Strategic Plan for Skilled Nursing Facility

Provide a brief overview of the organization you have selected

Long term care facilities particularly skilled nursing facilities have become complex. This is because they are currently accepting patients from the hospital just a few days post-operatively or with recent acute illness (White & Truax, 2007). According to White & Truax (2007), long term care facilities are a subset of the overall health delivery system in the US. The key factor in determining whether a facility provides long term care is to know if its mission is providing ongoing care versus acute care and how the facility is licensed in the state.

Beta Pham skilled nursing facility was licensed by the Washington state in 2005. The facility provides long term, chronic care residents and short term hospital patients admitted for the purpose of rehabilitation before they are discharged to home. Medicare covers patients admitted in Beta Pham nursing facility who have a 3-day eligible stay in the acute care hospital for short term rehabilitation (White & Truax, 2007). Beta Pham nursing facility is privately owned and is not for profit. The facility has a capacity of 300 beds and is owned by a single person. The mission statement of Beta Pham nursing facility “is to improve the quality of care provided and other related services to patients”. The Beta skilled nursing facility provides a full range of clinical long term care services.    

Describe the organizational structure

Beta Pham nursing facility uses a functional organizational structure. This type of organizational structure divides various responsibilities among groups or departments (Ilminen, 1999). Functional structure is set up so that each portion of the organization is grouped according to its purpose (Different types of organizational structure, n.d.). According to Ilminen (1999), the facility administration requires a versatile, resilient individual with a variety of technical, management and people skills. In addition, Singh (2010) indicated that the organizational structure of Beta Pham nursing facility includes the preceding functional departments. Each of these services is managed by a mid-level manager who reports directly to the administrator. Singh (2010) noted that the various support services found in functional structure are adjuncts to the central nursing care process and must interface with clinical care using a multidisciplinary approach. 

How will developing a well-constructed strategic plan benefit the organization?

The strategic plan will help the management of the nursing facility to address all aspects of the patients needs without duplicating or disregarding any patient needs. Singh (2010) noted that “the strategic plan will help the Beta Pham to tackle problems and issues from all pertinent disciplines through interacting and providing their professional inputs” (p. 246). A strategic plan will enable Beta nursing facility to predict of what the facility’s decision makers believe they must do to cope with the future (Allen, 2011). A strategic plan makes it possible to compare what actually happens to what is expected to happen. Allen (2011) indicated that to survive and prosper, the nursing facility must engage in strategic planning. The plan will integrate the facilities major goals, policies and action sequences into a cohesive whole (Allen, 2011).  

Identify key services provided by the organization

Beta nursing facility provides a range of services to the patients. The services provided by skilled nursing care include monitoring of unstable conditions, clinical assessment of needs; and treatments such as intravenous feeding, wound care, dressing changes or cleaning of air passages (Singh, 2010). The facility also provides post surgical orthopedic care after knee or hip replacement and cardiopulmonary rehabilitation that are essential after heart surgery (Singh, 2010).          

Description of management team

Nurse staffing ratios are a critical factor influencing the overall quality of care in Beta Pham nursing facility. The management team in Beta Pham nursing facility includes the director of nursing, assistant director of nursing, nurse managers, unit managers, care coordinators, medication or special treatment nurses, shift supervisors, staff nurses and nursing assistants (Ilminen, 1999). Charge nurses passes medications, provide treatments and documents patients. Treatment nurse changes dressings and provides wound care. The director of the facility plans and carries out diversional activities or recreation therapy for residents (Ilminen, 1999). 

The volume of business that is being done on a monthly or annual basis

The Beta Pham nursing facility serves approximately 400 patients each month. 10 distinct groups within the facility indicate the severity of the patient’s condition. About 25 patients are referred to the facility for evaluation each day. Varying number of patients is admitted to the facility after evaluation. Statistics indicate that 54% of referred patients are admitted to the facility. At the same time Beta Pham discharges about 15 patients every day. The facility charges $165 per day for admitted patients and $85 for outpatients who seek other services such as dressing and wound care. The facilities turnover is estimated to be $840,000 per month. This amount varies depending on the number of admissions undertaken on daily basis. The 400 patients served by the facility represent 37% of the total 650 patients seen and evaluated by utilization review nurse within the facility.      

Demographics of patients being served

Patients admitted and served by Beta nursing facility are evenly divided by gender. 65% were older than 65 years of age. White & Truax (2007) noted that patients enrolled in the outpatient therapy program are those with minimal deficits. Some of the patients who complete their hospital based inpatient program or have their rehabilitation at a skilled nursing facility.

The table below shows the demographics of patients admitted in Beta Pham nursing facility.

Characteristics	Percentage (%)
Age (years)
20-40	2
40-60	12
60-70	31
70-80	25
80+	20
Gender
Female	68
Male	32
Education
<12 years	54
>12 years	46
Marital status
Married	54
Unmarried	46
Average medical visits per year	57
Ethnic breakdown
Hispanic	20
American	58
Black American	22
Employment status
Employed	9
Unemployed (Retired)	91

 Demographics of the staff to include number of staff, types of positions, education level, etc

Beta nursing facility has a total of 20 members of staff. This is to ensure that the nursing staff is adequate to meet the needs of the residents living the facility. The facility has 5 charge nurses who are responsible for passing medications, providing treatments and documenting the patients. Beta nursing facility has 4 treatment nurses who provide wound care and manage gastronomy. There are 4 admission nurses who evaluate potential residents for admission and coordinate with hospital discharge planner to facilitate admissions from hospitals (White & Truax, 2007). The facility has 1 MDS coordinator who is responsible for gathering and transmitting all of the facility MDS data to Medicare. The facility has 3 infection nurses who are responsible for identifying potential sources of infection and preventing the spread of infections within the facility (White & Truax, 2007). Beta nursing facility has a 1 utilization review nurse who is responsible for evaluating the status of each resident to determine the ongoing requirements of care. The education level is a bachelor’s degree in nursing. The director of staff development nurse is responsible for the orientation and ongoing education of the unlicensed staff.    

The table below shows the demographics of the staff of Beta Nursing Facility.

Type of position	Number	Gender	Education Level
Administrator	1	Female	Masters Degree in Nursing
Charge nurses	5	2 male, 3 female	Nursing Degree
Treatment nurses	4	1 male, 3 female	Nursing Degree
Admission nurses	4	2 Male, 2 Female	Nursing Degree, Diploma in healthcare administration.
MDS coordinator	1	Male	Nursing degree and Diploma in healthcare administration.
Infection nurses	3	1 Male, 2 Female	Nursing Degree and Diploma in Clinical studies
Utilization review	1	Female	LPN Degree
Director of staff development nurse	1	Male	Degree in Nursing and Diploma in Administration