Walk through the back office of any skilled nursing facility and you'll find the same thing: a handful of Amazon boxes that bypassed the vendor catalog, invoices from vendors nobody in finance recognizes, and a department head who ordered directly from a sales rep because "it was faster."
This is maverick spending — and it's one of the most expensive problems in long-term care procurement that almost nobody is actively managing.
CIPS benchmarks and Simbo AI healthcare research put maverick spending at 10–20% of total procurement savings in organizations without procurement controls. For a facility spending $1.5M per year on supplies and services, that's $150,000–$300,000 in negotiated savings that evaporate before anyone sees them. At a 10-facility operator, the math becomes staggering.
The harder problem: most administrators know maverick spending exists in their facility. They just don't know how to stop it without creating friction that makes care operations harder.
What Maverick Spending Actually Means
Maverick spending — also called rogue purchasing or off-contract buying — is any purchase made outside your approved procurement process. That means:
- Orders placed with vendors not on your approved list
- Purchases made without a purchase order
- Buying from a contracted vendor but at non-contracted pricing
- Personal card purchases submitted for reimbursement
- Orders placed through channels not connected to your procurement system (Amazon, direct vendor calls, retail stores)
It's not fraud. It's not malicious. In most cases it's a well-intentioned department head trying to solve an operational problem quickly. That's exactly what makes it so persistent — the people doing it are often trying to do their jobs well.
Why It Happens in Long-Term Care Specifically
Maverick spending exists in every industry, but long-term care has structural features that make it particularly common.
Care comes first, processes come second. The culture in skilled nursing facilities is, appropriately, focused on resident care. When a nursing supervisor needs gloves and the purchasing system requires three clicks and an approval, calling the local pharmacy directly feels like the responsible choice. The process is the obstacle, not the rule.
No dedicated procurement staff. Most SNFs don't have a dedicated purchasing department. Procurement is a secondary responsibility for administrators, business office managers, and department heads who are already operating at full capacity. When procurement is a distraction from the primary job, shortcuts are inevitable.
High turnover creates knowledge gaps. Long-term care has some of the highest staff turnover rates in healthcare. New dietary managers, new nursing supervisors, and new maintenance staff don't know your approved vendor list. They order from vendors they've used before, at facilities they've worked at before, through channels they're comfortable with. Every new hire is a potential source of off-contract spending.
The approved process is often slower than the workaround. If getting approval to order from an approved vendor takes two days and calling a vendor directly gets supplies delivered the same afternoon, the operational incentive is clear. Processes that don't fit the pace of care operations get bypassed.
Multi-facility complexity. In a multi-location LTC organization, each facility often develops its own vendor relationships over time. What looks like maverick spending from a corporate perspective is standard operating procedure at the facility level — because nobody connected the dots.
What Maverick Spending Is Actually Costing You
The most visible cost is the loss of negotiated pricing. When a department head orders from an unapproved vendor, the organization's contracted rates with approved suppliers don't apply. The facility pays whatever the non-contracted vendor charges — typically 10–25% more than the negotiated price for comparable products.
But that's just the direct cost. Maverick spending creates cascading downstream problems.
Budget visibility collapses. Purchases that don't flow through your procurement system don't appear in your real-time spend data. You lose the ability to track spending against budget until invoices arrive — often weeks later. By then, the budget impact is done.
PPD tracking becomes unreliable. Per-patient-day cost is the operational heartbeat of long-term care. If a meaningful portion of your actual spend is flowing outside your system, your PPD numbers are wrong. You're making operational decisions based on incomplete data.
Vendor consolidation becomes impossible. One of the key levers for procurement savings in LTC is consolidating spend to fewer vendors and negotiating volume-based pricing. That strategy requires channeling spend through a defined vendor base. Maverick spending fragments volume and eliminates negotiating leverage.
Audit exposure increases significantly. CMS surveys and state audits look at procurement records. Purchases without POs, from vendors not on approved lists, paid through informal channels — these create documentation gaps that become compliance vulnerabilities. In a regulatory environment where documentation is everything, an incomplete audit trail is a real risk.
AP complexity and cost go up. Invoices from unapproved vendors can't be processed through standard workflows. Each one requires manual research, approval chain reconstruction, and often direct contact with the department head who made the purchase. APQC data puts manual invoice processing at $9.87 per invoice — and maverick invoices take even longer than average.
Why Policies Alone Don't Work
The instinctive response to maverick spending is to write a policy. "All purchases over $X require a PO." "All vendors must be approved through the business office." "No purchases on personal cards without prior authorization."
These policies exist at most facilities. They don't stop maverick spending, because policies don't change the underlying incentive structure.
If the approved process is harder than the workaround, people will use the workaround and deal with the policy violation afterward — if it's even caught. If there's no real consequence for off-contract buying, the deterrent is theoretical. If the person enforcing the policy is the same person whose department needs supplies today, enforcement is inconsistent.
Policy is documentation that the right behavior is expected. It's not infrastructure that makes the right behavior easier than the wrong behavior. That's what a procurement system does.
The System-Level Fix
Maverick spending doesn't stop because people decide to follow the rules. It stops when the approved process becomes the path of least resistance.
That requires a procurement system that makes compliant purchasing easier, faster, and more intuitive than the workaround — while making non-compliant purchasing harder.
An approved vendor storefront gives every department head access to a curated catalog of pre-approved vendors and contracted pricing. Instead of calling a vendor directly or ordering from Amazon, they shop from an interface that looks familiar, shows real prices, and submits an order with one click. The right behavior is the easy behavior.
Requisition-based ordering ensures every purchase starts with a documented request before it becomes a commitment. The system captures who ordered, what they ordered, from which vendor, against which budget — before any money is spent. The audit trail is automatic.
Budget guardrails prevent purchases that would exceed department budgets or trigger PPD alerts. Instead of discovering a dietary overspend at month-end reconciliation, the system flags it when the order is submitted. Department heads self-correct because the feedback is immediate.
Tiered approval workflows right-size the approval burden to the purchase value. A $50 cleaning supply order clears automatically. A $5,000 equipment order routes to the administrator. A $25,000 vendor contract routes to corporate. Nobody is waiting two days for routine purchases, but significant commitments get appropriate oversight.
Automatic audit trail captures every purchase decision — request, approval, PO, receiving, invoice, payment — in a permanent, searchable record. When an auditor asks about a purchase from eight months ago, the answer takes seconds.
The Numbers After Implementation
Facilities that implement procurement controls consistently see maverick spending drop to under 3% of total spend within the first year — compared to the 10–20% industry baseline for uncontrolled environments.
For a 100-bed SNF spending $1.5M annually on supplies and services, closing that gap is worth $105,000–$255,000 per year. Add the AP processing savings from eliminating manual invoice handling, the early payment discount capture from faster approval cycles, and the compliance risk reduction from complete documentation, and the ROI calculation isn't close.
Adelpo is built specifically for this problem in long-term care environments — with an approved vendor storefront, integrated PPD budget tracking, and procurement workflows designed for the pace and culture of SNF and assisted living operations. Implementation takes 3–4 weeks. Most facilities see full ROI within 2–4 months.
If maverick spending is a problem in your facility, book a 15-minute demo to see how Adelpo structures compliant purchasing without slowing down operations.