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Principals Christine Bassett and David Roush founded Radius Management Services, Inc. in 1999 in response to the growing need on the part of post-acute and senior care organizations for regionally based full service management. The confluence of several factors, including a growing elderly population, chronic underfunding, staff shortages and the deterioration in the quality of patient care, created a demand for Radius' specialized expertise.
Currently, the company owns 11 skilled nursing facilities encompassing approximately 1,600 beds. Collectively, these facilities employ approximately 2,600 individuals. The company also manages a skilled nursing facility and an assisted living community for a Massachusetts not-for-profit organization.
Radius Management delivers services in a number of specialized areas including operations management, clinical services, regulatory affairs, financial services, managed care contracting, rehabilitation services and marketing and sales. For those organizations needing a less comprehensive program, the specialized professionals at Radius offer transitional or a la carte services as well as short term crisis management options.
Members of the Radius team have been working for over two decades in long-term healthcare in Massachusetts and combine a wide range of professional capabilities. They recognize that it is the provision of solid, regular on-site management combined with regular access to specialized professional services that create the quality management service offered by Radius. Principals and Senior Associates of the firm are directly involved in the management work relating to their areas of expertise.
Radius Management Services, Inc. provides full service or a la carte management services to post-acute care and senior service organizations.
Radius Management Services is comprised of a team of seasoned professionals who are skilled in a wide range of capabilities including
- Operations management
- Clinical services
- Regulatory affairs
- Financial services
- Strategic planning
- Development
- Rehabilitation services
- Network development
- Marketing and sales
- Managed care contracting
We provide comprehensive management, transitional management, a la carte management support, and ad hoc consulting services. Organizations with a preference for a la carte services dictate that our team of specialists take on the most challenging problems.
The hallmark of Radius Management is the delivery of dependable, regular on-site management combined with consistent access to specialized professional services. It is our practice to directly involve the principals of the firm in the management work in their areas of particular expertise.
More information:
Operations
Financial Services
Clinical Services
Business Development
Marketing
Admissions
Rehabiltation Services
Human Resources
Operations
The Radius Management Operations Department oversees all aspects of facility operations to ensure that all our residents receive the highest quality care and service.
I. Key Areas of Focus
Operational Integration - Radius Management operations includes financial, clinical, admissions, marketing, rehabilitation, human resources, nutritional, environmental and purchasing departments. Many of these areas will be addressed in detail in separate sections throughout this document.
System Development - Radius Management has established operational systems to provide structure, accountability and support to the staff who care for the patients and residents who reside in the Radius network. These systems respond to the challenges posed by numerous outside forces by creating facility-based enriched environments where a cadre of interventions and supports address the needs of our constituencies.
Interdisciplinary Focus - Our approach to the delivery of management services incorporates an interdisciplinary focus. Programmatic changes, issues, problems and innovations are managed through inter-facility participation and individual facility project groups with corporate involvement. Individual expertise and innovation are recognized and rewarded.
Dementia Unit Development - Our Radius Dementia Specialist developed and implemented an internal work plan which included input from staff in all departments when developing our first dementia unit. That model 'project group/work plan/staff involvement/staff training/ongoing evaluation' has been duplicated throughout the Radius system.
Group Purchasing - Ancillary expenses and vendor relationships are closely monitored. Medical supplies, pharmaceuticals and durable medical equipment purchasing patterns receive in-depth analysis on a regular basis. Contracts and group purchasing opportunities are also evaluated to ensure that cost effective decisions are inherent in our system.
Environmental Services - To ensure that our residents are cared for in safe, comfortable and efficient facilities, the Radius Director of Environmental Services regularly monitors life-safety compliance. Maintenance and housekeeping supervisors meet regularly to share ideas and to provide support and assistance to their colleagues.
Recruitment and Retention - A combination of corporate, regional and facility-based recruitment efforts have resulted in a significant reduction in nursing-purchased services.
II. Regional Focus
Radius facilities are currently categorized by geographic region. There is a Regional Director for each area and this individual, with the Executive Directors, monitors and manages all aspects of facility operations.
III. Corporate Committee/Meetings
Staff involvement in planning, program development and monitoring is reflected in team meetings or existing work groups.
