IT’S

TIM

ETO

TEA

RD

OW

NTH

ES

ILO

S!

NO

UR

ISH

TEA

MW

OR

KA

ND

CO

MM

UN

ICAT

ION

Cha

nge

conc

epts

iden

tifie

d:

Expe

ct a

nd s

uppo

rt e

ffect

ive

com

mun

icat

ion

with

sta

ff an

d be

twee

n st

aff.

Be c

lear

in y

our

expe

ctat

ions

—T

he a

rt o

f CO

MM

UN

ICAT

ION

incl

udes

the

art

of

LIST

ENIN

G

Why

–

Red

uce

clin

ical

err

ors

Impr

ove

resi

dent

out

com

es

Impr

ove

proc

ess

outc

omes

Impr

ove

resi

dent

sat

isfa

ctio

n

Incr

ease

fam

ily s

atis

fact

ion

Red

uce

staf

f tur

nove

r

Red

uce

resi

dent

and

fam

ily g

riev

ance

s an

d co

mpl

aint

s

The

y ar

e co

mfo

rtab

le a

skin

g fo

r he

lp, a

dmitt

ing

mis

take

s an

d lim

itatio

ns a

nd t

hey

take

ris

ks.

The

y ta

p in

to o

ne a

noth

er's

skill

s an

d ex

peri

ence

s.T

hey

avoi

d w

astin

g tim

e ta

lkin

g ab

out

the

wro

ng is

sues

and

rev

isiti

ng t

he s

ame

topi

cs o

ver

and

over

aga

in.

The

y m

ake

high

er q

ualit

y de

cisi

ons

and

acco

mpl

ish

mor

e in

less

tim

e an

d fe

wer

re

sour

ces.

The

y ca

n pu

t cr

itica

l top

ics

on t

he t

able

and

hav

e liv

ely

mee

tings

.T

hey

can

alig

n th

e te

am a

roun

d co

mm

on o

bjec

tives

and

goa

ls, a

nd t

hey

can

reta

in

star

em

ploy

ees.

Team

pla

yers

offe

r su

ppor

t an

d en

cour

agem

ent

to e

ach

othe

r.T

hey

keep

the

line

s of

com

mun

icat

ion

open

so

that

oth

ers

can

feel

free

to

shar

e id

eas.

The

yar

eco

mfo

rtab

leas

king

for

help

adm

ittin

gm

ista

kes

and

limita

tions

and

they

Char

acte

rist

icss

off H

ighh

Perf

orm

ingg

Team

s…

THE

FIV

ED

YSFU

NC

TIO

NS

OF

ATE

AM

.. PP

ATR

ICKKK

LLLEN

CIO

NI

COO

MM

UN

ICAT

ION

ISA

FFEC

TED

BY.

..

Pers

onal

Fac

tors

M

ood

/ene

rgy

leve

l / fa

tigue

Bo

dy la

ngua

ge

Envi

ronm

ent/

nois

e /t

empe

ratu

re

Wri

tten

, spo

ken

lang

uage

Gen

erat

iona

l diff

eren

ces

Oth

er d

istr

actio

ns

Whe

ther

we

use

old

tech

nolo

gy o

r ne

w, e

ffect

ive

com

mun

icat

ion

incl

udes

act

ive

liste

ning

, cho

osin

g ou

r w

ords

ca

refu

lly a

nd m

atch

ing

them

with

our

bod

y la

ngua

ge.

LEA

RN

ING

TOC

OM

MU

NIC

ATE

We

are

NO

T b

orn

with

the

abili

ty to

com

mun

icat

e

Taug

ht b

y fa

mily

, fri

ends

, com

mun

ity th

roug

h fo

rmat

ive

year

s

Som

etim

es w

e ne

ed t

o ge

t ri

d of

old

com

mun

icat

ion

styl

es

Som

etim

es y

ou n

eed

to b

ring

mor

e sk

ills

to th

e w

orkp

lace

Act

ion

Pla

n…Im

prov

e yo

ur c

omm

unic

atio

n an

d yo

ur te

amw

ork

will

impr

ove!

