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Genesis Healthcare and Le Dung Son, MD, Podiatrist Synthesis

This semester I completed part of my internship at Genesis Healthcare. I found out about this

internship opportunity from a close family friend, Jacob Lorhri, who also completed an internship with

Genesis at the same location. With the help of my academic advisor, Mrs. Carrie White and Genesis

Health Care Administrator Chris McBee, I was able to complete this wonderful experience. I completed

my internship at the Follansbee, West Virginia location of Genesis Healthcare, which is a 54 bed facility.

Genesis Healthcare was created in 2003 as a spin-off of Genesis Health Ventures. In 2003, the Board of

Directors for Genesis Health Ventures decided to separate the company’s in-patient care, forming Genesis

Healthcare. Genesis is privately owned with its mission statement stating “We improve the lives we

touch, through the delivery of high quality healthcare and everyday compassion.” Throughout this

internship I worked under the supervision of Doug Wagstaff, Director of Nursing, and Chris McBee,

Healthcare Administrator.

Genesis Healthcare is one of the nation’s biggest skilled nursing and rehabilitation therapy

providers available, and employs approximately 95,000 people. Genesis has continued to increase in size,

and now extending their locations to 500 facilities in 34 states. As we continue to age as a community,

Genesis plans to keep seeing the increasing rate of residents, as well as growth and development of new

facilities. Genesis Healthcare is a very important within its industry, as stated earlier, Genesis is one of

nation’s largest skilled nursing and rehabilitation providers, therefore is one of top profit producers for the

Genesis Organization.

Genesis’s main competitors include but not limited to National Healthcare Corporation, Corvel

Corporation, Health Stream Inc., and Capital Senior Living Corporation. Genesis Healthcare’s

organization’s competitive advantage is their competitive compensation and benefits purchase, as well as

being known for their honesty and integrity for caring shown to those that work with or for Genesis.

The only Financial Analysis I was able to use was “PPD”, Patient-Per Diem. The patient-per

diem for Genesis is the amount each facility can spend on each patient per day. Each patient will have

different needs, in which patient-per diem will fluctuate among the residents of a certain facility. The only

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month of “PPDs” I was able to view showed Genesis being over budget, in which some name brand items

were substituted for a generic brand of the certain items. By Genesis purchasing generic brand over name

brand, they were able to adjust the budget to be in a situation to reach budget for the month of June.

Genesis’s Marketing Plan is to make one’s stay as short as possible when placed in it Power back

Rehabilitation program. When placed in Genesis’s Power back Rehabilitation program, a resident will be

graded in the “RUG category” in which a resident will have a certain amount of visits and minutes

available. Once the visits and minutes run out, a resident will be regraded to see whether or not he or she

will need more time in the rehab department. Genesis offers a virtual tour on their website in which they

use as a marketing program, as well as having all their information about the facility available online on

their website.

My internship employer was very well organized. Chris McBee, my employer, was very neat, as

well as having documents filed and located in proper location where access to these was available upon

request of other staff members. The management philosophy shown by Mr. McBee was a “Lifestyle

Coaching” technique. With the Lifestyle coaching aspect, one practices supporting other individuals

through the process if achieving a specific result. The training I received was of Lifestyle coaching along

with the seven key servant leader practices. I feel that the training I received through Mr. McBee gave me

an advantage in helping myself in a Leadership role and in the role of critical thinking “on the spot”.

Genesis uses technology in every aspect of the facilities roles. By having access to all information

on computer systems, decision-making can be an easier process. By having the technology up-to-date,

Genesis is able to operate at an efficient level, where one can access what he or she needs at a single

request.

My overall personal experience was a wonderful experience in the Healthcare Administration

role. With my supervisor accepting a new position midway through my internship, I was not able to

complete a project, but instead experience working in every department at Genesis, from the

Administration role to Housekeeping, along with being able to attend and participate in a “site visit”. I

had many fun moments along with challenging moments throughout my internship. One moment over the

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summer sticks out to me particularly in my memory. I was working in the Recreation Department with a

skilled nurse named Charlotte, for privacy rights I will only use her first name. In the Recreation

department, Charlotte would develop different programs for the different groups of residence, each being

equally time consuming along with challenging the residents for full potential of the task. On this

particular day I was helping Charlotte with a group recreation of The Alzheimer and Dementia suffering

residents. The activity we completed was looking through magazines for pictures the struck a memory in

the residents life, once he or she found the pictures they wanted, we assisted them on cutting them out of

the magazine and gluing them onto construction paper. As I was helping one resident she suddenly

became very confused, but instead of being upset with what we were doing, she was upset with herself

and the grief she was causing me. Instead of getting upset with her, I explained to her that it was okay,

and we did not have to complete the magazine collage right now. After I got her calmed back down, I

asked her to tell me a little about herself. Once I asked this resident this, her face went from a confused

state, to a resemblance of young child on Christmas morning. After we each discussed our lives, we

finished the activity, then went to the cafeteria for lunch. Once I helped Charlotte get all the residents

down to the cafeteria for lunch I went back by myself to clean out the mess left from the activity so

