ASC Leadership: Keep Long-Term Employees Happy

It’s a given that when you hire excellent employees, you want them to be happy with their work and stay for the long haul.

Building a team of experienced, reliable professionals benefits your ASC in many important ways over time. Satisfied long-term employees help provide outstanding patient care, create a supportive company culture, and lower expenses for ASCs.

Employee turnover is costly, resulting in approximately $10,000 to $12,000 in replacement costs (recruitment, training, and onboarding) – and for certain key positions, much more – for each full-time employee. If you improve your center’s retention rate, you’ll not only maintain a dedicated staff, you’ll also make a positive impact on your bottom line.

Follow these four steps to cultivate a healthy and happy work environment for your employees.

  1. Offer fair compensation.

You must pay people what they’re worth if you want to attract and retain qualified employees. Gather information from credible industry sources, such as ASCA, to determine fair and transparent compensation ranges for each position. To help ASCs with this process, MedHQ developed a 100-question job analysis guide as a starting point to calculate pay for different roles. Ensure that your employees are paid accurately and on time every single pay period.

  1. Get the benefits right.

Your center’s employee benefits plan is another important factor in reducing turnover. Employees feel valued and taken care of when they receive competitive paid time off, health coverage, and retirement savings options. Automate these processes to eliminate risk and keep employees informed about every detail of their benefits – without creating additional work and stress for your HR department.

  1. Offer room for growth.

Great employees will continue to learn and grow over time, investing their expertise back into your center. But to do so, they need ongoing opportunities to advance their career and expand their skills. Prioritize professional development, mentorship, and leadership for employees at all stages of their career.

  1. Create a culture where employees thrive.

Organizational culture plays a huge role in whether employees decide to stay or leave. A job with great pay, benefits, and growth potential won’t be enough to keep an employee if the culture supports harassment, poor management, or other toxic behaviors. Be intentional about hiring for cultural fit, addressing risks and problems immediately, and nurturing a work environment that reflects your center’s core values.

Download MedHQ’s whitepaper on saving money and improving employee happiness through better HR. 

Expert HR Decisions can have Significant Impact on ASC's Financial Performance | MedHQ

The Risks & Costs of Under-Performing Employees

A patient’s experience – positive or negative – largely depends on the facility’s staff.

Human capital is the largest investment that ambulatory surgery centers (ASCs) and physician practices make. When employees perform their jobs with diligence, professionalism, and integrity, an organization can deliver excellent care and build patient trust.

But when negative employee issues go unaddressed, the entire organization is exposed to high-stakes risks. Consequences include diminished patient satisfaction, damaged employee morale, and millions of dollars in financial liabilities.

HR problems do serious harm to an organization’s bottom line. For the average center:

  • Reducing unwanted employee turnover by 25% saves around $55,000
  • Improving productivity by just 3% generates $110,000 in savings
  • Reducing employment practices risks and improving cost efficiency saves an additional $85,000

In a recent survey of 32 surgery center managers, MedHQ found that managers’ biggest concern is employee disciplinary issues. At 58.1%, this problem was cited more than twice as often as the next highest category (employee benefits issues, at 25.8%). Administrators said that among employee disciplinary issues, they are most troubled by employees’ at-work attitude and employee interactions and disputes.

Here are three important steps organizations can take to minimize HR risks and ensure they employ the best workforce for their needs.

  1. Hire the best employees.

Administrators must have a clear idea of what the organization’s culture and values are, and how employees are expected to uphold them. These fundamental beliefs should be central to the hiring process. When vetting new candidates, managers also need to identify the required skills necessary to do the job so they are prioritizing the right qualities. Peer evaluators should be involved in applicant interviews to help find a good cultural match.

  1. Coach and mentor managers.

Promoting from within an organization is common and has many benefits. Current employees are already aligned with the mission and operations of the center. However, not all those who are promoted are prepared for the HR part of their new managerial role. It’s important for administrators to set them up for success with mentorship and coaching. They need to develop the ability to manage employee conflicts, handle challenging performance issues, and get the most from their team.

  1. Manage risks pro-actively.

The consequences of employee problems affect every part of an organization. Leaders ought to establish HR processes and procedures to address them early on and mitigate risks. They can develop best practice solutions for specific issues – ranging from employee attendance and works compensation, to inappropriate work behavior and harassment claims – and share them with managers throughout the organization.