EFFE

CTI

VE

CO

MM

UN

ICAT

ION

•M

eani

ng o

f any

com

mun

icat

ion

lies

only

in

wha

t the

rec

eive

rs t

akes

it t

o m

ean,

re

gard

less

of t

he s

ende

r's in

tent

ion

•It

isn’

t wha

t we

mea

n by

our

co

mm

unic

atio

n, b

ut w

hat o

ther

s th

ink

we

mea

n.

CO

MM

UN

ICAT

ION

?

MA

RK

TWA

INS

AID

….

•“I

f we

wer

e su

ppos

ed to

talk

mor

e th

an w

e lis

ten,

we

wou

ld h

ave

two

tong

ues

and

one

ear”

•“T

he m

ost b

asic

and

pow

erfu

l way

to c

onne

ct

to a

noth

er p

erso

n is

to li

sten

. Ju

st li

sten

. Pe

rhap

s th

e m

ost i

mpo

rtan

t thi

ng w

e ev

er

give

eac

h ot

her i

s ou

r atte

ntio

n.”

Rac

hel N

aom

i Rem

en

7. O

THER

BES

TPR

AC

TIC

E

Hud

dles

-W

hat

is it

?

A b

rief

5–1

0-m

inut

e di

scus

sion

hel

d as

soo

n as

pos

sibl

e fo

llow

ing

stab

iliza

tion

of

resi

dent

aft

er a

fall.

An

oppo

rtun

ity

for

staf

f to

disc

uss

the

pote

ntia

l cau

se o

f the

fall

and

pote

ntia

l m

isse

d op

port

unit

ies

for

prev

enti

ng t

he fa

ll.

An

oppo

rtun

ity

to d

eter

min

e th

e m

easu

re t

hat

will

be

impl

emen

ted

to p

reve

nt a

re

peat

fall

and

to in

form

sta

ff of

the

res

iden

t w

ith

a hi

gh fa

ll ri

sk s

tatu

s.

If a

new

inte

rven

tion

can

be

dete

rmin

ed a

t th

at t

ime

it is

add

ed t

o th

e ca

re p

lan.

An

oppo

rtun

ity

to le

arn

toge

ther

.

TOP

PER

FOR

MER

S…

Lead

with

a s

ense

of p

urpo

se, r

ecru

it an

d re

tain

the

ri

ght

staf

f, co

nnec

t w

ith r

esid

ents

in a

cel

ebra

tion

of

life

and

nour

ish

team

wor

k an

d co

mm

unic

atio

n. T

hey

help

res

iden

ts a

nd fa

mili

es u

nder

stan

d an

d th

ey u

se

hudd

les

to a

ssis

t w

ith p

ost

asse

ssm

ents

.

QU

ESTI

ON

S?

BU

DG

ETIN

G10

1

AD

MIN

IST

RA

TO

R 1

01

WO

RK

SH

OP

MIS

SO

UR

I H

EA

LTH

CA

RE

AS

SO

CIA

TIO

N

OBJE

CTIV

ES

QIP

MO

Bud

get

plan

ning

-H

isto

rica

l A

naly

sis

•C

ensu

s•

Rev

enue

•E

xpen

ses

Bud

get

Dev

elop

men

t•

Rea

listi

c an

d ac

hiev

able

Bud

get

Man

agem

ent

•H

ow o

ften

to

revi

ew?

Bud

get

Impl

emen

tati

on•

Dep

artm

enta

l buy

-in

WHA

TIS

ABU

DGET

?

Sim

ply,

a b

udge

t is t

he e

stim

atio

n of

reve

nues

and

ex

pens

es w

ithin

a sp

ecifi

c tim

e fr

ame.

Th

e bu

dget

is y

our o

rgan

izat

ion’

s ann

ual f

isca

l pla

n th

at

will

incl

ude

finan

cial

goa

ls a

nd o

bjec

tives

, pla

n fo

r re

venu

es a

nd e

xpen

ses,

and

influ

ence

s the

org

aniz

atio

n on

the

best

use

of a

ll re

sour

ces.

WHA

TIS

ABU

DGET

?

Orga

niza

tions

typi

cally

use

two

type

s of b

udge

ts.

Ope

rati

ng B

udge

t: Th

e op

erat

ing

budg

et is

a c

ombi

natio

n of

kno

wn

expe

nses

, exp

ecte

d fu

ture

co

sts,

and

a fo

reca

st o

f rev

enue

s ove

r a p

erio

d of

tim

e, w

hich

is u

sual

ly o

ne

year

.