A. Senior Management - monthly meeting
B. Operations Meeting - monthly meeting with CFO, VP of Operations, Regional Directors and Executive Directors to review financial reports, A/R status, bi-weekly Flash Reports, and operations in general
C. Facility Update Meetings - weekly review of each facility's clinical program with Clinical Director and Clinical Specialists, Reimbursement Specialist, Rehab Director and Admissions/Marketing Director
D. Regional Updates - biweekly meeting with VP of Operations and Regional Directors
E. Quarterly Departmental Committee meetings by discipline with facility-based department heads
F. Monthly meeting with Purchasing services, Nutritional services and Environmental services
IV. Facility Reporting
A. Immediate - Regulatory Agency visits
B. Daily Reports
- Census Information
C. Weekly Reports
- Clinical - Agency Utilization; Nursing Staffing Analysis
- Operations - Weekly Operations Report
- Financial - Information Systems Update; Payroll Variance report
- Rehabilitation - Utilization Report
D. Bi-weekly Reports
- Financial/Operations - P&L Predictors - "Flash Report"
E. Monthly Reports
- Clinical - Facility Monitoring Report
- Operations - Key Performance Indicators Operations Report
- Financial - P&L Variance Report
- Admissions - Admissions/Marketing Summary Report
- Rehabilitation - Utilization Summary Report
F. Quarterly Reports
- Competitor Rate Analysis
- Wage and Benefit Surveys
Financial Services
The Financial Services Department of Radius Management Services, Inc. is a dedicated group of individuals, each with expertise in his/her area of specialty.
I. Areas of Specialty
A. General Accounting
B. Financial Reporting (internal and external)
C. External Compliance Reporting
D. Cash Management and Forecasting
E. Financial Analysis
F. Operational Finance
G. Accounts Receivable
H. Accounts Payable
I. Payroll
J. Third Party/Government Compliance
K. Information Systems
L. Purchasing
M. Contract Negotiation
II. Internal and External Reporting
A. Monthly Financial Statements
B. Bank Compliance
- Weekly line of credit borrowing base
- Monthly line of credit reporting
- Quarterly financial statement reporting
- Covenant calculations
- Ongoing communications with lenders/equity partners
C. Cash Flow Forecast - updated weekly
III. Operational Finance
A. Weekly Payroll Actual to Budget Reporting
B. Daily census monitoring
C. Bi-monthly P&L "Flash Reports"
D. Monthly meetings with facility Executive Directors
E. Daily interaction with corporate and facility-based operations, clinical and marketing personnel
IV. Accounts Receivable
A. Experts in Medicaid, Medicare, and Commercial Insurance
B. Monthly Cash Collections Targets
C. Days in Accounts Receivable Targets
- 80% of facilities are under 50 days in A/R
- Incentives for staff
V. Other Key Areas of Expertise
A. Financial Due Diligence for Acquisitions
B. Managed Care Contract Negotiation
C. Vendor Contract Negotiation
D. Government Compliance
- Medicare and Medicaid Cost Reports
- State Wage Passthrough Reporting
- Cost Report Audits
- Accounts Receivable Credit Balance Audits
Clinical Services
The Clinical Services Department of Radius Management Services offers a broad spectrum of expertise and services from our Clinicians. We divide our services into three areas of specialty: Quality Improvement; Clinical Reimbursement; and Risk Management.
I. Quality Improvement
A. Clinical Program application and monitoring:
- Nutritional Management
- Skin Management
- Fall Prevention
- Behavior Management
- Alzheimer/Dementia Care
- Restorative Nursing Program
- Respiratory Therapy
- Assessment and Care Planning
- Reimbursement Maximization
B. Education in areas of Management, Regulatory Compliance, Clinical Assessment and Program Implementation
C. Internal System Management
D. System/Program Assessment Development
E. Consulting Services
II. Clinical Reimbursement
A. System Review and Development
B. Financial Interface
C. Expertise in MMQ, Medicare, Managed Care Maximization
D. Consultation Services
E. Education and Training
F. Outcome-Oriented Data Collection
III. Risk Management
A. Accident Investigation and Documentation Review
B. Annual and Periodic Mock Survey
C. State and Federal Regulatory Compliance Review
D. Training and Education
E. Quality Indicator Interpretation
F. Audit Tool Utilization
G. Risk Reduction Strategies
H. Risk Trend Analysis
Business Development
The goal of the Radius Business Development group is the alliance of each facility to the needs of local acute-care hospitals, physician groups and other related healthcare entities, resulting in census growth and revenue enhancement.
