NACS IT Department · Confidential · FY2026
A Case for Restructure
A proposal for sustainable specialization, operational accountability, and cost-effective scale as NACS grows to 16 facilities and beyond.
6
IT team members
12→16
Facilities (4 incoming)
~$26K
Net annual cost increase
Feb 2026
Prepared for review
Section 01
The Problem
Six gaps currently limit the IT department's ability to support NACS at its current size — and each one compounds as the organization grows. Addressing them before the next four facilities come online is materially less expensive than addressing them after.
Structural Gaps
Software Governance Vacuum
Until recently, no formal owner existed for the enterprise software portfolio. The result: shelfware, unchecked licensing spend, security exposure, and vendor relationships with no accountability. Governance is now being established — but the role must be formally recognized and resourced to be sustained.
Unmanaged SaaS = waste, risk, and bloat at scale
No Gold-Standard Coverage Model
This is a case for building the kind of IT department that market leaders — operators like Ensign Group — already run: specialized functions, defined ownership, structured field coverage, and IT infrastructure that scales with the business. The goal is not to maintain the status quo at 16 facilities. It is to build something that works at 30.
Current model not designed for scale · no formal structure
Risks
Compensation Inversion
Two contributors are significantly below market for their actual scope. Anthony manages enterprise systems and strategy at VP-level output on an IT Director salary. Francis carries the operational load of the Service Center, manages the helpdesk, and handles procurement and deployment — at $66K, nearly half of what the Database Administrator earns for a scope he routinely outperforms.
AT: $93K vs $180K+ market floor · FF: $66K vs $85K+ market floor
Security Visibility Gap
NACS has endpoint protection (SentinelOne) and email security (Coronet), but no network-layer behavioral detection. Network Detection & Response tools — such as Darktrace or ExtraHop — identify threats that endpoint tools cannot see. As the facility count grows and network complexity increases, this gap grows with it. It sits directly in the proposed security scope.
East-west traffic unmonitored · no NDR deployed · exposure growing
Morale & Retention Risk
Compensation equity gaps do not stay invisible. High-performing contributors who observe significant pay disparity relative to peers at lower output levels will eventually act on that information. The cost of losing an engaged, irreplaceable contributor — in institutional knowledge, onboarding delay, and operational continuity — far exceeds the cost of correcting the disparity proactively.
Compensation inequity · high replacement cost · continuity risk
Roadmap Blockers
Helpdesk Scalability — No AI Layer
The helpdesk operates as a fully manual function with no formal tiers or automation. Every ticket requires direct human handling. With no Level 0 routing — AI-assisted auto-resolution, self-service, and triage — demand scales linearly with facility count. A formalized helpdesk function with an authorized owner is the prerequisite for introducing automation and reversing that curve.
No L0 automation · each new facility adds proportional manual load
No IT Visibility at the Executive Level
There is currently no structured mechanism for communicating IT posture, risk, investment rationale, or strategic direction to the C-suite. IT decisions are made in a vacuum relative to broader business strategy. A VP-level role creates the formal bridge — turning IT from a cost center into a visible, accountable business partner at the leadership table.
No regular IT posture reporting · no formal C-suite representation
Section 02
The Solution: Specialization
The answer to scaling is not more headcount — it is the right structure. When each function has a defined owner, accountability is created, gaps become visible, and the team moves in parallel rather than competing for the same generalist bandwidth.
| Function | Current State | Proposed Owner |
|---|---|---|
| Software Portfolio Governance | ⚠ Unowned — no lifecycle management, shelfware untracked | ✓ VP, Business Systems & Technology (Anthony) |
| Helpdesk & Service Delivery | ⚠ Unstructured — no tiers, no SLAs, no escalation workflows | ✓ IT Service Delivery Manager (Francis) |
| Enterprise AI & Automation | ⚠ No roadmap — 100% manual triage and routing | ✓ VP (strategy) + IT Service Delivery Manager (execution) |
| IT Infrastructure | ⚠ Managed informally — no formal accountability structure | ✓ Director, IT Infrastructure & Security (Geremia) |
| Security & Network Detection | ⚠ Partial — endpoint and email covered, no NDR layer | ✓ Director, IT Infrastructure & Security (Geremia) |
| Executive Communication & IT Posture | ⚠ Ad hoc — no structured reporting or C-suite representation | ✓ VP, Business Systems & Technology (Anthony) |
| Clinical Systems | ⚠ Project-based — no sustained platform ownership | ✓ Clinical Systems Specialist (Rogi) |
| Facility Field Support | ⚠ Senior staff on-call — not scalable as team role shifts | ✓ Regional MSP Partner (per-site contract) |
VP, Business Systems & Technology — Expanded Scope
Establish and enforce IT SLAs across all service categories
Vendor contract negotiation and lifecycle management
Monthly IT posture reports to C-suite
Technology roadmap and strategic planning
Department standards: service quality, response times, professional presentation
Cross-functional project board representation (NetSuite, EHR migrations, etc.)