Capi

tal B

udge

t:Th

e ca

pita

l bud

get i

s a p

roje

ctio

n of

any

maj

or p

urch

ases

whi

ch m

ay in

clud

e eq

uipm

ent,

reno

vatio

ns, l

and,

and

new

cons

truc

tion.

FORE

CAST

ING

Cens

us e

stim

atio

n an

d re

venu

e pl

anni

ng is

usu

ally

the

first

step

in p

repa

ring

a b

udge

t. Ce

nsus

and

pay

er m

ix

will

det

erm

ine

the

reve

nues

(inc

ome)

for a

faci

lity

and

will

giv

e yo

u an

idea

of h

ow m

uch

mon

ey y

ou w

ill h

ave

to

oper

ate

on e

ach

mon

th.

REV

ENU

EPL

AN

NIN

G

Occ

upan

cy

•H

isto

rica

l Dat

a •

Rev

iew

pri

or 1

2-18

mon

ths

Paye

r M

ix

•M

edic

are

Man

aged

Car

e•

Med

icai

d

P

riva

te P

ay

Rat

es

•M

edic

are

Man

aged

Car

e•

Med

icai

d

P

riva

te P

ay

PRIM

AR

YPA

YER

MIS

SO

UR

IM

EDIC

AID

SPE

ND

ING

CO

ST

AS

SO

CIA

TED

WIT

HTH

EP

RO

VIS

ION

OF

SER

VIC

ES

CONT

ROLL

ABLE

VS.

NON-

CONT

ROLL

ABLE

COST

S

Expe

nses

are

cat

egor

ized

as c

ontr

olla

ble

and

non-

cont

rolla

ble

cost

s. A

cont

rolla

ble

cost

(var

iabl

e) is

one

that

is in

fluen

ced

by a

dep

artm

ents

man

ager

. For

exa

mpl

e, la

bor c

osts

, su

pplie

s, tr

avel

, equ

ipm

ent r

enta

ls, e

tc.…

wou

ld b

e co

nsid

ered

cont

rolla

ble

cost

s.Q

IPM

O

CONT

ROLL

ABLE

VS.

NON-

CONT

ROLL

ABLE

COST

S

Expe

nses

are

cat

egor

ized

as c

ontr

olla

ble

and

non-

cont

rolla

ble

cost

s. A

non-

cont

rolla

ble

cost

(fix

ed) i

s one

that

a d

epar

tmen

t m

anag

er h

as n

o in

fluen

ce o

ver.

Rent

, mor

tgag

e, a

nd

insu

ranc

e w

ould

be

non-

cont

rolla

ble

cost

s tha

t rem

ain

the

sam

e no

mat

ter t

he ce

nsus

num

ber.

QIP

MO

CO

ST

CEN

TER

S

Nurs

ing

Mai

nten

ance

/Lau

ndry

//

Ho

usek

eepi

ng

Dini

ngg S

ervi

ces

Acti

viti

es/S

ocia

ll Se

rvic

es/O

ffic

e

Expe

nses

A Co

st C

ente

r cos

t th

at v

arie

s re

lati

ve to

Co

st C

ente

r Act

ivit

y.

Exam

ple::

Cat

hete

rss u

sedd

perr

patie

nt.. C

ostss

incr

easee

ass

patie

ntt vo

lum

ee in

crea

ses.

An o

verh

ead

expe

nse

that

var

ies b

ased

on

som

e m

easu

re o

f ac

tivity

. Ex

ampl

e: N

utri

tion

al

Serv

ices

exp

ense

s in

crea

se

rela

tive

to n

umbe

r of

pat

ient

da

ys.

A Co

st C

ente

r Co

st th

at d

oes

not v

ary

rega

rdle

ss o

f ac

tivity

. Ex

ampl

e: D

irec

tor

of

nurs

ing

cost

doe

s no

t in

crea

se r

egar

dles

s of

vo

lum

e.

An o

verh

ead

expe

nse

that

do

es n

ot v

ary

rega

rdle

ss o

f ac

tivity

. Ex

ampl

e: M

ortg

age

cost

do

not i

ncre

ase

rega

rdle

ss o

f vo

lum

e.

