4-Step Strategy for Onboarding Senior Care Acquisitions

Consolidation through mergers and acquisitions is a fact of life in long-term, post-acute care (LTPAC). A typical scenario is a large, multi-facility operator buying a freestanding facility or small chain of facilities, bringing economies of scale that can make the acquired facilities more profitable. Part of what is acquired is the technology infrastructure. We’re often asked to come in as the technology consultant as part of these transactions. We help the acquirer understand what they’re getting and create a roadmap for shifting the operations from the old umbrella to the new. Allow us to share the benefit of our experience.

1. Start with a Thorough Inventory

Even if the seller has inventory records, inevitably, something gets overlooked. Often, there are items that were never documented. Current services and providers might have been switched and the information was never updated. Put together a very thorough list of categories of items to be considered, from computers to network infrastructure to service providers. Think from a process perspective as well: How is data being backed up? What about remote access? This can lead you to items that might be otherwise missed.

Then, sit down with someone from the seller’s organization who can help you work through the list to gain a fuller picture of the inventory. A good approach is to start from the perspective of the service-point entrance and work through the various segments of the network. What services actually come into the building? Typically, there is, at minimum, Internet, phone and television from one or more service providers that goes to a network room. From there, how do the services propagate out to the rest of the environment? What is the network layout? Finally, arrive at the end nodes and take into consideration the OS, systems accessed and the software and licenses involved.

2. Don’t Overlook Anything: Do an Onsite Analysis

Even with a detailed inventory, items get overlooked. Going onsite will fill in the gaps — and undoubtedly, there will be gaps to find. Sometimes, you may find items that individual departments installed without the knowledge of the IT department, or network closets that were nearly forgotten. Many facilities were not originally built with IT requirements in mind, so network infrastructure can be behind unmarked doors or in other unexpected locations. Once, we found a forgotten and critical medical alert server hidden behind a potted plant. Another time, there was an entire wing with several dozen wireless access points, but the points were hidden in the drop ceiling and were not included with the inventory.

Ask for administrator credentials to log in to the systems. Check network speeds and talk with IT and end-users to understand what the environment is like.

3. Clarify What’s Going to Get Transferred

When it comes to transferring IT assets, sellers have different policies. To limit their exposure to compliance issues raised post-sale, some will pull all end-user systems and servers offsite before the new owner takes over. Others transfer the computing hardware, but wipe the systems clean. Still others are willing to leave everything as-is, and simply turn the keys over. Even if the computing assets will remain in place, it is likely that the acquirer will be switching to new EHR and other clinical systems, as well as business systems, to put the organizational efficiencies into place that they expect to realize. The pre-existing hardware and systems might not be up to the task. Bottom line? No two onboarding scenarios are alike, so make sure both sides are clear on expectations.

4. Develop a Transfer Plan

Given the above, some difficult operational and financial decisions might need to be made. The decision to retain the pre-existing equipment or replace it has to be balanced against the financial realities of the upfront costs, alongside the operational downsides of systems that can’t meet performance standards.
Above all, LTPAC, senior care and skilled nursing facilities deliver care 24/7. There is no option to shut things down for a weekend to make the switch, as might be possible in some other industries. Making older equipment work could be false economy, because it typically involves workarounds or finding fixes for systems that are past support. That means the transition takes longer and front-line care workers need to contend with more downtime or even resort to paper charting. All of this needs to be accounted for to arrive at a transfer plan that makes operational and financial sense, adheres to regulations, and preserves continuity of care.

At FIT Solutions, we’ve done dozens of onboarding projects and have complete systems and procedures in place for streamlining IT transfers in merger and acquisition scenarios. We account for the business realities and care-delivery issues, as well as the IT aspects. And since every scenario is different, we never stop learning, refining and improving our methodology. If you’re considering an acquisition, let us pave the path for you. Give us a call at 888-339-5694.

5 Practical Tips for Year-End IT Budgeting and Procurement

As year-end approaches, many of our customers take a critical look at their budget and budget-planning processes. That can involve 1) looking at the current year’s budget for opportunities to make potential procurements in order to get those expenses in before the year-end, as well as 2) setting the budget for the coming year.

Here are a few things to consider as you set priorities for new investments and upgrades. Don’t overlook changes that can lower your operating costs.

Items for Consideration

  1. License renewals. This is perhaps the most crucial item, since if you allow licenses to lapse, you lose the use of critical software and systems. License considerations are especially important this year, with Windows 7 end-of-life coming January 14, 2020. We covered this topic in an earlier post, especially the compliance implications. Include Windows 10 upgrades in your budgeting plans. Look at the age of your Windows 7-licensed workstations, and decide whether it makes more economic sense to replace them entirely with new Windows 10-licensed systems.
  2. Aging equipment. There’s a tendency to wait until something fails before you replace it. But if a system is near or past the end of the warranty period, it might be better to replace it proactively and avoid the costs and inconveniences of downtime while you wait for replacement of a broken machine.
  3. Network refresh. Take a closer look at your networking equipment, such as switches, routers and wireless access points. If they’re older, possible failure is a concern, but you also need to determine whether they can keep up with current network standards and expectations. Would a faster or more-capable switch improve performance or manageability? Would upgrading your older wireless access points or adding new ones improve network coverage or get rid of dead spots?
  4. Security. You can never be too secure, but there are a few additions that will improve your security posture immensely. One is free: enforcing a password policy that requires strong, regularly changed passwords. Another that is inexpensive or free is implementing multi-factor authentication (MFA) anytime a user logs on for the first time, or from a different machine or remote location. There are third-party solutions, or you can use the MFA capability built into Office 365.
  5. Service providers. Take a look at your monthly fees paid to service providers, and consider whether a different solution could give you a lower price, better performance, or new features. Feature-rich voice-over-IP systems have much to recommend them over traditional telephone services, and are generally less expensive. The same is true of replacing an older Internet connection with a vendor who delivers over fiber. If you have a large number of printers, there are printer management services that can save you money on consumables by controlling the use of color toner and ink, and curbing unnecessary printing.

Planning Proactively

At FIT Solutions, we help our clients look at the big picture of their technology, project future needs and plan proactively. One of the services we offer is the development of a Technology Business Plan that considers many of the areas above and more. It includes a Technology Infrastructure Roadmap that looks at short-, near- and long-term needs on a quarter-by-quarter basis so that you can budget effectively, accurately and proactively.

This holistic view will guide you to a more stable infrastructure, tighter security and increased performance while serving as a guideline for prioritizing and decision-making. If you’d like to get started, call us at (888) 339-5694.

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