Grand Strategies and Operational and Tactical Plan The possession of grand strategies is important as it helps foster the institution's growth, development and long-term sustainability, helping it to be better placed as a facility that tends to the needs of the elderly in society. The grand strategies aim to address the external/internal factors that influence the organization's operations. The strategies include: diversified care, dealing with market equilibrium prices to clients, availability of care to the patient; physically and virtually, and promotional strategies to get a good brand name Diversifying care LOOKS GREAT! The management needs to determine what can be done to increase care diversity. With diversified care options, families will be at ease to commit their elderly to the facility. The use of Geographic Information Systems would be a great way to find out information such as the number of households in the location of the facility (Pliskie & Wallenfang, 2014). After finding the number of households that are in existence through GIS, it is possible to find out the commonalities in pathologies exhibited by the geriatric patients (that stem from these households) and then after working hard to ensure that all their needs are attended to (Rajan et al., 2014). The more diversified care is, the more the facility will realize an increased number of patients. Besides, patient families that bring their patients to the facility are always interested in knowing that their every need can be attended to (diversity) (Pliskie & Wallenfang, 2014). Diversification of care can also come in the name of telemedicine. Telemedicine is about communication with patients and their families virtually so that they can realize the benefit of enjoying care services in the comfort of friends and family. Dealing market equilibrium prices to clients THIS IS AN OPERATIONAL OBJECTIVE, WHICH WOULD FIT NICELY UNDER GRAND STRATEGY DIVERSIFYING CARE. Adjusting prices to ones that are considerate of customers' financial needs will help attract customers who may have been hesitant to be admitted to the nursing home or admit their loved ones because they thought the prices were too high. To lure more patient families into bringing their elderly to the facility, there is a need for the administration of the hospital to see to it that their prices are reasonable. For the prices to appeal to existing and prospective customers, there is a need for second-mover price leadership to be considered (Metcalfe & Lapenta, 2014). In this case, a second-mover price leadership will involve market research, determining what the top senior care facilities are charging for their services and then charging a lower price to lure customers. Note that, as previously mentioned, the quality of the services provided has to be top tier so that customers do not associate low prices with limited quality. The importance of charging slightly lower prices (provided that they make the centre realize margins) is that it will help realize scalability. Scalability is the capacity of a system to increase or go down in performance and cost for alterations in system and application processing demands (Rajan et al., 2014). In the case of the centre that is taking care of the old, an increase in the number of customers will compensate for the low prices charged, and the shorter margins realized. In the long run, there is a high chance that the facility will have great instances of profit. Availability of care to the patient; physically and virtually PUT UNDER THE DIVERSIFYING CARE STRATEGY. Availability of care physically and virtually will address limitations tied to customers wanting the nursing home facility they take their patients to be available on call whenever necessary. The availability of care is important to patients. As such, patients and their families prefer that care is available to a patient or family member at a place where they can visit easily. Having a couple of brick-and-mortar facilities in a few states is not enough. It is best if the centre builds many facilities (at least 50) across the 50 states to be more available to existing patients, prospective patients, and their families (Górecka & Szałucka, 2014). High-quality care centres where patients can be assisted by personnel and visited at any time with their families are very desirable and would make a great impact in convincing many Americans to bring their parents on board. In addition to many physical locations, it is high time the facility embraces telemedicine. Telemedicine refers to the remote diagnosis and treatment of patients utilizing telecommunications technology. When families of senior citizens want help from the facility and stay with them at home, they will appreciate it if they can communicate with physicians and get help immediately (Rajan et al., 2014). Note that there is also a chance that families may want to pick up their loved ones from the centre so they can spend a day or two with them, and they would appreciate it if they were given directions on how to take care of them. Promotional strategies to get a good brand name THE GRAND STRATEGY IS MARKET EXPANSION. Promotional strategies for the nursing home will help address the limitation many customers are unaware of and may have difficulty finding a competent facility simply because of lack of information. Promotional strategies, if implemented well, will address the fact that limited knowledge of the company has been making sales volumes constantly go on a downward spiral. Promotion is publicizing a product and service portfolio in a professional setting to increase sales or public awareness. In this instance, there is a need for the centre to market its products and services so that potential customers who have never heard of it make bold steps and bring their family members on board (Rajan et al., 2014). Some approaches the facility can use to promote its services include television, print, radio, and social media. Although expensive, television adverts will help the organization reach a great number of people across the 50 states, i.e., make them aware of the services offered. A partnership with media houses would be a great way for the nursing facility to market its portfolio (Metcalfe & Lapenta, 2014). The best time when the centre's advertisements should be aired is in prime time, i.e., a time when most people are tuned in to watch news or soap operas. Second, print media is a great way for the health and care facility to advertising its services. Newspapers' classifieds sections and billboards are an example of a great way to start the day by making the company famous. Moreover, using the radio for advertisement would help the company reach lovers of music and people who listen to the radio all the time, such as truck drivers in transit. Listeners could end up being customers or share what they have heard with potential clients. Finally, social media sites such as Facebook, Twitter, Whatsapp, Snapchat, and Instagram would be a great way for the facility to market its services and reach more potential clients (Rajan et al., 2014). This is respective to the fact that many Americans carry their phones everywhere. Since social media is greatly used to communicate with family and friends, it could be a great way for the company to market its services. While advertising will take a lot of the company's resources in the short run, the long run benefits (making a good impression of the company and increasing sales volume) will be worth the trouble. Operational and Tactical Factors to Accomplish Grand Strategies MAKE IMPROVEMENTS TO THE GRAND STRATEGIES AND THEN WORK ON THIS SECTION AGAIN. Operational and Tactical Factors to Achieve Diversified Care For the hospital to achieve diversified care, there are several factors