Watch out for “Smart” people
This ain’t rocket science. Stop hiring smart
people. They just mess up your system.
We have a benign inside joke at MVI. When we say a
CFO, or some other Manager, is a “smart” person, we
are really saying this person is too smart for their own
good. Hospice is full of highly intelligent people who
stumble over simplicity. As predictable as a Hallmark
movie, they add layers of complexity, requiring more
and more staff . . . and provides less actionable
information to prove how smart they are.
When I first started processing Hospice Medicare cost
reports several years ago, I quickly saw a correlation
between census and profitability. Bigger is better?
No, it’s the opposite. The sweet spot for profitability is
between 35 and 70 average daily census. Most large
Hospices don’t know how to do economies of scale.
As organizations get larger, the “smart” people tell
us we have to do this and buy that. And we don’t tell
There are only a few metrics needed to run a
Hospice. “Smart” people can’t see them. These
smart people often come from Hospitals and big
corporations and they want to bring a 747 panel of
management tools to you. Think about that . . . do
you really want your Hospice to run like a Hospital?
Forego the smart people. We want talented people
who can simplify our systems.
What do we really need? A good chart of accounts,
some simple reports that can be understood by a CNA
or a CPA is all you need and high-quality visit from
thinking from the chair! MVI 101.