Annual Business Assembly Ma May 28 th th , , 2019 Welcome! - - PowerPoint PPT Presentation

Continuing Care Council Annual Business Assembly

Ma May 28th

th,

, 2019

Welcome!

Continuing Care Council: Highlights of Recent Activities

May 28th, 2019 Josie Ryan, Chair

Continuing Care Council

Who We Are and What We Do

• A 15 person member group representing Long Term Care, Home Care (nursing

and support services) and Adult Residential and Rehabilitation Services

• 8 long-term care representatives
• 5 home support representatives
• 2 ARC/RRC (Diverse Abilities) representatives
• Our mission is to be a meani

ning ngful ful and d influential luential vehic icle le for positi tive e chang nge e in Nova Scotia’s continuing care sector through collaborative action and knowled ledgeable geable leader dership hip.

• We advance this mission through issue identification, sector

representation, stakeholder engagement, and facilitating evidence- informed solutions.

3

Continuing Care Council

Members

• Josie Ryan (Chair) – Executive Director In Care Living, Northwood
• Joyce d’Entremont (Vice Chair) – CEO/Administrator, Mountain Lea Lodge/The Meadows Community
• Lisa Beckwith – Assistant Director of Care, Windsor Elms Village
• Millie Colbourne – CEO, Breton Ability Centre
• Sharon Crane – Agency Director, Cape Breton County Homemakers
• Jeff Densmore – Regional Executive Director, VON Canada – Nova Scotia
• Roberta Duchesne – Administrator/Health Services Manager, Harbourview Lodge
• Denise Halloran – Executive Director, Guysborough County Home Support Agency
• Tammy MacKenzie – General Manager or Resident Care Services, Macleod Group
• Dana Power – Regional Director Enhanced Care Operations, Shannex Healthcare Inc.
• Christa Quinn – Client Services Manager, Closing The Gap Healthcare
• Anthony Taylor – CEO/Administrator, Oakwood Terrace
• Janet Watt – Senior Manager, VON Colchester East Hants
• Carson Samson – CEO, Richmond Villa
• 2nd Diverse Abilities NS Position – New Position to be Filled

4

Provincial & National Stakeholder Engagement

Regular Communication/Discussion with DHW & NSHA

• We have well-established vehicles for bringing issues to key

government decision makers and facilitating collaborative approaches to resolutions.

• Regular attendance at Council meetings by senior staff with DHW

and NSHA

• Through these vehicles, we are constantly advancing key issues

such as HHR, model of care, finance and resource challenges, complexity and acuity of care, access and flow, policy development, etc.

5

Regular Engagement with Partners and other Key Stakeholders

• Chairs of Council, Continuing Care Association of Nova Scotia (CCANS), and

Nursing Homes of Nova Scotia Association (NHNSA) meet on a bi-monthly basis

• Share information and, as appropriate, share or collaborate in

development of common strategies to address issues of mutual concern related to the LTC sector

• We build and maintain productive and positive relationships with
• rganizations who have shared goals or whose mandate otherwise positively

contributes to Council’s response to identified issues on behalf of our members.

• For example, AWARE-NS, Health Care Human Resource Sector Council

(HCHRSC), WCB, MSVU Centre on Aging, NSCC, etc.

6

Membership in Canadian Association for LTC

• Canadian Association for Long Term Care’s Strategic Priorities:
• Address the seniors care labour shortage by updating

governments health human resources strategy, with federal leadership.

• Support innovation in health care and evidence-based decisions

by mandating and funding a standardized data collection solution across Canada to provide a baseline of data which will improve the quality of services in long-term care.

• Invest in seniors housing where care is provided by building new

long-term care homes and modernizing old homes.

National Stakeholder Engagement

7

• HANS is a member of CALTC, the national voice for the long-term care

sector

• HANS brings the voice of our members to the national advocacy

agenda

• CALTC developed a MP Engagement Toolkit which HANS modified for

use in Nova Scotia

• Overall objective is to introduce Nova Scotia MPs to the Council and

to CALTC

• Council participated in CALTC’s first annual #BecauseYouCare week

which was held from February 10-16, 2019

• National initiative to raise awareness about the challenges faced in

LTC sector by urging MPs to visit at least 1 LTC facility in their riding.