that the management must consider. The first step involves conducting market research to gain knowledge of what patients and their families expect from a nursing facility [Pliskie, J., & Wallenfang, L. (2014). The second step would be looking for funds through debt or equity and using them to mould the product and service portfolio to the wants and needs of clients. The third step would involve monitoring and implementation to decide the services to stick with and the ones to do away with. Operational and Tactical Factors to Help Charge the best Prices For the nursing facility to charge the best prices that would attract and lock in customers, there is a need to research what competitors in the industry are charging. For example, the marketing department of the nursing home could use the internet to create a list of the current prices of competing nursing homes (Rajan et al., 2014). The measures of central tendency (mean, mode, and median) of the information found should then be used to determine the most common prices charged for specific services. Finally, the best prices should be announced to existing and prospective customers immediately after they take effect. Operational and Tactical Factors to Increase Availability of Care To increase the availability of care, there is a need for the nursing home to be keen on what customers want. Talking to existing customers and learning about their preferences would be a great first step. A second approach that would work best to favour the company is using data from websites of an organization such as the CDC to determine the number of potential clients in every state. A final step would involve building facilities in regions where the potential number of clients is high. Operational and Tactical Factors to Increase Promotion To increase the promotion of the nursing facility, a couple of steps could be adhered to. The first objective would be to hold a meeting with stakeholders and find out the best approach to advertising the nursing facility. The second step would concentrate on ensuring that the funds required are sought and found through the company reserves or overdrafts from a bank. Finally, the third step into promotion would involve monitoring whether the approaches used are effective and scaling costs. References Górecka, D., & Szałucka, M. (2014). Application of MCDA methods and stochastic dominance rules in the entry mode selection process in international expansion. Multiple Criteria Decision Making, 9, 5-31. Metcalfe, L., & Lapenta, A. (2014). Partnerships as strategic choices in public management. Journal of Management & Governance, 18(1), 51-76. Pliskie, J., & Wallenfang, L. (2014). How geographical information systems analysis influences the continuum of patient care. The Journal of Medical Practice Management: MPM, 29(5), 282. Rajan, D., Kalambay, H., Mossoko, M., Kwete, D., Bulakali, J., Lokonga, J. P., ... & Schmets, G. (2014). Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008-2013. BMC Health Services Research, 14(1), 1-9. Key Performance and Evaluation Indicators Introduction It is important to understand that Key performance indicators (KPIs) helps management and leaders understand the performance of the organization and employees. There are different ways to utilize different strategies in understanding and measuring the performance of their organization. However, it is important to understand that this usually depends on the company's success which is basically a set of targets, objectives, or industry peers. Furthermore, just like any other organization, a company needs appropriate leaders and management who can effectively evaluate the Key performance indicators (KPIs) which are basically the measurable indicators used to assess the long-term performance of an organization (Karadag, 2015). On the other hand, performance benchmarks need also to be considered. Performance benchmarks help the management determine the success factors of their company. Performance benchmarks usually involve the management in evaluating and collecting qualitative data related to the success of the organization. It is important to understand that this is usually considered as the first phase since it helps the leaders and the management identify the gaps that exist in the organization. Besides, in benchmarking, leaders need to acknowledge and state the differences that exist between their company and other companies. Performance benchmarks are all based on being intelligent enough to learn how to match—or perhaps surpass—others at something while remaining humble enough to acknowledge that others are better at it. KPIs assess an organization's performance in relation to a certain activity (such as projects, programs, products, and other activities) that it does. Sometimes success is defined in terms of moving closer to strategic goals, while other times success is merely the repeated, periodic attainment of specific levels of operational goal (e.g., zero defects, 10/10 customer happiness). Selecting the appropriate KPIs depends on having a solid understanding of the organization's priorities. What is considered significant frequently varies on the department measuring the performance; for instance, the KPIs given to sales will be different from those beneficial to finance (Gopal & Kumar, 2015). Numerous methods to evaluate the current situation are needed since it is necessary to comprehend clearly what is significant. The choice of performance metrics is accompanied by a variety of approaches to evaluate the current health of the company and its core competencies since it is essential to understand what is significant. Performance indicators are frequently linked to assessments since they frequently lead to the identification of prospective adjustments. This study will greatly focus on stating and discussing the key performance indicators, performance benchmarks and evaluation indicators. 3 Key Performance Indicators There are several key performance indicators (KPIs) that are appropriate for the grand strategies. Grand strategies are essential for a company's development, expansion, and long-term viability because they put it in a better position to serve the needs of the residents in community. The major plans are designed to deal with the internal and external forces that affect how the organization operates. Multidisciplinary service, addressing market equilibrium prices to clients, accessibility to treatment for patients both physically and online, and brand-building tactics are some of the measures. The first KPI is revenue growth. Revenue growth is basically used to track whether sales are rising or falling over time. This kind of KPI typically highlights what has to be changed within the organization in order for the business to improve and the brand to present itself to the audience in the best possible light. Additionally, this kind of KPI will demonstrate to management the success of the objectives set forth to alter and enhance the product. By monitoring this kind of KPI, management may more clearly grasp the goals that are met by examining the performance of the workforce, the rate of sales growth, the level of audience engagement, and whether or not customers are satisfied with the items. The organization must construct a sound strategy plan based on the defined targets in attempt to optimize performance tactics and move the warehouse closer to success. Therefore, the organization makes sure that employees are concentrating on the quantifiable aim when setting targets. They must motivate all corporate divisions to appropriately carry out the business plan. The second type of KPI that needs to be considered is the revenue per client. One of the key metrics that directly affects the organization's financial development as well as budgetary issues is revenue per client. The likelihood that budgetary projections will be met increases when staff members generate more money for a company by providing high-quality goods and services. Therefore, management must pay close attention to how much time employees spend on everyday activities and must offer reliable information on the results of each work assignment. Time management is essential in healthcare facilities and has a direct impact on the standard of goods and services provided to patients. The third type of KPI that needs to be considered is client retention rate. Any sort of organization's major objective is to increase client retention rates by 20% in six months by undertaking a consumer listening program to identify areas where value can be added. This involves gathering client feedback through routine website and social media online surveys that will give performance reports about how satisfied current consumers are. By incorporating this feedback, Jasper Gardens can enhance its offerings to better meet the requirements of its patients and their families, engage with them, and boost patient retention. 