How can we help you become one of the most successful Senior Care Communities in your area?
See ROI from other clients below.
•
Culture Building
•
Cost savings
•
Financial growth
•
Regulatory Compliance
•
Census Stability
•
Rate Optimization
•
Customer Satisfaction
•
Employee Engagement
• Culture Building • Cost savings • Financial growth • Regulatory Compliance • Census Stability • Rate Optimization • Customer Satisfaction • Employee Engagement
Think management fees are expensive? Consider the cost if you don’t get help.
-
Derby Health & Rehab is a privately owned 74-bed skilled nursing and rehab facility located in Derby, KS. It opened in 2009 with all beds being dually licensed for both Medicare and Medicaid. The facility was facing significant challenges related to regulatory compliance and financial unsustainability. Struggling to meet the rigorous standards of the healthcare industry, the facility needed a comprehensive turnaround. Axiom Healthcare Services, renowned for its expertise in healthcare management and operational excellence, was engaged to address the complex issues and lead the transformation of DHR.
-
Financial and Cash Flow Struggles: The facility was experiencing financial hardships, with declining revenues, inefficient cost structures, and inadequate financial management systems in place. As a result, the facility lost several hundred thousand dollars a year, and was on the verge of running out of cash. DHR’s ownership realized they were unable to make the course correction necessary due to the financial, regulatory and clinical challenges and understood they needed to engage a management company with the expertise to do so.
Regulatory Compliance Struggles: DHR was grappling with overwhelming compliance issues, leading to numerous and severe citations. This resulted in significant regulatory penalties and a strained survey reputation with surveyors in Kansas and with CMS.
Leadership Challenges: The facility leadership was ill-suited to effectively operate and manage this complex and challenging multi-million dollar a year business.
-
DHR’s owners made the difficult decision to invest in a partnership with Axiom Healthcare Services. As such, Axiom went to work right away and adopted a multifaceted approach to address the challenges faced by DHR. The strategy focused on the following key areas:
Financial Revitalization: Axiom Healthcare Services implemented a detailed financial analysis to identify the root causes of the facility's financial struggles. The team conducted a comprehensive review of revenue streams, cost structures, billing processes, and reimbursement systems. Based on these findings, a customized financial restructuring plan was developed, focusing on optimizing revenue generation, reducing unnecessary expenses, and implementing efficient financial management practices. DHR was also immediately added to Axiom’s GPO partnerships in order for them to benefit from the substantial saving’s discounts on products and services. Axiom's experts provided ongoing financial oversight and guidance to ensure sustained improvement.
Regulatory Compliance: A thorough assessment of DHR's regulatory processes and systems was conducted to identify compliance gaps and develop a comprehensive compliance plan. Axiom's team of experts worked closely with facility staff and leadership to implement robust policies, procedures, and training programs, ensuring adherence to local, state, and federal regulations. Regular audits and performance evaluations were conducted to monitor and maintain ongoing compliance.
Leadership Enhancement: To improve overall operational results, Axiom Healthcare Services quickly discovered that the Administrator and Director of Nursing did not possess the skill, competence, motivation, expertise, or drive needed to turn DHR around. As a result, both positions were immediately upgraded. Axiom worked with the new pairing to implement a strategic turnaround plan that included streamlined processes and procedures, staff training programs to enhance employee skills, job satisfaction, and performance and a vigorous focus on improving the overall customer experience. Axiom also facilitated the implementation of advanced healthcare technologies and systems, enabling seamless information flow, improved patient care, and efficient resource allocation.
-
The collaboration between Derby Health & Rehab and Axiom Healthcare Services yielded remarkable results:
Financial Turnaround: Through the implementation of the financial restructuring plan, DHR had a 13% increase in Medicare rates, 14.3% increase in Medicare Replacement and a 27.9% increase in private insurance rates. DHR’s average census was 58 prior to Axiom’s led turnaround. Following the implementation of Axiom’s strategic plan, DHR’s average census increased to 68 and they are on pace to average 69 in 2023. For the five years leading up to Covid, DHR experienced an average of $400,000 in profits per year maxing out in 2019 at almost $600,000 in profits. DHR is also on pace to generate almost $500,000 in profits in 2023.
