Waterloo, Illinois
Government, division of Monroe County
211-bed skilled nursing facility
Fixed Price, Heavily Regulated Environment
Affiliations: None

Background

Growing rural community southeast of Saint Louis, Missouri. Quality of nursing care is excellent—deficiency free in 2000. Long history of operating income deficits. Dependent on non-operating revenue and county subsidies. Significant morale issues between management and line staff. Poor communication between Administrator and County Commissioners. Significant decrease in census over a 12 month period. Existing facility in need of replacement.

Results under MPA leadership

• Return to operational profitability within 10 months
• Overall census up by 7%; Medicare rehab census up by 71%
• Facility being replaced and re-positioned for delivering new services— expanded dementia services and supportive living

Key Moves

• MPA provided interim management and began turnaround; subsequently retained as permanent Manager
• Revised operating budget
• Renegotiated all vendor contracts
• Implemented marketing program to emphasize the Medicare rehabilitation program.
• Revamped service delivery on Alzheimer’s unit; no reduction in FTEs

Leadership Strategy

• Instituted a forward-looking culture
• Established accountabilities between Management and County Commissioners, and between Administrator and Department Managers
• Implemented consistent enforcement of policies and procedures
• Improved communication between line staff and Administrator
• Adapted service offerings to what community would support