Charlotte could have her lunch. As I was just about finished cleaning Charlotte returned and asked to

speak with me. At this point, my heart was racing as I thought I might have handled the situation with the

elderly woman being confused. As Charlotte and I talked, she explained to me that what I did for the

woman was a wonderful deed that should not go unnoticed. The only thing I could do was smile and

thank her for the wonderful compliment. After I was able to gather my thoughts I told her that her

compliment and the woman being happy, rather than confused was enough for me. The look Charlotte

gave me was a smile that was a mile wide, and at the moment she made a comment to me that will forever

stick a vivid memory. Charlotte told me “if you put forth that much effort, and that much caring

compassion into your career, there is nothing that will stop you of reaching your goals.” After she told me

that, I was in shock, a fellow employee who had only knew me for a short couple of months, thought that

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highly of me. When I have hard times or days with my college work, I think back to this day, and what

Charlotte said to me helps get me through the struggle I was enduring.

I feel my performance in my job was at a rate of a competitive level. What I learned about the

industry of Genesis is to truly run a top facility you must find the perfect blend together concentrating on

the business standpoint as well as making sure your residents receive the best care possible for them. If

you can find the perfect blend of these two aspects, you can have a highly successful facility. I was able to

apply classroom concepts into some areas of my work duties, however I had to use Critical Thinking as

well as trusting my “gut instinct” on certain scenarios rather than use a school taught skill. Some of the

strengths I showed was being early every day, strong people skills, and being very passionate about my

work. Some skills I need to improve on are my multi-tasking skills as well as learning how to balance

between operation and direct interaction. The prospects for future success of Genesis is, I feel they will

continue to grow in size and success. After completing part of my internship with Genesis Healthcare, I

feel that I would also like to see the clinical aspect of the Healthcare Administration role before making a

career choice.

For the second part of my internship I experienced the clinical aspect of a Healthcare

Administrator. With my father having surgery this past fall and needing my assistance with his recovery

along with managing our family farm, Mrs. White and I decided I could complete the rest of my

internship with Dr. Le Dung Son’s Podiatrist Clinic. Dr. Le Dung Son’s Podiatrist Clinic is located in two

locations, the first is his main clinic Glen Dale West Virginia, while his second location is generated for a

more rural community at Sistersville General Hospital, in Sistersville West Virginia. Dr. Le’s clinic was

founded in 2000 by himself in which is privately owned and strives on the mission statement “to provide

the best possible patient care to all patients.” Under the supervision of Dr. Le, my job duties were those

of the administrative role. With my job duties I experience the scheduling, charting, and I also shadowed

Dr. Le through a few procedures.

Dr. Le’s clinic is part of the healthcare industry. The clinic is small, but it also serves as the

“home base” for several satellite clinics served by Dr. Le. Minor Podiatry procedures are handled at the

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clinic such as trimming toenails, removing ingrown toenails, shaving bunions, and the casting of

orthotics. Surgery and more complex procedures are performed at nearby Reynolds Memorial Hospital.

The clinic has, along with its off-site services, a constant patient flow. As the area population ages, an

increase of age related symptoms can only raise the patient volume. If we take in to account the changing

insurance environment and factor in the increasing age relation, the volume can only grow. The

significance of the Le Podiatry Clinic within the healthcare world is positioned by the “walk-in” policy of

patient care. Removing the necessary t

The main competitors is the Glendale Foot and Ankle clinic and the multiple podiatrists located at

Ohio Valley Medical Center. The “walk-in” policy gives the clinic a competitive advantage. The local

competitors will schedule appointments or suggest you go to your local emergency department if you

cannot wait. Dr. Le’s flexible and patient first policy is one-of-a-kind in this area.

When the Le Clinic was founded in 2000, Dr. Le established it on minimal budget. The growth in

assets has been accomplished by keeping expenses low and offering exceptional patient care thus

increasing the volume along with the revenue. Outsourcing the billing component of the clinic allows

optimum revenue capture. Removing the necessity of a billing staff also eliminates overhead. With billing

off-site, all attention is focused on providing the best possible patient care. Another important factor has

been not to grow so big, that expenses are more than income. The clinic is dated and small, but remains

manageable. Expense is geared to improving direct patient care and not toward being modern in style.

