Executive Director's Report - Staying True to Our Mission

As WAHSA's Executive Director, I have worked with a number of our members' Boards of Directors in addressing possible future directions for their organizations. These sessions are always spirited and engaging. While each Board has its own history, leadership style and expectations, these organizations frequently confront the same fundamental question: Given the challenges of Medicaid cutbacks, state long term care redesign initiatives, Medicare PPS, managed care, automation requirements, housing regulations, and tax threats, how can our organization best position itself to succeed in an increasingly more threatening environment?

Although the future will require our members to tackle some difficult issues and necessitate adoption of an accelerated learning curve, I do not side with those few who believe the future of our not-for-profit members will be insuperable. Yes, the days ahead will compel us to embrace out-of-the-box thinking, partner with heretofore unaligned entities, and pursue new revenue streams. However, I remain convinced that the future forces of change, while perhaps more technologically complex, will not pose any more of a relative challenge than the obstacles hurdled by our members in the past.

Perhaps a little perspective is in order. Many years ago a group of religious and community leaders were drawn together to address an unmet need; namely, the lack of suitable health and housing for area elders. This group, without the availability of governmental assistance, pursued its vision to create a place in which elderly and disabled persons could live with dignity and respect, while receiving the highest quality care and services. From this vision, not-for-profit long term care organizations were born, facilities were built and extensive volunteer networks were formed. Later on, Medicare, Medicaid, and HUD programs were authorized -- along with all their rules and regulations, forms, and convoluted cost reporting requirements. Despite our initial misgivings about some of the bureaucratic aspects of these programs, members soon learned to

effectively operate within these programs to serve more persons and expand their complement of service options. More recently, federal budget bills brought voluminous nursing home survey and enforcement regulations, funding cuts for low-income housing, and a conglomerated entanglement of data, payment, and billing mandates. 

Once again, we are entering uncharted waters, with the added challenge of a possible redesign of Wisconsin's long term care system adding to our uncertain future.   But we have our mission to guide us and we are experienced in leading our organizations towards the ultimate destination - quality care and quality services for our customers.

That is WAHSA…that is you…looking over your shoulder and looking out towards the future. In contrast, consider the following:

"Our Strategy Works…….

More than ever, in 1996 we began to act as one company dedicated to a common purpose. These efforts have attracted the attention of others. Fortune's annual ranking of the nation's most admired companies included (the company) as the highest rated healthcare company. In addition, a report from the Advisory Board, a healthcare research organization, cited (the company) as the new competitive standard for American healthcare providers. The report cites our impressive quality record, our growing admissions, and our willingness to invest in the future."

This effusive pronouncement, written almost two years ago, rings with pride and confidence regarding the company's past and future. It boldly conveys a message that the company is, and will remain, the preeminent healthcare corporation in country.

The company is Columbia/HCA. The quote is an excerpt from the company's then-CEO/President's message in his 1996 annual report to shareholders.

What is the message? Columbia now is the target of unprecedented federal investigations into fraudulent billing practices. Its stock value has plummeted. It has given managed care a black eye. The top ranking CEO and other managers are gone.

Why? What is the difference? Columbia missed the obvious. In their quest for higher profits, they lost sight of their mission; they seemed to have forgotten that their first order of business was to provide quality health care and services.

As long term care redesign concepts take hold, we will see many entities fighting to protect their identity and pushing to carve their niche in the future of health and long term care. That is not our ultimate mission. Our mission is to work towards a continuum of care that best serves our customers, provides them the highest possible quality of life and embodies good stewardship. If we can pursue that mission, if we can achieve that level of quality, if we can obtain that future
for our customers, our future will seem less dubious.

In your strategic planning sessions, I  encourage your continued efforts to force change into new and unexplored territories of health and long term care. But, as you do so, never, ever loose sight of your mission. You are more than facilities and community programs. You are all about people. That is your business. That is your mission. Focused on that mission, you will chart a course toward an unwavering commitment and an unquenchable quest for only the highest quality in every service you provide for each and every customer and potential client.

WAHSA will continue this journey with you -- striving for ever-higher quality in every facet of every service. Working together -- always guided by the light of our mission - we eagerly race toward a future where we continue to focus on our business of serving and caring for people.

Respectfully submitted,

John Sauer

Wisconsin Association of Homes and Services for the Aging
204 South Hamilton Street
Madison, WI 53703
Telephone: (608)255-7060