Resident Directed LivingResident Directed Living© Choice Dining Choice Dining DevelopmentDevelopment

STRATEGIC OBJECTIVES – TACTICAL IMPLEMENTATIONSTRATEGIC OBJECTIVES – TACTICAL IMPLEMENTATION

Execution – Evaluation – Measure – Adjust - Apply

Teaching - Aligning Experiences - Expectations – Resources – Outcomes

Spring ConferenceHelena, MTMarch 17, 2011

Agenda

• Program evolutions

• Execute

• Evaluate

• Measure

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"For every complex, difficult problem,There is a simple solution.And, it is probably wrong!"

H.L. Mencken

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MHA Spring Conference

Environment & Constituencies

• Fiscal landscape transformation

• Emergence of non-traditional models

• Regulatory transition & interpretive inconsistency

• Deliberate seeking for “better”

• Competition

• Silver Tsunami

• Diversity of constituents and locations

• Expand servable constituencies

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Changing Demographics

• More Couples

• More Choice & Selection

• More Control

• More Flexibility

• Experience Consumers

• More Knowledgeable of CCRC Living

• Healthier – Wellness Important

• Seamless Experience

• Broader Constituencies

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Assumptions

• Thoughtful Culture & Service Change to Liberate Community Culture

• Envision the Future, Honor the Tradition

• Imposition of Dining

• Until the Dining Experience is Resident Directed, New Culture will not Take Deep Root

• What is Current Does Not Work As Well As It Can & Should

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Slide 7

Insanity – to continue to do the same things and expect different outcomes

To liberate the culture of the community, it is increasingly clear that we need to change the environment, practices and service model of caring for and with residents. What we have been doing is not as effective as necessary or possible.

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MHA Spring ConferenceSlide 8

Self Directed CultureResidents, Leadership, Care Teams

Initiatives Must Contribute to Strategic Objectives Choice Is The Vision for Community Dining Experience What Is History of “Transformation” Projects?

What Were Expectations How Defined and Structured How was it trained & accepted? Creating a Collaborative Evolution Process Dining as the catalyst

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Resident Directed LivingResident Directed Living

The core of RDL is the opportunity to exercise choice – residents’ for how they choose to live their day and staff choice for care delivery. This creates a collaborative coalition of residents and caregivers working together in a living environment. RDL facilitates the delivery of care, the experience of living and the dignity of self-determination.

RDL is a management principle that aligns the natural rhythms of residents and the support they need. The organizing principle of RDL is that people should be able to make meaningful choices in their daily lives – on their own or with assistance. RDL relies on caregivers to help define and achieve outcomes that balance individual choice and system efficiency.

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Planning

The only way to avoid mistakes is to gain experience. The only way to gain experience is to make mistakes.

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Planning• Discovery

• Recommend

• Execute

• Evaluate

• Words to initiatives

• Consciously apply protocols

• Honest

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MHA Spring Conference

Assessment Points for RDL Implementation

Stages are defined against the requirements of:• Administration: fiscal, management and leadership considerations• Regulatory: compliance criteria (grouped by clinical and operational

considerations) • Systems: software programs, forms, policy & procedures, protocols• Personnel: staffing requirements, training, HR. The impact on each care

disciplines is identified by department• PP&E: Property, Plant & Equipment necessary to perform the tasks and

functions• Community: Communications, Resident & Family education; community

collaboration

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Program GridStrategic Objectives

Community of Distinction

Financial Enhancement

Quality of LivingQuality of Work

OperationalEffectiveness

Step #1Strategic Objective Benefit

Step #2Benefit Measure

Measurement Tool

Step #3 Administration Regulatory Operations Personnel PP&E Community

Operational Resource Requirements

Budget Impact $/FTE’s

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Program GridStrategic Objectives

Community of Distinction

Financial Enhancement

Quality of LivingQuality of Work

OperationalEffectiveness

Step #4Collaborating Departments

Nursing Resident Services

Therapies Pastoral Housekeeping Maintenance Activities

Task

Step #5Task Implementation

Nursing Resident Services

Therapies Pastoral Housekeeping Maintenance Activities

Procedure

Policy

Resource Requirement

Inform/Train

Measure

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Alignment

• The appropriate positioning of systems and resources to attain a defined goal, mission, outcome or culture

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Execute

• Develop

• Implement

• Engage

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Evaluate

• Measures / KPI’s

• Analysis

• Adjust

• Re-apply

• Evaluate

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MHA Spring ConferenceSlide 22

The ROI Of A Dining ExperienceDining establishes the daily quality of life for all members of a senior living community. The

culture defined by the dining experience resonates with and dictates that of the entire community. The dignity and joy of making self-determined choices are at the core of any

good dining experience.

BAD DINING

EXPERIENCE

GOOD DINING

EXPERIENCE

High Staff Turn-Over/Contract Labor = High Costs & Poor Morale/Service

High Staff Retention = Lower Labor Costs

High Food Waste/Use of Supplements = High Food Cost

Low Food Waste/Elimination of Supplements = Lower Food Costs

Low Appetite/Unanticipated Weight Loss = High Care Costs

Healthy Appetite = Lower Care Costs

Poor Image = Higher Marketing Costs and Lower Income

Great Dining Program = Lower Conversion Costs & Higher Occupancy

Key Performance Indicators

• Dashboard driven compliance leadership

• KPI’s developed from the recommendation process while mapping

• Best Practices

• Regulatory requirements

• Case/care management

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Impacts

• Team revised words – new vocabulary

• Team defined initiatives – new direction

• Team defined process – new means

• Project management – new process

• Resident Directed Care – new paradigm

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"The significant problems we face today

cannot be solved at the samelevel of thinking

we were at when we created them."

Albert Einstein

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