8

Looking forward… ➢ How can Council/HANS become more actively involved with CATLC? ➢ How can we engage our members in that process?

Member/Sector Representation

Access and Flow Discussions with NSHA

• Tim Guest (VP Health Services and Chief Nursing Executive), Susan Stevens

(Sr. Director Continuing Care), and other NSHA senior staff attended May 9th Council meeting to discuss access and flow issues and solutions

• Goal was to provide an opportunity to build awareness of the realities faced

across the system, promote a shared understanding of the process issues that are contributing to the pressures on emergency departments, and arrive at joint solutions to improve access and transition to services across the continuum

• Council members stressed the importance of the continuing care sector

being at the table to ensure a collaborative approach in addressing these challenges

• Resulted in appointment of LTC and HC representatives to the NSHA

Access and Flow- Ambulance Offload Project Steering Committee.

9

10

Presented to Long-Term Care Expert Advisory Panel

• Council, NHNSA, and CCANS jointly presented to the Long-Term Care

Expert Panel on November 5th, 2018

• Council developed and submitted a response to the LTC Expert

Advisory Panel Report & Recommendations

• Council is monitoring plans for implementation/funding of the

recommendations

• Council representatives were invited to a meeting with DHW, NSHA

and the LTC Expert Panel May 23rd, 2019

Management Compression/Inversion

• Council sent a letter to DHW in March 2019 requesting a meeting

to discuss current management compression/inversion issues

• HANS Compensation Analysis staff conducted a survey with

members to gather current management salary data and presented the high level findings and proposed solution was presented during a meeting with DHW in May 2019

• DHW committed to come back with a response and next steps in

the coming weeks

11

LTC Wait List Data

• Council sent a letter to DHW in March 2019 expressing concerns with

information on average wait time data being reported for nursing home placement on the Nova Scotia Wait Times website

• Numbers appear to be inconsistent with the individual facility data

being reported and it is unclear what methodology is being used to arrive at these average wait times; members felt this can be misleading to clients, families, and the public

• Meeting was arranged with DHW in May 6, 2019 to discuss the

concerns

• HANS is currently working with the DHW Continuing Care Branch to

address the issue

12

Participated on Wound Care Consultation Team

• Council sent a letter to DHW in June 2018, outlining concerns with

the new wound care reporting requirements that were being implemented

• HANS President/CEO echoed Council’s concerns during a meeting

with DHW senior leadership in June 2018

• As a result, Council’s Chair and Vice Chair were invited to

participate on the wound care consultation team

• The consultation team developed an action plan, including

mitigating barriers to obtaining wound care products and equipment, provision of training and policy development

13

Licensing and DHW Policy Requirement Discrepancies

• Council raised concerns to NSHA and DHW at the January meeting

regarding the challenges with the lack of communications between licensing/DHW/NSHA

• A meeting with providers, NSHA, DHW, service delivery and

auditing/licensing was held on May 23rd to discuss issues and possible resolutions

Ensuring Members have a Voice at the Table

• Disability Support Program - Transformation Steering Committee
• Workplace Safety Action Plan Advisory Committee
• LTC Expert Panel, Implementation Planning

14

Other Representation

• Provincial Nursing Network
• Workplace Safety Action Plan for Health and Community Services
• Long Term Care Placement Policy
• PNN Committee for RN/LPN Leadership Program
• Project Advisory Group Representation Nursing Leadership
• RN Prescribing Strategy
• Academic Health Council

15

Policy Work

Formed Positive Attendance Steering Committee

• Used the Collective Impact Framework as the foundation for

the work of the Steering Committee

• Goal is to look at the root causes of, and holistic

approaches to, employee absenteeism

• Formed and populated to include representatives from the

Long-Term Care, Home Care, and ARC/RRC sectors

• Also includes representation from DHW, DCS, NSHA, and

WCB NS

• The Chair of this Committee will provide a more detailed

update later today

16

Policy Work

17

Formed LTC Strategic Financial Planning Working Group – Reporting and Data Collection Subgroup

• Purpose is to develop methods that enable more relevant &

consistent financial reporting across the LTC sector

• Identify relevant statistical & financial indicators so that reliable

data is available to inform decision making by both the sector & DHW, and develop a reference handbook for use by finance directors

• A review of the work to date will be provided by Eric Doucette,

chair of the working group.