Download MedHQ’s whitepaper, How to Mitigate Your ASC’s Top 5 Employment Risks

The Top Oversights in Physician Credentialing & How to Fix Them

Physician credentialing is one of the most important (and most painstaking) tasks that administrators in ambulatory surgery centers manage.

Patients place their trust in their doctors – and it’s a center’s responsibility to verify that all practicing physicians have up-to-date credentials and documentation. ASCs must develop a thorough credentialing process in order to maintain efficient operations and comply with regulatory standards, including requirements for the Joint Commission and Medicare.

Credentialing guidelines are complex, with industry, municipal, state, and federal variations. Here are a few of the primary challenges administrators encounter throughout this process, as well as best practices for addressing them.

  1. Credentialing a new provider takes time.

It can take 60 to 90 days to fully credential a new provider, which has to be completed before they can take on any patient cases. ASCs must meet the requirements for their state; and while most states have similar prerequisites, the specifics do vary.

Administrators should start early, and go through a physician’s file with a fine-tooth comb, verifying education, training, licensure, and employment history. If they discover any red flags or have unanswered questions, it’s wise to do additional research. Taking a closer look now can bring potential problems to light, and protect the ASC from risk.

  1. Peer references are hard to track down.

Since physicians have busy schedules and manage many responsibilities, it is often a struggle to secure peer references for credentialing. The best approach is to have the physicians reach out to their peers first, notifying them that a request is coming, and proposing a timeframe for its completion. Then administrators can follow up, checking in on the reference’s progress, offering support, and reviewing it for accuracy.

  1. Documenting a long career is difficult.

For physicians who have many years of experience, the credentialing process is even more exacting. They are obligated to document their extensive work history, providing details about every hospital and center where they practiced.

The good news is that electronic medical records have made it easier to find this information. It will be more demanding for administrators to locate data from decades ago, but once they do, it can be saved for later use in secure cloud storage.

  1. Keeping physicians up-to-date is daunting.

For ASCs to stay current for Joint Commission surveys, practicing physicians are required to have their credentials reevaluated every one to three years. But because physicians all have different timelines for reevaluation, this is a complicated juggling act for ASC administrators. To streamline this process, they should use a comprehensive software solution that enables them to organize records, monitor deadlines, share files, and search for documents. One staff member can be the point person for credentialing tasks, checking in every week to make sure the ASC is keeping up with all necessary requirements.

ASCs interested in learning more about MedHQ’s credentialing process can learn more here.


MedHQ Named on “150 Top Places to Work in Healthcare” List

MedHQ earned a place on the Becker’s Healthcare “150 Top Places to Work in Healthcare” list for 2018.

The highly regarded list identifies healthcare organizations doing outstanding work to further professional development, leadership, diversity, and engagement among their staff. Becker’s selects hospitals, health systems, and healthcare companies that offer employees exceptional opportunities to grow and thrive. It is the second consecutive year that MedHQ has been featured on the list.

“We are thrilled to be named one of the best places to work in healthcare,” said MedHQ CEO and Co-Founder Tom Jacobs. “Our mission is to help our clients create a culture where employees love their work, and receive the support and mentorship to deliver excellent patient care. It’s an honor to be recognized by Becker’s for instilling this same supportive culture in our own company.”

In 2017, MedHQ experienced significant growth across all services – Human Resources Services, Accounting Services, and Physician Credentialing. But the greatest growth was within HR Services, where the company saw a 50% increase over the past two years, as it built lasting partnerships with ASC management companies.

To support this development and continue its focus on company culture, MedHQ added a new executive team member in December 2017: Rita Hernandez-Figi as Vice President, Human Resources Services. Hernandez-Fiji brings a wealth of human resources experience to the company. Before joining MedHQ, she spent 16 years as Vice President of Human Resources at Insurance Auto Auction, directing HR operations across 14 international and 170 domestic locations.

“A strong company culture starts at the top,” said Hernandez-Fiji. “The leaders must have a clear vision of what kind of organization they want to be. They have to model and communicate these core values, and foster an environment where employees can do their best work.”

Learn more about MedHQ’s HR Services.

Why ASCs Should Partner with HR / Staff Management Firms

MedHQ was recently consulted by a colleague about a growing healthcare management company. With over 100+ employees in ten facilities across the Midwest, the management company expects to double by the end of the year and is looking for systems to help manage the growing employee base.

To assist with the growth, the management company is looking for an applicant tracking system (ATS) to assist in tracking candidates throughout the application and interviewing process, as well as a human resources information system (HRIS) to manage offer letters, tax forms, compliance issues and more. In addition to that, the management company will likely transition to larger payroll company by the end of the year.

