1. Lakeland Health Care Center 2015 Budget Preparation The Impact & Importance of Cultural Change May 21, 2014

2. Medicare’s Shared Savings Program “Policy makers and health care providers increasingly recognize that coordination between acute care hospitals and post- acute providers is essential to improving the overall quality of care and reducing health spending.” Rich Umbdenstock, President & CEO, AHA

3. It takes 5 – 7 Years to change culture. LHCC Team Meetings Quality Assurance Committee Meetings Medicare “Stand Up” Meetings Safety Committee Meetings Care Conference Planning Meetings Process Improvement Planning (PIP) Triple Check Meetings Toilet Talk Open Door Policy

4. It’s time to tie it all together. Resident Centered Care Consistent Assignments Food Service Assignments Resident Service Workers Accountable Care Organizations (ACO)

5. ACO Sample Selection Criteria Five-Star Rating Program Specialties Staffing – esp. RN Staffing Therapy Provision (5-6-7 days per week) Electronic Health Care Record INTERACT Deployment and Use 30 – 90 Day Readmission Rates Survey History Community Discharge Rates Ability to Admit 24/7

6. Staff Budget Prep Discussions Certified Medication Assistants Specialized Teams and Programs Scheduling Practices Medical Records – New Coding System The Dementia Care System Redesign Plan

7. Cultural Change – We’ve Come Along Way! We no long hear “it can’t be done.” Everyone from the treating physician to the cleaning staff has a role to play in optimizing efficiency. The maintenance and dietary employees form important relationships with the residents.