Partnered with HANS Clinical Engineering Staff to Develop Specifications for LTC Beds

• Council and Diverse Abilities NS are supporting the

development of safety specifications for long term care beds

• A working group was developed and led by HANS Clinical

Engineering Team

• Work is close to completion and an update will be shared

with the sector in the near future

18

More Exciting Work On The Horizon…

• Council is in the process of restructuring to best

represent and serve our LTC members

19

Thank You!

20

Continuing Care Council:

Restructuring

May 28th, 2019 Mary Donovan, Director of Member & Partner Engagement

Restructuring of the Continuing Care Council (CCC)

The Impetus to Change

• Continuing Care Council Strategic Planning: 2016/2017
• Council’s conversation turned to the need for mobilization
• Sector challenges remain unchanged
• Issues are complex
• Need to mobilize
• Now, more than ever, the sector needs to come together – united -- working together,

sharing information and best practices, and innovating in the collective address of common issues and challenges

• Council needs to change to ensure we are actively engaging our long term care members in

setting and advancing Council’s policy agenda and communicating with one voice

22

Restructuring of the Continuing Care Council (CCC)

Responding to the Need for Change

• CCC requested that HANS leadership develop proposed models for restructuring
• Models that would help ensure improved engagement & representation of HANS LTC members
• Council’s agenda is dominated by LTC issues, however, we need to better connect and

support all of our 92 92 LTC members across the province

• Models that would provide a forum for the sector to….
• Network on a regular basis;
• Share information and best practices; and
• Ensure active participation by all members in responding to the top issues impacting the

sector

23

24

Proposed New Structure for HANS CCC

CONTINUING CARE PR NETWORK

• Public Education
• Sector Promotion
• Media Relations Support

(Supported By HANS)

HANS CONTINUING CARE COUNCIL

• 8 LTC seats
• 5 Home Care seats
• 2 Diverse Abilities NS seats

DIVERSE ABILITIES NS

→Meets twice a year and rotates location among zones →Each Zonal Group will meet every 2 months

Provincial LTC Forum and Zonal meetings will be

• pen to non-

HANS members during the first two years and evaluated after that time in consultation with

• ur members.

→Will evaluate required meeting frequency after period of transition, possibly reducing meeting schedule to quarterly

HANS HOME CARE NETWORK LONG TERM CARE NOVA SCOTIA

WESTERN LTC MEETING (Zone 1) NORTHERN LTC MEETING (Zone 2) EASTERN LTC MEETING (Zone 3) CENTRAL LTC MEETING (Zone 4)

Proposed New Structure for HANS CCC

What Does the Proposed New Model Look Like?

• Council’s primary mandate will continue to centre on identifying and proactively responding to

issues spanning the entire continuum and supporting advancement of the strategic priorities or sector-specific issues being addressed by the Home Care Network, Diverse Abilities NS, and the “to be created” provinci ncial al LTC Forum

• This includes Council’s mandate to advocate on behalf of the sector(s) we represent and to

facilitate the development and implementation of collaborative, evidence-informed solutions to system challenges among providers, government and NSHA, as appropriate

• Council’s current mandate for communication with the public will be more strategically focused
• n advancing public education, raising the profile of our members and the sectors they

represent, and providing a unified, balanced voice on issues appearing in the media as appropriate

• We need members’ input to shape what that voice

ce will look like

25

Proposed New Structure for HANS CCC

What Does the Proposed New Model Look Like?

• The provinci

ncial LTC Foru rum will provide an opportunity for all LTC providers to meet regularly to network, share information and best practices and ensure we have strong processes in place to identify and advance the top issues impacting the sector

• The forum will be fully supported by the HANS policy team, including the development and

implementation of a sector-specific policy agenda, focused on provincial issues and

• challenges. For example, HHR shortages, funding and resource challenges, model of care

(staffing mix), etc.

• The 8 LTC representatives on the Continuing Care Council will be the liaison between the

Council and the LTC Forum’s activities and bring issues forward to Council for address

26

Proposed New Structure for HANS CCC

What Does the Proposed New Model Look Like?

• HANS will host

t zonal meet etings ngs of LTC providers, providing a further opportunity for networking, information and best-practice sharing and to support the completion of policy-related projects. For example, the development of policies on sexuality in long term care, resident transfer, over the counter drug use, etc.