The question the healthcare management company posed was, “Should we build it, or should we buy it?”

Many companies opt to build the systems themselves because they are unsure if traditional PEOs, long-term staffing companies and HR Outsourcing (HRO) firms in general can resolve all their concerns while also maintaining a high standard of employee satisfaction. However, once a company reaches significant growth, outsourcing day-to-day human resources operations can free up valuable time and resources. Or, on the other hand, perhaps the company has a wonderful HR team internally that helped them get to where they are currently. For either scenario, we could make the case for HRO (“Buy”) instead of investing further in the internal HR function (Build).

If the growth has outpaced the internal operations, an HRO firm delivers an out-of-the-box solution that handles the areas mentioned with technology operated by HR and payroll professionals that have full proficiency in their roles. There are many good ATS and HRIS platforms; at least as important is how they are set up and how well the staff is trained and practiced in using the systems.

For development of an internal HR function, the question is whether it’s best to focus some or any of the executive management attention and capital investment in a support function. What creates value for a company? Likely that it includes developing relationships and delivering top clinical care to more and more patients – these and similar areas is likely what gets executive management’s focus and most capital investment.

At MedHQ we specialize in the healthcare industry, and because of this, can better understand our clients unique HR needs. Currently, we use PrismHR, which happens to be built specifically for the HR outsourcing industry. This system is automating our employee onboarding (paperless), benefits enrollment (paperless) and, of course, handles payroll. We have integrated PrismHR with our time and attendance system and we have an applicant tracking system as well. PrismHR just recently added a CRM capability to its core platform and we’re going through the implementation of that component now – this capability is going to greatly enhance our service to employees through more effective case and task management.

As an HR Services company, we will continue to invest in the best solutions that hit the HR market because these investments will drive value in our company. We find, however, that companies that opt to build internal solutions are susceptible to having those systems atrophy due to lack of ongoing investment.

What an HRO firm is and what it isn’t: HRO’s handle back office matters that are extensive – we break it down to a dozen or so areas and 100 or so separate activities – but almost entirely in a “support” mode. Management (the customer’s management team), on the other hand, is the “front office”. The HRO handles the essential or basic HR functions, while Management supervises and develops the organization. An HR Generalist fits well within the typical service model of a HRO, while an organizational development consultant is best fit within Management Consulting. A HRO’s leverage is its size and risk sharing model. The size creates efficiencies for the customer; the risk sharing removes barriers that get in the way of a customer’s growth.

Lastly, when it comes to culture, we would consider the development of a company’s culture to be the responsibility of the Management team. While we love to work on culture-supportive programs, we believe that for an organization to intentionally create a culture requires top leadership to spearhead the effort.

Interested in learning more about MedHQ’s unique HR services, click here.

Learn more about mitigating employment risk by downloadingHow to Mitigate Your ASC’s Top 5 Employment Risks. 

Steps to Take to Manage Involuntary Terminations

Every ambulatory surgery center needs a professional, dedicated staff to provide excellent patient care and operate efficiently. Successful ASC leaders are thorough in recruiting and hiring employees who are the best fit for their team, and modeling the culture they want to see in the organization.

But despite these efforts, there will still be times when an employee is not working out, and an involuntary termination is the best course of action. This is a delicate situation that can cause financial strain and employee stress for an ASC. Research suggests that a single termination, poorly handled, can cost $80,000 to $125,000 in legal fees and severance, compared to expenses of $5,000 to $10,000 when managed properly.

The following human resources best practices will mitigate risks associated with involuntary terminations.

Have direct conversations about performance and behavior.

When an employee is not meeting expectations or is behaving in an inappropriate way, management must step in and address the problem early on. A direct, private conversation with the employee should focus on specific examples of what is happening, and what needs to change going forward. Is there a reason for the employee’s behavior? Has something, such as a new work process or a problem at home, triggered this change? Leaders in the organization are responsible for starting this conversation, exploring possible solutions, and setting next steps.

Follow a progressive discipline process.

