Strategic Mapping & Program Alignment

1. Strategic Mapping & Program Alignment Aligning Experiences – Expectations – Resources – Outcomes

2. Session Agenda • Introduce Sears • Introduce Project Initiative • Review application of Choice in dining service • Present process for mapping from a strategic objective to a tactical initiative • Conduct the Mapping Exercise for Craig • Conduct the Mapping Exercise for the Corporate Program • Review Process, Q & A TAHSA Annual Meeting - 2005

3. Session Objectives • Discuss need for new service options • Introduce Choice as a service culture • Present process for mapping from a strategic objective to a tactical initiative • Discuss outcome benefits and barriers TAHSA Annual Meeting - 2005

4. SMRS Strategic Objectives • Community of Choice • Financial Enhancements • Quality of Living/Quality of Work • Operational Effectiveness TAHSA Annual Meeting - 2005

5. The Customer Value Of Positive ExperienceA Memorable Feeling Created By You As A Result Of Us Relative Customer Value EXPERIENCE SERVICE GOOD RAW MATERIAL Created Within The Customer Source Of Customer Loyalty Created By A Provider TAHSA Annual Meeting - 2005

6. Operational Culture Rhythms of Daily Living is an operational culture that aligns resources and expectations of service experiences. RDL works in collaboration with initiatives of environmental culture change advocated by other organizations. The core service model for liberating residents and staff from an institutional paradigm is dining service. Dining is a catalyst and enabler to initiate change across coordinated services. TAHSA Annual Meeting - 2005

7. The core of RDL is the opportunity to exercise choice residents’ for how they choose to live their day and staff choice for care delivery. This creates a collaborative coalition of residents and caregivers working together in a living environment. RDL facilitates the delivery of care, the experience of living and the dignity of self-determination. RDL is a management principle that aligns the natural rhythms of residents and the support they need. The organizing principle of RDL is that people should be able to make meaningful choices in their daily lives – on their own or with assistance. RDL relies on caregivers to help define and achieve outcomes that balance individual choice and system efficiency. Rhythms of Daily Living TAHSA Annual Meeting - 2005

8. “Some facilities studied, usually the lower turn-over ones, were in the process of thinking about how to increase individualized care. For example, the researcher asked, what are you doing if anything about resident choice. ‘We are looking at it. Ideally, we want them to eat when they want. We encourage them to tell us what care they want, a shower or bath, or to get up when they want.” Page 5-49 Appropriate of Minimum Nurse Staffing Ratios in Nursing Homes, Phase II Final Report prepared by Abt Associates for the Centers for Medicare and Medicaid Services, December 2001. TAHSA Annual Meeting - 2005

9. Alignment The appropriate positioning of systems and resources to attain a defined goal, mission, outcome or culture TAHSA Annual Meeting - 2005

10. When Landing A Plane, What Is The Main Thing?1 Left Of Runway Altitude Too High Aligned Pitch Altitude Air Speed Cross Winds Wind Speed 1. Concepts and Diagrams From The Power of Alignment - How Great Companies Stay Centered and Accomplish Extraordinary Things By G. Labovitz/V. Rosansky TAHSA Annual Meeting - 2005

11. The Main Thing For SMRS Choice TAHSA Annual Meeting - 2005

12. Evaluate “Readiness” With Leadership, Managers & Residents/Families • Define Outcomes Baseline and Expectations Plan Transition Process and Commit Resources • Write Program Transition Budget and Operating Narrative Organize For Culture Change Define Service Functions and Outcomes For Each Experience • Identify Beneficiaries/Benefits and Diagram Service Functions • Establish “Experience” Alignment Teams To Define/Implement Transition Codify Policies/Procedures and Training By Function • Write & Task Procedures/Training Using RDL© Base Choice Dining AlignmentPlan and Develop Evaluate Organize Define Plan Codify TAHSA Annual Meeting - 2005