• This will allow for the address of unique zonal issues while providing a mechanism for sharing

innovation and learnings across the province

27

Proposed New Structure for HANS CCC

Continuing Care PR Network

28

Proposed New Structure for HANS CCC

Status to Date

• Over the past several months, HANS has been working to create new zonal LTC provider groups,
• r build upon existing zonal groups
• Central Zone – HANS began providing policy/research/project support at the existing

Central Zone Group meeting on May 1st, 2019

• Eastern Zone – HANS will be starting to work with the existing Eastern Zone Group in the

coming weeks

• Western Zone – HANS is in the beginning planning stages with how support will be provided

for the existing Western Zone Group meetings

• Northern Zone – HANS is planning to create a new Northern Zone Group, with the first

meeting scheduled for June

• Council will be regularly connecting with existing member networking groups
• Overall, there has been a positive reaction and overarching support received from members on

Council’s proposed support of regular interaction with zonal groups

29

Thank You!

30

Diverse Abilities NS: Highlights 2018-2019

May 28th, 2019 Joyce d’Entremont, Chair

Diverse Abilities NS

Who We Are

• Comprised of the 8 major organizations supporting persons with disabilities through

residential care, group homes, and other independent living programming.

• We support individuals ranging in age from 19 to 80+ years with:
• Moderate to severe intellectual and/or physical disabilities
• Chronic mental illness
• Addictions
• Acquired brain injuries
• Dual diagnosis

32

Diverse Abilities NS

Our Purpose

• Seeking ways to improve the quality of life for persons with disabilities by collaborating

with individuals, groups, organizations and government;

• Seeking opportunities to promote a positive image of our members;
• Utilizing collective skills and knowledge in planning for the future;
• Providing opportunities and encouragement for employees to gain education and

knowledge which will assist in the provision of services; and

• Promoting the understanding and acceptance of individuals with disabilities.

33

Diverse Abilities NS

What We Do

• Provide a continuum of progressive services and supports that are designed to empower

people with diverse abilities to make their own choices, participate in decision-making, and to be contributors to and participate in their local community.

• Services include:
• Independent living services (community and facility-based)
• Access to employment opportunities
• Vocational training and skills development
• Social enterprise
• Access to a range of medical, health-related and other specialty services
• We follow a person-centred model that creates a customized plan for each resident based
• n their needs and abilities.

34

Highlights 2018-2019

Association Rebranding

• Worked with HANS to develop a new communications strategy and rebranding of the

ARC/RRC Association

• Wished to promote:
• Understanding of the role that we play in the DSP sector
• Continuum of services and programs that we offer
• Difference it makes in the lives of the individuals we serve
• Embarked on a new visual identity exercise
• Selected a new name and logo that reflects the theme of a community embracing

persons with diverse abilities and the overarching characteristics of a sector that is innovative, leading edge, person-centred, caring, future-oriented, and valued.

• As of September 20th, 2018 the ARC/RRC Association became known as Diverse Abilities

NS New Website: https://diverseabilitiesns.ca/

35

Highlights 2018-2019

DSP Transformation Update

• Have been working with DCS to safely plan DSP Transformation
• We are supportive of transformation
• Our organizations are building business plans to align with new vision
• We are emphasizing client choice, social inclusion, the best supports based on individual need
• Diverse Abilities NS is represented on DSP Transformation Steering Committee
• Breton Ability Centre and Quest have agreed to support analysis and planning
• Have been working with government to determine what capacity-building is required to transition

participants into community living

Stakeholder Relations

• Presented to various sector groups to raise profile and understanding of our organizations, and how we

can work better together (i.e. sharing expertise)

• Organized the Community Programs Working Group for Diverse Abilities NS members, community

managers, and ILS managers, to discuss different ILS program processes and opportunities for the sector

36

Highlights 2018-2019

Collective Address of Emerging Operational/System Issues

• WCB dental funding gaps
• Access to palliative care nursing services
• Access to High Dose Flue Vaccine
• Video Surveillance – Policy
• Cannabis in the Workplace – Policy
• Recruitment strategies
• Management/non-union compensation
• Compression/inversion

37

Thank You!