Progressive discipline is designed to bring unacceptable behavior or poor performance to an employee’s attention and outline the changes necessary to avoid involuntary termination. For example, if a manager notices an ASC employee who has a problem with arriving for work on time or missing shifts, this process might look like this:

  • First incident: Manager clarifies job expectations and responsibilities, and issues a verbal warning about the consequences of missing work
  • Second incident: Manager pulls the employee aside when the employee has arrived at work 40 minutes late, emphasizing that this is the behavior that must change, and documents the issue in writing, using a formal written reprimand
  • Third incident: Manager involves human resources and a determination is made as to whether an Employee Consultation or a final formal written reprimand is the next step. (In some situations, a suspension or demotion may be warranted)
  • If an Employee Consultation is scheduled, the employee and manager will have the opportunity to review the fact. After consideration of facts, a decision is made regarding involuntary termination.

Diffuse the impact on remaining employees.

When an involuntary termination is necessary, it’s important for leaders to take proactive and professional actions to make the transition as seamless as possible. The conversation that ends the staff member’s employment should be brief and respectful; it will not be a surprise, as it is a culmination of many previous steps and conversations. Immediately after a termination, management must inform the remaining staff of the change and prevent rumors from spreading. Leaders need to be prepared with a plan – answering questions, sharing what they need from employees in the short term, and showing that they are working to fill the vacancy as quickly as possible.

Learn how MedHQ uses its expertise to help ASCs mitigate HR risks.

Alleviating Hostile Work Environments & Harassment Claims

Ambulatory surgery centers rely on a highly skilled, experienced, and engaged workforce to run efficiently in a change-driven industry. These healthcare professionals have demanding and fast-paced jobs, and they need to work in a safe and supportive environment in order to provide the best patient care.

ASC leaders are responsible for creating a culture where all employees are treated with kindness and respect, regardless of gender or other characteristics. The following best practices aim to mitigate risks associated with sexual harassment, general harassment, and a hostile work environment.

Adopt a “top-down” approach.

ASC leaders must model the standards and behaviors they want to see in their organization. It is their duty to define and enforce clear harassment policies, both in formal guidelines and casual everyday conversations. An employee handbook should outline in writing the processes and procedures to be followed if a harassment claim is filed. And leaders should talk often about the behaviors they expect, and those they won’t tolerate.

Be proactive about addressing risks.

Negative interpersonal behaviors can sour a work environment quickly. Leaders must be proactive about preventing them, incorporating steps such as:

  • Online and in-person training about unacceptable behaviors
  • Frequent conversations about shared beliefs and values
  • Positive recognition of those demonstrating company values
  • Programs to strengthen culture
  • Leaders demonstrating desired behaviors
  • Zero tolerance policies for harassment

Address problems early on.

To foster a positive work environment, employees must feel supported in speaking up about any complaints they have. Whether they are bothered by an uncomfortable incident or an ongoing pattern of harassment, they need to have a safe space to air their concerns. This may involve a short, in-the-moment conversation when someone says something improper. Or it might require more official protocols. Especially with delicate situations, managers shouldn’t hesitate to involve human resources experts who can guide productive discussions, facilitate conflict resolution, and follow up with additional actions.

Learn how MedHQ utilizes its expertise to help ASCs mitigate HR risks.

New White Paper by MedHQ Delivers Proactive Strategies to Mitigate High-Risk HR Events for Surgical Facilities

When it comes to high-risk human resources events, ASCs need to ensure they understand how improperly handling adverse events in human resources (HR) can significantly derail workforce productivity, cost tens of thousands of dollars and cause upward pressure on insurance rates. To assist with that effort, a new guide from MedHQ titled, How to Mitigate Your ASC’s Top 5 HR Risks, provides ASC leaders practical and proven strategies to implement at their facilities.

Launched in 2003, MedHQ assists ASCs with improving revenue, enhancing company culture, and taking time-consuming tasks off the plates of administrators, allowing them to focus on the high-value priorities of running and managing surgery centers. Since 2011, MedHQ has tracked a “Top 10” of HR risk management issues, assigning a monetary risk factor to each event. Today, the company has hundreds of such events in a database, and helps clients gain the benefit of that history.

“In an environment of rapid change, ASC leaders are already stretched thin,” says Tom Jacobs, Co-Founder and Chief Executive Officer of MedHQ, the leading provider of human resources staffing and onsite management services focused specifically on the ASC market. “This topic matters for ASCs and out-patient healthcare businesses because HR risks divert the attention of senior management, distracting them from their goals to improve the quality of care, and improve business results.”

MedHQ’s Vice President of Human Resources, Rita Hernandez-Figi works with ASCs nationwide to provide the business insight they need, so organizations can keep their focus on their patients. “When it comes to preventive practices, it’s all about being proactive vs reactive. An experienced HR team knows how to craft a job description, recruit the right candidates, and implement an interview process that brings candidates with the best skills and fit to the top.”

