Act NOW - Waiting Won't Improve Things

Last week I presented to a large room full of home care and hospice agency managers.  I also attended the funeral of one of my favorite people, my uncle Mark.  This morning Linkedin sent me a great article, "14 Lessons From Benjamin Franklin About Getting What You Want in Life", which I read and appreciated.  These three events may sound isolated, but to me, they each reinforce the strong message of the importance of ACTION over words.

Through the 90 minute presentation at last week's Southwest Regional Home Care Conference the audience of 80 or so appeared engaged.  Responding with a knowing nod at all the right times.  No one fell asleep or left, as far as I could see.  Good presentation, right?  The answer is "we'll see".  I have presented at home care conferences for years.  At first thinking the "knowing nods" meant everyone understood and would go back to their agency and make the necessary changes.  I now know that is rarely the case.  There was hearing, reading, sometimes note taking and, or course, head nodding, but, if history is any indicator, very little action.

My uncle Mark was a great guy.  A thinking, challenging, fun, contrarian, awesome guy.  He was a monk in training, a Marine, a professional photographer, a poet, a writer and many other things.  He believed there is a type of evolution to society.  That every generation was supposed to "learn from the previous generation by taking the good stuff and building on it while getting rid of the bad stuff."  Change and evolution are natural so the world requires action.  While others talked he acted with purpose.

The Linkedin article link about Benjamin Franklin ( www.businessinsider.com/14-action-inducing-lessons-from-benjamin-franklin-2012-4 ) sounds like it was written precisely for the current challenges of today's home care industry.  The author of the article introduces the lessons this way, "Here are 14 action-inducing lessons from him:".  I guess it is human nature to fear action and to fear change.  I won't list them all out here but it is a great Monday morning eye opener.

Hopefully, as you read this, and the Franklin article, you nod along in agreement.  Take the following quote to heart and when you've finished reading the last line then ACT.  "Well done is better than well said.", Benjamin Franklin (although it could have been said by uncle Mark).

If you don't know how then ask.

Steve

5 Things...#1 STRATEGIC PLANNING

Every business must have a documented mission and routinely update, in writing, short and long term strategies and actions.  Just like no plane would take off without a flight plan, no home care or hospice agency should operate without a documented plan.

First, don’t get hung up on the terms.  What’s important is to have a documented mission, whether or not it meets someone’s definition of “mission statement” or “vision statement”.

Why it matters:  I see agencies with stand alone mission statements that hangs on the wall or live in a dusty binder somewhere on a shelf.  I am sure it was drafted with the best of intentions and might even represent what the agency thinks is important, but if it does not drive every action in the agency then it is just pretty words.  A good mission is the heart for the agency, and if used, it is powerful!  

Here’s a simple process for establishing and supporting a documented mission.

1. Document your goal.  What is the most important goal your agency is trying to achieve?  It is OK to sound like Miss America here.  Whatever you put here will be vetted when you create your flight plan and the details are flushed out.
2. Document your flight plan.  Now start asking yourself “How are we going to accomplish our goal?”.  This should be a short list of bullets points.  Now, address each bullet point and ask again, “How are we going to accomplish it?”.  Do this as many times as you want.  At some point you start getting into actions and outcomes.  These are the details of the structure, tools and numbers that will be used later to manage the agency.
3. Now evaluate your work.  Does your documented goal still represent the agency’s highest goal?  Do the details flushed out in step 2 represent your agency’s actions and setup?  If they don’t then you can either change what you wrote or change the agency so it can achieve the goal.
4. Formalize it!  Once you have the goal and the first level of the flight plan where you want them then make it official, this is your documented mission!   Keep all levels of detail you created for the flight plan.  They will be used later.
5. Now use it!  Post it, quote it, ensure everyone knows it.  Open meetings by quoting it, “This agency is here to ...  We will accomplish that by ....”.  That is a best way to ensure you are accomplishing the agency’s work and not just busy work.  Use it to start interviews with prospective employees.  Use it when you market to the community.  Use it when you update processes, job descriptions, business planning, etc.  Use it!

EXAMPLE:  Our goal is to be the largest Medicare home care provider in the service area.

We will achieve our goal by:

• helping our patient’s achieve the best possible outcomes; we will achieve this by...
• hiring and retaining highly skilled and caring clinicians
• providing all training, mentoring and tools required 
• etc...
• continuing to grow our Medicare home care patient base; we will achieve this by...
• helping patient’s achieve the best possible outcomes
• hiring and retaining highly skilled and caring marketing staff
• etc... 
• running a successful business
• be knowledgable
• be efficient
• etc...

Even though this is just an example, you can see that the goal and first level of the flight plan (in bold) is the documented mission of the agency.  It can be said in less than 30 seconds so it can be easily used.  It can be expanded to define actions and metrics to allow the agency to be managed to achieve its mission.

Let me know if you have any questions (steve@phcm.net).  Next we’ll get into STRUCTURE.

IMPORTANT NOTICE
(provided by Joie Glenn, Executive Director of the New Mexico Association of Home and Hospice Care)

CMS Issues Revised Notice of Medicare Non-Coverage (NOMNC)

and Detailed Explanation of Non-Coverage (DENC)

It is a requirement that Medicare beneficiaries who are receiving services from a skilled nursing facility (SNF), home health agency (HHA), hospice, or comprehensive outpatient rehabilitation facility (CORF) be given a notice to inform them that their Medicare covered services are ending, which gives them the opportunity to request an immediate, independent review of the proposed discontinuation of the covered services. When a review is requested, an additional notice is given to provide a more detailed explanation as to why the coverage is ending.

Prior to March 2012, different notices were given depending on whether the beneficiary had original Medicare or was enrolled in a Medicare health plan. This was confusing, not only for the beneficiaries, but for the health care providers. In March 2012, CMS announced that they were issuing a revised, combined NOMNC and DENC.

Providers are required to begin issuing the new combined notices as soon as possible, but no later than May 1, 2012.

Providers can access the notices on the CMS website at http://www.cms.gov/Medicare/Medicare-General-Information/BNI/FFSEDNotices.html or http://www.cms.gov/Medicare/Medicare-General-Information/BNI/MAEDNotices.html.

Steve