Beaufont 2011 Business and Marketing Plan

2011 Business and Marketing Plan Going from Good to Great

The Beaufont Butterfly Effect

PlannedAdaptation

& Success

Changes and ChallengesGrowth and

Expansion

Growth and Expansion

New 60 bed Addition

M2 Goals increased

New Positions Needed Unit Manager / ADON

Faster Pace / Discharge Focus

60 Bed Kitchen Mentality

Couldn’t keep up with our success

No Systems in place

BEAUFONT TO BUTTERFLY

Resting on our Laurels

Celebrating accomplishments of the past

Getting by / Wind in our sail

Realization that we to Change

System Break Down

Policy and Procedure Holes

Identification of Systems

Developing the Eye of Expectation

Managing Systems

Recognizing Success

BEAUFONT TO BUTTERFLY

Employee Terminations / Turnover

Commitment Generating

Implementation

Resident Concerns – Status Quo disrupted

QA Development

Commitment Generating

Implementation

Beaufont Health and Rehab Center


The Laurels of Willow Creek

Long standing relationships at Johnston Willis Hospital

M2 Market Leader several years

2 miles from Johnston Willis Hospital

Physical Plant dull and unattractiveTherapy Area unimpressive - Basic Equipment

Census Development 2010

• Said that we would increase our Market share % by 50% in 2009

2009 CJW Discharges: 2031 2009 BEF Admissions from CJW: 518 = 26%2008 Market Share Percentage: 17% = 50% increaseProjected to hold at 26% for 2010CJW 5% increase 2132 Discharges45.6 / month average from CJW to BEF =547 Admits2010 Projection = 26%








Census Development 2010We were to create awareness of our new 60 bed addition

• December 2009 met with the CEO and COO of CJW medical to develop a relationship, invite for tour and speak on ARC

• Jan 2010 met with Case management team at St. Francis Hospital to discuss our ARC program and expansion

• February 2010 Director of Case Management In our facility to tour with Sharon Hayes the COO or CJW system

• April 2010 – Meeting with the Hospitalist Group for HCA to present ARC and speak on our Expansion. Medical Director Participation

• August 2010 Meeting with case management to discuss the rollout of the new CHF Cardiac Pilot program

• 2010-2011 Leverage the relations we have established this year to promote business








Customer Service

We were to implement a pervasive customer service program.

• Bridge Builder program initiated: Awareness created and it was made part of our QA process. Ongoing training and discussion of daily concerns involve the associated bridge builder.

• CNA Mentor Program Implemented with success – members recognized in all staff and will participate in interview process.








Customer Service

2010-2011 Initiative:

• Joe Groten scheduled to train facility on New Bridge Builder and 24 hour Experience process

• Bridge Builder Champion Selection to ensure continued focus

• Experience Excellence Program: 24 Hour experience with F/U welcome packet and red carpet treatment

• Customer Service Woven into the fabric at Orientation. Every presenter has a segment on Customer service and its importance

• Mentor Program to be expanded to other departments and positions

• Family Council Meeting: First meeting to be held on October 20th








What We Do

We Don’t Sell Stuff

Our Business is SERVICE!!!

In 2010 a major ingredient was missing

Center 2008 M2 2008 M2 Market Share

2009 M2 2009 M2 Market Share

MS Chg

Center Name

Beaufont 35 20 39 20 -----

Laurels of Willow Creek

50 29 54 27 -2%

Envoy of Stratford Hills

34 20 38 19 -1%

Envoy of Westover Hills

29 17 26 13 -4%

Laurels of Bon Air

25 14 40 20 +6%

Total M2 Volume

173 197

Beaufont M2 Market Share Trends 2008-2009

2007 2008 20090

500

1000

1500

2000

2500

0510152025303540455055

23.0

17.0

26.0

409316

518

1770 18532031

Medicare Discharges Center Admissions Market Share

Market Share TrendShare Analysis- Total Discharge Based

CJW Medical Center

Market Share TrendShare Analysis- Total Discharge Based

2007 2008 20090

50

100

150

200

250

300

350

400

450

0510152025303540455055

6.010.0

16.0

20 3662

316357

398

Medicare Discharges Center Admissions Market Share

St. Francis Medical Center

M2 Actual and Budget


Sept '09

Oct '09

Nov '09

Dec '09

Jan '10

Feb '10

Mar '10

Apr '10

May '10

Jun '10

Jul '10 Aug '10

0

10

20

30

40

50

60

70

M2 Actual M2 Budget

What Does this mean

?

We experience essentially no M2 growth from September 2009 however the M3 average grew by

13.