Regulatory Compliance Success: DHR achieved full compliance with all regulatory standards and requirements. The facility successfully eliminated penalties and regained its reputation as a reliable and responsible healthcare provider. DHR is now a regulatory compliance leader in the profession having received three back-to-back-to-back Deficiency Free Annual State Surveys and they fluctuate between four and five stars via CMS’ star rating.
Industry Recognition: As a testament to the facility's remarkable transformation, DHR has received several awards and accolades for its exceptional care, regulatory compliance, and financial sustainability. The facility became a recognized leader in the healthcare profession, attracting both patients and highly qualified staff. The facility has won the American Health Care Association’s 2016 Bronze Malcolm Baldridge National Quality Award and followed that up by also winning the 2018 Silver Award, one of only five ever awarded in the state of Kansas. DHR has applied for the Gold Award and plans on being Kansas’ first recipient ever. Finally, DHR has also been recognized by US News Best Nursing Homes and the NRC Excellence in Action Award.
Strong and Empowered Leadership: The leadership team at DHR underwent a significant transformation, becoming more effective, confident, and influential in driving organizational change. They gained the skills and knowledge necessary to lead with purpose and inspire their teams. As of 2023, over 20 employees have been internally promoted and 98% of the leaders in the facility have been home grown.
-
The partnership between Derby Health & Rehab and Axiom Healthcare Services brought about a remarkable turnaround, transforming the struggling entity into an award-winning and profitable healthcare facility. Through the expertise and dedication of the Axiom team, DHR achieved regulatory compliance, revitalized its financial health, and gained industry recognition. The owners could not be happier for or prouder of their beloved DHR and they could not be more grateful that they made that magical decision long ago to invest in a partnership with Axiom Healthcare Services.
Derby Health & Rehabilitation
Would you like to be the next success story?
-
Derby Assisted Living is a privately owned for-profit facility. It is located in Derby, KS, just south of Wichita, KS and is licensed for 35 private pay assisted living beds. It was constructed and opened in 2012.
-
Cash Flow Crisis: In 2012, DAL lost $267,500 and by the end of 2013, the facility had lost another $63,000. The owners had provided capital to fund the operational cash bleed during the forecasted census ramp-up period; however, those funds were virtually depleted and the facility was about to run out of money. DAL was also struggling a bit with some outstanding account receivables.
Census and Revenue Crisis: DAL’s average census in 2012 was 8 and it was only able to increase census to an average of 23 by the end of 2013. Even though the facility’s census was growing, it was doing so at a painstakingly slow pace. DAL did not have the processes, systems, and expertise to deploy a strategic census growth plan to rapidly fill the beds. DAL was also facing stiff new competition in the market.
Expense Control Challenges. In addition to facing several challenges on the revenue side, DAL also struggled in managing its expenses. The absence of robust expense control processes, systems, resources, and tools resulted in inefficient and expensive financial operations.
Staffing Challenges: Much like many healthcare facilities, DAL struggled with employee recruiting, retention, and engagement. They were utilizing traditional employee advertising with some success and had not deployed any effective strategies tied to employee satisfaction, engagement, or retention.
Quality and Regulatory Compliance Challenges: DAL had managed decent regulatory and survey compliance early on. However, it lacks the proper knowledge and support needed to help it achieve the stellar results the owners had envisioned for the facility.
