F-2: Strategic Performance Improvement & Driving Change for Sustainability

NAB; HRCI – 1 Credit Hour | Thursday, June 6th. 10:15 AM – 11:15 AM

Session Description:

Operating senior living assets– skilled nursing facilities, supportive housing, assisted living, home care– requires a passionate data driven focus on performance improvement and a tireless continuing performance improvement approach to ensure success and sustainability. This presentation provides an overview of how senior executives in these settings can approach this strategic performance improvement process in their organizations to ensure success. The process begins with an environment scan of the regulatory and reimbursement environment, community demographics, referral source needs, and regional trends. Then the organization conducts a self-assessment and identifies key performance indicators with trending over the past several years, and an analysis of where that trend is headed. Rather than benchmark organization performance to the average of competitors, the presentation will describe how to benchmark against one’s own performance in a constant pursuit of excellence, The development of a multi-year financial proforma and its usefulness as a projection and scenario planning tool will be explained. Finally, the presentation will describe how to develop strategic performance improvement initiatives and to map their anticipated results on the proforma will be show. All throughout this presentation, the critical management and leadership skills necessary for these tasks will be explained, as well as the importance of employee engagement and communication with stakeholders. The strategic performance improvement initiatives described may include, but are not limited to, new clinical services to better meet the needs of the community or referral sources, initiatives to change payor mix or acuity, census development initiatives, quality measure and cost of care improvement initiatives, and improved recruitment and retention of staff. The presentation draws from lessons learned from our extensive experience working with struggling organizations through a turnaround process, as well as with working with healthy organizations who pursue strategic planning and best practices.

Learning Objectives:

Describe the strategic performance improvement process and its components, and its effectiveness of helping organizations achieve success and sustainability.

Outline the steps for an environment scan and self-assessment, including development of a multi-year financial proforma.

Explain the critical leadership skills, employee engagement, and stakeholder communication necessary for successful strategic performance improvement.


Joseph Tomaino, Partner, Grassi Healthcare Advisors

Joseph Tomaino is the Chief Executive Officer of Grassi Healthcare Advisors, LLC and has nearly 40 years of healthcare management experience working in the not-for-profit, for-profit and government-sponsored segments. As a chief executive officer, chief nursing officer, consultant, and educator, Joseph has worked with provider organizations and payers across the U.S. as an architect of value based care — improving clinical effectiveness along with efficient use of resources. Joseph uses data to analyze populations being served and organizational effectiveness, then applies innovative structure and program designs to improve performance, helping clients transform to successfully operate in managed care and accountable care reimbursement environments.

Jaime Rapps, Partner, Grassi Healthcare Advisors

Jaime Rapps, CPA is a Partner at Grassi and brings nearly 15 years of audit, accounting and tax experience to his role. A member of the firm’s Healthcare practice, he specializes in financial reporting, audits, reviews, compilations and tax work for clients in these industries. Jaime focuses on financial statement audits and advisory work for skilled nursing facilities and their ancillary companies, such as landholding companies, staffing agencies, pharmacies and management companies. Jaime has experience providing financial statement audits for Continuing Care Retirement Communities, FQHCs, Hospices, assisted living and adult day care programs. Jaime’s expertise extends to OMB Uniform Guidance (formerly A-133) and HUD compliance audits. As a result, Jaime has extended these services to include compliance audits for recipients of Provider Relief Funds and the Shuttered Venue Operating Grant. Jaime’s experience includes financial statement audits of housing companies and employee benefit plans. He advises multifamily HUD housing projects on Section 8 and Section 202 compliance and low-income housing tax credits.