How To Read An Income Statement

This is an important skill for all business owners, entrepreneurs, or anybody interested in making a business work. There are a myriad of financial forms, graphs, and other documents that are available to help you look at your business, but the income statement can give you some of the best data available. And it's really not as hard as it sounds.

Jeff Cornwall, director of the Belmont University Center for Entrepreneurship, gives the secret:

"It is important to look beyond the numbers presented in the income statement and examine the percentages that each of those numbers represents. Look at major expenses every month to see what percentage of sales is being used to pay for each expense."

The rest of the simple article gives some good examples on how to use that little nugget of information, but the key is to 'look beyond the numbers' and look at trends over time. Did you really make any money when you got that new account after all of the time spent courting them? Was the hassle of getting that custom product rushed in from a new vendor worth it financially? Will I be able to continue doing business with Medicare and the new competitive bidding reimbursements?

It's important to balance what is seen on the paper with what is going to work for your business. You may show that your initial investment in that new account is sucking you dry on paper, but it may be worth it for the future revenues. Just make sure you have a way to re-examine your loss leaders before your whole business is a loss.

One of my favorite managers to work under shared the monthly income statement with her staff during the first team meeting of each month. She stepped everybody through how to analyze the data on the sheet as well as what that data meant in relation to each person's contribution to the branch. It didn't take long before everybody felt ownership and a sense of pride when numbers were up and also felt a sense of urgency when numbers were down.

Not everybody shares financial numbers with their staff. If you don't, why not? If you do, what changes have you seen in staff productivity and ownership?

Build a Safety Program You Can Be Proud Of

How do you keep your self/employees safe in the field?

There was an interesting discussion on the MedGroup forum about delivery driver safety in bad neighborhoods after hours and late night on-call visits. We have all been there. I know that I have been in some pretty shady areas and have unknowingly asked my employees to enter into some bad areas. One day about a month ago, I had two technicians in two different cities that both felt concern for their personal safety. In one case, we didn't know the area was a rough neighborhood and in the second case, we didn't know the technician would be in the area after dark. In response, and out of concern, we held a couple team meetings to come up with a way that the drivers would feel safe when they are in the field. Here's what we came up with:

If an unknown bad neighborhood:
1. Technician in the field has the right to refuse the appointment based on feelings of personal security. (This only works if you can trust your field personnel to not use this as an excuse to slack off)
2. Office personnel mark client file as one that requires special appointment handling.
3. If technician decides to complete appointment than the steps for a known bad neighborhood are followed.

If a known bad neighborhood:
1. If at all possible, set the appointment for daylight hours
2. Technician reports in to office at arrival.
3. Technician attempts to park in a well lit area if possible.
4. Technician spends as little time outside as possible
5. Technician reports in to office when leaving appointment. (If after hours, reports in to manager by cell phone)
6. If technician does not report in to office after a reasonable amount of time to complete the appointment, office personnel proactively attempt to contact the technician. If no contact is achieved, office personnel contact the police in the area local to the appointment.

In all situations our technicians are trained to keep their eyes open and be aware of their surroundings. We double checked with one of our clients that works for the Sheriff's office that it is legal in our area to carry pepper spray. All field technicians are issued pepper spray to keep on their key chains now. The pepper spray is kept in a pocket to prevent escalating an issue unless needed. All field technicians are also trained to use the 'panic' key on their vehicle remote key fob.

We may never have a technician get into trouble or come into harm while in the field, but I would hate to think that if something should happen to an employee that there was no attempt to mitigate the problem. With the new protocols and the pepper spray ($10.00 at Ace Hardware), the technicians feel more safe during their appointments and feel part of the solution since they all contributed to the new procedures.

What are your plans to keep your employees safe in the field?

Tips and Tricks for Traveling With a Wheelchair

Stephen Hawking had the ultimate roller coaster ride when he got to experience zero gravity. Do you have clients that travel or are getting ready to travel for the first time with their wheelchair? Their are plenty of horror stories and their can be some serious barriers, but Holly at SpinaBifidaConnection.com has assembled some good tips that you can share with your clients like:

Whether the service is good or bad, get names and write them down. This alerts people that they will be held accountable-for better or worse-for their actions. If you do have a problem, save all tickets, receipts, dates, times and names.

I know that when I've had clients travel, I usually only hear the stories when they come back for repairs after their chair has been abused by baggage handlers. For some reason, the successful travelers tend to keep their tips secret.

Be a hero and share these tips in a knowledge library available to all of your clients.

Become a Grab Bar Guru [How To]

Grab bars can add a lot of safety and security to the bathroom environment. Nearly all DME retail outlets sell them. I even saw some at Albertson's today while I was shopping for groceries. But a grab bar in a box is not worth as much as a grab bar securely attached to a wall.

If you currently sell grab bars but do not offer installation services, set yourself and your company apart by adding a needed service. There may not be a huge profit margin in the grab bars, but the installation is fairly simple and labor is always good for the bottom line. This is also a chance to get into a clients home to perform a full home evaluation and find new ways you can help your client improve safety and independence at home.