As our Census Budget our Actual numbers plummeted

Inefficient Discharge ProcessDisengaged Admissions Dept

Total Admissions from all Sources


2005 2006 2007 2008 2009 2010 projected0

100

200

300

400

500

600

316 309

409

316

518501

12 17 16 25 34 34.56 16 20 36

62 72

Chippenham / CJW St. Francis

St Mary’s Medical Center Specific Admissions


2005 2006 2007 2008 2009 2010 YTD

0

5

10

15

20

25

30

35

40

12

17 16

25

34

23

St Francis Medical Center Specific Admissions


2005 2006 2007 2008 2009 2010 YTD- Aug

0

10

20

30

40

50

60

70

6

1620

36

62

48

CJW Medical Center Specific Admissions


2005 2006 2007 2008 2009 2010 YTD- Aug

0

100

200

300

400

500

600

316 309

409

316

518

334

Total Admission Volume


2005 2006 2007 2008 2009 2010 Projected0

100

200

300

400

500

600

700

800

900

1000

477 481

566614

778

873

Competitor Analysis – The Laurels of Willow Creek




M2 Market Leader several years (54 m2 avg)



Competitor Analysis – Laurels of Bon Air


Laurels of Bon Air: (An Emerging Strength)25 to 40 M2 growth (2008-2009) --- 70% growth and 6% market share increase

5 Star FacilityZero Deficiency Survey 2010

Private rooms for short term patientsPhone service in every room

Administrator is a Laurel (18 years) Served as admin at University Park and Bon Air)

Competitor Analysis – Tyler’s Retreat and Iron Bridge

Beaufont Health and Rehab Center - The Butterfly Effect

Saber HealthcareCreated in 2001 ( Purchased 2 facilities)

2009 Total of 29 Facilities

William Wesberg ( President/Owner) Turn Around Expert – Fix Failing Homes Focus on Census and Development Father was a Nursing Home Admin

Competitor Analysis – Tyler’s Retreat at Iron Bridge


Tyler's Retreat at Iron Bridge – 90 Bed Facility

New Facility – Large Rooms

60 Private rooms

14 Miles from CJW

Growing population of Skilled Patients AVG M2 24







Center StrengthsCombating the Enemy

• Hospital Proximity

• Strong team communication and follow-up

• Physician Services – Daily Visits and intervention

• Rehab Gym – Lifeworks, State of the Art Equipment

• Rehab Team – Recovery Map

• Bridge Builders

• Excellent Relationships with our primary referral centers

Next Level Building







Center StrengthsOutcomes

This will help to separate our services from

our competitors. No one can actually prove their therapy outcomes.

Discussion with hospitalist group – They want outcomes

Now tracked on PPS

New AD to send patient specific outcomes to case managers

Rehab Manager to visit orthopedic surgeons to discuss

Outcomes

Community Based Advertising







Center Branding and Awareness

• Seminar Advertising

• Radio Advertising

• Ruritan Club Membership and Involvement

• Partners in Healthcare Seminars

• Church Group Community Service – Health Fair

• Church Group Community Service – LTC Planning

Hospital Based Advertising







Center Branding and Awareness

Key Case Managers• Penny Woods• Leander Mondrey• Marrianna Thatcher• Sybil Jones

No True Relationship definite room for growth

Ground work has been laid for the new AD to build the

relationship with these. I have set the understanding that they will fully know what makes us

different.

Top Level Relationship Building• Peter Marmerstein – CEO• Sharon Hayes – COO• Jody Parker – Case Management Director

Developed Partnerships for ARC

Selected Exclusively to Pilot anew HCA Cardiac initiative

Personal Invitation from CEO to Attend quarterly meeting to improveHealthcare.

Hospital Based Advertising







Preparing the Product

What do Residents Think?

What do Employees Think?







My Inner View Survey Results - 2010







Dining Process

Implemented our Fine Dining Process in Feb 2010

2010 My Inner View Score 76% (National Average 72 - 2011 Goal 85%• New Dining Room Process Audit

1. Monitors Staff interaction 2. Service Flow3. Infection Control Items 4. Suggestions

Ensure Restaurant Style Dining that the quality of food is consistent

New RD and Dietary Manager will be vital in the implementation.







Quality Nursing Care

Quality RN/LPN Care: 14 percentage points lower than our peers

• DON to hold 15 minute meetings with her leadership team and set specific goals for the week and measure their success

• HR manager to assist in situational leadership and management for the DON and concentrate on top notch customer service to ensure that nurses understand the meaning of quality service and appropriate communication

• Improve the interviewing and hiring process with focus on panel interviewing and involving the Unit Managers along with other nurse management individuals.







