August 2005

August was more-of-the-same in terms of managerial issues: I have continued to fortify job responsibilities, accountability to statistics of production, and general expectations. Also, the new staff has started to become more familiar with each other and me. That brings in its' own challenges. The more familiar they become, the more the natural pecking order forms. Also, the more familiar they become, the more they state their thoughts for better or worse. I don't have any regrets because the statistics are better. Our patient volume, services, and collections are rising all up from July. As long as that happens I won't complain. I keep saying, Staff retention promotes patient retention. Cash flow remains a real issue. Our volume hasn't grown enough for me to be comfortable with the new expenses.

Despite the fact that I cut payroll (starting in May) it is still a challenge to make ends meet. (I won't even describe what a challenge it has been to deal with the staff attitudes regarding pay cuts.) In addition, insurance companies (a good portion of our income is generated through insurance coverage) have not only been slow to pay, but have been throwing up extra roadblocks to reimbursements. In fact, I have spent nearly three weeks re-analyzing our prices, reimbursements, write-offs, and accounts payable in fine detail. I am still working on it; trying to understand exactly what has already happened so that I can better project cash flow for the future . In addition, I decided to re-evaluate our collections department. (That begins next week. I am going through the training from A to Z, hoping I can ferret out any glitches on our side of the collections process.) The cash flow problem has been distracting me from the more fun, creative executive plans I had for the month of August. I don't think it hurts the business in the long run; in fact, it probably helps UHI. (I am learning so much, and have never been so tuned into the financial side of this business.) However, psychologically, it is brutal.

August has been a comedy of errors (at least it should be funny in the future). Our payroll company messed up payroll twice (one of those times being a double-debit). Our bank returned a check despite the fact that the account was properly funded. The air-conditioner broke (90 degrees in Chicago, thank you). Our mail woman went on vacation and her replacements did not show up 5 out of 20 days (i.e. no mail delivery equals no income from the mail). And, an important part-time employee resigned to go to a full-time job elsewhere. (And those are just the highlights. On the personal side of it, during one week of August I did not have a nanny for my 3-year old daughter. It was nearly impossible to work, and I was very anxious knowing the projects were piling up. My husband just got up and went to his office, as usual (never gave it another thought). Midweek of that week I talked to him about it, and he seemed genuinely surprised. He told me that he [had] to work. (He owns his own business, too, so he could have taken time off, even though it would also have been difficult. It just seemed that I would take care of it all and he would never have to think about it. If this happens again and I bet it will he agreed that he is going to take care of our daughter for 50% of the time. At least we ironed that out.)

Meanwhile, at home, my carpenter did not show up during the week he was supposed to finish his job (and our place goes up for sale at the end of September). Finally, and sadly, I grieved the death of my 17 year-old best-buddy cat companion, Khufu. I battle every day to keep my self-talk sensible, positive, or, at least benevolent. It 's not easy; when I get frustrated I am the first person I beat up. I think this is a painful learning curve. I have been through them before, and they are not fun - in retrospect, satisfying, learning experiences, but not fun.
See you next month!