PALs - The Paper Flow

Although PALs can be setup for electronic entry, most users setup PALs using the paper mode.

In this setup, operationally, only three reports are regularly needed:
1. Shift Assignment Sheet - one report per shift per week or day (depending on the size of the community;
2. SAR - Service Administration Record - one per resident per month; and
3. MAR - Medication Administration Record - one per resident per month.

Shift Assignment Sheet - This report lists all the services from all the residents service agreements, in time order, that need to be performed during the shift. For smaller communities, with few service changes, each shift assignment may be printed for seven days, placed in a sheet protector and re-used and reprinted for the days effected by changes in a resident's service plan. For larger communities, with daily changes in resident services, a shift assignment sheet should be printed for each shift, every day.

SAR - This is a record of services provided and looks like a MAR. One page per resident per month. Using the Shift Assignment Sheet for notes, staff document on the SAR prior to ending their shift. This form may also be used by the nurse to orient staff to the resident's plan of care.

MAR - This record is used to document medications administered or observed. Again, one page per resident per month. This report is usually stored with the medications and staff initial to document medications administered.

Operationally, using PALs in the paper mode, requires very little paper flow.

Please visit our website at http://www.palssoftware.com/ and download a free trial of PALs Executive and experience it for yourself.

Organizational Integrity in Assisted Living Communities

Organization Integrity, simply stated means, doing what you say you will do.

It begins when you develop a service agreement with a resident. In this agreement, you state what services you will provide, personalized for the individual resident, when you will provide them, for how long, and the price. If you "package price" for a group of services, these services should be unbundled and personalized for the resident.

So a bath on Wednesday night at 8pm will be included in the service agreement, along with all the other services a resident will receive and be expected to pay for.

PALs Software will automatically add this service to the "shift assignment sheet" for the pm shift on Wednesday. Before the staff person performing the pm shift leaves work, they will document that they provided the service (or if not, why not) on another form that looks like a MAR but for services.

At the end of the month, all services are automatically billed, along with any ala carte services. If the resident or family question any item billed, an audit trail is available.

PALs - Professional Assisted Living Software will:

1. Print the Service Agreement
2. Automatically include all service agreement tasks on the shift assignment sheet so someone is accountable for providing the service.
3. Print the Service Documentation form to document the provision of service.
4. Automatically create an invoice to bill for services provided, packaged, individual, or ala carte.

All the above promotes "Organizational Integrity" meaning you do what you say you will do, which in turn, builds your organization's "brand".

To download a free trial of PALs go to www.PALsSoftware.com

Staff Scheduling in Assisted Living Communities

How Assisted Living Communities develop staff work schedules, impacts both Staff and Resident Satisfaction and PROFITS. Integral to this discussion, is an understanding of "Shift Productivity".

Shift Productivity is the ratio of Service Hours to Work Hours. For example, if staff work an 8 hours shift, during which time they provide 6 hours of direct resident service, 6/8= 75% shift productivity.

If Shift Productivity was 100%, staff would be exhausted, residents may not get there service on time since one resident taking more time would throw off all the other services. Residents would feel as though staff was not available and therefore not interested in their welfare.

Shift Productivity also effected profits. If it is set too low, say 50% or only providing 4 hours of service for each 8 hour shift, would staff costs would double, and compared to your competition, possible price you out of the market.

PALs suggests pricing services based on 15 minutes of staff time. To figure your staff cost calculate your "fully loaded" hourly rate x 1+(100-shift productivity). So if your hourly rate for an aide is $16 and your shift productivity is 75% then your price per 15 minutes of staff time is, 16/4 x 1+(1.00-.75) = $5.00 per 15 minutes. Add on Overhead and Return-On-Investment (30%) and staffing become a revenue center when you charge (5 x 1.30) or $6.50 per 15 minutes. And all your staff time is paid if you take into consideration Shift Productivity when developing the staff work schedule.

Another advantage of using this Shift Productivity ratio is that it eliminates "Service Creep". If you define service creep as unpaid service, if all your staff time is "paid for", service creep becomes a service opportunity not a problem to be eliminated.

This Shift Productivity ratio also equalizes shifts, so one shift is not seen as providing more service than another. And staff are provided an incentive to report all additional services, otherwise they may be working harder than another shift.

In summary, when scheduling staff and pricing services, you need to factor in Shift Productivity. PALs will do the calculations for you and monitor compliance.

For related information see "7 Steps to Profits" below.

To download a free trial of PALs, just visit our website at http://www.palssoftware.com/

MAR Form for Assisted Living Communities

PALs offers seven MAR formats,and now we've added an eighth in response to user's request.

In the past week two users requested a MAR that would be used when meds are ordered for specific days; e.g. Mon/Wed/Fri, or Odd or Even days of the Month. We were happy to oblige and the new form is called, MAR_Daily and can be seen clicking here (note order stating Odd or Even days).

