IDEAS YOU CAN COUNT ON On a consultant job, McCormick says
he’ll often ask people to define different levels of care or service offerings. Not only do people rarely know—they don’t even have it written down or filed somewhere. This denial is also a problem for other
residents, who may experience a service dip if caregivers are consistently doing extra work. McCormick points out that service level agreements are often on contracts and in marketing language and collateral. Not adhering to these can lead to misunder- standings among newcomers or prospective residents. “Even if it’s just minutes, those are
minutes taken away from somebody else,” McCormick says. When there’s a documented need for a
service-level change, leadership can make the case for more staff. When no one reports or documents residents’ changing needs, it can create a downward spiral—staff could become overworked, and quality could suffer. While it can be “quite awkward,” McCor-
mick says, having the difficult conversation can result in a win-win: “It helps staffing levels. It helps the community. And the fam- ily recognizes that the services are needed and need to be charged for appropriately.” “Let's just get it out in the open and be honest about these things.”
The easy places to save With the difficult part out of the way, we could talk about finding the low-hanging fruit. McCormick points to three things to look at first to increase efficiency: • Regularly talk to direct care workers who have been there for years about what they see. These dedicated workers know the residents very well.
• Challenge why we have certain meetings. Many are formed out of habit and need to be refreshed or changed periodically.
• Efficiency around shift changes causes the most overtime related to documen- tation or mealtimes. Staggering some shifts leaves time for all tasks.
The third idea can have a big effect for a relatively small change. “Sometimes we see in communities with strict shifts that over- time ends up happening. The first shift is coming in to take care of residents, but the third shift person didn’t have time to wrap up their documentation, because they were busy helping residents,” McCormick explains.
But staggered shifts provide overlap—
residents are seamlessly cared for, and asso- ciates can finish records and documentation on their regular shift hours.
Delegate and empower Related to this is the problem of the ex- ecutive director who has too much to do. Empowering department heads, delegation, and the right tools can make a difference— and quickly. “I’m always surprised at what ideas people can come up with,” McCormick says. “All department heads can have some level of responsibility to look at operations.” Ask what
technology could help, or
what role departments can play in census development. Even if there are no revolu- tionary ideas, you end up with the whole team aware of each other’s challenges and the community-wide ones. A maintenance director may point out that the carpet needs shampooing more often, or the plants in the front need mulching. With empowerment, ideas start to fly. “It’s an energy boost,” McCormick says.
Tracking this information can take some
serious software. Fortunately, there are many options in the senior living space. McCormick mentions PointClickCare as a good product, but stresses that there are many other quality choices. But users don’t always understand all the ways they can use the software. “Another kind of low-hanging fruit is
interfacing with your software company and having them look at how you're utilizing their software. Sometimes they have modules that you aren't even using, or not using to the fullest. Maybe retraining might be necessary. “People blame the software, but it's often
not a software issue. It's more about setup and appropriate training.”
Today, and five years out Long-term strategy is carried out a day at
a time; a financial strategy should connect to the daily budgeting and documentation. “Too often people just budget year by
year,” McCormick says. “Frankly, you end up being very operationally focused, and not strategic.”
“Our contingency planning is more robust than what it would have been even six months ago. There is an opportunity to reflect, particularly in some of those areas that aren't as hard-hit right now.”
Data (and software) is critical Labor costs account for two-thirds of a typi- cal community’s overall expense structure, McCormick says, so it makes sense to watch it carefully. Here’s how: • Monitor total paid hours by pay period • Watch overtime by department • Determine how you manage non-pro- ductive time related to trainings or PTO
• Create a baseline for each department and monitor it by pay period.
• Adjust hours budgets for changes in census
The most informative data you can get is on hours—and it’s even better if you can watch it daily (see p.12 for an example).
12 SENIOR LIVING EXECUTIVE SEPTEMBER/OCTOBER 2020 “I consider it a kind of financial architec-
ture—because there’s an art to this, too,” he says. An executive director setting her sights on interactive training or sensor-based technologies needs to budget for it. “By looking at it from a bigger-picture
perspective, you can figure out how to make sure you get the right return, not in the individual year, but over time,” McCormick says. “I think that's where a lot of people fall short—they look at it operationally year by year, instead of saying, if I make this investment this year, here's what happens over a three-year period.” Another kind of low-hanging fruit is deter-
mining the actual cost of services and pricing accordingly. A community may fall into the practice of following the price lead of other
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60
