Behind every home healthcare office is a leader balancing strategy, people and purpose. Haley Todd, director of business operations (DBO) for Maxim Healthcare’s Boston, Massachusetts, regional office, brings all three together in her role—overseeing daily operations while shaping the long-term vision for her team and community. For this blog, we sat down with Todd to discuss what it takes to lead effectively in a fast-paced, ever-evolving healthcare environment.

What does a DBO do?

According to Todd, a DBO oversees the full scope of an office’s daily functions, aligning workflows, policies and best practices with Maxim’s standards as well as state and federal guidelines.

“At its core, the DBO position is about building an environment where teams thrive,” says Todd. “By fostering collaboration across operations, clinical staff, field support and corporate partners, DBOs help create a workplace rooted in accountability, communication and shared goals. DBOs focus heavily on team development—prioritizing cross-training, setting clear expectations and empowering staff to perform at their best.”

While managing the day-to-day, Todd says that DBOs also keep an eye on the bigger picture. Strategic planning is a key part of the role because it helps offices prepare to meet both current patient needs and future market demands.

A path built on experience and curiosity

Many DBOs grow into the role through hands-on experience, building a deep understanding of how each part of the business connects along the way. Todd’s path at Maxim reflects that progression. She began in July 2014 as a seasonal flu program coordinator supporting clinics across the Greater Boston area, then quickly advanced through roles as a client coordinator, recruiter and recruiter lead. She later moved into leadership as a business development manager, overseeing recruiters and client coordinators, before being promoted to operations manager in 2019 and director of business operations in November 2021.

“What initially drew me to this position was the opportunity to lead a team and play a meaningful role in shaping how an office operates,” says Todd. “I’ve always enjoyed balancing higher-level strategic work like building a five-year plan for the branch and the pace of day-to-day operations.”

Todd credits much of her growth to a mindset she developed early in her career as a recruiter. Rather than limiting herself to her job description, she took a proactive approach to learning every aspect of the business—from clinical operations to the field support group. By investing in self-development, researching company policies and building cross-functional knowledge, she became a go-to resource for her peers. That experience shaped her leadership philosophy today, reinforcing the importance of cross-training, collaboration and taking ownership of professional growth—values she now works to embed across her teams.

What does operational excellence look like at Maxim?

Operational excellence in a decentralized, community-based model like Maxim depends on two key factors: strong processes and a healthy culture.

“In larger offices or markets, consistency is everything,” says Todd. “Clear workflows and communication channels help teams stay aligned and effective. At the same time, a positive culture drives motivation and collaboration. DBOs also play a critical role in keeping teams informed about evolving regulations and industry changes. Because home healthcare is constantly shifting, the ability to adapt quickly—rather than react—sets high-performing offices apart.”

Why efficiency matters for patient outcomes

Operational efficiency plays a critical role in shaping both patient outcomes and the overall care experience.

“Efficiency isn’t just about productivity; it’s directly tied to patient care,” says Todd. “When teams operate smoothly, there’s less risk of delays, errors and miscommunication. Clear processes and strong internal relationships help families and caregivers receive accurate, consistent information. This builds trust while improving overall satisfaction. Equally important is caregiver support. Offices that prioritize strong team dynamics and retention create more consistent care experiences for patients.”

Building the right caregiver-patient match

Successful care begins with the right match for patients with caregivers. Operations teams partner with recruiters and caregivers to thoughtfully align each caregiver with a patient’s clinical needs and personal preferences.

“Strong relationships and open communication are key,” says Todd. “The better teams understand both caregivers and families, the more effectively they can create meaningful, lasting matches.”

Supporting Veterans and military families

Providing care for VA and TRICARE populations requires an added layer of sensitivity and support. Many Veterans and military families face unique challenges, and navigating government-funded care can be complex.

“We should approach with extra patience and understanding, especially since military families may not always be aware of the resources available to them,” says Todd. “DBOs and their teams take a hands-on approach, educating families about the process, staying current on regulations and working closely with government entities. The goal is to make accessing care as simple and stress-free as possible.”

Leveraging technology to improve care

Todd says that Maxim is continually strengthening care coordination and operational performance by leaning into data, technology and digital tools that simplify processes for offices, caregivers and patients so teams can spend more time focused on delivering quality care. This includes better communication tools, smarter use of data, stronger senses of community and adapting services to meet evolving and unique needs in each local market. As technology advances, the focus remains on making care more accessible, intuitive and responsive.

“A recent example is the transition to electronic paperwork and Medication Administration Records, which has been a major improvement for caregivers and has helped reduce errors and delays,” says Todd. “Maxim also regularly evaluates how offices operate and looks for opportunities to increase efficiency and overall effectiveness. What really sets the organization apart is how receptive the teams are to real time feedback, listening to office team members, caregivers and patients and using those insights to drive meaningful improvements across the company.”

Leading with accountability and culture

A strong culture of accountability and continuous improvement is central to Todd’s leadership approach as a DBO.

“Our office has always had strong processes aligned with Maxim’s policies as well as state and federal regulations, but a big part of the DBO role is continuously evaluating what’s working, what isn’t and making adjustments where needed,” says Todd. “I operate with the mindset that there is always a solution, but we just need to figure out what it is. And I believe there is always an opportunity to turn things around. Even small wins build momentum and motivate teams to keep improving. This balance of accountability and encouragement create an environment where the team feels supported.”

Growing with purpose

Todd says that while expanding into new or underserved communities requires market insights to identify areas of need, growth is achieved by a people-first mindset.

“It starts with staying connected to real market data and understanding exactly where the needs are,” says Todd. “I’m always looking at how the market is behaving, what gaps exist, where families are struggling to access care and where our services could make the biggest impact. That means consistently reviewing community needs and using that information to guide thoughtful, strategic expansion.”

Todd says that DBOs must also be honest about staffing capabilities, so families set realistic expectations and receive quality care from day one. She also highlights the importance of maintaining a consistent level of quality and treating every community with fairness and respect.

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