PALs, the most feature rich Assisted Living Software, now offers one more feature for its users. For more information on PALs, please visit our website at http://www.palssoftware.com/

MAR - Medication Administration Record

PALs Assisted Living Software is pleased to offer the Medication Manager. This program sells for only $250.

Enter medications once and print MARs, Physician Orders, and Pharmacy re-order reports. Other reports include Medication Setup (when using a dosage box system), Medication Profiles, and a variety of Medication lists as well as a resident roster.

To download a free trial or for more information please visit our website at: http://www.palssoftware.com/

Can Software Help to Increase Profits?

Absolutely. But it is how they assist that makes all the difference. As a rule, there are two approaches:

1. Track all services (minutes) provided and bill for it. Revenue side focus.
2. Provide management with the tools they need to manage Profits = Revenue - Costs

Option 1 is doable in most software today by simply adding an "ala carte" or one-time service for billing purposes. The downside of this approach is that is does not control your costs, staff hours, and may result in compromised customer satisfaction. Residents feel that staff/management only see them as dollar signs!

Option 2 focuses on relating service pricing and staffing hours so that all staffing hours are paid for, thus controlling costs, and any increase in revenue goes straight to the bottom line.

PALs will support your efforts in either approach. See "7 Step to Profits" (below), for further discussion of option2.

What PALs offers, and most others don't, is the ability to enter your staff work schedule and compute the "Shift Productivity Ratio" (service hours per shift/staffing hours per shift). By using this Ratio in both pricing and developing staff work schedules, all staffing hours will be paid-for. Since additional services would represent additional revenue, staff are really profit-centers, NOT cost-centers.

With the management tools provided by PALs, incentives are aligned: Staff do not feel overworked, management has no incentive to understaff, and most importantly, residents feel valued as individuals and not as dollar signs.

For more information please visit our website at: www.PALsSoftware.com

Customer Service

I had a nurse call yesterday to say she was delighted to find that PALs has a Standing Orders feature that eliminates having to enter the same medication into all residents medication list. But...

She wanted to control the number of lines for documenting on the related MAR. So if a standing order was limited to one time daily, only one line would print and if a medication could be given every 2 hours up to six times daily, six lines would print on the MAR.

After a little discussion and clarification, we agreed to make the changes and had an update to her within four hours of the request.

So now PALs has an enhanced feature, thanks to our customer, that is available for you to download from our website at http://www.palssoftware.com/
when you download our PALs Executive program - the Standard in Assisted Living Software.

Lead Manager for Assisted Living Communities

PALs is pleased to offer it's Lead Managers program FREE to Assisted Living Communities that download PALs Executive - Assisted Living software.

PALs Lead Management software offers the following features:

1. Track leads through a user-defined phases (pipeline). 1 Inquiry -> 2 Tour -> 3 Negotiation -> 4 Move-In and report both numbers in the "pipeline" and ratio's of Leads to Tours / Negotiation / Move-In.

2. Add marketing dollars and print report to show cost per lead.

3. Assign each lead to a "Lead Manager" and document each contact and optionally set a "To Do" date for follow up.

4. Each day the Lead Manager reviews their "To Do" list and takes approproate action.

5. Quickly and easily print form letters or send emails or merge to WORD Documents.

6. And when your lead Move's In, data is automatically sent to PALs Assisted Living Software.

7. PALs Lead Manager can be used for contacts other than "Leads" to serve as your general "contact manager".

8. Includes 25+ reports including mailing labels.

Happy New Year - and please download your lead manager from our website at: http://www.palssoftware.com/

7 steps to Profits

Seven Steps to Assisted Living PROFITS with PALs

PALs will guide you to guaranteed PROFITS by giving you the tools to ensure that: "Revenue is greater than Costs".

The common denominator between service revenue and service costs is minutes. By converting both revenue and costs into minutes, PALs will guide you to profits. The examples will use "Per 15 minutes" but you could as well use per 10 or 5 or 1 minute.

PALs will calculate all the following:

1. Revenue = charges "Per 15 minutes" of service (see below) X total "15 minutes" for all Resident Services

2. Charges "Per 15 minutes" = Wages & benefits "Per 15 minutes" X Shift Productivity (defined below) X Overhead & ROI. This formula ensures that ALL of your staff time is "paid for" plus a profit margin. This mitigates "service creep" and converts staff from a cost center to a profit center since both Overhead & ROI are included.

3. Shift Productivity - is the ratio of all Resident Service Minutes divided by Shift minutes. Six hours of Resident Services during an 8 hour shift yields (6/8=0.75) = 75% Shift Productivity ratio.

