Several years ago, Sister Mary Jean Ryan, Chair/CEO, SSM Health Care spoke to a young, growing, for-profit nursing home company [see her bio here]. She leads SSM, the first Malcolm Baldrige award winner in Healthcare.
SSM’s story is impressive: The system began with five religious sisters who journeyed to St. Louis in 1872 from Germany to be of service to people in need. In their early ledgers, the sisters listed patients who could not pay for their care as “Our Dear Lord’s.” To this day, SSM ensures discounts for people without health insurance. Based in St. Louis, the system is sponsored by the Franciscan Sisters of Mary and owns, manages and is affiliated with hospitals and nursing homes in four states: Wisconsin, Illinois, Missouri and Oklahoma. In 2009, more than 2 million people came to us for care.
I was at that meeting several years ago. She spoke for about 45 minutes. I don’t remember what she spoke about, except for one key statement/theme. Sister Mary said …
“No Margin, No Mission.”
Another way of putting that is “No Profit, No Purpose.” There’s a persistent debate in long-term care about what’s better, for-profit (FP) or not-for-profit (NP). I’ve seen arguments from the NP group that their care is superior because they don’t have to meet shareholder ROI expectations. The implication is that FP providers will cut needed services down to the bone and sacrifice quality care in order to make more money. I’ve seen arguments by the FP group that NP providers take care of such a low-acuity patient base that comparing the two provider types is apples to oranges. “How hard is it to have great surveys and clinical outcomes when you’re only taking care of long-term care residents?”
At times the NP vs. FP providers seem worlds apart.
They think they’re so different.
But, they’re not. In order to be built to last, both NP/FP operators need to follow Sister Mary’s guidance:
- Be committed to quality care (MISSION)
- Make money (MARGIN)
I now see two types of operators. The two types are not FP and NP.
The two types are the ones who are Built to Last (Margin & Mission) and those who are being purchased by the Built to Last operators.