Yes Virginia, There is a Santa Claus!

If you have been following my Blog, you know that we have been waiting (not so patiently) for the State to issue our new 2009 and 2010 Medicaid rates. This past week nursing homes finally received written notice of their 4/1/09-12/31/09 and their initial 1/1/10-3/31/10 Medicaid rate.

As a quick refresher, the new rates were to incorporate several new rate-setting methodologies that would ultimately result in both winners and losers among nursing homes across the state.We were hopeful that the preparation and work we have put in over the past 2 years, to help maximize our Medicaid rate reimbursement, would make us a winner and result in a higher rate for us.


Although we had some guidelines to make some reasonable estimates, not enough was known to compute an accurate rate for 2009 or 2010. Until the actual rates would be published, we opted to use the existing rate of $ 155 for the 2009 interim financial statements and established 3 budget scenarios for 2010 using a worse case ($155 rate), moderate case ($163 rate) and best case ($171 rate). Based on these scenarios, we estimated we would need to enact a deficit reduction plan of $300,000 under the moderate case and a $600,000 reduction plan under the worse case.

Well it looks like Christmas may have come late for Kirkhaven this year. Both our 2009 and 2010 rates calculate to $183.00/day (better than even our best case scenario). This should result in a retro settlement payment for 2009 of around $ 750,000 . That will pay off our $500,000 line-of-credit and other short-term borrowings and bring us to a decent surplus with our 2009 financial performance .


For 2010, the $183 rate will eliminate our need to enact any immediate deficit reduction plan, and result in enough of a surplus to resume fully funding our depreciation expense (reserving for future capital replacements) and perhaps enact a wage increase for staff. How and when we would spend any projected surplus will still need to be evaluated and approved by the board.


The issue still for 2010, is that the $183 rate is only "solid" until 4/1/10, at which time a whole new rate methodology (regional pricing) is expected to be put in place. Similar to what we just went through in 2009, nobody really knows the impact of this methodology and thus our rates could go down, up or stay consistent. Since the 4/1/10 rate will have a significant impact on our 2010 budget assumptions, we may have to still be cautious with granting wage increases or other spending until we have a clearer picture.


Regardless, we are at a much better place now than we were before. 2009 has been salvaged and 2010 is off to a good start. We still don't know when these new rates will actually be paid. They must be approved by CMS and run through the Medicaid administrative process. It could be weeks or months but as far as we know, it is just a matter of standard process and protocol. I'll be "dancing on the tables" when we actually receive the cash, but in the interim, I'm still smiling on the inside and will sleep a little sounder.


Kudos to all the staff at Kirkhaven who have worked tirelessly and professionally as new strategies, policies and procedures have been implemented in preparation for maximizing our reimbursement rates. Our higher rates are not an accident or a whim, we earned them!

Yes Virginia, there is a Santa Claus!

At Seniorsfirst, Our People make the Difference!

There is a proven relationship between the level of job satisfaction by the staff and the level of quality outcomes by the organization. In the senior services field, quality care and service cannot be provided without satisfied employees.

Therefore, as CEO, it is important to me that I ensure and foster an organization that has a high level of staff satisfaction. My philosophy is that if I can keep our family of staff happy and joyful in their work, than Seniorsfirst will always be a happy and joyful place for our residents and clients. Sounds simple enough, but it is a challenge and something we must work at every day!

To monitor our success in this endeavor, we routinely hire an outside, independent consultant to confidentially coordinate, compile and report on an employee satisfaction survey process and its results. We want to know how are employees are doing and how they rate their employment experience at Seniorsfirst.

We recently completed the 2009 Employee Opinion Survey and I'm pleased to say that the results continue to be outstanding. We will be sharing the results with staff at special employee meetings, but all my blog readers can get an advanced peek at the summary results.

At Valley Manor, with 66% of the staff responding:

• 80% are satisfied overall with the organization's leadership
• 88% are satisfied overall with the direct supervision they receive
• 68% are satisfied that they receive a fair wage for the work they do
• 81% are satisfied overall with their benefits package
• 95% are satisfied overall with the work environment & safety conditions
• 82% are satisfied with the communication within the organization
• 95% would recommend Valley Manor as a good place to work
• 91% would recommend Valley Manor to family and friends for service
• 90% are satisfied overall with the job environment
• 86% believe the survey results will be used to make Valley Manor better

These scores far exceed industry standards (our consultant tells us) and have been attained and sustained for the past several years.

At Kirkhaven, with just under 50% of the staff responding:

• 68% are satisfied overall with the organization's leadership (65%)
• 79% are satisfied overall with the direct supervision they receive (69%)
• 57% are satisfied that they receive a fair wage for the work they do (54%)
• 80% are satisfied overall with their benefits package (67%)
• 88% are satisfied overall with the environment & safety conditions (70%)
• 66% are satisfied with communication within the organization (60%)
• 85% would recommend Kirkhaven as a good place to work (73%)
• 82% would recommend Kirkhaven to family and friends for services (71%)
• 86% are satisfied overall with the job environment (69%)
• 80% believe the survey results will be used to make Kirkhaven better

These results represent even greater improvement from the previous year and in all cases are higher than what the national averages are within the nursing home field (shown in parenthesis).

As senior service facilities continually work to develop a comprehensive approach to quality outcomes, assessing employee satisfaction is essential. Providers that monitor and foster staff satisfaction and commitment to their work, position themselves for better success in retaining the best employees and the best quality of service.

I am both thankful and proud of our employee satisfaction results and pledge to continue to support staff in as many ways as we possibly can to ensure continued and improved results. For we all know that, at Seniorsfirst, Our People make the Difference!