38

Home Care Network: Updates 2018-2019

May 28th, 2019 Helen Marsh & Jeff Densmore, Co-Chairs

Home Care Network

Who We Are

• Representatives from 19 public & private agencies from across NS
• Meet 4 times per year
• Teleconferences between meetings
• Purpose:

A meaningful vehicle to come together to discuss issues of common concern, respond to & proactively address issues impacting the provision of home care.

• Chairs:
• Helen Marsh, New Waterford Home Care
• Jeff Densmore, VON

40

41

Highlights 2018-2019

Highlights

• Held provincial Skype session with NHSA to discuss home care service provision challenges
• Future sessions being planned for the fall to maintain communication link
• Next Session Topic: Care Coordinators to provide insight into their work, challenges etc.
• RN & LPN College Joint Practice Guidelines modified to address problematic language associated with the

application of medicated creams and ointments by CCA’s

• Education session regarding the interpretation & application of the guidelines

42

Highlights 2018-2019

Highlights

• HCN Strategic Planning Session
• Re-affirm our identity – Network is a strong and influential voice
• Re-energize ourselves – Easy to get bogged down in challenges
• Re-focus our work – Continue the day to day work but also focus on the future, sustainability & innovation
• Strategic Priorities
• Leverage our power
• Collaborate & build stronger relationships
• Educate ourselves & others
• Guide the future of Home Care

Highlights 2018-2019

Performance Based Contracts

• Existing Home Care contracts have been extended to 2022.
• Ongoing work related to the development of appropriate KPI’s:
• Working with DHW/NSHA to overcome some of the ongoing challenges with definitions/collection
• DHW presented initial KPI results at Workshop on May 24 indicating:
• KPI’s supporting the identification of larger system issues
• Positive conversations with agencies surrounding resolutions

43

Highlights 2018-2019

On the Horizon

• Leverage & Participate in ongoing work related to recruitment and retention challenges faced by sector
• Continue collaborative efforts with Continuing Care Council regarding Positive Attendance Committee
• Participation and support for the implementation of the Workplace Safety Action Plan

44

Thank You!

45

Questions? Comments?

46

Positive Attendance Steering Committee: Updates 2018-2019

May 28th, 2019 Millie Colbourne, Chair

Positive Attendance Steering Committee

Purpose

• Engage continuing care partners and collaboratively build a common agenda to address

shared goals;

• It is anticipated that by taking a holistic approach to examine the root causes of employee

attendance issues, the sectors will see a reduction in vacancies, sick/injury time and related costs, and increased levels of employee engagement.

Responsibilities

• Champion the work and collective impact approach
• Refine common agenda and ensure ensuing work is aligned
• Define theme-based activities and found appropriate working groups
• Ensure synergy/no duplication
• Align with other provincial initiatives
• Identify quick-win opportunities
• Develop overall shared measures

48

Positive Attendance Steering Committee

Representation

• Representative of the long-term care, home care, and ARC/RRC sectors
• Representative of rural & urban areas, large & small facilities

Members

• Joyce d’Entremont, Annapolis County Municipal Housing Corporation
• Eric Doucette, Seaside Manor
• Denise Halloran, Guysborough County Home Support Agency
• Janet Watt, VON Colchester East Hants
• Millie Colbourne, Breton Ability Centre
• Matthew Spicer, Department of Community Services
• Barb Baker, Nova Scotia Health Authority
• Jonathan Tyson, Workers’ Compensation Board of Nova Scotia (Workplace Safety Action Plan)
• Vacant Position, Department of Health and Wellness (Awaiting replacement for MJ MacDonald)

Backbone Organization

• Health Association Nova Scotia

49

Scope and Activity Themes

Meetings to Date

• The group is still in the preliminary stages of work, having met 3 times over the past

several months

• Significant amount of time has been spent on education, information sharing, and

reviewing research, to aide in the development of the common agenda and key areas

• f focus (themes)

Scope

• Focus is employee engagement, workplace culture, and workplace environment

Themes

• Three themes chosen to fit within scope:
• 1. Total Health & Wellness (Physical & Mental)
• 2. Workplace Engagement
• 3. Safety Culture

50

Possible Focus of Theme-Based Activities

Total Health and Wellness (Physical & Mental) Focus on activities related to inter-relationships between mental health, environment, and culture; this includes a provincial approach to supportive attendance

• Facilitate the spread of training and resources
• Education for managers
• Research to develop strategies and tools on employee health and wellness
• Today’s workshop is aligned with this work, as well as the recent GoodLife Fitness

Health and Wellness Leadership Summit, which was sponsored by HANS to enable members access to this quality conference on employee engagement and leadership at a reduced rate

• Develop consistent processes, practices, & principles regarding supporting attendance

programs

• Examining Possible Pilot Project: Attendance Management
• Ultimately, make the case for dedicated funding for absence management in the

continuing care and residential care sectors.