-
Cash Flow Crisis: Axiom quickly completed a detailed analysis of DAL’s cash flow and cash projections. It became quite clear that the facility was going to run out of capital … and fast. Axiom’s accounting department worked with the ownership to explore any and all options ranging from requiring a “cash call” to borrowing money in the market. At the conclusion of the analyses, both parties agreed that Axiom would provide a short-term loan at slightly below-market rates, using the real estate as collateral. Axiom’s experienced accounting department also went to work straightaway with DAL’s office manager to completely assess their accounts receivables. It was clear that they lacked much of the fundamental processes around timely billing, communications, and collections. Axiom fully deployed it’s proven AR system within the first 60 days to sure up collections going forward and help the office manager collect and clean up most of its outstanding accounts.
Census and Revenue Crisis: Axiom quickly discovered that DAL did not possess any sophistication regarding its ability to really drive census or revenue. In short order, Axiom implemented its proprietary “Be Full Census Program” which strategically targets the increase of qualified referrals, converting more of those qualified referrals into admissions and ethically, safely, clinically, and medically keeping patients in the facility as long as possible. Axiom also completed a comprehensive assessment of the rates, levels, and ancillaries being charged to the customers and were able to find creative ways to adjust these to be more in line with a premium, top tier facility.
Expense Control Challenges: It did not take Axiom long to discover DAL lacked expertise in effectively managing its expenses. Axiom got busy right away and deployed an array of processes, systems, and tools needed to get a handle on out-of-control spending. These included the implementation of a robust budget, more sophisticated financial reporting, proper scheduling protocols, detailed labor tracking, and spend-down sheets to name a few. In addition, Axiom was able to save DAL significant money by utilizing many of the strategic partner vendors in Axiom’s GPO.
Staffing Challenges: It was clear that DAL needed a lot of support tied to all things staffing. Axiom started by focusing on improving the overall employee experience. An employee friendly satisfaction survey was implemented, as well as employee “town hall” meetings to boost feedback. Once the employees felt fully understood, things got better quickly, even more so once they saw that Axiom and the leadership team actually followed up on many of the survey and feedback items. Axiom also implemented several employee appreciation, engagement, and recruiting initiatives that great improved the overall staffing situation at DAL.
Quality and Regulatory Compliance Challenges: Axiom has had a longstanding belief that “money follows quality.” To this end, Axiom implemented a whole host of customer centric processes from enhanced care planning to exhilarating activities and completely digitizing medical records to dining experiences that would rival 5-star restaurants. 24/7 survey readiness processes and systems were deployed as well as tons of trainings and resources. Within several months, the residents were receiving world class care and services and the facility was ready for any survey compliance with eagerness.
-
Cash Flow and Financials: DAL experienced significant improvements in overall cash management and financial results. In 2012 and 2013, the facility virtually ran out of money and lost over $300,000. Beginning in 2014 and leading all the way until the COVID Pandemic, DAL averaged over $135,000 in bottom line profits per year. In 2022, DAL made $218,000 in profits and are on pace to earn $260,000 in 2023. Due to the financial success, the facility was able to repay the loan ahead of schedule. Beginning in 2014 and all the way through 2023, DAL census has averaged 32.5 or 93% occupancy. Finally, tied to AR, days sales outstanding (DSO) has averaged zero from 2014 to current.
Staffing: To give you some sense of just how impactful Axiom has been at improving the overall employee experience at DAL, the facility has never used one hour of agency, even during COVID. Their employee retention has averaged over 73% and their employee satisfaction scores have average about 90% for years.
Quality and Regulatory Compliance: Since working with Axiom, DAL’s overall quality and compliance has gone through the roof. They have received four zero annual deficiency free surveys in a row, and they have never had a single complaint survey deficiency. DAL is also a very highly decorated facility as evidenced by receiving the 2018 Bronze Level Malcolm Baldridge National Quality Award and they have also applied for the 2023 Silver Award. DAL was also honored by winning the 2017 KHCA/KCAL Director of Nursing of the Year Award, the 2018 Making a Difference Award and the 2022 Administrator of the Year Award. In 2018, their Director of Nursing also won the Wichita Business Journal’s Nurse Leader of the Year Award. Finally, DAL’s resident and family satisfaction scores have averaged in the 90 percentile for years.
