Your Numbers are your Truth

July 18, 2019 - 5:00pm -- bill.taylor@mul...
Which is better, to run a Hospice with a census of 30 with top CAHPS scores or to run a giant 1000 ADC Hospice with mediocre scores? Which Executive Director gets more respect at big Hospice association events?
Here’s what we have learned: When you focus on the visit first, your quality first, then your other numbers fall into place.
Two examples I saw just last month at large Hospice organizations.
I was talking with a CEO, CFO and a Clinical Director. I was advocating a concept we’ve taught for years: All service failures should be reported to the CEO or Executive Director immediately. We teach this not because we expect the CEO to address each one. We want the CEO to feel the pain. Pain is a spiritual value. Change comes from pain. But, the poor CFO in the conversation said, “What if there are a lot? The CEO won’t get any thing done but read about service service failures.” Long pause. And, of course, I said, “If there are that many service failures, then the CEO should have to deal with them.”
It was a big Hospice. Lots of VPs and leaders and such. Mediocre quality scores and weak financials. Clinical leadership brought us in to pitch quality innovations to management. It was going great until the CEO walked in the the room and sucked all the air out. Sometimes a big census leads to arrogance in top leaders. They think a big census is evidence of their superiority over the rest of us. Your can’t give water to a person who doesn’t know he’s thirsty.
Here’s your truth. In the right order.
  1. If you have high on-call costs and mediocre CAHPS scores, you have a quality-of-visit problem. Address the mission first. Build our your visit structure and Standards. Make them clear, impressive and sustainable. Then stick to them. Nothing is more important than the visit.
  2. Do you have an operational profit of at least 14%? 10% if you have an IPU? Nope, you can’t count donations or grants. Get this piece right next. The expectation of continuous profitiability means you can focus on the mission today . . . and for a thousand tomorrows.
  3. Then comes census. But when you perfect your visit, census follows. We’ve seen it over and over.
This is your truth.


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