I T ’ S TIME TO TEAR DOWN THE SILOS !
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Transcript
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
.
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