3 Performance Benchmarks KPIs evaluate whether a person, business, initiative, and organization execute in relation to the achievement, as opposed to a benchmarking, which compares a firm's procedures, services, and activities with those of other organizations. Performance benchmarking is essential for improving productivity in the any type of an industry as well as estimating, work planning, and process management. Crew productivity and profitability performance data collection and sharing is very beneficial to both client and developers (Wayland & McDonald, 2021). When managing employees, quality improvement is crucial in creating a platform for better cooperation and interaction among many stakeholders. Within the field of investment management, there are numerous common standards for assessing investment performance. Most managers assess their own performance against that of other managers in the same industry or sector, which has become popular for two major reasons: ease and naive allure. It is imperative that data is extremely easily accessible. A superior manager should always be able to produce above-average performance over a lengthy period of time (three to five years). Benchmark portfolios typically integrate the salient and enduring aspects of a manager's investment in the absence of overt management. They are a passive approximation of a manager's investment approach. Benchmarks are straightforward, alternative investments, quantifiable, suitable, and indicative of existing investment possibilities, among other qualities that support their validity. In essence, standards are set up to provide managers with areas where they can offer value. If management truly performs better than healthcare facilities, they should outperform them by at least 50%. A number of valid benchmark attributes, including highly pigmented, reduced turnover, positive act leadership roles, alternative investment position dimensions, diminished observed energetic danger, high extra-market refund correlation between the managed portfolio and the benchmark, and comparable vulnerabilities, can be used to assess the quality of a benchmark. 2 Evaluation Indicators The two most common evaluation indicators that will be discussed are specifically the participation rates and individual behaviors. The rate of labor force participation has drastically changed over time. One must first comprehend the concept of labor force participation rates in order to comprehend the potential causes of the reduction (Agundu & Imegi, 2014). The proportion of the citizen, non- governmental individuals 16 years of age and older that are employed or actively seeking employment is known as the workforce participation rate. A few theories can be regarded as credible explanations for the drop in the workforce participation rate. There is a good possibility that when someone experiences any kind of shift, such as obtaining power over others, their behavior will adjust to fit the new circumstance. People's individual traits or personalities will determine how they employ the skills or abilities they acquire. Some people would abuse their position of power to exploit others for their own selfish benefit. The nature of the interaction between an individual and an organization is founded, in its most basic form, on give and take (Walston, 2018). An employer rewards a worker for their contributions with salary, employment rights, perks, prestige, and possibilities for advancement. An employee offers their time, talents, energy, aptitude, devotion, and capabilities. Organizational relationships, in a broad sense, are a network of specific psychological connections made by workers when they collaborate. Several concepts govern the psychological layout of organizational relationships. Unity of purpose, which denotes shared objectives, mutual respect, and resoluteness in worker interactions. Along with the agreement of rights and obligations and the division of labor in line with work responsibilities, the accountability of workers for order to enhance productivity also contributes to the contract between the employer and the staff. References Agundu, P., & Imegi, J. C. (2014). Domestic debt and strategic financial management imperatives in Nigeria: Casual diagnosis. Journal of Financial Management & Analysis, 27(1), 41-53. Ciobota, G., & Velea, A. (2015). The strategic positioning of the financial banking companies – Key factor for achieving competitive advantages. Knowledge Horizons, 7(1), 103-106. Food and Agriculture Organization of the United Nations. (1997). Chapter 6 – Investment decisions – Capital budgeting. Retrieved from http://www.fao.org/docrep/W4343E/w4343e07.htm Gopal, S. & Kumar, D. M. (2015). Strategic interventions in tackling poor performance of service departments: Study on Muhibbah engineering. Journal of Economics and Behavioral Studies, 7(4), 6-13. Retrieved from https://www.researchgate.net/publication/281544969_Strategic_Interventions_in_Tackling _Poor_Performance_of_Service_Departments_Study_on_Muhibbah_Engineering_M_Bhd_Mala ysia Karadag, H. (2015). Financial management challenges in small and medium-sized enterprises: A strategic management approach. Emerging Markets Journal, 5(1), 26-40. Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration. Wayland, M. S., & McDonald, W. G. (2021). Strategic analysis for healthcare: Concepts and practical applications (2nd ed.). Health Administration Press. Lacking an adequate number of quantifiable indicators. You should have measurable indicators for every operational objective/tactic. Mission and Vision Statement Mission Statement Because old age requires the best care and empathy, we are dedicated to providing a home-like environment to help our residents feel comfortable and relaxed. We achieve this by ensuring that our residents have access to a clean, convenient and serene environment. Our residents also enjoy the comfort of a state-of-the-art dining facility in our institution. We espouse care, love, and dedication while dealing with our senior citizens. Vision Statement Our vision is to create a comfortable and friendly environment for our residents to ensure they thrive and find inspiration, joy, and meaning in life upon retirement. Core Values Respect and Dignity Every human being deserves respect and dignity. Upon retirement, we believe that every individual should be able to access an environment where they are treated with utmost respect and dignity. Compassion The aging process brings forth many challenges in the life of an individual. With this in mind, we strive to be understanding by listening to the needs of our residents. We believe every resident