Dire

ctIn

dire

ct

Fixe

d

Vari

able

{

{

Actu

al G

L co

sts a

ssoc

iate

d w

ith co

st ce

nter

bas

ed o

n pa

yrol

l, ac

crua

ls an

d ex

pend

iture

s.

Allo

cate

d to

cost

cent

ers

base

d on

stan

dard

fact

or

such

as s

quar

e foo

tage

, %

of to

tal e

xpen

ses,

hist

oric

al

usag

e.

TOP

DEP

AR

TMEN

TAL

EXPE

NS

ES

Nur

sing

Labo

r

Supp

lies

Equi

p. R

enta

ls

Din

ing

Serv

ices

Raw

Foo

d

Labo

r

Supp

lies

Hou

seke

epin

g/L

aund

ry

Labo

r

Che

mic

als

Line

n

Plan

t

Util

ities

(E

lect

ric)

Labo

r

Supp

lies

BU

DG

ETD

EVEL

OP

MEN

T

DA

TA

SO

UR

CE

S-L

INE

IT

EM

S-R

EA

LIS

TIC

DAT

AS

OU

RC

ES

•His

tori

cal D

ata

•Qua

lity

Mea

sure

s•P

BJ•Q

API

•CA

SPER

•Sur

vey

Rep

orts

•Dep

artm

ent M

anag

ers

QIP

MO

DEV

ELO

PIN

GTH

EB

UD

GET

Cen

sus

driv

es t

he b

udge

t. H

avin

g a

real

istic

pro

ject

ion

of c

ensu

s nu

mbe

rs a

nd p

ayer

mix

will

be

criti

cal

whe

n de

velo

ping

the

bud

get.

Per

Patie

nt D

ay (P

PD)

is a

ter

m u

sed

in h

ealth

care

to

dete

rmin

e th

e nu

mbe

r of

pat

ient

day

s (o

ccup

ancy

).

100

Res

iden

ts*3

0 D

ays=

3000

Pat

ient

Day

s

HPP

D is

the

det

erm

inat

ion

of s

taffi

ng n

eeds

beg

ins

by a

sses

sing

the

tota

l hou

rs o

f nur

sing

car

e (o

r ot

her

depa

rtm

ents

) bas

ed o

n ce

nsus

24

hour

per

iod

also

kno

wn

as th

e ho

urs

per

patie

nt d

ay (H

PPD

).

Tota

l Dire

ct C

are

Hou

rs/C

ensu

s=H

PPD

170/

60=2

.83

HPP

D

DEV

ELO

PIN

GTH

EB

UD

GET

•D

epar

tmen

t bu

dget

s ar

e br

oken

dow

n by

spe

cific

“cat

egor

ies”

als

o kn

own

as

budg

et li

ne it

ems.

Budg

et li

ne it

ems

may

be

reve

nues

or

expe

nses

and

can

be

very

bro

ad o

r ve

ry d

etai

led

depe

ndin

g on

the

org

aniz

atio

ns p

refe

renc

e.

CEN

SU

SD

ATA

/REV

ENU

E

•C

ensu

s D

ata

•A

vaila

ble

Bed

s

•M

edic

are

Bed

s

•O

ccup

ancy

Rat

e

•C

ensu

s D

ays

•A

vera

ge C

ensu

s

•Pa

tien

ts b

y Ty

pe

–P

riva

te

–P

riva

te R

CF

–P

riva

te S

peci

al C

are

–P

riva

te B

ehav

iora

l

–P

riva

te N

on-C

erti

fied

•Pa

tien

ts b

y Ty

pe-C

ont.

