Enhancing Organizational Structure and Centralization for Mission Effectiveness October 28th, 2017 / 1:15 PM Sponsored by
Facilitator: Susan McDonough Catholic Elder Care Specialist Ziegler
Presenter: Paul MacGiffert President & CEO The Carmelite System, Inc.
PRESENTER Paul MacGiffert President & CEO, The Carmelite System, Inc.
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.
Our Mission The 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 Vision The 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
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
Healthcare is dynamic We must be too
Organizational Change is Not Easy! It requires effective and timely communication and process
Confirm the Why s
Key Steps for Success 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
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
Clarity of Roles within Realm of Influence
The Carmelite System Finance and Operations Organizational Chart COO Director of Revenue Cycle, Director of Payroll Corporate Director of Operations Vice President of Finance 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 Our Team Mid West Facilities External Client 1 External Client 2 Home Health Clients 3 BLrs & Fac Stf 4 BLrs & Fac Stf 2 BLrs & Fac Stf 3 BLrs & Fac Stf Positions aligned to drive operational success Positions aligned with proper technology to succeed Fin Rpt/Bud CM, Villas 2 entities Fin Rpt/Bud Invst, Contrib & I entity Fin Rpt/Bud 2 entities Fin Rpt/Bud/ NY Cst Reports, 2 entities Front End And Collections Experienced staff willing to do the work Hands on System Wide Accounts Payable, Annette Each Member of the Team needs to be engaged and focused on working together to deliver results for the Carmelite Ministry and its Clients
What did we accomplish 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
Top Organizational Risks/Priorities: Market Share Preferred Provider Discharge Planning Scope of Services CMS Payment Policy Value Based Purchasing Manage Care Mission Leadership / Formation Capital Prioritization / Access New Entrants / Home Services Cost Structure Attracting/Retaining Staff RN, LPN C.NA Information Technology / Security Margin Compression / Organizational Agility Facilities Attractive / High Quality Pay Rate Pressures Labor Shortages Direct Care
Significance of Information to our organization. Managing by metrics, versus managing by gut Effective Decisions: Leveraging Data, Information, Experience and Wisdom Common feedback, Mangers don t know Use information as a tool, not a weapon Futur e Lean In / Lead Up Toda y
Execute Bringing Everything Together: Planning/Messaging/Acting Phase 1 Phase 2 Phase 3 Culture of Excellence Employee Engagement Training Competency Accountability Risk Managemen t Role of System vs Role of Home Standardization Tools / IT / Web Training Transparency/Tru st Leveraging Regionalizatio n and Shared Services Best Practice Sharing Lowering Cost of Administration and Support Services 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.
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
Thank you. Paul MacGiffert President & CEO The Carmelite System, Inc. paulmacg@carmelitesystem.org www.carmelitesystem.org Susan McDonough Catholic Elder Care Specialist Ziegler smcdonough@ziegler.com www.ziegler.com