enhancing organizational structure and centralization for...
TRANSCRIPT
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Sponsored by
Enhancing Organizational Structure and Centralization
for Mission EffectivenessOctober 28th, 2017 / 1:15 PM
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Facilitator:
Susan McDonoughCatholic Elder Care Specialist
Ziegler
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Presenter:
Paul MacGiffertPresident & CEO
The Carmelite System, Inc.
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Paul MacGiffertPresident & CEO,
The Carmelite System, Inc.
PRESENTER
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
❖ History
• Founded by Mother Angeline Teresa McCrory in 1929 in New York.
• Mother Angeline had been a member of a French Religious Congregation (the Little Sisters of the Poor)
but felt a calling to provide for the elderly according to the American traditions. She formed this new
Congregation with seven residents and seven Sisters in St. Elizabeth’s Rectory in Upper Manhattan. In
1931, St. Patrick’s Home in the Bronx became the first full fledged home.
❖ Current Membership is 163 serving in 20 facilities:
• Thirteen sole sponsored facilities
• Seven Diocesan sponsored or co-sponsored facilities served by the Order
❖ Facilities are located in eight states including, New York, Massachusetts, Pennsylvania, Florida, Ohio,
Kentucky, Illinois and Iowa, as well as one in Ireland.
❖ Sisters serve in various positions including Administration, Pastoral Care, Social Services, Nursing, Dietary
and Activities at each facility.
❖ The Avila Institute of Gerontology, Inc., founded in 1988, serves as the educational arm of the Congregation
providing workshops and seminars to enhance the knowledge of those who care for the elderly.
❖ The Carmelite System, founded in 1999, was established to help perpetuate and strengthen the long term
health ministry of the Carmelite Sisters in the United States and Ireland.
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Our MissionThe Carmelite System fosters the healing ministry of Christ in Catholic
health care by proclaiming the value and dignity of the aged and infirm and
providing collaborative ways to meet the needs of today’s elderly. A
commitment to compassionate, loving care of the highest standards with
wise stewardship of resources is the hallmark of programs and services
rendered.
Our VisionThe Carmelite System will be a beacon of Catholic health care to the aged
and infirm and to all those whose lives we touch. It will proclaim the value
of life and the beauty and dignity of old age and will strive to maintain a
leadership role in the shaping and delivery of services and programs of
care for the elderly
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Programs and Services
Service Model Core Programs
1. Mission Enhancement
2. Resident Care & Clinical Program Support
3. Centralized Insurance program
4. Group Purchasing
5. Employee Benefits
6. Self-Funded Health Plan
7. Collaboration and Networking
8. Advisory Services
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Healthcare is dynamic
We must be too
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Organizational Change is Not Easy !
It requires effective and timely communication and process
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Confirm the Why’s
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
▪ Vision, Education, Buy In▪ Leadership and Talent (Get the right people on the
bus)
▪ Decide (Build or Buy)
▪ Commit (Time and Money) -- It took us 18 months – 13 Facilities
▪ Build Infrastructure (IT Software)▪ GL (Jan 2016)
▪ AP (Jan 2016)
▪ Revenue Cycle and Clinical (7/2016 to 5/2017)
▪ Scheduling / Productivity (2/2017)
▪ Payroll (3/2017 to 7/2017)
▪ Align Staff and Technology
Key Steps for Success
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Programs and Services
Governance Change
1. Obligated Group Financing Structure
2. Regional Structures-Finance and Reporting
3. Centralized Revenue Cycle Management
4. Centralized Payroll
5. Scheduling and Productivity