I. Conducts corporate and facility-wide strategic planning of short and long term goals.
A. Conducts market assessments, including competitive analyses
B. Assists in determining the strategic vision of the organization
C. Develops feasibility studies when needed
D. Researches demographic factors to capitalize on market share
II. Develops and implements programs and objectives through vision, leadership and commitment to facility expectations and new endeavors.
A. Develops comprehensive work plans aimed to meet or exceed desired goals
B. Prepares protocols, systems and training programs in preparation for new business
C. Implements timelines to ensure goals are met in desired timeframes
III. Prepares and executes marketing budgets, plans, and promotion of company-wide branding.
A. Implements and monitors comprehensive marketing plans and programs
B. Assists in review of current materials and development of new collateral materials for branding purposes
IV. Identifies and executes company growth opportunities through public relations and political contacts.
A. Determines key political contacts; promotes networking capabilities.
B. Assesses community and public relations opportunities.
V. Develops census and revenue enhancement through development of the leadership role of marketing management.
A. Analyzes census information to implement improvement measures where necessary to meet desired payor mix goals.
B. Analyzes admission reports to monitor and analyze close ratios, admission payment sources, referral sources, and discharge destinations.
C. Develops referral relationships at all levels to assess referral satisfaction and develop new senior management and corporate level relationships.
Marketing
The Radius Marketing Department creates the direction and sets the standards for Marketing in our continually growing business. A successful marketing program encourages customers to think of our facilities for their nursing and rehabilitative needs.
I. Referral Base Expansion Initiatives
A. Expanding the referral base through targeted referral sources
B. Negotiating new managed care contracts
C. Developing and nurturing relationships with Managed Care organizations, Hospital Case Managers, Physicians and Hospital leaders
D. Branding through name recognition
E. Collateral Development
F. Expanding Advertising and Media contacts
II. Recruitment, training, management and evaluation of the internal Admission/Marketing Coordinator and Clinical Liaisons
III. Internal System Development
A. Conducting Monthly Sales and Marketing Meetings to organize, direct and target overall census development efforts based upon the strategic sales and marketing plan
B. Ongoing Sales Training
C. Competitive Analysis Evaluation
D. Creation of statistical profiles of residents, customers and their market area
E. Trending Length of Stay for Medicare and Managed Care patients
F. Creation of tracking tools
IV. Marketing Plans
A. Development of Facility-Based Marketing Plan
V. Development of a Customer Service Program
A. Staff training
VI. Medical Marketing Initiatives
A. Quarterly meeting with physicians groups and insurance case managers to review physician and patient satisfaction
B. Assessment of short-term resident satisfaction surveys with follow-up telephone interviews
C. Initiating medical presentations for the community in conjunction with physician groups and HMO's
VII. Community Marketing and Community Service Initiatives
A. Planning and implementation of individualized facility programs with area senior centers, assisted living communities and schools on a monthly basis
B. Involvement in local civic organizations and membership in the Chamber of Commerce and Rotary Clubs
C. Guiding facility participation in community initiatives
D. Co-sponsored informational programs with pharmaceutical companies, physicians, law enforcement and insurance companies
E. Initiating new and nurturing existing relationships with local government officials
Admissions
The Radius Admissions Department responds to the needs of our referral sources utilizing Radius assessment and cost evaluation tools.
I. Pre-Screening Process
A. A referral log is kept by the Clinical Liaison to track all referrals. This log provides the facility with the origin of the referral, diagnosis, payment source and is used to track information for further analysis.
B. A clinical evaluation form is used to collect medical information on patient clinical needs and potential cost to the facility. Included in the cost analysis are medications, durable medical equipment, therapy and nursing hours.
C. All information relative to payment source is obtained prior to the admission of the patient.
D. Senior Liaison
- The Senior Liaison is responsible for the day to day coordination of the Clinical liaison team with the assistance of the Radius Director of Marketing. This responsibility includes patient evaluation, leading the group in planned marketing functions, physician contacts, implementing the Radius criteria for screening requirements, daily reporting to the Radius Director of Marketing and VP of Operations with census and case-mix, and coordination of the monthly Admissions/Marketing meetings.