–M

edic

are

–M

edic

aid

–M

edic

aid

Spec

ial C

are

–M

edic

aid

Beh

avio

ral

–M

edic

aid

Oth

er

–M

enta

l Hea

lth

–M

enta

l Hea

lth

Cer

tifie

d

–V

A -

SNF

–V

A -

ICF

–V

A -

SNF

Cer

tifie

d

–V

A -

ICF

Cer

tifie

d

–R

espi

te C

are

–H

ospi

ce

NU

RS

ING

DEP

AR

TMEN

T

•W

ages

-D

ON

•W

ages

-A

DO

N

•W

ages

-LP

N

•W

ages

-C

NT

•W

ages

-C

MT

•W

ages

–R

N

•W

ages

-MD

S C

oord

inat

or

•W

ages

-Sta

ff D

evel

opm

ent

•Pa

id D

ays

Off

•Pa

yrol

l Tax

es

•Em

ploy

ee B

enef

its

•W

orke

rs’ C

ompe

nsat

ion

Ins

•N

ursin

g Su

pplie

s

•N

on L

egen

d D

rugs

•N

ursi

ng C

onsu

ltant

s

•M

edic

al D

irect

or

•M

edic

al C

onsu

ltant

•U

tiliz

atio

n R

evie

w

•Tr

aini

ng &

Edu

catio

n

•C

NA

Tra

inin

g Ex

pens

e

•Eq

uipm

ent R

enta

l

•Eq

uipm

ent R

epai

r

•Em

ploy

ee R

ecru

itmen

t

•C

ontr

act

LPN

•C

ontr

act

CN

A

•C

ontr

act

CM

T

•C

ontr

act

RN

•M

ed S

heet

s

DIN

ING

SER

VIC

ES

•W

ages

-D

ieta

ry•

Paid

Day

s O

ff•

Payr

oll T

axes

•Em

ploy

ee B

enef

its•

Wor

kers

’ Com

pens

atio

n In

s•

Raw

Foo

d•

Food

Sup

plem

ents

•

Supp

lies

•U

tens

ils

•C

onsu

ltant

•Eq

uipm

ent

Ren

tal

•Eq

uipm

ent

Rep

air

SP

ECIA

LS

ERV

ICES

/AN

CIL

LAR

YS

ERV

ICES

•W

ages

-A

ctiv

ities

•W

ages

-So

cial

Ser

vice

•Pa

id D

ays

Off

•Pa

yrol

l Tax

es

•Em

ploy

ee B

enef

its

•W

orke

rs’ C

ompe

nsat

ion

Ins

•A

ctiv

ities

Sup

plie

s/C

rafts

•So

cial

Ser

vice

Sup

plie

s

•M

edic

al R

ecor

ds C

onsu

ltant

•So

cial

Ser

vice

Con

sulta

nt

•Ph

arm

acy

Con

sulta

nt

•O

ther

Con

trac

t Se

rvic

es

•M

isc.

Res

iden

t Ex

pens

e

•Eq

uipm

ent

Ren

tal

•W

ages

-R

esto

rativ

e A

ide

•Ba

rber

& B

eaut

y Ex

pens

e

•Ph

ysic

ian

Fees

•Pa

id D

ays

Off

•Pa

yrol

l Tax

es

•Em

ploy

ee B

enef

its

•W

orke

rs’ C

ompe

nsat

ion

Ins

•Fl

u Sh

ots

•A

ncill

ary

Expe

nse

LAU

ND

RY/

HO

US

EKEE

PIN

G

•W

ages

-La

undr

y

•Pa

id D

ays

Off

•Pa

yrol

l Tax

es

•Em

ploy

ee B

enef

its

•W

orke

rs' C

ompe

nsat

ion

Ins

•Li

nen

& B

eddi

ng

•Su

pplie

s

•C

ontr

act S

ervi

ce

•Eq

uipm

ent R

enta

l

•Eq

uipm

ent R

epai

r

•W

ages

-H

ouse

keep

ing

•Pa

id D

ays

Off

•Pa

yrol

l Tax

es

•Em

ploy

ee B

enef

its

•W

orke

rs' C

ompe

nsat

ion

Ins

•Su

pplie

s

•C

ontr

act S

ervi

ces

•Eq

uipm

ent R

epai

r

PLA

NT

(MA

INTE

NA

NC

E)

•W

ages

-Pl

ant

•Pa

id D

ays

Off

•Pa

yrol

l Tax

es

•Em

ploy

ee B

enef

its

•W

orke

rs‘ C

ompe

nsat

ion

Ins

•Li

abili

ty In

sura

nce

•G

as/F

uel B

uild

ing

•El

ectr

icity

•C

able

Tele

visi

on

•W

ater

/Sew

er

•Sa

nita

tion/

Tras

h

•A

larm

-Sp

rink

ler

•Se

curi

ty S

ervi

ces

•M

aint

enan

ce S

uppl

ies

•R

epai

r an

d M

aint

.