-
It was clear that the owners were concerned about many things tied to DAL’s overall operation. This included dyer cash flow and financial challenges, struggling with staffing and concerns about compliance. The owners realized that they did not have the experience or expertise to oversee a very complicated and complex senior healthcare facility and were a bit over their ski’s. The owners were also very concerned about adding additional expense burdens on the facility via a management contract. Now that all that is behind them, the owners have sat back and watched in wonder all the amazing results highlighted above and are overwhelmed with appreciation and gratitude for making one of the wisest decisions ever … to partner with Axiom Healthcare Services.
Avita Senior Living of Derby
Would you like to be the next success story?
-
The Cottages at Garden City (GC) is a for-profit Home Plus facility located in Garden City, KS designed to provide nursing care to individuals that can no longer live at home and require assistance with activities of daily living. This model allows residents to live in a beautiful, non-institutional home setting with care tailored for each resident. This is a 12-bed, private pay (with the option for HCBS) facility that was opened in 2017 and is privately owned.
-
Leadership Challenged: The Cottages at Garden City consistently struggled with leadership turnover. This revolving door led to a lack of consistent expertise to successfully run and operate the facility and resulted in substantial underperformance in most of the traditional Key Performance Indicators. These included poor census, survey deficiencies in the double digit, continuous year-over-year financial loses, and running out of cash.
Census Development Crisis: The building opened in July of 2017 and for the first six months only averaged three residents a month. For the next several years, the census only grew to an average of six or a dismal 50% occupancy. The Garden City team did not have the proper leadership or expertise to create, deploy or execute an effective strategy for census development.
Financial Performance Crisis: From 2017 through 2021, GC lost money every year and racked up almost three quarters of a million dollars in losses. The owners had funded an original capital account for projected ramp up losses; however, it was insufficient to meet the ongoing losses and multiple “cash calls” had to be executed to keep the facility afloat. While recognizing that COVID was a substantial negative factor in the 2020 and 2021 losses, GC was still experiencing the symptoms of broken or non-existent financial best practices and processes.
-
Leadership Challenge: Axiom Healthcare Services believes that having the right people in the right roles is a key component for success and it all starts with having the right leadership in place. To this end, Axiom deployed its robust executive recruitment and retention initiatives and upgraded the facility’s leadership team in short order. It accomplished this with one internal promotion and one upgraded external hire. Working with new and inspiring executives, Axiom launched an overall facility Strategic Plan focused on key performance areas. These included: leadership development, support, and accountability, a high focus on the overall employee experience, rock solid quality, and compliance processes, protocols, and procedures, a person-centered approached customized to each resident, a comprehensive census development plan, as well as revenue maximization and expense control measures.
Census Development Crisis: Axiom worked closely with the new leadership team at the Cottages at Garden City to implement key components of the “Be Full Census Development Plan.” This focused on three critical success areas: increasing qualified referrals, converting more of the qualified referrals into admissions, and safely keeping the residents for the proper amount of time, i.e., length of stay. The team also aggressively marketed the facility's growing achievements and success stories that included showcasing positive outcomes, resident testimonials, and emphasizing the personalized care provided in a non-institutional home setting. This improved the facility's reputation in the market and attracted more families’ interest in admitting their loved one into GC.
Financial Performance Crisis: Axiom Healthcare Services completed a thorough review of the financial reporting system in place and quickly recognized that it was antiquated and lacked sufficient detail. The facility was also operating without a proper budget, forecast, or proforma. Axiom quickly instituted a proven financial reporting solution that afforded a much greater level of granularity. Axiom worked with the new leadership team to also create a realistic budgeting process, which were then added to the detailed financial reporting. GC was added to Axiom’s GPO to grant them immediate access to instant savings on many products and services. Axiom also provided extensive financial training, as well as improved expense monitoring tools, resources, and solutions.
