Management Performance Associates

DeKalb County Rehab & Nursing Center

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


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 County government facing replacement of badly outdated 194-bed skilled nursing facility.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 Business Office Management, 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

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