-town roots run deep: he grew up in a small steel-belt community nestled along the Ohio River and now runs a small farm with horses, cattle, chickens, and ducks.

That breadth shapes Keystone’s point of view: strategy must work at the board table, at the bedside, and everywhere in between. Each engagement is grounded in candid analysis, respect for the people carrying the work, and a bias toward decisions that hold up in practice.

Capabilities

Services

Executive-level operating judgment for assignments that demand clear diagnosis, practical direction, and disciplined follow-through.

01

Operational assessment & performance improvement

Focused reviews of structure, workflow, staffing, quality, compliance, and financial performance—translated into a prioritized, executable plan.

02

Turnaround & transition advisory

Steady guidance through ownership change, receivership, leadership transition, portfolio integration, and other high-stakes periods.

03

Executive & board advisory

Independent counsel for leaders and governing bodies weighing strategy, organizational design, growth priorities, and critical operating decisions.

04

Quality, compliance & accreditation readiness

Preparation and improvement support grounded in operating experience, including CARF/CCAC accreditation work and multi-state oversight.

05

Continuum & capacity strategy

Alignment across hospitals, physician services, skilled nursing, senior living, home health, personal services, and post-acute pathways.

06

Expert witness & independent case review

Objective analysis and testimony for post-acute and nursing-home matters, informed by hands-on clinical and operational leadership.

Engagement model

Senior attention from first question to final recommendation.

Keystone is deliberately principal-led. The person shaping the work is the person doing the work—and remains accountable for the result.

01

Diagnose precisely

Start with the operating context, isolate root issues, and define what success must look like.

02

Design for execution

Build recommendations around real constraints, clear ownership, measurable priorities, and achievable sequencing.

03

Stay through momentum

Support leadership as decisions become action, obstacles emerge, and durable progress begins.

One accountable lead. Broader expertise when needed.

When an assignment calls for additional depth, Keystone can bring in carefully selected specialists on a contract basis. The team expands to fit the work without adding layers between the client and the principal.

Founder & Principal

Roger L. Davis, Jr.

Healthcare leadership shaped from the ground up—and tested across clinical, operational, regional, and executive roles.

Roger began his healthcare career in 1993 in one of the least glamorous—and most instructive—places in a nursing home: the kitchen, scrubbing pots and pans. That ground-level start gave him an early view of care as a complete operating system. Meals, maintenance, staffing, clinical judgment, leadership, and trust all have to work together before a resident ever experiences the result.

He carried that perspective forward as he became a registered nurse, licensed nursing home administrator, facility leader, regional operator, chief operating and nursing officer, and executive vice president. His career has moved from the daily realities of a single building to the strategic demands of complex, multi-state organizations, without losing sight of the people who do the work or the people who depend on it.

Across more than three decades, Roger’s responsibilities have spanned skilled nursing, assisted living, independent living, home health, personal services, physician clinics, supply chain, quality, compliance, capacity management, and organizational transition. At Oakdale, he held vice president and executive vice president roles serving communities across the Midwest to the Atlantic Coast.

As COO and CNO of UPMC Senior Communities, Roger’s work reached across senior-care operations, physician clinics, advanced practice nursing, supply-chain value analysis, hospital consultation, transitional recovery, and post-acute capacity. He helped leaders think beyond an individual facility and consider how bed management, clinical readiness, referral pathways, and care transitions affect the performance of the entire continuum.

Earlier, as a regional vice president with Aedos Health Services, he led skilled nursing facilities across three states through receivership and into successful new ownership while sustaining quality outcomes and compliance. His experience also includes executive-director leadership, regional support, leadership onboarding, and the steady work of helping organizations operate through uncertainty rather than waiting for conditions to become easy.

Quality improvement has been a consistent thread. Roger has supported CARF/CCAC reaccreditation, initiated a portfolio-wide CARF accreditation effort, and worked with teams translating regulatory expectations into practical operating routines. He also served on various UPMC-related boards and on the board of Faith Affiliated Insurance Partners, bringing a governance and risk perspective to the same issues he has managed in operations.

Teaching and professional development remain important parts of his work. Roger serves as adjunct faculty at the University of Pittsburgh College of Nursing, has led nurse aide training programs, and previously taught introductory courses in medical programs at Belmont College. His professional service includes the AMDA (The Society for Post-Acute and Long-Term Care Medicine) Moving Needles Committee, 2022–September 2026—a five-year CDC cooperative agreement to improve immunization rates among post-acute and long-term care residents and staff; the project concluded September 2026. Since around 2018, he has provided independent case review and expert witness testimony in post-acute and nursing-home matters, helping attorneys and other stakeholders understand how standards, policies, and real-world operations intersect.

His operator’s perspective extends beyond healthcare. Roger has owned R&A Davis Real Estate LLC since 2000 and has experience with long-term rentals, small commercial properties, renovation projects, property maintenance, and foreclosure management. That work reinforces a practical understanding of capital, physical assets, risk, and the difference between a plan that looks good on paper and one that can be carried out responsibly.

Faith and family are central to Roger’s life. He shares life in Rayland with his wife, Amy, and is the proud father of two successful daughters. His small-town roots run deep: he grew up in a small steel-belt community nestled along the Ohio River and now runs a small farm with horses, cattle, chickens, and ducks. The farm offers its own daily reminder that stewardship is active work—showing up, noticing what has changed, and taking care of what has been entrusted to you.