Quality CNA Care

Quality CNA Care: 2 percentage points lower than our peers

• Engage the CNA mentoring program with Department support along with constant recognition of facility mentors

• Extended orientation class to include ongoing BASIC CNA skills classes delivered as refresher course

• Closed units implemented July 1. CNA’s hired for specific units ( LTC vs Rehab)








Clinical Outcomes

Goal: Clinical Systems to be implemented at 100%• For our Revisit we are promising 0 deficiencies• 3 star in quality measures• Clinical Indicators are our guide to quality and success• 0% in-house by Ensuring Weekly Skin

monitoring/sweeps • Continue trend of decreasing falls ( Behavioral

Committee and Tracking through Falls instrument)• Falls as an IDT – Psychiatrist to intervene when

necessary – Discussion of appropriate interventions and if they are successful daily and in QA








Clinical Outcomes

Slip in the clinical product

– 7 systems down from 8 last inspection

– 3 Stars in quality clinical outcomes down from 4 stars

– My Innerview results significantly lower than national average








Clinical Outcomes

• Leverage the Medical Director to Funnel Patients and help with developing relationships with key referral Partners

• Nursing Administration Team– Management Training and Support– Reduce Turnover and Bring Stability to Nursing Staff

• Leverage Strong Nurse Consultant to Help Implement Systems

• Emphasize QI/QM Reconciliation, Med-Pass Audits, MAR/TAR Audits

• Unplanned Discharged Monitoring through War Room Process – Staff Developer Engaged to provide case review when necessary

• Manage to Systems and not People








Employee Relations

• Most Recent Employee Opinion Survey Rated as an Orange

• Much of unrest is due to changes: MDS, physical plant, focus on facility vision ( LTC vs Short Term Rehab), Rehab Focus of Productivity.

• Top Concerns: Staffing, Communication between shifts, Supplies being available.

• Staying in front of the staff – communicating at every opportunity especially in all staff to reduce probability of confusion. Having the plan in place prior to changes occurring. (expect the change)








Employee Relations

• Staying in front of the staff – communicating at every opportunity especially in all staff to reduce probability of confusion. Having the plan in place prior to changes occurring. (expect the change)

• Communicating the upcoming events prior to implementation – ensuring they feel as if their voice is heard

• Employee Recognition through Making a Difference Program.

• “Bumble Bee” Team- Focus on morale and employee events. Meets Monthly

Turnover and Retention Trends

2008 2009 20100

20

40

60

80

100

120

38.9246.63 44.7

107.198.57

90.19

Turnover Retention









Labor Hour and Expense Control

Precisely Manage to Adjusted Census Levels

• Goes hand and hand with creating a “Census Culture”

– Knowing census daily and managing their department from a PPD standpoint

– Department Heads Report daily on PPD’s, Staffing and that days plan to correct if necessary

– From Staffing to Expenses using staffing adjustment sheets and Budget spend down sheets weekly








Labor Hour and Expense Control

Manage Overtime Aggressively - Below 2%

• Staff to take ownership in their department through monitoring time punches, meal breaks, staffing needs, being good stewards of the resources that have.

• Open Positions make it difficult to manage this component.

• Instill “It Is My Money” Mentality

Operating Vs Patient Days


Sept '09

Oct '09

Nov '09

Dec '09

Jan '10

Feb '10

Mar '10

Apr '10

May '10

Jun '10

Jul '10 Aug '10

0

50

100

150

200

250

Operating Linear (Operating) Patient Days








Cash Collections

• Weekly A/R Meetings ( BOM and Administrator) with Consistent follow-up and note documentation – collection on small amounts as well – focus on A/R clean up – Admin to assist.

• 5 months in a row currently with a pick up from diligent A/R Activity

• Ensure collection policies are followed– Warrant and Debt not last step– Private pay residents paying up front

• Back-up admissions team in place to insure that we get contracts signed – Contract Status to be discussed daily

• Backup team to include department heads have been trained on the electronic contract process.

• Verify payor source prior to and on admission• 5 day discharge planning meeting addressing potential financial

concerns early on.

Measurement of Our Success

Annual Survey Results

Resident Satisfaction

SurveyQuality

Indicators

Bridge Builder

Feedback









Strategic Focus Summary

• Position to be the pre-eminent provider of high quality, customer-centric, transitional rehabilitation services in the Richmond market.

• Accomplish this strategy by executing the following initiatives:– Effective marketing, positioning, and Relationship Building .– Implementation of a pervasive and complete Customer Service

program and culture.– Improve Clinical Outcomes with a focus on system implementation– Improve employee relations by focusing on retention via

employee customer service, communication, and training.– M2 Market domination – Averaging 55 m2 census through

messaging and continued presence.

Beaufont 2011 Business and Marketing Plan

Documents

Transcript of Beaufont 2011 Business and Marketing Plan