The Le Clinic’s marketing effort is directed more to interaction with the general public rather

than billboards and ad space. Hands-on health fair participation is the marketing favorite. Meeting

potentials patients face-to-face, listening to their experiences whether good or bad, getting to know their

families, increase the likelihood that you will threat them in the clinic. While the clinic does not conduct

research or customer feedback, word of mouth increases in volume. Patients will often share that family

or friends had nothing but good to say about Dr. Le and they encourage them to make an appointment.

The clinic will sponsor youth sports and ads for the betterment of the community when requested.

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The Le Clinic is organized as Dr. Le being the CEO/Chair and Lynn Rogers as the office

manager. The organization is so small that Dr. Le makes the decisions and policy is directed from him.

The management philosophy is one of the patient care being the best possible at all times, no exceptions.

Patients will always receive one-on-one attention, unlimited time for questions, and concerns, and the

option to phone Dr. Le when they need immediate attention. I received training directly from Dr. Le. I

worked alongside him and he instructed me as we worked. When he felt I needed to work with his office

manager, he would tell Lynn and myself what he wanted me to do that day. I felt my training was most

effective and adequate as I learn the best when I am allowed the opportunity to actually perform the task

rather than just read about it or listen to it being explained to me.

Dr. Le is very old school. No EMR for him, he is all pencil and paper. He will use the internet to

look up symptoms he finds questionable, but does not use a laptop. He has a desktop computer in his

dictation room he uses for research. The technology of his clinic is dated and light years behind the

healthcare industry.

I did not complete a single themed project, rather I worked a typical office day. I went to work

thinking that whatever the day would bring, that I would learn from the experience. Dr. Le was open to

including me in all aspects of the day. My organization was to be readily available at all times, do

whatever was asked of me, and to not be afraid to ask questions (after the patient left). Dr. Le is a great

teacher and I feel the project helped him realize the great knowledge he has to share. I ask a lot of

questions, a lot, but he was most patient and understanding. I learned from the project the importance of

patience, always making them feel he or she is the important, and that no question is stupid or wrong and

deserves an answer that satisfies the patient.

Dr. Le does many office procedures. He provide the chance to experience removing an ingrown

toenail, “burning off” warts, shaving bunions, casting inserts, and injecting tendons.

It would be difficult to choose one moment that highlighted my experience with Dr. Le’s Clinic.

The procedures were challenging and sometimes difficult as I have not been exposed to blood and

infection in such a variety of situations. I must admit the smell was something I had a difficulty accepting.

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I have not previously known “burning skin” and it was disturbing and rather sick-to-my-stomach

sensation. Dr. Le found it funny, but was kind and reassuring. He reminded me that it was just something

you get used to and one day you no longer notice the burning smell.

I feel I performed well in my job. I made an honest effort to do everything I was asked to the best

of my ability and I was not afraid to ask questions or ask for instruction. Dr. Le was easy to work with

and so was Lynn.

I learned there no constant in healthcare and you must keep yourself informed and educated.

Rules and regulations are always changing and you will quickly fall behind and to recover is not an easy

task. Technology is a large component and critical to patient care. I applied classroom concepts in patient

interaction, regulations, and patient confidentiality

The strongest skill I observed in my internship was the Le Clinic’s ability to use communication.

Communication between Dr. Le and patients, communications with his office manager, and

communication with facilities that Dr. Le refers. Without communication Dr. Le would not be able to run

his clinic at the level he expects it to be.

The greatest weakness is the lack of technology. I feel the clinic would increase its volume and

decrease the time spent on medical records if it were to move forward with EMR. Scheduling would also

be more efficient if it were computer based. Cost would initially be expensive, but in the bigger picture

would be recovered in opening more time for patient care and less for progress notes.

The future success of the clinic should be promising. The “Baby Boomers” are coming of age and

with age comes new medical needs. The “walk-in” concept will continue to encourage the instant

gratification generation to become affiliated with Dr. Le.

To conclude, I am more driven to provide the best possible patient care. Both of my internships

instilled in me that success is measured by patient satisfaction and compassionate care. I was positive

patient interaction and an open door communication. I feel I can take what I have learned and experience

from both my Genesis Healthcare and Le Podiatry Clinic and use it as guidance I will be able to become a

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successful Administrator. After seeing both the Skilled Nursing and Rehabilitation Facility side and the

clinical side of Healthcare Administrator I feel I would be more comfortable working in the clinical side.

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Sources

1.) Chris McBee, Personal communication, June 15,2015

2.) Doug Wagstaff, Personal Communication, July 29,2015)

3.) http://www.genesishcc.com/career-opportunities

4.) Dr. Le Dung Son, Personal Communication, November 24,2015)