51

Possible Focus of Theme-Based Activities

Workplace Engagement Focus on organizations becoming a workplace of choice and on retention as an outcome

• Explore, research, and compile information and tools regarding employee engagement,
• rganizational culture, and becoming a magnet organization

Safety Culture Focus on injury prevention

• Align with, and support advancement of, Workplace Safety Action Plan as appropriate

52

What’s Next?

Short-Term Next Steps

• Finalize common agenda and priorities
• Develop shared measurements
• Focus the required research (i.e. reasons for employee absenteeism)
• Develop a communication strategy

53

Questions? Comments?

54

Thank You!

55

LTC Strategic Financial Planning Working Group

Data Collection and Reporting Sub-Group Update

May 28th, 2019

Eric Doucette, Chair

Attention Grabber

Is This What We Want for Our Residents, Our Families, Ourselves?

57

CTV National News: Troubling Nursing Home Stats Documents show waits for long- term care stressing Nova Scotia hospitals: NDP Injuries among Nova Scotia nursing home workers caused by residents rising: board

Reality Check

Points of Agreement Regardless of Funding Formulas

• Using best practices to improve the quality of life and physical well-

being of aging Nova Scotians requiring long term care

• Providing necessary, effective, and cost- efficient health services to

a rapidly increasing number of aging Nova Scotians with diverse service requirements

• Providing safe, effective, ethical resident-centred care to residents

with complex health challenges, including multiple diagnoses or co- morbidities, and complicating chronic diseases

59

Points of Agreement Regardless of Funding Formulas

• Enhancing the skills and morale of staff by improving working

conditions, work-loads, and providing ongoing training opportunities

• Strengthening communications with LTC members, residents, families,
• ther health care providers (including those in acute, continuing, and

home care organizations), and government to encourage innovation and the adoption of best practices across the sector

• Continuing to make efforts to improve perceptions of the LTC sector

60

The Gap:

Resources Growing Need

GAP

Long Term Strategic Finance Committee- Background

• Long Term Care Strategic Financial Workgroup was established in summer of

2016 (Yr of 1% global budget cuts)

• Established under the auspices of Health Association Nova Scotia (HANS),

reporting to the Department of Health and Wellness (DHW).

• The purpose of the working group is to:
• promote understanding of fiscal challenges share collective concerns and

provide feedback

• create and consult with the sector on proposed solutions and

recommendations

• present solutions for consideration by DHW and NSHA long-term care

sector organizations on issues related to fiscal planning and strategy in the long-term care sector.

62

• 5 Subgroups created with defined deliverables
• Labour & Staffing--- Linked to CCEG &Collective Impact: Absenteeism
• Shared Resourcing– Resource Binder to Field
• Legislative and Policy Development
• Models of Care
• Reporting and Data Collection
• Develop evidenced-based standardized expense codes, definitions, and consistent

reporting tool;

• Identify relevant statistical and financial indicators so that reliable data is available to

inform decision making by both the sector and DHW; and

• Develop a reference handbook for use by finance directors.