should have a voice, and each need should be addressed without hesitation. Safety Everyone needs an environment where one can thrive and feel peaceful. For this to be possible, it is vital to create a safe environment where our residents can interact and spend their time without worrying about injury or physical strain. Quality of Care Each resident deserves a high quality of care. Our institution is dedicated to providing the best care available by ensuring that the institution is endowed with the best medical, physical, and psychology specialists around the clock. Privacy Our institution recognizes the need to provide privacy to every resident. We believe that privacy is a needed ingredient for the comfort and safety of our clients. Mission and Vision Statement Mission Statement Because old age requires the best care and empathy, we are dedicated to providing a home-like environment to help our residents feel comfortable and relaxed. We achieve this by ensuring that our residents have access to a clean, convenient and serene environment. Our residents also enjoy the comfort of a state-of-the-art dining facility in our institution. We espouse care, love, and dedication while dealing with our senior citizens. Vision Statement Our vision is to create a comfortable and friendly environment for our residents to ensure they thrive and find inspiration, joy, and meaning in life upon retirement. Core Values Respect and Dignity Every human being deserves respect and dignity. Upon retirement, we believe that every individual should be able to access an environment where they are treated with utmost respect and dignity. Compassion The aging process brings forth many challenges in the life of an individual. With this in mind, we strive to be understanding by listening to the needs of our residents. We believe every resident should have a voice, and each need should be addressed without hesitation. Safety Everyone needs an environment where one can thrive and feel peaceful. For this to be possible, it is vital to create a safe environment where our residents can interact and spend their time without worrying about injury or physical strain. Quality of Care Each resident deserves a high quality of care. Our institution is dedicated to providing the best care available by ensuring that the institution is endowed with the best medical, physical, and psychology specialists around the clock. Privacy Our institution recognizes the need to provide privacy to every resident. We believe that privacy is a needed ingredient for the comfort and safety of our clients. SWOT Analysis Template Strengths Weaknesses • Ample land area for future expansion of the facility. • Continued reduction of staff at the facility by the administration • Availability of therapy staff within the institution • • Availability of nursing and pharmacy services Overburdened nurses since one nurse are expected to take care of half of the residents • Increasing employee grievances • Reliance on wheelchairs for transportation leads to on-site accidents • Presence of private rooms for residents • Up-to-date technology such as wireless internet • Nearness to referral hospitals such as Middleboro and Capital City Lack of enough doctors at the facility. • Aggressive administration policies lead to reduced quality of care • Understaffed registered nurse (RN) with a burdened work schedule leading to poor performance • • • Reliance on Medicare and private health insurance as the main methods of payment Availability of fine dining facilities Opportunities • Availability of off-grid energy that can last up to 12 days Threats • Unionization of workers within the facility • A deficiency-free survey from the department of health • Urbanization encroaches on the facility’s natural resources • Teamwork with the police in caring for residents within the shopping centers • Increasing employee compensation as a result of work-related injuries • Legal guidelines restricting the expansion of bed capacity in the facility by more than 5 percent each year • Facility policy that hinders hospitalized residents from having a reserved bed at the facility • The trend of an aging population increases the burden of care to the facility. • Availability of recreational specialists improving recreational processes within the facility • Utilization of an Electronic Health Records system • Utilization of Alzheimer’s and dementia wing Expound upon the Os and the Ts in two separate section of the narrative section. Swot Analysis Narrative Thesis statement: This narrative aims at discussing the strengths, weaknesses, opportunities, and threats of the Jasper Gardens health institution with the aim of utilizing the analysis to ensure an improved performance and quality of care at the institution. I. INTRODUCTION II. STRENGTHS OF THE INSTITUTION a) Ample land b) Availability of therapy specialists c) Availability of pharmacy services d) Presence of private rooms e) Up-to-date technology f) Nearness to referral hospitals g) Reliance on Medicare h) Availability of fine dining facilities III. WEAKNESSES OF THE INSTITUTION a) Reduction of staff b) Overburdened nurses c) Increasing employee grievances d) Reliance on wheelchairs e) Lack of enough doctors f) Aggressive admin policies g) Understaffed registered nurses IV. OPPORTUNITIES AND THREATS IN THE INSTITUTION a) Off-grid energy b) Deficiency-free survey c) Teamwork with police d) Recreational specialists e) EHR f) Unionization of workers g) Urbanization h) Employee compensation i) Legal guidelines restricting expansion by more than 5 percent. j) Facility policy of denying residents bed reservation during hospitalization. Swot Analysis Narrative Behrouzi, Shaharoun & Ma'aram (2014) posit an emerging need for healthcare institutions to embrace performance measurement systems to ensure that the quality of care offered within these institutions is enhanced. The scholars lament that the principal problems within the healthcare setup arise from the culture within the healthcare organization. Moreover, organizational practices also contribute significantly to the witnessed challenges. This narrative aims to discuss the strengths, weaknesses, opportunities, and threats of the Jasper Gardens health institution to utilize the analysis to ensure improved performance and quality of care at the institution. Strengths of the Institution Jasper Gardens is endowed with ample land. This factor was chosen as a strength of the organization due to the importance of ample space within a healthcare institution. According to South, Hohl & Kondo (2018), an environment's physical conditions significantly affect the community's mental wellbeing. Since Jasper Gardens provides care to aging citizens, it is essential the physical environment is ample and not constricted. According to the researchers, constricted spaces have been associated with mental health illnesses. Therefore, ample land is an essential strength of the institution. The studied healthcare institution provides therapy specialists within its facilities. Kim, Kim, Woo & Hyun (2015) posit a great need for hospital service specialization. The scholars assert that to increase the efficiency of patient care, healthcare facilities need to focus on specific diseases. Similarly, there is a need for nursing homes to provide specific health-related services to have a competitive edge in the industry. The provision of therapy specialists in the Jasper Gardens nursing home ensures that the facility can provide therapy-based care to its residents. This measure is helpful since the facility can be associated with therapy care, curving a niche. The availability of pharmacy services is also another strength of the Jasper Gardens nursing home. According to Lee, Mak & Tang (2019), pharmacists in nursing homes play a crucial