The road to quality doesn’t have to be the road to ruin.
 
“Even a not-for-profit still has to make a surplus,” says Ted Goins Jr., president and chief executive officer of Lutheran Services Carolinas.
 
So, how has Lutheran Services managed to rack up quality awards yet still expand even as so many others in the sector are retreating?
 
“You can’t just invest in staff. You still have to pay the bills,” Goins acknowledges. “We are finding ways to become more efficient. You need to be able to provide a really high level of care by staff that care for the residents. But everything else is best business practices. So we’ve got to be the best purchasers.”

Business Practices

■ Technology. Technology is one key investment, Goins says. Lutheran Services is completely paperless now, after a four-year transition. Staff can make the computers “sing,” but it has also drastically cut down on wasted paperwork hours, as well as having improved Lutheran’s billing system, Goins says.

■  Education. But even the continuing training that the company prides itself on can be gotten on the cheap. The company’s vaunted “New Pathways” education system, a kind of hybrid of the Eden Alternative/Wellspring models, costs about $5,000 per year to implement, Lutheran Operations Director Jill Nothstine says.

“We are able to get by on this low figure because we hold our meetings in locations that provide us the space without charge,” Nothstine says.

“Additionally, we try to use speakers that will charge us nominally, or not at all. We also use our own staff whenever appropriate.”

■  Donors, grants. It has helped to find donors who are committed to culture change, too, Nothstine says. Lutheran has reaped grants from private and public donors to put in playgrounds, buffet tables, libraries, and even bistros.

There are other opportunities outside the sector, experts say. A Brooklyn nursing home this year won a grant from a musicians’ union for a classical training program.

■ Positioning company as community resource. Two years ago, Lutheran Services Carolinas merged with its sister organization, Lutheran Family Services, with its army of social workers and family experts.
 
“We’re really trying to turn our facilities not just into skilled nursing facilities, but as the true, community services that we already are,” Goins says.
 
“The feds keep trying to put us in a box—we’re just institutional care. But I wish people could see outside the Beltway, what a great community resource we really are.”

Staff Buy-in Makes It Happen

Goins admits, in retrospect, that he’d doubted he’d have the money to make the kind of investment that quality required. In fact, the first year Lutheran opened its New Pathways training, “some people were unhappy because there weren’t televisions in every room,” he says. “But it was the best we could afford.”
 
Any doubts were quickly overcome, Goins recalls. He was walking to his car after a session and saw that two certified nurse assistants were converging on the seminar’s featured speakers.
 
“I’m watching these two groups collide,” Goins says. “All of a sudden, these two CNAs were hugging the instructors and crying. I’m not making this up. I thought, ‘This is what it’s all about. If they can inspire that kind of passion through a little, old training, we’ve really hit on something big.’”