A merger or acquisition is more than a change of name or a change of leadership. It is an enormous operational and cultural change for everyone involved on either side of the deal. Both the incoming and outgoing operators have
their own needs, priorities and histories, and the more each party can understand, anticipate and meet the other’s needs, the more straightforward the process will be.

To achieve a seamless integration, there must be a road map that drives the full scope of clinical and other operational changes expected to occur. Management should not focus its attention solely on changes that directly affect target goals and profits, but those that indirectly affect them as well.

Below are a few tips for achieving better clinical and operational outcomes during M&A transactions:
Keep an Open Line of Communication
Understandably, there are certain details that cannot be communicated early on while due diligence and contract negotiations are taking place. But do not wait too long to bring employees into the fold. They already have a lot on their plate just trying to get through the tasks of each day, and adding the stress of a merger or acquisition can be very overwhelming—especially if they feel kept in the dark. As an investor who will likely be calling many of the employees their own, it would be beneficial to establish a level of trust from the beginning, by being open and honest about plans for the organization.

Speaking of trust, do not lose sight of how organizational and clinical changes will impact the patients and residents of the facility; they too should receive timely notification of the change. Note that if any rate changes are slated to occur, the provider is legally required to provide adequate notice.

Align Your Talent Strategically
While there are many similarities in the way a merger and an acquisition are managed, one area where they differ is staffing. A merger is more likely to result in duplicative roles, so decisions will need to be made on retaining and/or potentially relocating staff. Investors will want to consider the quality and skill sets of staff they are inheriting, and weigh that against the challenges of recruiting new talent in today’s job market.

In an acquisition, the buyer may need to consider adding a layer of management, especially if they have added multiple properties to their portfolio. Rather than operating each property independently, a regional or corporate management team can be better positioned to employ standardized processes and lead organizational change. This responsibility should not be shuffled onto just anyone, though—make sure this individual or individuals have the right credentials for the role.

Standardize Protocol and Workflows
From an employee’s perspective, one of the most frustrating aspects of a merger or acquisition is the lack of an established workflow. Some employees become so agitated that they end up leaving the company. To prevent poor employee performance and avoid loss of essential talent, evaluate both sets of protocols and decide early on which one will be retained. This should include processes not just for clinical, but also revenue cycle management, financial management and human resources. Once protocols are established and communicated, employees should receive training or refreshers on the systems, policies and workflows they are expected to adhere to.

Cover Your Bases With MDS Assessments
To participate in Medicare and/or Medicaid programs, long-term care providers must participate in Minimum Data Set (MDS) assessments to help ensure quality of care. During a change of ownership, the operator must decide whether to assume liability of the current operator or decertify it. When liabilities are not assumed, the facility is not considered certified. Therefore, all residents must have an MDS discharge assessment completed and an MDS admission assessment completed under the new ownership. When liabilities are assumed, an MDS discharge assessment is not required.

Address Cultural Integration
At the end of the day, it doesn’t matter how well an organization is positioned strategically or financially on paper if the human factor is lost along the way. The individuals on the ground are the ones who are greeting the patients, administering their medications, issuing invoices, collecting revenue and everything else in between. These are of course all standard tasks that occur daily in every facility, but the manner in which they are executed could vary drastically—depending on the company culture.

An organization’s values, beliefs, attitude, communication style, work ethic and management style all play a role in a company’s culture. When separate entities with two unique identities come together, they must work to create harmony. If cultures collide and employees resist change, then morale, productivity, retention and patient care will all suffer consequently. The shift from two existing operating models into one is a challenge that can only be met with extensive research, planning, communication and collaboration.