6. EHR/Clinical and Financial IT
7. Clinical Reimbursement
8. Information Technology Coordination
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Clarity of Roles within Realm of Influence
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Our Team
…
Each Member of the Team needs to be engaged and focused
on working together to deliver results for the Carmelite
Ministry and its Clients
Front End And
Collections
System Wide Accounts
Payable, Annette
External Client 2
2 BLrs &
Fac Stf Fin Rpt/Bud 2 entities
Home Health Clients
3 BLrs &
Fac Stf
Fin Rpt/Bud/ NY Cst Reports, 2
entities
Mid West Facilities
3 BLrs &
Fac Stf
Fin Rpt/Bud CM, Villas 2
entities
External Client 1
4 BLrs &
Fac Stf
Fin Rpt/Bud Invst, Contrib & I
entity
MA Rev Cycle and
Mast File,
2 Blr, Fac
Staff
Payroll Adjustments
Analyst
Revenue & Clinical Systems
Integration Analyst, Fin Rpt/Cons, 3 entities
NY Facilities
6 BLrs &
Fac Stf
Masterfile and
Reporting Analyst
Prod & Fin System Integration
Analyst, Fin Rpt/Bdg, 3 Entities
The Carmelite System Finance and Operations Organizational Chart
COO
Director of Revenue Cycle, Director of PayrollCorporate Director of
OperationsVice President of Finance
• Positions aligned to drive
operational success
• Positions aligned with proper
technology to succeed
• Experienced staff willing to do
the work – Hands on
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
▪ 13 facilities on common IT platforms▪ Accumatica
▪ Point Click Care
▪ OnShift
▪ Ultipro
▪ Shared Service Centers▪ Centralized Revenue Cycle
▪ Centralized Reimbursement
▪ Financial Reporting, Centralized Audit,
▪ Centralized PBJ
▪ Productivity / Scheduling
▪ Centralized Payroll
▪ Able to right size to non-Carmelite sponsored entities. One size does not need to fit all……
What did we accomplish
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
▪ Top Organizational Risks/Priorities:
Mission Leadership /
Formation
Capital Prioritization /
Access
New Entrants / Home
Services
Facilities Attractive / High
Quality
Margin Compression / Organizational
Agility
Information Technology /
Security
Attracting/Retaining Staff RN, LPN
C.NA
Cost Structure
CMS Payment
Policy
Value Based
Purchasing
Manage Care
Pay Rate Pressures
Labor Shortages
Direct Care
Market Share
Preferred Provider
Discharge Planning
Scope of Services
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Significance of Information to our organization.
• Managing by metrics,
versus managing by “gut”
• Common feedback,
Mangers don’t know
• Use information as a tool,
not a weapon
• Lean In / Lead Up
Toda
y
Futur
e
Effective Decisions: Leveraging Data,
Information, Experience and Wisdom
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Bringing Everything Together: Planning/Messaging/Acting
•Employee Engagement
•Training
•Competency
•Accountability
Culture of Excellence
•Role of System vs Role of Home
• Standardization
• Tools / IT / Web Training
•Transparency/Trust
Risk Managemen
t
•Regionalization and Shared Services
• Best Practice Sharing
•Lowering Cost of Administration and Support Services
Leveraging
Phase 1 Phase 2 Phase 3
Phase 3 of the Plan will require organizational alignment and support. It will
result in some difficult decisions, loss of some autonomy, narrower scope of
responsibility (focus), ability to accept and implement change, willingness to
hold individuals accountable.
Execute
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Emerging Risks, Areas of Focus at the Facility
Level
▪ Readiness for Value Based Purchasing
▪ Publicly reported measures (PBJ)
▪ Nursing shortage / Staff Turnover / Preceptorship
▪ Wage-rate pressure, particularly CNA and HSK
▪ IT Security / Infrastructure
▪ Shorter length of stay requiring, increased admissions (market share concerns)
▪ Patients / Referrals have significant behavior issues
▪ Declining Reimbursement
A d v a n c i ng t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g
Paul MacGiffertPresident & CEO
The Carmelite System, Inc.
www.carmelitesystem.org
Thank you.Susan McDonoughCatholic Elder Care Specialist
Ziegler
www.ziegler.com