LTC Strategic Finance Committee- Background

Annual Budget Process Budgets Released Organization delivers services based on funding Organization Manages to Budget Annual Audited Statement & Accountability Report

Current State

Based on old funding formula Economic Adjustments Labor Negotiations Increasing Fragility & Complexity HHR Challenges Consumer Expectations No DHW Financial Program Performance Standards Variability in Accounting No Financial Indicators No financial analysis (trends) No outcome measures No Key Stats

Data Collection and Reporting- Burning Platform for Change

• There is no standardized method of assessing financial performance
• therefore no strategy for evaluating operations, programs, services and

financial stability in long-term care (LTC) organizations

• No financial indicators/ratios, key statistics measures, financial analysis

(trends), or outcome measures

• There is no standardization set out in the form of financial program

requirements by the DHW

• The LTC sector lacks a standard chart of accounts with expense code

definitions, SOPs on Financial Management & Administration

65

Data Collection and Reporting- Burning Platform for Change

• Current year end accountability report is silent on ratios
• Annual budget process is based on old funding formula
• Increasing fragility and complexity
• HHR challenges
• Consumer expectations
• Financial ratio analysis offers the sector a standardized way to assess an
• rganization’s overall financial status and provides a way to measure
• perational effectiveness and efficiency

66

Data Collection and Reporting Subgroup: Desired State

• Financial ratio analysis offers the sector a standardized way to assess an
• rganization’s overall financial status and provides a way to measure
• perational effectiveness and efficiency
• Standardization in how LTC organizations code revenue and expenses and

report financial information to the DHW is paramount if financial analysis comparing organizations is to be meaningful and valid.

• Currently, DHW advises that they are unable to complete meaningful

financial analysis to inform policy development and/or operational decisions because there is a lack of standardization in how each LTC Facility codes revenue and expenses and reports financial information

67

Data Collection and Reporting Subgroup: Desired State

• Provides an Indication of current financial situation, or sustainability especially

as it relates to resident quality of care

• Allows internal organizational and provincial benchmarks to be set

68

• Resistance to change/standardization
• Flexibility, patience, perseverance, ramped implementation
• Articulate the return on change investment
• DHW Resource challenge
• Leverage development off Ministry of Health and LTC Policies and procedures:
• Education for Directors of Finance
• Could be built in as day 2 of Continuing Care Forum update
• Distribution, Access, updates
• E- available on DHW web page

Anticipated challenges

• Commitment to running quality homes
• Commitment to quality health outcomes
• Meet LTC Program Standards
• Business Operations
• Make Decisions based on based available evidence/data
• Current Resource Levels

What’s Not Changing

Reporting and Data Collection Subgroup: Focus of Work to Date

Inventory of Past Finance Projects

• A chronological inventory of financial projects dating back to the 1980’s was

developed and reviewed Financial Health Ratios/Indicators, KPIs, Financial Statistics

• Articles containing ratios used to help measure the financial health of a not-for-

profit organizations were discussed, and those useful to LTC were identified

• A balance scorecard initially developed by DHW Finance contained a list of

financial indicators as well as Internal control indicators, Compliance and Occupancy Rates

71

Reporting and Data Collection Subgroup: Focus of Work to Date

Chart of Accounts, Standardized Expense Codes & Definitions

• Chart of Accounts has been drafted
• Expense codes and definitions for the clinical piece of the balanced scorecard

have been drafted Balanced Scorecard

• Subgroup has developed a draft balanced scorecard
• Financial Health, Resident Health, Health of Internal Operations and Staff

Health /Learning Development

• To be presented to the sector for review and consultation

72

Data Collection and Reporting Subgroup

Proposed Balanced Scorecard

73

Financi ncial He Health h Indicat cator

• rs

s Ratios ios Resid iden ent t Health h Clinic nical al KPIs Interna ernal Operati tions

• ns Health

th Effici icien ency cy Indica icator

• rs

Staff f Health h Learning g and Growth th Indica icator

• rs

Liquidity Ratios- Current Ratio

74

• The current ratio measures your company's ability to generate cash to meet

your short-term financial commitments.

• It is calculated by dividing your current by your current liabilities
• The higher the ratio (i.e. >2.0) the more liquid the organization
• < than 2.0 may indicate an inability to pay current financial obligations with a

measure of safety Current Assets

(e.g Cash/Inventory/Receivables)

Current Liabilities (Line of Credit balance, payables current portion of LT debt

Liquidity Ratios- Quick Ratio

75

• Used by Banks to gauge financial stability
• The quick ratio measures your ability to access cash quickly to support immediate
• demands. Also known as the acid test, the quick ratio divides current assets

(excluding inventory) by current liabilities (excluding current portion of long-term debts).