•Eq

uipm

ent M

aint

enan

ce

•G

roun

ds M

aint

enan

ce

•D

epre

ciat

ion

-Veh

icle

•G

ain/

Loss

-A

sset

Dis

posi

tion

AD

MIN

ISTR

ATIO

N

•W

ages

-M

edic

al R

ecor

ds

•W

ages

-Be

autic

ian

•M

edic

al R

ecor

ds S

uppl

ies

•R

esid

ent V

ehic

le E

xpen

se

•W

ages

-Adm

inis

trat

ors

•W

ages

-Offi

ce

•Pa

id D

ays

Off

•Pa

yrol

l Tax

es

•Em

ploy

ee H

ealth

Insu

ranc

e

•W

orkm

en's

Com

pens

atio

n

•Em

ploy

ee B

enef

its

•R

ecru

itmen

t Adv

ertis

ing

•Tr

aini

ng a

nd E

duca

tion

•Tr

avel

-O

ther

Tha

n M

eals

•Tr

avel

-M

eals

Onl

y

•O

ffice

Sup

plie

s

•Pr

intin

g

•D

ues

and

Subs

crip

tions

•Po

stag

e an

d Fr

eigh

t

•Te

leph

one/

Com

mun

icat

ions

•Ye

llow

Pag

e A

dver

tisin

g

•Pr

omot

ion/

Publ

ic R

elat

ions

•Le

gal F

ees

•Li

cens

es a

nd F

ees

•Pr

ofes

sion

al F

ee's

•Eq

uipm

ent

Ren

tal

•Eq

uipm

ent

Rep

air

•Ba

d D

ebts

•Pr

ovid

er T

ax

•O

ther

Tax

REA

LIS

TIC

APP

RO

AC

H

BUD

GET

Rea

listi

c

Iden

tify Pl

an

Rec

ogni

tion

Qua

lity

Car

e

Effic

ientIden

tify

A

reas

of

Impr

ovem

ent

BU

DG

ETIM

PLE

MEN

TATI

ON

AN

DM

AN

AG

EMEN

TIM

PO

RT

AN

CE

OF

DE

PA

RT

ME

NT

AL

BU

Y-I

N

DEP

AR

TMEN

TAL

BU

Y-IN

•Sh

are

the

DR

AFT

budg

et w

ith y

our

team

. Inv

olvi

ng y

our

team

and

hel

ping

th

em u

nder

stan

d th

e bu

dget

ing

proc

ess

crea

tes

a se

nse

of s

hare

d ow

ners

hip

and

enco

urag

es y

our

empl

oyee

s to

find

cre

ativ

e w

ays

to m

anag

e ex

pens

es.

INPU

TA

ND

FEED

BA

CK

•In

put

–A

sk fo

r de

part

men

t lea

ders

inpu

t whe

n pl

anni

ng a

nd p

repa

ring

the

budg

et.

–A

sk t

hem

if t

hey

have

a “

wis

h lis

t”.

–D

o th

ey n

eed

incr

ease

in s

taffi

ng h

ours

or

wag

es, s

uppl

ies,

or o

ther

bud

get

line

item

?

•Fe

edba

ck–

Let t

hem

rev

iew

the

bud

get

if po

ssib

le.

–A

sk t

hem

if it

is a

ttai

nabl

e/re

alis

tic.

BU

DG

ETIM

PLEM

ENTA

TIO

N

•O

nce

the

budg

et is

fina

lized

and

has

bee

n re

view

ed, i

t m

ust

be im

plem

ente

d.

–R

evie

w t

he fi

nal b

udge

t with

dep

artm

ent m

anag

ers

–Pr

ovid

e de

part

men

t man

ager

s w

ith th

eir

resp

ectiv

e de

part

men

ts P

PD’s

–C

lear

ly c

omm

unic

ate

expe

ctat

ions

and

ram

ifica

tions

in r

egar

ds t

o va

rian

ces “

Thi

s is

wha

t ha

ppen

s if…

”

MA

NA

GIN

GTH

EB

UD

GET

•H

ow o

ften

to r

evie

w–

Staf

fing

shou

ld b

e re

view

ed d

aily

to

effe

ctiv

ely

man

age

a st

affin

g H

PPD

.

–R

evie

w p

ayro

ll re

gula

rly-

Keep

an

eye

on o

vert

ime!

