Case Studies

Navarro Regional Hospital 


"In today’s competitive healthcare climate, a friendly hospital staff and a clean, infection-free environment can make the difference between a good patient experience and a bad one—in real time and in HCAHPS time—something a 17-point increase in top box scores would prove at Navarro Regional Hospital (Navarro) in Corsicana, Texas."

For Navarro CEO Xavier Villarreal, the need to improve HCAHPS scores by engaging EVS staff is what drove the hospital to switch EVS vendors and pursue a new partnership with Crothall Healthcare at the start of 2013. 

Especially at a facility like Navarro—which is the sole hospital provider in the community—having an EVS team that feels genuinely appreciated and engages with patients can dramatically impact survey performance. In less than a year, a significant rise in HCAHPS scores is proving that when housekeepers are inspired to shine, patients notice. 


Navarro Regional Hospital is a 162-bed full-service facility located about 55 miles south of Dallas. It is part of Community Health Systems (CHS)—one of the nation’s leading operators of acute care hospitals. 

Prior to 2013, the personal touch—that today’s patients expect—was missing. Housekeeper morale was low, and this was reflected in HCAHPS scores. When the administration began considering a switch in EVS vendors, Crothall came to mind because the hospital already had a relationship with Crothall’s sister food company, Morrison Healthcare. Villarreal said he had been impressed by the professionalism and high level of satisfaction within Morrison’s team. If Crothall could bring this same spirit to EVS, that could provide the engagement and results that were lacking. 


Navarro’s EVS contract with Crothall began in March 2013. As with any change, it came with some trepidation; yet, there was also a sense that the hospital’s EVS employees wanted something different and were looking for leadership who would care about them, Crothall’s Brian Myrick, Director of Housekeeping, explained. 

According to Regional Manager Mike Bahar, coming into the account as a new housekeeping partner, it was important for Crothall to reassure the EVS staff and build their trust and confidence. One of the first things Crothall did was to resolve a payroll issue for the EVS staff with the hospital executive team. 

This win set the tone for the way employees would be treated moving forward. “We made sure the employees were genuinely taken care of and their concerns were heard and resolved. The high employee morale and engagement we see now are the hallmarks of our success,” Bahar said. 

Also, Crothall immediately stepped in to provide a uniform allowance and pay for laundering costs, so employees are no longer burdened with these expenses. Now, EVS employees come to work every day feeling good about how they look, and people have commented on their “fresh” and professional appearance. 


“Crothall had a very formal approach to the transition,” said Ricky Villarreal, assistant administrator at Navarro (who is not related to CEO Xavier, although they share the same last name). There was a “regimented time frame” for each step in the process, and items were checked off as they were completed. “We were always ahead of the curve,” Ricky said. 

With Crothall, EVS initiatives are now regularly communicated to the executive team, noted Ricky Villarreal. He and other administrators are often invited to EVS lunches and gatherings, where they can engage with staff and reaffirm to housekeepers that their work is valued. This aligns with Xavier’s management style and keeps administrators in the loop. 

“With some contractors, we would see a lot of corporate support up front, and they would go away,” Xavier Villarreal said. “With Crothall, that is not the case. I think that’s important.” 


Today, clear direction from Crothall sets a housekeeping standard of providing four patient “touches” (or interactions) per day. This is the personal element that Xavier was looking for, and it is supporting HCAHPS gains. As of the second quarter of 2013: 

  • HCAHPS scores had risen 17 points to 84 percent (top box) from 67 percent (top box) one year prior. 
  • EVS had moved from the 8th percentile ranking to the 87th percentile ranking. 

Vicki Arnett, director for the Therapy Center at Navarro and community cares champion (a position that helps to promote a stronger patient experience), said she has noticed that EVS staff now see their role as being much broader than just cleaning. EVS Director Myrick is instilling in them a greater understanding of how they can positively interact with patients and support a better overall experience, she said. Also, Arnett observed that the more interactive EVS approach helped housekeepers in supporting the hospital’s “no-pass-zone” policy, which requires all staff to stop and help if a patient call light is on. 

“ The success at Navarro shows what can happen when “taking the extra step to recognize, respect, and appreciate people.” 

– Mike Bahar, Regional Manager  


In addition to managing EVS at the hospital, Crothall has recently been given the housekeeping contract for the medical office building next door. With that change, Navarro is paying slightly less and is getting better results, along with having emergency services available, Ricky Villarreal noted. 


Bahar concluded that the success at Navarro shows what can happen when “taking the extra step to recognize, respect, and appreciate people.” 

“There’s so much trust and synergy between Crothall and the client,” he said. “That’s what drives sustainable results.” 

“HCAHPS scores are rising, morale is tenfold better, and we’ve realized savings,” echoed Assistant Administrator Ricky Villarreal. “[Crothall has] done a great job.”