Hernandez-Figi uses her deep expertise as she addresses the top five high-risk HR events including: FMLA/ADA interactions, workers’ compensation claims, involuntary termination, sexual harassment and hostile work environments.

For ASCs, the key to success with high-risk events is to leverage an expert HR skill set to mitigate risks by aligning HR best practices to business strategy and integrating competent HR execution into every day operations.

ASC leadership interested in more tips and recommendations for leveraging accurate, insightful leadership counsel can download the full white paper here.

How to Mitigate FMLA/ADA Interactions

For many busy healthcare executives, employment practices matters are often secondary to more immediate problems. But while employee/employer challenges might not seem pressing in the moment, if they aren’t addressed, they can become critical and costly in the future. Executives must anticipate and mitigate these risks before they damage an ASC’s reputation, finances, or work environment.

One of the top employment risk management issues is the intersection of the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA), which oftentimes comes on the heels of a workplace injury and workers’ compensation insurance claim. The following action steps are designed to help ASCs make plans to protect their employees and their organization.

Understand the rules.

FMLA and ADA, along with worker compensation laws, exist to establish protocols for employees and organizations to follow in specific scenarios. The regulations are intended to safeguard all parties involved. Healthcare executives should have a comprehensive understanding of the laws and their parameters. Under which circumstances does FMLA or ADA – or both – apply?

Outline clear job descriptions.

Every position within an ASC must have a detailed job description that outlines its essential tasks and responsibilities. This is a vital element of managing the interaction between FMLA and ADA; it prevents misunderstanding and clarifies expectations.

Negotiate accommodations.

With a concrete description in place, it is easier to separate mandatory job functions from tasks that may allow for flexibility. This clarity facilitates an FMLA/ADA discussion and minimizes cause for dispute. For example, an office manager with a back injury may be able to negotiate reasonable accommodations for the job, such as delegating filing and moving boxes to another employee. But for a nursing position, accommodation may not be possible if this condition makes essential functions of the job – like lifting a patient – impossible.

Determine next steps.

Conversations about FMLA/ADA issues should happen early and often. It’s especially important for ASC executives to manage situations carefully when an employee is nearing the end of the 12-week, FMLA-allowed leave. This intersection point between FMLA and ADA is where ASCs often make mistakes, putting them at risk for claims. Every situation is different, so assumptions are dangerous.

Executives must work with employees to determine medical limitations, essential job functions, and options for returning to work. Sometimes it’s possible to temporarily restructure a position, or offer a short-term, modified description of job duties. In other scenarios, there isn’t as much room for adaptability. HR professionals are valuable resources in this phase, bringing their expertise to the process.

Learn how MedHQ helps ASCs mitigate HR risks.

10 Ways to Save $10,000 in Human Resources: Better Unemployment Claims Management

As ambulatory surgery centers (ASCs) face more competition in the marketplace and falling reimbursements, they need to operate as efficiently as possible. Saving money on HR-related costs is one way they can thrive.

MedHQ has worked with over 70 healthcare facility partners to find HR savings that also deliver the benefits of improving employee satisfaction and reducing risk.  Through the process, MedHQ gleaned a host of key findings that guided the creation of the MedHQ 10-Point HR Audit (10-Point HR Audit). The 10-Point HR Audit identifies inefficiencies that, when addressed, can result in six-figure savings for a healthcare facility.

One money-saving strategy the audit identified is to better manage the unemployment tax. When an unemployment claim is filed, states lean heavily in favor of the employee. However, there are things a surgery center can do to keep claims minimal.

States have different taxable wage formulas and the rate at which wages can be taxed can vary from 1-7%.

“The tax rate percentage can be negotiated to a lower rate,” said Tom Jacobs, MedHQ CEO. “And not all employers stay on top of this. MedHQ has audited centers with an unemployment tax rate as high as 9% or as low as 3%.”

Centers can save $3,500 – $10,000 annually by better managing unemployment tax.

Click here to download the MedHQ white paper, “10 Ways to Save $10,000 in Human Resources.”

About the MedHQ 10-Point HR Audit
It takes approximately one or two hours for back office staff to gather the information necessary for the 10-Point HR audit. Typical savings = six figures. Request your risk-free 10-Point HR Audit today. If MedHQ fails to identify $25,000 in savings, the audit is free.

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