4. Staff Cost "Per 15 minutes" = Staff wages & benefits "Per 15 minutes" X Shift Hours (converted to 15 minutes units)

5. PROFIT = Revenue – Staff Costs or Service Profit = (Pricing X service minutes) - Staff Costs

PALs will perform all the above calculations for you. Remember, the final number must be marketable (or offer a competitive advantage) in your service area.

Given the goal is to keep Revenue greater than Costs, PROFITS are GUARANTEED if you follow these 7 steps when using PALs.

1. Calculate your "Per 15 minutes" charges using PALs Template

Use the "Per 15 minute Charge" section to determine your charges for "Per 15 minutes" of service. See footnotes. By adding in the Overhead and ROI, each staff person becomes a revenue generator, as opposed to a cost center.

Determine what your agency's "Shift Productivity" will be by policy. Be sure to follow this policy when scheduling staff in step 7 below.

2. Price Services and charge by "Per 15 minutes" as calculated above. Enter services and charges based on the charge "per 15 minutes" as calculated above. When complete, click on "Print" button and review your Service Assessment template. You will use this to gather data to enter into the next two steps. Hint, enter services based on "encounter" rather than ADL. For example, AM_Care is the service (encounter) and it may include (multiple ADLs) dressing, grooming, toileting… depending on the resident.

3. Assess Resident's need for above services.

PALs will create a service template that will be applied to each resident in the form of an assessment. You only create this once. Then edit and use if for all residents. When administrating this assessment, remember you are only assessing for minutes of care. You do not have to enter the service need, only the minutes. You will enter the service description when developing the Resident Service Agreement in the next step.

It is recommended that this Assessment be done prior to admission, then 14 days after admission using the Service Documentation sheet from step 6 below as your data source. Your "Resident Service Agreement" should also state that service charges are reviewed regularly and will be adjusted as defined by your "Levels of Care".

4. Enter Resident Services using the Services from 2 and 3 Above
Enter resident services and assign each service to a specific shift, at a specific time and enter the number of minutes from the Resident Assessment (step 3). On the "Service Description" tab, describe how this service should be customized for this resident.

5. Shift Assignment Sheet/Checklist

Print the staff schedule daily to capture changes in services. Using this "checklist" will ensure that all services promised in the Resident's Service Agreement, are provided and billed as scheduled or any variation is documented.

6. Service Documentation - Staff Charting

Now have staff document services using the monthly "With Minutes/Variation" form. Use this documentation to trigger a re-assessment. Consistent variations may indicate a "Change in Condition" and warrant a different "Level of Care".

7. Staff Work Schedule – Schedule and check the "Shift Productivity" ratio

Enter the staff work schedule and click on the "Review Shift Productivity" button to ensure that service hours divided by Shift Hours is equals to or greater than the Shift Productivity ratio used when figuring costs "per 15 minutes" in step 1 above.

Bonus - No UN-controlled Service Creep. All staff hours are "paid for" since the charge "per 15 minutes" includes the Shift Productivity factor. Additional services or added time to current services present an opportunity not only for additional revenue, but more importantly, additional PROFITS!

Also, the incentives are aligned between management and staff. Staff is given an incentive to report additional services or work harder (more minutes) than another shift that reports all additional service time. And management is given an incentive to make sure sufficient staff are working since they are now revenue generators and revenue finders and contributing to both overhead and ROI.

Summary: With the above management tools, You can now manage for PROFITS!!

To download a trial copy of PALs go to http://www.palssoftware.com/

Assisted Living Software - Quality and Systems

Peter Drucker, the famous management guru, defined quality as simply a "reduction in variation". If there is a "right way" to do things, then the variation around this "right way" needs to be minimized. If there is no "right way", then your organization adds no value!

By carefully defining your "value added" as the "right way" and transmitting this to your employees, you create a "competitive advantage".

In addition to defining this "right way" in your Policies and Procedures" and otherwise transmitting this to your employees, I suggest that software is another tool or system to use in improving the quality of your organization.

Consider the following example. You decide that your organization will distinguish itself by doing what it says it will do, on time, and meet or exceed resident expectations in the process.

Your software should print a resident Service Agreement, to specify what services will be provided, when (time), by whom (shift) and how long (in minutes). This Agreement is signed by both parties.

Now when staff come to work, their "shift assignment sheet" is printed to remind staff of promises made to residents. After the service is completed, the resident may be asked to initial and evaluate the service.

These same services are printed on a Resident specific documentation form, which is initialed by the staff person and used to verify that services were provided. The final step, is to print an invoice that reflects the services provided (including any additional services).

The above process is facilitated by having systems in place, a software program, that, once the services are entered, will automatically generate the Resident Service Agreement, Shift Assignment sheet, Service Documentation form, and monthly invoice.