DeKalb, Illinois
Government, division of DeKalb County
194-bed skilled nursing facility
Fixed price, heavily regulated environment
Affiliations: None

Background

Growing community west of Chicago. Nursing center occupancy high with excellent reputation for quality of service. County government facing replacement of badly outdated 194-bed skilled nursing facility. County heavily subsidizing operations (up to $700k per year). County willing to replace facility if profitability determined to be feasible.

Results Under MPA Leadership

• Within a year, profitable from operations with expenses fully loaded; reserves at $4.4 million after 5 years
• No County subsidies since 1997, when MPA assumed management
• County able to continue its mission as a safety net provider

Key Moves

• Prepared Business Plan for new facility indicating profitability
• Assumed role as Interim Manager
• Negotiated elimination of an unfunded liability of $1.4 million to the federal Hill-Burton Program
• Assumed leadership as Permanent Manager
• Established financial accountabilities and operating targets; re-formed and trained management staff
• Instituted economy of scale via shared financial reporting, saving 40 percent annually

Leadership Strategy

• Restructured facility governance, moving away from a politically appointed committee to an Operating Board independent of political influence
• Re-organized management staff and fixed responsibilities and accountabilities
• Developed Medicare rehabilitation program as a source of private pay residents