• A ratio of 1.0 or greater is generally acceptable. It should never be less than 1.0
• Difficulty in meeting obligations, not able to take advantage of opportunities requiring quick

cash

Current Assets Inventory and Prepaid Expenses Current Liabilities

(Line of Credit balance, payables current portion of LT debt)

Liquidity Ratios- Operating Margin

76

• Important forecasting ratio because it illustrates your organizations

ability to produce a potential surplus.

• The operating profit margin ratio indicates how much surplus a not for

profit company experiences after paying for variable costs of production such as wages, supplies , etc.

• Ratio range is sector specific

Revenues – Expenses Revenues

Efficiency Indicator - Accounts Receivable Aging

77

• Measures effectiveness of collection functions
• The higher the ratio the greater the impact on cash flow
• Lower ratios suggests prompt payment with favourable impact on

cashfow

• Especially important as it relates to collection of resident perdiems

Accounts Receivable >90days overdue Total Accounts Receivable

Efficiency Indicator - Accounts Payable Aging

78

• Measure of health of cash flow
• The higher the ratio the greater the likelihood of inability to continue to

pay accounts in a timely manner

• Potential to have increased costs associated with late fees

Accounts Payable Outstanding >90 Total Accounts Payable

Additional Indicators- Internal Operations

79

Resident Day Ratio

• Measures effectiveness of organizational in managing the admission process

and minimizing loss days due to ineffective processes, outbreaks etc.

• Considers budgeted occupancy rate
• Ideal ratio 1.0
• the lower the ratio the more ineffective the placement/admission process

impacting negatively on per-diem collection

Actual total # of Resident Days Total # of Available Resident Days (113x365.25x98%)

Additional Indicators- Internal Operations

80

• ADT -through put measure
• Total numbers Admissions, Deaths, Transfers (quarter/year)
• Resident Turnover Rate

Total number of Turnovers (Admissions +Transfers) Total number of available beds x Occupancy Rate

• The higher the turnover rate the greater the impact on operational

expenses

• Lost Days related to Outbreak Closure

Additional Indicators – Staff Health (LG)

81

• Voluntary Turnover of Staff

Total number of unit producing voluntary departure Total number of unit producing active staff

• Involuntary Turnover of Staff

Total number of unit producing involuntary departures Total number of unit producing active staff

• Current number of vacancies (RN, LPN, CCA) by quarter
• Absenteeism Rate
• Total absent hours (paid sick, unpaid sick, absent)
• Total hours worked

Additional Indicators – Resident Health

82

• Number of residents with pressure injuries by stage by quarter
• Prevalence by quarter
• Number of Residents with pressure injuries
• Total number of Residents
• Incidence by quarter
• Number of new admissions within the quarter who developed

pressure injuries )

• Number of New Admissions who developed pressure injury
• Total number of new Admissions
• Number of falls per 1000 resident days per quarter
• Total number of falls x1000 days
• Total number of resident days

Key Points

• The Balanced Scorecard would be part of the DHW annual reporting

requirement

• Data for the Indicators (Balance Sheet, I&E Statement)
• Enable the DHW to identify cross sector trends, individual organizational

health

• Provide DHW with an understanding of organizations who may need further

assistance to maintain financial health

• Enable the DHW to have a deeper understanding of the rationale for

surpluses/deficits

• Have presented work to date to senior DHW Continuing Care & Finance Staff

83

Next Steps

• Academic affiliation to bolster evidence to support work
• Create a chart of accounts with expense code definitions
• Create a DHW Finance SOPs Handbook
• Present Draft Chart of Accounts, Definitions and Balanced Scorecard for

review, comments, and suggestions by LTC Sector

84

Thank You!

Sector Members

• Eric Doucette, CEO, Seaview Manor
• Michele Thompson – CEO, RK MacDonald Nursing Home
• Gayle Marie Grant – Director of Finance, RK MacDonald Nursing Home
• Brenda Ennis – Director of Finance, Dykeland Lodge
• Debra Boudreau – Administrator, Tideview Terrace

DHW Members

• Jeanne Thorne – Lead Financial Advisor

HANS Support

• Mary Donovan – Director, Member and Partner Engagement
• Sara Limpert-Woods – Policy Analyst, Member and Partner Engagement
• Amber-Lee Nickerson – Policy Analyst, Member and Partner Engagement

85

Questions? Comments?

86

Questions/ Comments

Thank You!

87