-
Expertise\Leadership: Finding the right combination of leadership and expertise in a facility sometimes comes from within. The business office manager had been in place for a few years, and we recognized her potential for immediate advancement. As such, Axiom placed her into the Assisted Living Operators Course and after successfully completing said course, she was promoted to the role of Operator. Axiom provided the needed support and training she needed. She has turned out to be one of the organization’s superstars and we could not be prouder of her. Axiom also significantly upgraded their DON position. She worked very closely with Axiom’s Chief Nursing Officer to accomplish the monumental task, among many other things, of correcting their survey compliance challenges. The result was that GC went from having 15 deficiencies in 2019 to back-to-back deficiency free surveys over the last 2 years.
Census Development: In working with the new leadership at GC, Axiom was able to help them improve their customer and employee experiences and boosting their overall reputation in the market. The average census per month for the first several years of operation was six. Starting in 2022 to present, they have been averaging 12 or 100% occupancy, with a growing waiting list. Garden City has been so successful over the last year or so, Axiom is beginning the process of evaluating the expansion efforts for the campus to double in size by constructing a second 12-bed house.
Financial Performance: From 2017 through 2020, Garden City lost money every year culminating in a loss of $172,000 in 2020. However, through the above-mentioned leadership changes, census development initiatives and strategic cost control measures, Axiom was able to help GC turn the corner. Even in the depths of the ominous throws of COVID and the extra expense of hiring a first-class management company, by 2022’s year end, GC was profitable for the first time netting $55,000. Furthermore, their 2023 Y-T-D annualized profits are projected at over $150,000, placing GC in their best financial position since its inception.
-
Axiom Healthcare Services began managing the facility in May of 2020. Although COVID greatly expanded the breath and width of a facility already in the throes of countless challenges, Axiom worked with the new leadership team to address the growing concerns head on. Now, it is not the challenges and struggles that are growing but Garden City’s census, profits, waiting list, quality, compliance, overall reputation, and success. Garden City owners, filled with a new sense of esteemed pride, now sit back in gratitude, awe, and amazement at what their precious project has transformed into.
The Cottages at Garden City
Would you like to be the next success story?
-
Spring View Manor, owned and operated by a family that started it 50+ years ago, is located in rural Conway Springs, Kansas. It is licensed for 45 beds and is dually certified by Medicare and Medicaid. SVM had initially hired another management firm to help with challenges related to operational inefficiencies, poor survey results, outdated systems, and limited profitability. After working with this competing company for a few years, the owners felt this organization had taken on more than they could chew and were not happy with the lack of overall results. Even though said company had regional and corporate personnel, they lacked the bandwidth and expertise to deliver on their promises. As such, the facility's founders made the important strategic decision to upgrade their management company and decided to partner with Axiom Healthcare Services to revitalize their overall operations and position the facility for a potential future sale with increased value on the market.
-
Low Market Value: The owners of SVM had run the facility as a family business for decades and were exhausted. They hoped to sell the facility for a fair price and a decent return; however, several years of overall poor performance had tanked its value on the open market leaving them with feelings of hopelessness and despair.
Leadership Crisis: Spring View Manor had been struggling to find the right executive leadership and management company for several years. The lack of a consistent proven Administrator, an ongoing vacancy in the Director of Nursing role, and inconsistent support and guidance from the current management company led to many issues in most of the key areas of the business.
Financial Performance: Spring View Manor’s financial performance and cash reserves were dwindling. Once a profitable facility, SVM’s rolling 12 prior to Axiom taking over had them losing thousands of dollars a month on average. The census had averaged only 32 out of 45 beds or a dire 71% occupancy. Their expenses were not well controlled, and they lacked the proper processes, systems, and tools to effectively get a grip on overall spending.