Software governance and compliance oversight
Evaluation and onboarding of AI/automation tooling
Budget oversight and allocation within IT department
Section 03
Team — Before & After
For team members with proposed title changes, both columns show market position: first for the current title (demonstrating underpayment even at existing scope), then for the proposed title (demonstrating the ask is at or near market). Market ranges sourced from Salary.com, CompTIA, HIMSS, and Robert Half for healthcare IT in Southern California.
| Team Member | Current Base | Market Position | Proposed | Δ | Status |
|---|---|---|---|---|---|
|
Anthony Trujillo
IT Director, South
→ VP, Business Systems & Technology
|
$93,000 |
Current title — IT Director
Proposed — VP, Business Systems
|
$200,000 | +$107K | Primary Ask |
|
Francis Ferma
Network Administrator
→ IT Service Delivery Manager
|
$66,000 |
Actual scope — IT Svc Delivery Mgr
|
$100,000 | +$34K | Secondary Ask |
|
Jon Andrews
Database Administrator
→ Position consolidating FY2026
|
$120,000 | –$150,500/yr savings (all-in) |
–$120K | Consolidating | |
|
Geremia Doan
IT Director, North
→ Director, IT Infrastructure & Security
|
$133,000 |
Proposed — Director, Infra & Security
|
— | — | Phase 2 · Q4 |
|
Tom Jarrell
Network Administrator
→ Systems Administrator
|
$75,000 | — | — | No change | |
|
Rogi Poblete
Clinical Project Specialist
→ Clinical Systems Specialist
|
$75,000 | — | — | Phase 2 |
All-in cost = base × 1.25 + $500 (taxes, benefits, employer contribution). Jon consolidation all-in savings: $150,500/yr. ● Current ● Proposed | Sweet spot marker
Section 04
The Math
The Jon Andrews consolidation funds the majority of the compensation corrections. Adjust the sliders to model different proposed salaries and see the real-time net impact. Slider ranges correspond to market floors and ceilings — dragging below the floor models negotiation scenarios.
Interactive Budget Impact Model
Drag sliders to explore · Jon toggle activates consolidation savings
Jon Andrews consolidation active — saves $150,500/yr all-in
Section 05
Field Coverage Model
As the team transitions into specialized strategic roles, facility-level on-site support requires a dedicated solution. The current model — senior staff traveling to sites on escalation — is not compatible with the scope and drive times involved.
Current (12 facilities)
West Anthony → 4 west facilities (Santa Monica area)
North Geremia → 4 north facilities (1.5–4 hrs each)
East Tom → 4 east facilities
Senior staff driving to sites on escalation. Anthony's west facilities now represent 4+ hour round trips. Geremia's north coverage is already at geographic capacity. Field visits compete directly with strategic and administrative work.
→
Proposed (16 facilities + MSP)
West Anthony → strategy & oversight
North Geremia / Tom → strategy & oversight
East Tom → strategy & oversight
+4 New 3 north · 1 south — assignment TBD
MSP Regional partner → on-site field tech, all sites
Facility assignment for the 4 incoming sites is under review. Geremia cannot absorb 3 additional north facilities (7 total at 1.5–4 hrs each) while maintaining administrative duties. MSP coverage is the viable path for geographic scale.
Why MSP vs. added headcount? A regional MSP partner embedded near each facility cluster covers on-site break/fix, hardware installs, and end-user support without adding IT headcount. Coverage scales per site — so adding facilities means adding contract scope, not staff. This is how operators at Ensign's scale handle distributed field tech.
In development: Detailed MSP coverage plan by facility cluster, RFQ (Request for Quotation) process, per-site cost modeling, and final assignment of the 4 incoming facilities. This will be presented as a follow-on to this proposal.