role in the care of residents. Lee, Mak & Tang posit that these pharmacists ensure that the residents have access to quality medicine administration, leading to a reduced fall rate among them. Therefore, the presence of pharmacy services in the institution is an immense strength as it significantly contributes to the quality of care administered in the said facility. Brown et al. (2021) theorize that crowding in nursing homes has been associated with the fast spread of Covid 19. To mitigate this issue, nursing homes must provide private rooms for their patients. The studied healthcare facility provides semi-private and fully private rooms to its residents. This measure is thus seen as a strength of the institution as its residents are cushioned from the spread of Covid 19. Additionally, private rooms give the residents personal spaces that buoy their comfort and joy. The availability of up-to-date technology such as wireless internet is also an added advantage to the facility. In essence, the availability of this form of the technology enables the residents to have easy access to information and entertainment. The impact of this factor is that the facility's residents have an avenue to mitigate idleness and, consequently, stressful occurrences in their daily lives. Quigley et al. (2020) discuss nursing homes need nearby referral hospitals to mitigate healthcare emergencies. The scholars posit that there exist challenges when nursing homes don’t have access to referral hospitals where their residents can be easily referred to. In the current setting, the Covid 19 pandemic has proven the necessity for this measure. Therefore, nearness to referral hospitals ensures that the nursing home can respond to a health emergency in time, reducing cases of preventable fatalities. Also, the reliance on Medicare and private healthcare insurance cover ensure that these residents have quick access to medical aid. The reliance on Medicare also ensures that the facility can streamline its financial obligations and avoid bad debts, which may negatively affect its daily running. The availability of a good dining facility is also an essential aspect of the nursing home. The fine dining facility allows the residents to enjoy an atmosphere of sophistication which positively affects their well-being. Weaknesses of the Institution French et al. (2022) warn of severe consequences resulting from the understaffing of registered nurses (RN) in healthcare facilities. According to the research conducted by these scholars, it was reported that the understaffed nurses reported cases of burnout and job dissatisfaction. Additionally, the nurses desired to quit their positions due to poor working conditions. This shows that the understaffing of RN in Jasper Gardens nursing home could result in severe consequences of burnout which would adversely affect the quality of care administered. Patel et al. (2018) also lament that the understaffing of physicians in nursing homes offers an outstanding liability to the affected institutions. The reason for this is that these physicians also experience fatigue. These factors may severely affect the quality of services offered at Jasper Gardens nursing home. Reduction of staff, especially the firing of nurses, is also a great weakness of the Jasper Gardens nursing home. If the reduction of workers continues to persist, neglect of chores within the facility may prevail. The reliance on wheelchairs is also a significant weakness of the nursing home. The reason is that many cases of wheelchair crashes happening within the facility have been reported. Gowran et al. (2021) argue that these crashes happen because of a lack of appropriate wheelchairs in nursing homes. This is a great weakness for the institution since these cases greatly impede the quality of health of the residents. In case of fatal crashes, the nursing home can face legal liabilities and a tainted industry name. There are also increasing cases of employee grievances. Lee & Shin (2020) report that nurse grievances are primarily due to low wages. This factor is a great weakness to the institution since low wages result in reduced job esteem and satisfaction. Also, the researchers argue that low wages also lead to increased nurse turnover rates. The impact of this factor is the defection of employees. The defection of workers is a dangerous trend that brings about undesired consequences such as straining the remaining labor force. Threats and Opportunities in the Institution The availability of off-grid energy capable of lasting up to 12 days is an excellent opportunity for the nursing home. This is because the residents are assured of an unaffected schedule within the facility. Also, teamwork with law enforcement ensures that residents who get lost in the shopping centers find their way back to the facility. This is an excellent opportunity of increasing the welfare of residents. A deficiency-free survey from the department of health indicates that the nursing home is dedicated to providing quality care to its residents. Therefore, the nursing home can use the survey to attract more residents. The availability of electronic health records (EHR) and recreational specialists is also an added advantage to the facility. The nursing home can utilize these additional features to increase the welfare of their clients further. On the other hand, the nursing home suffers from several threats. One of these threats is the unionization of workers. This measure may lead the employees to have a collective bargaining power that may affect the facility's profitability. Urbanization is also a threat to the environmental conditions at the facility. Erection of buildings around the facility may reduce flora and fauna, leading to increased cases of mental illness amongst clients. Employee compensation resulting from work-related injuries is also a threat to the facility's financial position since realized profits may be used to settle these compensations. On the other hand, legal guidelines limiting the expansion of bed capacity to more than 5 percent check the facility's possibility of expansion. This is a threat since, without expansion, modest profits cannot be realized. Lastly, the facility's policy of denying bed reservations to hospitalized clients may lead to the defection of residents. This is because the residents may perceive such a policy in bad faith. This makes it difficult for the facility to retain residents. References Behrouzi, F., Shaharoun, A. M., & Ma’aram, A. (2014). Applications of the balanced scorecard for strategic management and performance measurement in the health sector. Australian Health Review, 38(2), 208-217 Brown, K. A., Jones, A., Daneman, N., Chan, A. K., Schwartz, K. L., Garber, G. E., ... & Stall, N. M. (2021). Association between nursing home crowding and COVID-19 infection and mortality in Ontario, Canada. JAMA internal medicine, 181(2), 229-236. French, R., Aiken, L. H., Rosenbaum, K. E. F., & Lasater, K. B. (2022). Conditions of Nursing Practice in Hospitals and Nursing Homes Before COVID-19: Implications for Policy Action. Journal of Nursing Regulation, 13(1), 45-53. Gowran, R. J., Bray, N., Goldberg, M., Rushton, P., Barhouche Abou Saab, M., Constantine, D., ... & Pearlman, J. (2021). Understanding the global challenges to accessing appropriate wheelchairs: position paper. International Journal of Environmental Research and Public Health, 18(7), 3338. Kim, H.-S., Kim, Y.-H., Woo, J.-S., & Hyun, S.