Jobs and Growth Tax Relief Act of 2003

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Jobs and Growth Tax Relief Act of 2003

  1. 1. Getting From Here to There: Meaningful Performance Improvement Lutheran Services In America Thursday, April 19, 2007
  2. 2. Your Presenter Today Is Sophie Campbell, MSN, RN, CRRN, RAC-CT Director scampbell@parentenet.com 724-775-5933 2
  3. 3. From Here to There • How do you go from where you are to where you WANT to be? • What is the difference between the two points? • Why do you think you want to be somewhere else? • Will it make a difference to go there from here? • What makes it meaningful? 3
  4. 4. Agenda • Key Influences for Change • Performance Improvement Initiatives o Strategic o Financial o Operational • Implementation of Performance Improvement Initiatives • Sustaining Success 4
  5. 5. Key Influences of Change What is keeping you awake at night?
  6. 6. Key Influences of Change • Poor Financial Performance • Aging Physical Plant • Declining Occupancy 6
  7. 7. Key Influences of Change • Declining third party reimbursement • Rising expenses • Increased regulatory enforcement • Change in consumer preferences • Change in leadership – Board or management 7
  8. 8. Identifying Performance Improvement Initiatives What needs to happen to get from here to there?
  9. 9. Performance Improvement Assessment Strategic Initiatives
  10. 10. Strategic Initiatives • Boards of Trustees / Directors have a fiduciary obligation to fulfill the charitable mission of the non-profit organization it represents. – “No money (margin) – No mission” • As a result, Boards of Trustees / Directors need to ensure all areas of, and individuals in, the organization are held accountable. • Board must have a “working knowledge” of the industry. 10
  11. 11. Strategic Initiatives • Effective Board / Management relationship is critical – Trust: Board-Management, Management-Board • Management executes Board policy • Management keeps Board informed • Management holds all individuals throughout the organization accountable 11
  12. 12. Strategic Initiatives • Establish understanding of the organization • SWOT (Strengths, Weaknesses, Opportunities and Threats) • Establish understanding of the market place – Who are you serving • Currently • In the future – Who are your competitors? – Are there opportunities for affiliations and/or networks? 12
  13. 13. Performance Improvement Assessment Financial Initiatives
  14. 14. Financial Initiatives • Compliance with all applicable laws and regulation • Compliance with all long-term debt financial and other covenants 14
  15. 15. Financial Initiatives • Financial monitoring – Budgeting o Management team involvement – Education o Ownership and accountability – Production and analysis of accurate interim / annual financial statements o By level of care/service line – Finance Committee / Board review of interim / annual financial statements – Benchmarking / Ratio analyses 15
  16. 16. Financial Initiatives • Benchmarking – Every organization has its own unique characteristics (i.e. capital / debt structure, bed complement, fund development efforts, etc.) • If appropriate, benchmark against, and set goals for, your own organization first – No one benchmark / ratio should be considered in isolation – Results can be affected by unusual or extraordinary circumstances 16
  17. 17. Financial Initiatives • Benchmarking – Provides tools for analyzing an organization’s financial strengths and weaknesses – Assists organizations in identifying trends – Allows for “best practice” comparisons 17
  18. 18. Financial Initiatives • Margin / Profitability Ratios – Indicate excess or deficiency of revenues over expenses (i.e., operating results) – Measure by level of care • Operating Ratios – Types • Occupancy Levels • Payor Mix • Nursing Hours Per Resident Day • Overtime/Agency Costs • Dietary Cost Per Day • FTEs per 100, etc. 18
  19. 19. Performance Improvement Assessment Operational Initiatives
  20. 20. Operational Initiatives • Revenue Enhancement o Occupancy o Payor Mix o Case Management o Length of Stay o Ancillary Revenue o Campus Reconfiguration 20
  21. 21. Operational Initiatives • Expense Reduction o Agency Use o Overtime o Position Control Ancillary Services • Therapy • Pharmacy • Laboratory • Radiology • Medical Supplies o Human Resources • Wage Program • Hiring Practices • Employee Benefits o Campus Reconfiguration 21
  22. 22. Implementation of Performance Initiatives Do YOU have the strength and determination to move yourself from where you are to where you want to be?
  23. 23. Implementation • Establish Tone at the Top o “Buy In” o Communication o Eliminate “the unknown” for • Residents, Employees and Families • Identify Key Areas for Implementation o Correlate to your mission • Develop Specific Action Steps o Prioritize • Assign Responsibility – Individuals – Timeline – Repercussions 23
  24. 24. Implementation • Identify Outcome Measurements • Understand the Greater Good – Make the hard decisions 24
  25. 25. Sustaining Success This is what makes it meaningful!
  26. 26. Sustaining Success • Fluid Process – Continually monitor key performance indicators – Modify implementation plan – Smooth Sailing! 26
  27. 27. Conclusion In going from here to there, Meaningful is in the eye of the beholder If it is to be, It is up to me 27

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