Marilyn Bender's Mini Analysis: Skilled Nursing Center Administrator Orientation

Mini Analysis: Skilled Nursing Center New Administrator Orientation

Topic: This blended distance learning course will teach new Administrators of Skilled Nursing Facilities the corporate business model and how to apply that model to improve his or her facility’s operational and financial performance.

Customer: The corporate customer is a leading provider in the United States of short-term skilled nursing and rehabilitation care with over 500 facilities in 30 states. Its facilities include skilled nursing and rehabilitation centers, assisted living facilities, outpatient rehabilitation clinics, and hospice and home health care offices. The facilities are regionalized and the Administrator reports to a Regional Director of Operations. Those Regional Directors report to a divisional structure, which ultimately rolls-up to the corporate headquarters.

Audience: Audience members are facility administrators new to the company but not necessarily new to the skilled nursing administrator role.

Need: The corporation currently utilizes instructor-led orientation, conducted one-on-one through Regional leadership and consultants. In addition, new leaders travel to the corporate headquarters for a week-long New Leader Orientation which is held once per quarter and resembles a “show and tell” from each corporate division. Training needs and orientation objectives have been previously identified but there is little consistency between regions.

Industry-wide, there is high attrition rates among Administrators. The corporation needs to reduce training and travel costs for orienting and on-boarding its new Administrators. It wishes to explore blended training options including synchronous and asynchronous distance programs for both on-boarding and ongoing development of its administrators.

Mini Analysis: Give the short time-frame and Holiday weekend, developing and getting responses from a survey was not a viable option within this corporate setting. Face-to-face interviews were conducted with two Regional Director of Operations and the Vice President of Human Resource to explore options for training. The questions focused on prioritizing learning needs and exploring distance and technology enabled training options.

Analysis Results: The Regional Directors of Operations were very helpful in clarifying and prioritizing learning needs. An administrator leads all aspects of his or her facility’s business, essentially running his or her own, independent operation in accordance with corporate standards. Some of the common daily decisions the Administrator makes focus on marketing, staffing, supervision, case mix and budgeting. Key metrics of each facility includes financial performance focused on revenue growth, cost containment, margin improvement, patient type(s) and mix, as well as length of patient stay. They need to understand the cause and effect relationships of their daily decisions and how those decisions impact the operational and financial metrics for which they are accountable. The skills most critical to a new leader’s success are understanding the underlying business model used by the corporation and being able to read the Summary P&L document to analyze performance data, assess his or her operational and financial performance and correct identified operational problems.The VP of Human Resources added strategic leadership and employee relations as core skills for the new leader.

The current technology resources available for blended learning include asynchronous training using the corporate online University and a web conferencing and teleconferencing tool. Technology for forums is currently not available behind the company fire wall. However the VP is not opposed to using externally hosted sites for learner collaboration. He strongly recommended maintaining face-to-face coaching interactions with the learner’s Regional leaders. Both RDO’s and the HR VP liked the suggestion of using a business simulation as the main learning component within a blended design. However, they had little experience with that type of learning program and felt it would be important to work strategically to gain support for the idea among regional and corporate leaders.

Using this information: The most important take away from the interviews is the need to focus the instruction on the underlying business model and being able to use the Summary P&L document to successfully impact financial metrics. This focus is very different from the current orientation program. This training focus supports the selection of a business simulation as the key learning component of the program. Combining a simulation with a blended distance program can connect learners with their regional and corporate resources and provide the opportunity to build a community of support with other new leaders.