-J. (2015). An analysis of organizational performance based on hospital specialization level and strategy type. PLoS One, 10(7) Lee, J. Y., & Shin, J. H. (2020). Why Do They Stay? Intention to stay among registered nurses in nursing homes. International Journal of Environmental Research and Public Health, 17(22), 8485. Lee, S. W. H., Mak, V. S. L., & Tang, Y. W. (2019). Pharmacist services in nursing homes: a systematic review and meta‐analysis. British Journal of Clinical Pharmacology, 85(12), 2668-2688. Patel, R. S., Bachu, R., Adikey, A., Malik, M., & Shah, M. (2018). Factors related to physician burnout and its consequences: a review. Behavioral Sciences, 8(11), 98. Seidel, L. F., & Lewis, J. B. (2017). Case 7: Jasper Gardens Nursing Home. In The Middleboro casebook: Healthcare strategy and operations (2nd ed., pp. 230-256). Health Administration Press. South, E. C., Hohl, B. C., Kondo, M. C., MacDonald, J. M., & Branas, C. C. (2018). Effect of greening vacant land on mental health of community-dwelling adults: a cluster randomized trial. JAMA Network Open, 1(3), e180298-e180298. Quigley, D. D., Dick, A., Agarwal, M., Jones, K. M., Mody, L., & Stone, P. W. (2020 April 28). COVID‐19 preparedness in nursing homes in the midst of the pandemic. Journal of the American Geriatrics Society, 68(6), 1164-1166. 1 Strategic Planning in Healthcare Administration Student Name Institution Course Name and Number Instructor’s Name Date 2 Strategic Planning in Healthcare Administration 1. Strategic Management Plan 1. Mission statement “We promise to listen and strive to accommodate resident choices so that we can fulfill their wishes for daily living.” 2. Vision statement “Empowering residents and creating a home-like atmosphere are most important to the organization." 3. Core values 1. Care and compassion 2. Respect and appreciation for each other 3. Focus and discipline 4. Human dignity 5. Teamwork and enjoyment of working together 4. SWOT analysis 1. Strengths 1. Maintains a workforce of highly skilled and qualified professionals 2. Embraces diversity and values the diverse customer base and staff (Seidel & Lewis,2017). 3. Has over 60 years of experience working with older people in the assisted living sector 2. Weaknesses 1. Has a limited focus on expansion to other regions 2. The bed policy of the organization is not well structured (Seidel & Lewis, 2017). 3. Inability to increase staffing levels despite increased patient needs 3. Opportunities 3 1. The patients actively contribute to the organization's awareness through constant recommendations to the management. 2. An effective expansion plan focuses on inpatient hospice construction (Seidel & Lewis,2017). 3. Current efforts to upgrade the E.H.R system are successful 4. Threats 1. Increasing Medicaid rates are a threat to the organization 2. Understaffing has affected the organization’s operations 3. High competition from other establishments within the same sector 5. Grand strategies or long-term strategic priorities (3–5) 1. Reduction of expenses 2. Investing in training and development of the workforce 3. Improving customer care 4. Expansion and growth of the organization 5. Restructuring of operations 2. Operational and Tactical Plan (for each Strategic Priority listed above) 1. Reducing expenses 1. Measuring costs 2. Reevaluating spending 3. Analyzing revenue trends 2. Investing in Training and Development of the workforce 1. Ensuring the management is actively involved in training and development initiatives for the employees 2. Provide different types of training for employees, such as on-the-job training, seminars, and group discussions (Seidel & Lewis,2017). 3. Measuring employee satisfaction, especially in work-related activities and practices. 4 4. Create a formal plan for employee development, including setting goals and providing tools to help the training process of employees. 3. Improving customer care 1. Constantly inquiring the patients concerning issues affecting them. 2. Shoeing empathy to customers and acknowledging their issues. 3. Setting organizational communication standards (Seidel & Lewis, 2017). 4. Setting individual and team goals for all members of the organization. 4. Expansion and growth of the organization 1. Establishing regional dominance of the Jasper Homes Nursing Home 2. Promoting specialty niches for the nursing home, such as physical therapy. 3. Focusing on local community engagement for the brand's growth (Seidel & Lewis, 2017). 4. Focusing on remote and virtual care of patients as an expansion strategy. 5. Restructuring of operations 1. Implementing lean processes in the organization’s operations 2. Giving nurses more autonomy over decision making 3. Creating a primary care program for the organization (Seidel & Lewis, 2017). 4. Revenue cycle management strategies should be integrated into insurance follow-up and claim submission operations. 3. Evaluation Plan The evaluation plan focuses on increased quality of patient care while devising methods of improving staff training for better patient outcomes. It also includes creating a costbenefit analysis of current expansion strategies (Seidel & Lewis,2017). The efficiency of these aspects will be investigated based on different evaluation methods such as questionnaires and surveys. 4. The change management plan includes the following: 1. The size of the change and its impact on the community and the organization 5 This scenario's change management strategy focuses on expense reduction and quality management in Jasper Gardens Nursing Home. This is an organizationalwide change management activity that will have a tremendous impact on the organization and the community. It will help reduce costs of the organization, increasing productivity and decreasing risk, therefore improving profitability (Seidel & Lewis,2017). The community will experience better outcomes in service delivery and costs of services offered by the organization. This change will directly impact thousands of community members, and cutting expenses will help improve the organization's operations. 2. The organization’s readiness for change The readiness for change in this organization can be measured in different aspects. One aspect is the strength of the evidence for the proposed change and innovation (Seidel & Lewis,2017). It is also essential to consider the organizational capacity to facilitate change, and in this instance, the company has sufficient capacities to ensure change processes are successful. Preparing the organization for issues related to change is also critical to consider. 3. Change management strategy Implementing change includes creating a sense of urgency within the organization. The management will facilitate change by educating organizational members on the importance of immediate action to facilitate change. It is also critical to create a team that can facilitate change (Seidel & Lewis,2017). It will be critical to communicate the vision and strategy of the change and explain the possible benefits. For example, the management needs to explain how a cost savings strategy will benefit the organization, such as lower expenses, increased operational efficiency, and streamlining technology. 4. Team structure and responsibilities There are different change management team members within this healthcare facility, and they will have different roles to play in the process. These will include the nurses, members of the finance and the account departments, customer care team, management, patient support staff, nursing directors, and facility members (Seidel & Lewis,2017). These different individuals will have particular roles to play in the change management process in this nursing home. Since Jasper Gardens Care Home uses a flat management structure, this will be equally employed in the change management process. 