Question

Create a thoughtful Mission, Vision and Value Statement (s) for Sunrise Nursing Home.

The Sundown Nursing Home is a long-term care facility and Assisted Living campus that celebrated its 50^th year of operation as a long-term care provider. The staff at Sundown focus on making their senior living communities feel like a home. They work hard to provide a safe and loving place to call home and strive to be trustworthy, kind, and respectful of the resident’s rights.

An organizational mission is important to Sundown, but they have been working without one. The CEO has been in her position for the last twenty-two years, long before vision and value statements were taught in any college program. The organization hasn’t conducted a formal strategic plan.

The Sundown operation is a non-profit and faith-based organization. Church services are offered with a non-denominational spirit. Non-profit companies, such as Sundown, are formed by incorporators, and has a board of directors and officers, but no shareholders. These incorporators, directors, and officers may not receive a distribution of (any money from) profits, but officers and management may be paid reasonable salaries for services to the corporation. Sundown is a Non-Profit Corporation that has been in good standing with the Minnesota Secretary of State, in effect since January 15, 1968.

According to the The Centers for Medicare and Medicaid Services (CMS), Sundown has a 3-Star status, placing its ranking among the middle 40–60% of nursing homes in Minnesota. The three-star rating is selected from a scale of one through five stars, by CMS. The five-star rating of CMS consists of the domains of health inspections, nurse staffing, staffing, and success of reportable quality measures. Sundown received a three-star rating for health inspections, a two-star rating for quality measures, three-star rating for nursing staffing and a three-star rating for registered nurses only. Staffing at Sundown is based around Registered Nurses, Licensed Practical or Vocational Nurses, and Certified Nursing Assistants and Therapists. (Center for Medicare and Medicaid Services (2015). In 2010, collective bargaining occurred. Sundown now has two unions within their organizations; a nurses union and one for the environmental service workers.

Measures used to assess and compare the quality of healthcare organizations are classified as either a structure, process, or outcome measure. Known as the Donabedian model, this classification system was named after the physician and researcher who formulated it (United States Department of Health and Human Services). The Agency for Healthcare Research and Quality has a website that allows the consumer to make the right choices for their loved ones when placing them in care. Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services. Sundown has never conducted a survey of its residents or staff.

At one hundred and sixty beds (160) beds, the Sundown location in southern Minnesota is the largest facility, caring for a total of four hundred and fifty-six residents (456), the largest census for the organization found in its Assisted Living units, as of January 1, 2017. In January 1, 2013, the total population was six hundred and thirty-two (632). Their facility, located in western Wisconsin is the smallest with only 82 beds. (Medicare Nursing Home Profile, n.d). Sundown averages $175.00 per day for patients receiving Medicare benefits of payment, which is 30% of their population, and $135.00 per day for patients receiving care via private pay, which is 30% of their census, and $105.00 per day based on those receiving Medicaid services, which makes up 40% of their census, or case mix. Five years ago, Sundown provided Medicare Short Term Stays for acute care patients needing in-house care and therapy, in order to return home. This move increased their Medicare volume from 10% to its current 30% census. This brought Sundown from operating at a loss, to its current 2% profit margin.

All five of Sundown locations accept Medicare and Medicaid for payment of care provided. This acceptance will accommodate residents who otherwise would not have the means to afford long-term care, helping to relieve stress on both the resident and their families. In a time where several Assisted Living facilities limit or refuse residents on Medicaid, due to low reimbursement, Sundown doesn’t refuse anyone admission based on payment source. Sundown makes a 2% profit margin with its current case mix. With pay for performance measures coming into play, their payment will transition over to payment based on quality of care, or CMS Star rating.

Sundown has several various services they provide, allowing patients to recover from surgery, injury or serious illness. Their team of qualified therapists work toward the specific goals of achieving the patient’s highest functional level of independence. The first form of services provided is short-term rehab, as mentioned earlier. Short-term rehab is specialized to provide care right after that patient has left the hospital. They then go to a service, like Sundown, right before the person can go home and live on their own. Usually short term rehabilitation will follow major surgery or after an illness. Sundown uses the enhanced revenue from its newly constructed short term rehab unit to offset the losses from the low Medicaid reimbursements. The goal of the recovery is to help a person rehab return to home with optimal functionality, where the person is deemed safe to return to an independent living situation.

Problem!

Recently, the Sundown CEO learned of a new hospital undergoing constructed next to the Sundown facility. The hospital also built two hotels, nearby. Surgical patients of the hospital will be encouraged to stay at the hotels, with a nurse specializing in their type of case, visiting them in their rooms the following day or two, to assess their status. This new model of care will eliminate the need for a short-term stay at Sundown, in several cases.

     Sundown CEO and Board of Directors have a strategic planning session finally scheduled for spring. The Board chair insisted on a Strategic Planning retreat due to the changing healthcare climate and the impacts of the Patient Protection and Affordable Care Act. They have much to discuss, analyze, and plan and you’ve been hired to conduct their analysis.

Your Objectives:

You will present them (me) with your Mission, Vision, and Value statements, as though you wrote in collaboration key stakeholders for Sundown.

You will present the CEO (me) with your Action Plan for moving the Key Strategic Initiatives forward.

You will present the CEO (me) with your Balanced Scorecard.

Answer 1

Mission:Sundown Nursing Home provides cost effective and holistic healthcare services to one and all.

Vision: Sudown Nursing home will achieve community health through compassionate health treatments and complete healing.

Values: We are a non profit organisation. Compassion and dutifulness comes before any profitability of the organisation. All the employees are devoted to the complete treatment of patients and human values are always put before cost. We strive for total health benefits for the society.

Key Strategic Initiatives for Sundown Nursing Home:-

Define short term Mission and Long Term Vision statements.

Develop strategies towards achievement of the Mission and Vision incorporating Values on which the organisation runs. All employees be educated, activated and motivated towards the holistic implementation of these corporate/management strategies.

Set specific times goals for the implementation of those strategies. Each goal soulg be well defined without any confusion of thoughts. Measurement of those goals being effected in place. Seeting target and achieveing them.

Balance Score card is a methodology for devising best strategies for an organisation to achieve its Mission in the short term and Vision in the long term by incorporating the proganisation core values or competencies. Balanced Scorecard for ths helthcare unit is as under which also highlights the key strategies:

1. STAKEHOLDERS : All inducted patients+ Physicians, surgeons and nurses+all addministrative staff, management and board. Alos the government and society at large which gets benefitted from the various healthcare programs and welfare measures.

2. INTERNAL PROCESSES/METHODS: Safety measures for treatment, surgery and day care functions. Standard procedures and eployee reporting measures. Target oriented treatment approach and Performance Management for eployees. Constant monitoring at all levels to ensure no detrimental processes for the organisation is activated.

3. FINANCE: All capital intensive and investment measures to be affected properly. Productivity and Profitablity in treatment to per patient level be taken into account.

4. LEARNING AND KNOWLEDGE UPDATION: Proper recruitment, regular training be imparted to all employees to empower them with the organisations mission and vision and the healthcare industry at large.