–W

eekl

y de

part

men

tal c

heck

book

s ak

a sp

endd

own

shee

t.

–R

evie

w e

xpen

ses

mid

-mon

th to

ens

ure

atta

inm

ent o

f tar

gete

d go

als.

–R

evie

w fi

nanc

ial s

tate

men

ts a

s so

on a

s po

ssib

le t

o en

sure

acc

urac

y an

d to

look

for

targ

et

area

s.

MA

NA

GIN

GTH

EB

UD

GET

Act

ual v

s. Bu

dget

Rev

iew

with

D

epar

tmen

t M

anag

ers

Vari

ance

Rep

orts

. W

hy t

he

diffe

renc

e?

Act

ion

Plan

s

H

ow c

an y

ou

redu

ce c

ost?

Don

’t sw

eat

the

smal

l stu

ff. D

o be

tter

nex

t m

onth

!

REV

IEW

POLI

CIE

S

•Fi

scal

pol

icie

s an

d pr

oced

ures

–Is

cen

sus

data

cor

rect

?

–W

hat

is t

he p

olic

y fo

r ac

coun

ts r

ecei

vabl

e?

•Is

bill

ing

bein

g do

ne t

imel

y?

•Is

bill

ing

accu

rate

?

•Is

rev

enue

col

lect

ed t

imel

y?

•M

edic

aid/

Med

icar

e bi

lling

com

plet

e an

d ac

cura

te?

–W

hat

is t

he p

olic

y fo

r ac

coun

ts p

ayab

le?

•W

ho a

ppro

ves

expe

nditu

res?

•W

ho c

odes

invo

ices

?

•Fi

nanc

ial R

epor

ts–

Dep

artm

enta

l Che

ck R

egis

ters

–M

anag

emen

t Rep

ort/

Stat

emen

t of

Ope

ratio

ns

–Ba

lanc

e Sh

eet

–In

teri

m A

ged

Ana

lysi

s (A

/R A

ging

Rep

ort)

DEP

AR

TMEN

TAL

LEA

DER

SA

ND

CO

NS

ULT

AN

TR

OLE

S

DIR

ECTO

RO

FN

UR

SIN

G1Q

IPM

O

Any

reg

iste

red

nurs

e w

ho is

wor

king

as

the

Dire

ctor

of N

ursi

ng o

f a S

kille

d N

ursi

ng F

acili

ty (S

NF)

lice

nsed

by

the

stat

e an

d/or

cer

tifie

d to

be

a M

edic

are/

Med

icai

d pr

ovid

er s

houl

d ha

ve t

he fo

llow

ing

job

skill

s an

d pe

rfor

m th

e fo

llow

ing

func

tions

. The

iden

tific

atio

n of

the

se jo

b fu

nctio

ns/s

kills

is b

ased

on

the

assu

mpt

ions

that

:•

the

patie

nt/r

esid

ent p

opul

atio

n is

frai

l, co

mpl

ex in

nat

ure

and

expe

rien

ces

man

y ill

ness

es a

nd d

ysfu

nctio

ns;

•it

is im

pera

tive

to id

entif

y th

e es

sent

ial m

ix o

f nur

sing

clin

ical

ski

lls;

man

agem

ent a

nd le

ader

ship

ski

lls; a

nd k

now

ledg

e of

fisc

al m

anag

emen

t, et

hica

l pri

ncip

les,

stat

e an

d fe

dera

l reg

ulat

ory

requ

irem

ents

and

st

anda

rds

of p

rofe

ssio

nal n

ursi

ng p

ract

ice

that

the

Dire

ctor

of N

ursi

ng

mus

t pos

sess

in o

rder

to

deve

lop

and

impl

emen

t a s

yste

m o

f nur

sing

ca

re t

hat m

eets

the

nee

ds o

f the

faci

lity’s

pat

ient

/res

iden

t pop

ulat

ion.