5. Champion roles and responsibilities 6 There are different roles and responsibilities, and it will be essential to explain how these roles and responsibilities will be achieved for effective outcomes in the change management process. The change manager needs to know what to delegate to whom and also understand the strengths and weaknesses of the different team members (Seidel & Lewis,2017). It is also critical to create a clear communication channel and ask for feedback at every level of the change management process. In cost-cutting processes, the organization's financial team must work with the nursing director and other team members to realize effective outcomes. In quality improvement, the nursing team will have to collaborate with the customer care team to create solutions for implementing this aspect. 6. Planning and implementation The planning and implementation of change management will include defining the change and selecting the change management team. After this, it is critical to developing implement the change using different metrics and then implement the change in different stages (Seidel & Lewis,2017). Analysis of the change includes understanding any possible gaps to change or resistance to the change process. This process will involve regular meetings, the use of team suggestions, and the formation of a steering group to oversee critical operations. 7. Communications plan It is critical to communicate the change and how it will be implemented. It will identify the impact of change across the organization and how this will affect employees. It also includes an outline of consistent strategies and plans which ensure that the change goals are realized (Seidel & Lewis,2017). It will include the establishment of goals, the definition of critical audiences and the key messages, the creation of a tactical outreach plan, and also the specification of execution of change. Effective communication during this project will consist of regular emails and memos, which will help streamline communication. 8. Resistance management plan This will include the steps, strategies, activities, and possible approaches to identify, evaluate, and revoke any resistance to change that may occur within the organization (Seidel & Lewis,2017). It will include diffusing opposition to change and engaging employees. It also includes effective communication concerning the change. 9. Training plan 7 This includes steps the organizational leaders can take to guide the team through the change process. It includes a provision of the possible resources which can be used in addressing issues concerning change management (Seidel & Lewis,2017). The plan will tackle issues of concern that may be faced by the organization and possible steps for addressing these issues. The training will happen within the first month of the project, and short online courses will be used to update the workers at every stage of the plan implementation. 10. Incentives and celebration of key milestones and successes The change management plan will also include the creation of incentives and ways of celebrating the achievement of critical milestones and successes in the change management process. It includes the publication of achievements and also holding meetings to recognize these achievements. The organization's key sponsors and stakeholders need to be aware of the achievements of team members (Seidel & Lewis, 2017). The management needs to be actively involved in celebrating the realization of change objectives. The supervisors should be directly involved in recognizing employees who participated in the change management process. Employee incentives include gift vouchers, increased pay packages, and annual incentives. 11. Timeline/schedule of activities A proper timeline and schedule of the different activities in the change management processes must be set. This ensures that different stages of the change management processes can be achieved within the targeted period (Seidel & Lewis, 2017). It will ensure effective delivery of the change within the specified period. The projected timeline for this project is five years and six months for the achievement of each step of the program. 12. Budget for change management A proper budget for change management needs to be set for Jasper Gardens nursing home (Seidel & Lewis, 2017). The projected costs for this change management process are set at $1.2 million, which would focus on qualityimprovement initiatives and creating cost savings strategies within the nursing home. 8 References Seidel, L. F., & Lewis, J. B. (2017). Case 7: Jasper Gardens Nursing Home. In The Middleboro Casebook: Healthcare Strategy and operations (2nd ed., pp. 230-256).Chicago: Health Administration Press. Professor feedback: Here is my feedback IN CAPS on the grand strategies. Operational Excellence GREAT ONE! Organizational Turnaround - IN CLOSELY EXAMINING YOUR OBJECTIVES, THEY SOUND FRAGMENTED AS SOME OBJECTIVES ON CARE/CUSTOMER SERVICE ENHANCEMENT BELONGS UNDER OPERATIONAL EXCELLENCE AS THE GRAND STRATEGY. INSTEAD OF THIS PROPOSED GRAND STRATEGY, FOCUS A STRATEGY ON FINANCE. Leading and Dominating the Industry REWORK THIS AND FOCUS ON MARKET EXPANSION/PENETRATION AS THE GRAND STRATEGY 1 Change Management Plan Name Department: University Course Code: Course Name Professor Date 2 Change Management Plan After analyzing the Jasper Gardens case study, it was apparent that the organization's management anticipates a change in the forthcoming future due to the process of unionization of its staff. Although no union has ever represented the company’s hourly staff, the organization may be forced to hold elections and a bargaining unit. The new change would necessitate significant preliminary arrangements to facilitate the organization's smooth unionization of hourly employees. Therefore, the nursing home facility’s management staff should commission change managers to plan, implement, and evaluate the process of change within the organization. The change managers should be able to examine all the relevant stakeholders, resources, and entities, such as the accountable care organizations (ACO), to gain underlying competitive advantages (Macfarlane, 2014). For instance, the change managers should illustrate how the anticipated changes would affect Jasper Garden’s relationships with the Medicare Quality Improvement Organization and the Centers for Medicare & Medicaid Service (CMS). Courtesy of the ACO, the organization plans to launch new initiatives such as Hospice Care with Capital City VNA, a collaborative Medicare-certified inpatient facility within the organization's property. The ACO also facilitates the establishment of Living Facility and Retirement House Housing services and the development of its information systems by installing electronic health record systems. This paper presents a viable change management plan to facilitate a smooth transition and streamline potential challenges that Jasper Gardens may face during the anticipated change process. 