How Can Senior Care & Living Organizations Increase Efficiencies for Improved Results?
by Terry Mambort, NHA, Operations Specialist
Senior Care Industry Update, January 2008

Senior care and living organizations face a number of challenges, including declining reimbursement, compliance issues, staffing level issues, and quality service issues, to name a few. Often these issues have solutions; but you just need to take a fresh look.

Taking a fresh look can be accomplished by conducting an independent operational review. This kind of assessment is designed to provide solutions, resulting in increased efficiencies, recovery of lost revenues, and hundreds of thousands of dollars in savings from all major areas of operations.

Operations Assessment — Why Doesn’t Everyone Do It?

Why doesn’t everyone conduct an operations assessment? Some of the common barriers we see are:

• Lack of urgency - the bottom line is fine today, but providers lack future capital planning.
• The idea of change is not part of the organization’s culture.
• The organization isn’t creating buy-in from senior management, staff, and residents.
• Senior management is defensive about past and current performance.
• Management is not allowing enough time to implement solutions.

Many organizations conduct operational reviews when performance has reached a point where operational losses are significant and/or bond covenants have been violated. In actuality, operational assessments should be conducted when things are going well, as such a review can make strong organizations even stronger.

Operations Assessment — How Does It Work?

Once an organization has selected a qualified firm that understands senior living needs and objectives, operational assessments typically have five steps:

1. Information gathering, which allows the firm to become familiar with the organization.
2. An onsite review of policies and procedures, as well as interviews with various department heads and managers, to observe and validate processes.
3. An executable plan. This is a prioritized set of recommendations that includes the issues, proposed improvements, the staff responsible, and the cost benefits.
4. Presentation to owners and key management. While the numbers are important, this presentation focuses more on the organization’s initiatives and sets a path for implementation.
5. An implementation phase; depending on the organization’s resources, hands-on implementation can be provided.

Operations Assessment — How Do I Implement It?

Aside from contracting a consultant for actual implementation tasks, we find the following steps are integral. Successfully implemented solutions gleaned from an operational study:

• Create a review task force. This team of senior staff and owners should look at all recommendations.
• Evaluate recommendations. Typically, organizations classify recommendations into three categories: can be achieved, can be achieved with modifications, and will not consider.
• Prioritize recommendations. The task force evaluates the timing of execution of recommendations into short, medium, and long term.
• Focus on establishing polices and procedures around solutions that build toward best practices.
• Work the plan for short-term “wins” first.
• Look to involve department heads for new ideas that foster continuous improvements.

The Bottom Line

Oftentimes, organizations are too focused on day-to-day activities and procedures based on historic results. An operations assessment can help organizations gain that fresh perspective, increase efficiencies, and capture much-needed dollars toward the bottom line.