MED

ICA

LD

IREC

TOR

•T

he M

edic

al D

irect

or is

res

pons

ible

to

the

owne

r/go

vern

ing

body

/lice

nsed

ad

min

istr

ator

•T

he M

edic

al D

irect

or d

efin

es t

he

scop

e of

med

ical

ser

vice

s•

The

Med

ical

Dire

ctor

ens

ures

ph

ysic

ian

acco

unta

bilit

y. T

he M

edic

al

Dire

ctor

impl

emen

ts a

nd e

nfor

ces

polic

ies

and

proc

edur

es t

hat

cove

r es

sent

ial p

hysi

cian

res

pons

ibili

ties

to

the

patie

nts/

resi

dent

s an

d th

e fa

cilit

y, in

clud

ing:

•T

he M

edic

al D

irect

or p

artic

ipat

es a

ctiv

ely

in t

he fa

cilit

y’s q

ualit

y im

prov

emen

t pr

oces

s. •

The

Med

ical

Dire

ctor

hel

ps e

stab

lish

and

mai

ntai

n su

rvei

llanc

e of

the

hea

lth s

tatu

s of

em

ploy

ees

•T

he M

edic

al D

irect

or p

erfo

rms

othe

r es

sent

ial d

utie

s re

late

d to

clin

ical

car

e an

d ph

ysic

ian

prac

tices

and

the

pro

visi

on a

nd

qual

ity o

f car

e.•

The

Med

ical

Dire

ctor

pro

vide

s Pr

actit

ione

r ov

ersi

ght

FOO

DA

ND

DIN

ING

SER

VIC

ESM

AN

AG

ER

1QIP

MO

Hav

e th

e kn

owle

dge,

ski

lls a

nd a

bilit

y to

:•

Ass

essi

ng th

e nu

triti

onal

nee

ds o

f res

iden

ts;

•D

evel

opin

g an

d ev

alua

ting

regu

lar

and

ther

apeu

tic d

iets

, inc

ludi

ng t

extu

re o

f fo

ods

and

liqui

ds, t

o m

eet

the

spec

ializ

ed n

eeds

of r

esid

ents

;•

Dev

elop

ing

and

impl

emen

ting

pers

on c

ente

red

educ

atio

n pr

ogra

ms

invo

lvin

g fo

od a

nd n

utri

tion

serv

ices

for

all f

acili

ty s

taff;

•O

vers

eein

g th

e bu

dget

and

pur

chas

ing

of fo

od a

nd s

uppl

ies,

and

food

pr

epar

atio

n, s

ervi

ce a

nd s

tora

ge; a

nd,

•R

esou

rces

:•

Cer

tifyi

ng B

oard

for

Die

tary

Man

ager

s h

ttps

://w

ww

.cbd

mon

line.

org/

•M

isso

uri F

ood

Cod

e ht

tps:

//hea

lth.m

o.go

v/sa

fety

/food

safe

ty/p

df/m

isso

urifo

odco

de.p

df

DIE

TIC

IAN

•A

sses

s nu

triti

onal

nee

ds, d

iet

rest

rict

ions

and

cur

rent

hea

lth p

lans

to

deve

lop

and

impl

emen

t di

etar

y-ca

re p

lans

and

pro

vide

nut

ritio

nal c

ouns

elin

g.•

App

rove

pat

ient

men

us a

nd n

utri

tiona

l sup

plem

ents

.•

Adv

ise

patie

nts

and

thei

r fa

mili

es o

n nu

triti

onal

pri

ncip

les,

diet

ary

plan

s, di

et m

odifi

catio

ns a

nd fo

od

sele

ctio

n an

d pr

epar

atio

n.•

Prov

ide

nutr

ition

al a

sses

smen

ts p

er fa

cilit

y po

licy

and

regu

latio

n.•

Rev

iew

and

app

rove

men

us d

evel

oped

by

the

faci

lity.

•C

ouns

el in

divi

dual

s an

d gr

oups

on

basi

c ru

les

of g

ood

nutr

ition

, hea

lthy

eatin

g ha

bits

and

nut

ritio

n m

onito

ring

to

impr

ove

thei

r qu

ality

of l

ife.

•C

onsu

lt w

ith p

hysi

cian

s an

d he

alth

car

e pe

rson

nel t

o de

term

ine

nutr

ition

al n

eeds

and

die

t re

stri

ctio

ns o

f pat

ient

.•

Mon

itor

food

ser

vice

ope

ratio

ns t

o en

sure

com

plia

nce

to n

utri

tiona

l, sa

fety

, san

itatio

n an

d qu

ality

st

anda

rds

as p

er t

he c

ount

y, st

ate

and

fede

ral g

uide

lines

.