13. STRATEGIC OBJECTIVES – TACTICAL IMPLEMENTATION PROJECT MAPPING As dining options and program enhancements are discussed, specific initiatives are defined and envisioned by department management and staff. These new “dining experiences" require a specific definition process from concept to strategic alignment to tactical implementation. Executive and Board leadership must clearly identify specific strategic organizational considerations. Leadership must clearly define their expectation and measurement of a successful contribution to the community strategic vision. This must take place prior to the initiation of Map 1. TAHSA Annual Meeting - 2005

14. STRATEGIC OBJECTIVES – TACTICAL IMPLEMENTATION PROJECT MAPPING The following are the task requirements for this process: • Identify Service Initiatives • Define Their Contribution To Strategic Objectives • Define Appropriate Measurements Of Successful Experience Outcomes • Identification Of Resource And Operational Intersects • Identification Of Intersects And Roles Of Other Contributing Departments • Structure Of The Process For Resource Allocation To Develop The Defined Initiative • Sequencing Of The Tasks • Implementation of the Initiative. TAHSA Annual Meeting - 2005

15. Map Process #1, 2 ,3 TAHSA Annual Meeting - 2005

16. Map Process #4, 5 TAHSA Annual Meeting - 2005

17. Project Management TAHSA Annual Meeting - 2005

18. Craig MethodistWindflower Dining Program May 24, 2005 Aligning Experiences - Expectations – Resources – Outcomes

19. Discussion Topics Current Operations Overview Selection of the Initiative Contribution to the Strategic Objective Benefit Measure Operating Resource Requirements Collaborating Departments Development and Sequencing of tasks Implementation Review of Project TAHSA Annual Meeting - 2005

20. Current Operations • 64 Cottage Homes • 108 Apartments • 40 Assisted Living Apartments • 60 Bed Nursing Unit • 60 Bed Alzheimer's Unit • 109 Canyon’s Apartments (Lunch Only) TAHSA Annual Meeting - 2005

21. Selection of the Initiative • Improve quality of meals • More resident choice • Faster response to resident needs • Positioned for additional possible future initiatives • Maintain our position as a preferred service provider TAHSA Annual Meeting - 2005

22. Contribution to the Strategic Objective • Provide First Class Services • Enhance Residents Choice • Continue to Build Census • Develop “Seamless Service” TAHSA Annual Meeting - 2005

23. Benefit Measure • Community: Best of Amarillo • Financial Enhancement: Record breaking Census • Quality of Living: Improved Satisfaction • Quality of Work: Direct Interaction with Staff • Operational Effectiveness: Less Waste TAHSA Annual Meeting - 2005

24. Operating Resource Requirements • Administration: Co-Develop Plan, Approve finances • Regulatory: TDHS Involvement • Operations: Develop- Procedures and Operating Plan • Personnel: Staffing Requirements /Training • PP &E: Design Facility and Spec. Equipment • Community: Resident Involvement TAHSA Annual Meeting - 2005

25. Collaborating Departments • Nursing: • Resident Services • Housekeeping • Maintenance • Activities TAHSA Annual Meeting - 2005

26. Development & Sequence of Tasks • Dietary • Administration • Corporate • Nursing • Environmental Services • Activities TAHSA Annual Meeting - 2005

27. Implementation • Construction /Equipment • Staff Training / Procedures • Opening Plan in Phases • Daily Review of Operations TAHSA Annual Meeting - 2005

28. Sears MethodistCorporate Dining Program May 24, 2005 Aligning Experiences - Expectations – Resources – Outcomes

29. SMRS Operational Initiative • Resource Leveraging • Consistent Standards • Collaboration with Other Departments • Common tools & systems TAHSA Annual Meeting - 2005

30. Sears Dining Mapping Program TAHSA Annual Meeting - 2005

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34. Contact Dan Look – 770-565-4006 Dining Management Resources, Inc. 3605 Sandy plains Road Suite 240-269 Marietta, GA 30066 dcl@dm-resources.com www.dm-resources.com TAHSA Annual Meeting - 2005