Quality and Regulatory Compliance Challenges: Spring View Manor consistently struggled with quality, compliance, and overall patient care. Customer satisfaction was low, and the overall patient experience had a lot to be desired. They were experiencing a less than ideal regulatory reputation and their most recent survey prior to their contract with Axiom resulted in 13 deficiencies, even with only 32 patients.
Staffing Crisis: The facility was staffed almost exclusively with agency personnel and most of them were being provided by the prior management company’s staffing agency. The proper motivation for the prior management company to create urgency around solving this crisis did not appear to exist. Overall employee morale was at an all-time low, and turnover of the few facility employees had skyrocketed.
-
Low Market Value: SVM was in bad shape and faced challenges on multiple fronts. Axiom had to deploy virtually all of its resources in order to begin the massive turnaround. After quickly assessing the overall operations, Axiom created and deployed a comprehensive strategic plan aimed at the following key areas: Leadership Focus, Employee Focus, Quality Focus, and Financial Focus.
Leadership Crisis: The owners upgraded their management company and hired Axiom to take the reins. Axiom quickly deployed their executive recruiting strategies and tapped into their extensive network of proven leaders in the greater community. In short order, SVM was able to recruit and hire a seasoned Administrator and an up-and-coming RN manager with lots of promise as their DON. Extensive on-board training was provided for both key personnel and Axiom worked with them to create and deploy an effective overall strategic plan for the facility moving forward.
Financial Performance: Axiom's financial experts analyzed Spring View Manor's financial statements, identified areas for improvement, and formulated strategies to optimize revenue streams and reduce costs. This involved deploying Axiom’s proprietary “Be Full” census development program, optimizing reimbursement processes, reducing overall spend on agency staffing and implementing effective financial management practices. In addition to renegotiating contracts with some of their local suppliers, SVM was also added to Axiom’s GPO, affording them significant savings on many products and services.
Quality and Regulatory Compliance Challenges: After successfully filling the much-needed ED and DON positions, Axiom collaborated closely with them and the other nurse managers to develop a quality and compliance strategic plan aligned with their and the owners’ long-term objectives. This involved establishing key performance indicators (KPIs), optimizing workflows, and implementing evidence-based best practices to enhance the overall quality of care for the patients and to improve regulatory compliance.
Staffing Crisis: The staffing crisis at SVM was one of the worse ever inherited by Axiom. The first thing Axiom focused on was instilling the passionate belief that SVM could and would become agency free. To this end, milestones were created to measure progress as both teams worked hard to develop and deploy bold employee recruiting, retention, engagement, and satisfaction strategies. The key was to create a culture were employees felt they were a part of something bigger and more important than themselves, that they were trained in their disciplined so they could experience a sense of mastery, and to build enough trust where they had the autonomy to do the right thing.
-
Low Market Value: In less than 18 months, SVM’s overall results improved to the point that it allowed the owners to execute a successful sale at more than DOUBLE the price that they had been offered previously.
Leadership Crisis: With the owners’ hiring of Axiom and Axiom’s upgrading of the facility leadership, SVM was able to be successfully led through the much needed and massive turnaround leading to their successful exit.
Financial and Staffing Crisis: After implementing Axiom’s census and revenue optimization strategies, SVM was able to increase its occupancy from 71% to 82%, resulting in a 25% increase in revenue. Agency usage also decreased from an average of $55,000 a month to being agency free in about seven months. Unfortunately, COVID hit about this time and SVM experienced about a 30% increase in market wages which prevented them from reaching the goal of becoming fully profitable again.
Quality and Regulatory Compliance Challenges: SVM’s first and only annual survey under Axiom’s watch reduced their deficiencies from 13 all the way down to none resulting in their first deficiency-free survey in recent memory.
-
Spring View Manor's collaboration with Axiom Healthcare Services proved to be a transformative partnership that elevated the facility's overall performance, reputation, and market value. SVM emerged as a top-tier, highly sought-after, long-term care facility that commanded more than double its initial value and resulted in a very successful exit for the founding family.