E. Clinical Liaison
- Under the supervision of the Senior Clinical Liaison, the Clinical Liaisons represent the Radius group of facilities as a whole. Each Clinical Liaison can make the final decision for admission, with assistance from the Senior Clinical Liaison or the Radius Marketing Director, if necessary.
F. Admission Coordinator/Liaison
- Internal Admissions Coordinators report to the Radius Marketing Director, with a direct line to the Executive Director. Their responsibilities include the actual admissions process, chairing the internal marketing committee, community marketing efforts and, when necessary, clinical screening.
II. Case Management Process
A. Internal Utilization Review Meeting
B. Quarterly Quality Improvement Meetings with Managed Care Providers
C. Monthly Review of Medicare RUG categories/LOS and associated cost of care
D. Ongoing analysis of ancillary expenses compared with pre-assessment analysis
Rehabilitation Services
The Rehabilitation Services Department at Radius Management Services, Inc. provides for the development, oversight and management of the rehabilitation programs within our owned and managed facilities.
I. Clinical Programming
Our primary goal is to provide services that will maximize the cognitive and functional capabilities of each of our residents.
A. Sub-acute programming
B. Long-term care programming
- Contracture management
- Positioning
- Dining
- Ambulation
- Dysphagia management
- Activities of daily living
- Dementia care
C. Clinical Documentation and Assessment
II. Personnel Management
Our objective is to provide the highest quality of service, through the commitment and dedication of satisfied staff.
A. Daily staffing coordination
B. Review of staff performance and attainment of personal goals on a routine basis
C. Staff education/oversight to assure DPH, CMS, and JCAHO compliance
D. Monthly Rehabilitation Director meetings to establish objectives, review changes within the industry and to address needs within each of the facilities
III. Performance Analysis
Our responsibility toward our customers' expectations and needs is the foundation of our business.
A. Annual mock DPH survey
B. Documentation audits to assure CMS compliance, as well as competence within the documentation and provision of clinical services
C. Facility rounds with the therapy staff
D. Use of the quality indicator reports to minimize resident decline
E. Meeting with therapy staff to identify areas of opportunity
F. Completion of monthly/quarterly therapy outcome reports
IV. Financial Analysis
Our commitment is to maximize reimbursement through the provision of exceptional clinical services to our residents, while minimizing expense through the efficient use of the therapy staff.
A. PPS audits to assure that the rehabilitation RUG days and categories are being maximized
B. Establish therapy staff efficiency standards
C. Establish annual rehabilitation budgets
- Monitor financial fluctuations within each facility on a weekly basis
- Provide ongoing education and training to the rehabilitation managers and staff
- Prepare a monthly trending report inclusive of key indicators
D. Consult with the business office and administration for changes and updates in reimbursement
V. Results
Our clinical and financial outcomes are highly competitive within the industry.
A. Since the addition of a dedicated therapy management service, the facilities have demonstrated the following results:
- No therapy related deficiencies cited through the DPH process
- No denials in reimbursement by the fiscal intermediaries
- A 90% therapy staff retention rate
- A 61% increase in therapy services provided to the long-term care residents
- A 20% increase in the therapy departments' net operating income
Human Resources
The Human Resource department coordinates HR policies and programs with the emphasis on benefits administration, recruitment and retention and compliance with applicable laws and regulations
I. Recruitment - Radius Initiatives
A. Established corporate, regional and facility based Recruitment and Retention Committees
B. Radius Grant program for clinical staff
C. Facility-based recruitment personnel
D. Internal assessments of staff needs - focus groups
E. Direct mailing to MA licensed nurses
F. Open house events
G. Partnership with schools and colleges
H. Internal CNA Training Programs
I. CEU programs - open to public
J. Advertising: Newspaper, MECF, Monster.com, cable TV
K. Recruitment Bonus Programs
L. Modified Baylor Program opportunities
II. Payroll and HR Benefit Administration Compliance
A. Monitors compliance with the payroll administration and employee benefits program
B. Conducts facility audits to ensure compliance with FLSA, FMLA, COBRA, etc.
C. Develops and presents training programs for payroll staff
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