3 The size of the change and its impact on the community and the organization The unionization of Jasper Gardens' hourly workers would involve all cooks, assistants, registered nurses in charge, licensed-practical nurses in charge, certified nursing assistants, medical technologists, medical records, recreation staff, social services staff, physical therapists, physical therapist assistants, occupational therapists, certified occupational therapist assistants, and speech therapists. Therefore, the change process would involve more than three-quarters of the total staff in the organization. Courtesy of Jasper Garden's employees' unionization, the organization would enjoy reduced conflicts with its employees, who their union leaders would represent. The organization would also suffer increased labor costs due to increased hourly employee wages and benefits to reduce wage inequality. Other impacts of the unionization would include a reduction in working hours, safe workplaces, and discrimination free-workplace environments. On the other hand, unionization would facilitate improved economic and social welfare for the employees, who act as active members of the community. The organization’s readiness for change In the recent past, Jasper Gardens’ hourly employees have expressed three significant concerns against the organization: low wages below market norms, unfair employee benefits administration, and unclear job expectations. Despite the management’s efforts to standardize the wages and benefits for its employees, many employees still complain that they are still confused about their eligibility for the available benefits. Other employees also complained about unfair interpretations of sick leave policies, merit pay adjustments, annual leave policies, and part-time rates. Furthermore, the organization is yet to publish the new and expanded employee manual. The high prevalence of employee complaints and the management's sluggishness in providing a 4 new expanded employee manual and standards suggest that most of the company’s employees would likely vote for unionization. Change management strategy Prospective change managers in Jasper Gardens would utilize the developmental change management strategy to facilitate the company's planning, implementation, and evaluation of the unionization employees. The strategy enables organizations to streamline and improve existing processes, methods, conditions, and performance standards (Vinichenko, 2019). The change management strategy provides a framework to guide change managers in the change process. Team structure and responsibilities The following table illustrates the relevant change management teams and their respective roles and responsibilities. Serial Who 1. Jayne Winters 2. Michele Regan 3. Carol Hyde 4. 5. 6. Pyotr Alexis Fyodor Mckenzie Lisa-Anne Sanders What Chairing meetings Contact wintersj@jaspergardens.com Coordinating the hourly medical staff Presenting issues and conditions in human resource management. Representing the union Representing the union mregan@jaspergardens.com Checking legal issues and implications sandersla@jaspergardens.com hydec@jaspergardens.com alexisaldon@foreveryours.com mckenzief@foreveryours.com Sponsor roles and responsibilities The sponsors of the change management plan would include government and federal agencies, private organizations, and enthusiastic individuals. Their primary roles and 5 responsibilities would be to finance the plan's implementation to facilitate the unionization of hourly employees in the organization (Campbell & Evans, 2018). Furthermore, the sponsors must examine, assess, and evaluate the change during different phases and stages. Planning and implementation Although the planning responsibilities rest on Jayne Winters and her assistant, Carol Hyde, the entire organization is expected to be involved in implementing the change management plan. Considering that the change necessitates the unionization of the majority of the employees, the management should design adequate environmental conditions to facilitate the organization's inception. The management should also devise effective policies to ascertain that the introduced changes are incorporated and practiced in contemporary organizational processes and activities. Both hourly and non-hourly staff would be required to adhere to the policies. Communications plan Serial Stakeholder Objective Required Action/Message Present the rationale for unionization to the board and executive management. Writing a memo for all hourly employees 1. Jayne Winters Rationalizing the unionization to the management 2. Carol Hyde 3. Lisa-Anne Sanders Creating awareness about the union meetings Addressing legal matters regarding the change Collect and file all legal documents required in the process Level of Urgency (1-4) 2 Due date August 3, 2022 1 August 7, 2022 2 August 10, 2022 6 4. Gilbert Costa Ascertaining equity and freedom Listen to all employees and members of leadership teams 2 August 3, 2022 Change management resistance plan Despite the need for change by the management of hourly employees, several employees may resist the changes during the implementation stages. The table below identifies and describes the different types of resistance to the change. SOURCE OF RESISTANCE (TEAMS OR GROUPS THAT ARE LIKELY TO EXHIBIT RESISTANCE) ANTICIPATED TYPES OF RESISTANCE (TYPES OF RESISTANCE LIKELY TO BE EXHIBITED) IDENTIFICATION MECHANISM (HOW WILL THE PRESENCE OF RESISTANCE BE CONFIRMED/VALIDATED) Therapists Group resistance Social services Passive resistance Avoidance of new assignments Absenteeism Supervisors Individual resistance Poor communication and decision paralysis MANAGEMENT PLAN (STRATEGIES TO OVERCOME/MANAGE RESISTANCE) Agreement and negotiation Facilitating involvement, engagement, and participation Support and facilitation Training plan Considering that the unionization process would not require any new skills and competencies for the employees, hourly employees would only be required to attend a seminar to learn how they would operate under their unions. The seminars would not only serve to educate the employees about the unionization requirements but would also reveal their rights, roles, and responsibilities in the working environment. Employees would be trained to communicate their issues amongst themselves, with their representatives, union leaders, and management. 7 Incentives and celebration of successes Despite the anticipated benefits of joining the union, the management should not encourage or incentivize the unionization process. The decision to join or enter the union should be voluntary and independent (Johnson, 2020). The organization may celebrate the success of change if the majority of hourly employees vote for the unionization of Jasper Garden’s workplaces. Timeline/schedule of activities Action/Month July Formulate change management team Meeting with Board, Executive Management, and Relevant stakeholders. Assess current activities and practices Gather performance data Meeting with Union Representatives Elections Seminar Final Meeting Implementing Solutions August September October November December Budget for change management Considering that the implementation of the change would comprise the day-to-day activities in the nursing home, the organization would only incur costs during the planning phase 8 of the change management plan. During the planning stage, the organization would incur costs estimated at $2500 during the first meeting involving board members, executives, and relevant stakeholders. The organization would also spend $1300 during the final meeting with union representatives. Furthermore, the organization would spend $1200 and $1800 to furnish all the necessary deliverables required during the elections and the seminar. Therefore, the budget for the change management plan reads $6800. 9 References Campbell, C., & Evans, N. J. (2018). The role of a companion banner and sponsorship transparency in recognizing and evaluating article-style native advertising. Journal of Interactive Marketing, 43, 17-32. https://doi.org/10.1016/j.intmar.2018.02.002 Johnson, M. S. (2020). Regulation by shaming: Deterrence effects of publicizing violations of workplace safety and health laws. American Economic Review, 110(6), 18661904. https://doi.org/10.1257/aer.20180501 Macfarlane, M. A. (2014). Sustainable competitive advantage for accountable care organizations. Journal of Healthcare Management, 59(4), 263271. https://doi.org/10.1097/00115514-201407000-00006 Vinichenko, I. (2019). Formation of the investment management system activity of agricultural enterprise. Efektyvna ekonomika, (4). https://doi.org/10.32702/2307-2105-2019.4.6 Angood, P., & Birk, S. (2014). The value of physician leadership. Physician Exec., 40(3), 6-20. https://doi.org/10.1108/lhs-03-2014-0020 
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