Section 06
Cost of Inaction
This proposal is NACS IT's plan for making expansion cost-effective and operationally sound. Without the structure and specialization outlined here, onboarding additional facilities will be slower, more expensive, and more fragile.
✓ Cost of This Proposal
Anthony: $93K → $200K (base Δ)+$107,000
Francis: $66K → $100K (base Δ)+$34,000
Burden (25%) on deltas+$35,250
Jon consolidation savings–$150,500
Net annual impact+$25,750
Across 16 facilities: roughly $1,600/facility/yr. Less than the cost of a single unplanned support call to an outside IT consultant.
✗ Cost of Losing the Team
VP-level IT search retainer (20–25%)$40,000–$50,000
Onboarding & ramp, VP role (6–12 mo.)$50,000–$100,000
Service Delivery Mgr search + ramp$20,000–$50,000
Institutional knowledge lossUnquantifiable
Expansion delays (4 facilities)$50,000–$150,000
Conservative one-time cost$160K–$350K+
Replacement cost alone exceeds the annual raise cost before year one ends — and a replacement has none of the institutional knowledge, vendor relationships, or systems context built over years.
✗ Cost of Unstructured Scale
IT downtime per facility (est. ~$1K/hr)Risk grows per site
Onboarding delays w/o structured ITWeeks of delayed ops
Helpdesk w/o L0: each new site adds loadLinear cost curve
Security gap across each new networkCompounding exposure
Software governance failuresOngoing waste + risk
Cumulative exposureGrows with each site
Each new facility onboarded without a structured IT model adds cost, risk, and complexity with no defined owner to absorb it. This proposal is the onboarding strategy.
Anticipated Question
"Shouldn't an IT Director already be responsible for all of this? Why a VP title?"
The market data answers this directly. An IT Director managing 16 SNF facilities, an enterprise software portfolio, C-suite representation, and a strategic technology roadmap commands $110–130K at market — more than Anthony's current $93K. That scope, at that complexity, is what the industry classifies as a VP-level function. The title reflects the work, and the work reflects the market rate. Hiring an IT Director for this scope at market would cost more than Anthony earns today, and would come without institutional knowledge, existing vendor relationships, or continuity on active projects like NetSuite.
The restructure costs approximately $25,750/year net after consolidation savings — roughly $2,150/month for a complete reorganization of the IT function. The math is straightforward: one-time replacement costs for either key contributor exceed the annual cost of the proposal before the first year closes. The investment in structure now is what makes scaling to 16, 20, and 30 facilities operationally and financially viable.
Section 07
My Recommendation
Four paths are presented. Select one to see the detailed cost breakdown and what changes versus what is deferred. Options are ordered to show the full range — from no action through maximum strategic alignment.
Included — Phase 1
Deferred or Not Addressed
Section 08
What This Team Manages
Click any card to see where the number comes from.
~$1.75M
Direct IT spend annually (excl. personnel)
Source
Connectivity ($948K) + Security ($218K) + Software IT-owned ($298K) + Hardware ($288K) = ~$1.75M. Including personnel all-in (~$705K) brings total to ~$2.46M. View in Budget Planner →
12→16
Active facilities supported — 4 onboarding in FY2026
Source
Current: 12 active facilities. Incoming: 3 north, 1 south. Assignment and MSP coverage plan in development.
1,669+
Managed devices across all platforms
Source
NinjaOne: 753 (desktops, laptops) · Apple Business Manager: 502 (iPhones, iPads) · UniFi: 414 (cameras, APs, switches). Total: 1,669 tracked devices.
8
Function areas with defined ownership in proposed structure
Source
Per Section 02 specialization matrix: Software Governance, Helpdesk/SDM, AI/Automation, Infrastructure, Security/NDR, Executive Communication, Clinical Systems, Field Tech.
~$85K
Estimated per-facility onboarding cost — work in progress
Source
Estimate in development. Includes hardware provisioning, network setup, software deployment, and training. Full cost model forthcoming.
30×30
30 facilities by 2030 — IT structure is the critical path
Source
NACS strategic growth initiative. Each facility requires structured IT onboarding. Without the proposed IT framework, this goal requires proportional headcount instead of scalable infrastructure.
Click any card to see the source · $1.75M reflects direct IT spend · personnel ($705K all-in) brings total to ~$2.46M