That combination of bedside understanding, operating discipline, executive judgment, teaching experience, and small-town accountability shapes Keystone Strategies. Roger approaches each engagement with candid analysis, respect for the people carrying the work, and a bias toward decisions that hold up in practice. The goal is not a polished recommendation that sits on a shelf; it is a clearer path that leaders can own, teams can execute, and organizations can sustain.

Since 1993Healthcare experience across clinical, operational, and executive roles
RN + LNHAClinical and operational perspective in one advisor
MHA + MSNGraduate preparation in health administration and nursing

Regulatory library

Federal regulations

Primary CMS material for long-term care requirements, survey operations, complaint processes, and quality-improvement oversight.

Regulatory library

State regulations

Official long-term care and healthcare regulatory resources for Pennsylvania, Ohio, and West Virginia.

CMS oversight

QSO resources

A focused starting point for Quality, Safety & Oversight memoranda and related survey guidance.

CMS QSO memoranda communicate new, revised, and expired policy to state survey agencies and providers. The official archive should be treated as the source of record.

Official QSO memo archive

Search and review policy memoranda by date and subject directly through CMS.

Open the CMS archive
  • Verify whether a memo is new, revised, or expired.
  • Read the full source document rather than relying on a secondary summary.
  • Confirm effective dates and applicability to the provider type and jurisdiction.
  • Translate policy direction into operating ownership, education, and monitoring.

Professional reference only; not legal advice.

Sector watch

News & analysis

Selected 2026 reporting on nursing-home regulation, quality reporting, technology, operations, and growth.

Independent review

Expert witness & case review

Objective analysis for post-acute and nursing-home matters, informed by clinical credentials and decades of operating leadership.

Keystone brings an operator’s understanding of how policies, staffing, leadership decisions, clinical systems, and regulatory expectations meet in day-to-day care delivery.

Focused, practical analysis

  • Independent review of post-acute and nursing-home matters
  • Operational and clinical context for records, policies, and events
  • Clear explanation of industry practice and regulatory expectations
  • Expert testimony supported by executive, facility, and clinical experience

Discuss a potential matter

Use the contact page to connect directly and outline the scope, timing, and review needs.

Contact Keystone

Integrated operations

Continuum & capacity strategy

Practical alignment across acute care, physician services, post-acute care, senior living, and home-based services.

Capacity problems rarely belong to one department or one setting. Keystone evaluates the handoffs, incentives, operating constraints, and accountability across the continuum.

  • Hospital, physician, and advanced-practice provider alignment
  • Transitional recovery and post-acute pathway planning
  • Skilled nursing, assisted living, and independent living operations
  • Home health and personal services coordination
  • Capacity and bed-management decision support
  • Supply chain and value-analysis perspective

Built around execution

Recommendations are shaped for the teams, systems, and operating realities that will carry them forward.

Leadership continuity

Interim leadership placement

Seasoned professionals who can step into critical roles, stabilize operations, and create forward momentum while the organization determines its long-term path.

Leadership gaps do not pause the work. Keystone can draw from a suite of experienced professionals to match the assignment with the operating judgment, clinical perspective, and steady presence it requires.

Support shaped to the moment

  • Interim executive and operational leadership during vacancies or planned transitions
  • Clinical leadership support when continuity, quality, and accountability are essential
  • Experienced leaders for stabilization, integration, turnaround, and special-project assignments
  • Flexible placement scopes aligned to the role, organization, and transition objectives

Interim roles

Chief Executive Officer (CEO)Chief Operating Officer (COO)Chief Financial Officer (CFO)Chief Nursing Officer (CNO)Regional VP of OperationsLicensed Nursing Home Administrator / Executive DirectorAssistant AdministratorDirector of Nursing (DON)Assistant Director of Nursing (ADON)RNAC / MDS CoordinatorControllerDirector of Sales and Marketing / Admissions DirectorHuman Resources DirectorDirector of Social ServicesDirector of Dining ServicesDirector of Maintenance / Plant OperationsDirector of Activities / Life EnrichmentDirector of Quality / Compliance OfficerInfection PreventionistStaff Development CoordinatorWound Care Specialist

More than a résumé match

Keystone considers the assignment’s operating context, leadership demands, timing, and desired outcomes before recommending a professional.

Contact for placement details

Interim placement inquiry

Tell us what the role needs now.

Start a confidential conversation about the leadership gap, assignment scope, timing, and operating priorities.

Useful details for an initial conversation

The strongest match begins with a clear picture of the organization and the work. When you connect, be prepared to outline:

  • The role or leadership responsibility to be covered
  • The care setting, service line, or organizational environment
  • Immediate priorities, risks, and transition objectives
  • Desired start timing and anticipated assignment scope
  • Any required credentials, licensure, or specialized experience

Begin a conversation

Bring the challenge. Leave with a clearer path.

Available for project-based, advisory, interim, and expert-review engagements nationwide.

Start with the operating question.

Share the situation, what has changed, and what decision or result matters most. An initial conversation can establish whether Keystone is the right fit and what the next step should be.

  • Operational assessment and performance improvement
  • Turnaround, transition, and executive advisory
  • Quality, compliance, and accreditation readiness
  • Expert witness and independent case review