Click through the slide show to get a step by step illustration of just how easy it can be to add a new service to your product line. The slide show can also be viewed as a full screen presentation for training your technicians before tackling the next job.

Now You Can Be An Ergonomics Guru

Have you ever been asked to do an ergonomic evaluation? Use Ergotron's free ergonomic calculator to help you look like a pro. The page is geared towards desk based work environments, but some of the information can be used in other situations as well. Just choose the height of the person using the workspace and the measurements for seat height, keyboard height, and monitor placement are calculated automatically.

The same page has link to an interactive workspace evaluation, and a comprehensive list of ergonomics tips.

The company sells workspace equipment but backs their products up with a large amount of education materials.

5 Steps To A Solid Sleep Surface [Hospital Bed Hack]

I have two clients on the Sentech Medical, Stage IV 3000 Low Air-Loss mattress on top of an Invacare fully electric Home Care bed that recently complained of lack of lumbar support stating that they could feel the springs in the bed surface. Both clients received their mattresses within a few months of each other and both have been using their mattresses for about a little more than a year. While each mattress had seen approximately the same amount of service time, the beds had been in the homes for widely varying lengths of time. These same clients had a history of complaining about their mattresses that usually turned out to be user error or the result of product misuse or neglect.

Both clients are tall and overweight males that transfer in and out of their beds performing a very hard lateral transfer from their wheelchairs using maximum assistance from an aide.

Upon inspecting the mattresses at the client's homes there was no problem with the mattresses. All the air sacs inflated properly and the mattress pumps were operating well without any alarms. I turned the alternating pressure function off on the mattresses as a test, but the clients were still complaining of pain in the lumbar region and feeling the springs.

Since the beds were working and the mattresses were working, it was time to come up with a different idea. Working off the premise that a Roho cushion works better on a solid seat than a sling seat, we decided to give the spring foundation beds a solid pan surface. Since Sunrise Medical has discontinued their Grid-Style bed, I don't have a regular supplier that provides a solid sleep surface except for bariatric sizes. A simple modification to my clients existing bed seemed like the most effective route to take:

Materials needed:

• 1 8'x4'x1/2" sheet of plywood
• 14 1 1/2 x 1/4" carriage bolts and nylock nuts
• Paint or other sealant
  

Tools:

• Saw
• Drill (Cordless preferred)
  
• Cobalt drill bits (Three sizes up to 1/4" diameter)

This is a simple modification that is pretty inexpensive and gives a good result. The following instructions are for an Invacare Fully Electric IVC bed, but should work for most of the 'clones' that are out there. The most important thing is to verify the measurements of the wood sheets so that they do not interfere with the function of the bed. We chose not to cover the head and foot portions of the bed since the majority of the patient weight is located in the trunk and leg portions of the bed.

Step 1 - Cut to size
Cut the plywood to size. The sheet will need to be cut down to 4 pieces to allow the bed surface to move and to allow the bed rails to attach at the appropriate location. Cut the following pieces:

1. 34 1/4" x 15 1/2"
   
2. 34 1/4" x 8 1/2"
   
3. 34 1/4" x 14 1/4"
   
4. 34 1/4" x 15 1/4"
   

Step 2 - Seal and protect
Paint the plywood with a sealant. The clients I am working with are not incontinent but just in case I wanted to make sure that the wood was protected as well as providing a dust and splinter free surface for the mattress to slide on. Thompson Water Seal or Kilz primer would work, but we picked up a can of 'oops' paint at Home Depot for $5.00.


Step 3 - Drill holes
The individual sheets of plywood need to be secured to the frame using the carriage bolts. Take the bed outside to prevent dust and metal shavings from making a mess in your clients home. Place the sheets of plywood on the bed surface and drill your holes through the wood and the metal frame.

Take your time and use a good drill bit. The cobalt drill bits are a little more expensive but will perform the job better and faster than any of the cheaper bits. Start with a 1/8" pilot hole, move up to a medium size bit and then drill your final hole to 1/4" to match your carriage bolt. By drilling in 3 steps you will be less likely to break a bit and will not need to use cutting oil on the metal frame.

IMPORTANT TIP - Watch where you drill your holes. Avoid the areas of the frame that are reinforced with tubing that provides lateral frame support. Aim your holes for areas in the frame that are only one layer of metal thick.

I like to drill one hole at a time and place a bolt without a nut in the hole as I move on to the next corner. By just placing the bolt in the hole I can still move the sheet around if I need to adjust placement or verify what I am drilling into under the wood.


Step 4 - Bolt it up
Once all of the sheets and the frame are pre-drilled, start bolting the wood to the frame. Tip - Bang each carriage bolt into the plywood with a hammer until the square shoulder embedded in the wood. Bolt on the nylock nuts with a socket or open ended wrench. You may have to turn the bed surface on it's side to access some of the nuts that need to be tightened. Keep in mind that the wood needs to be inside the perimeter of the bed frame to prevent tissue damage during transfers.



Step 5 - Test it out
Set the bed up in the home, attach the mattress, and test out all of the bed functions. The first time I tried this hack, I used a spade bit to drill holes in the plywood surface to allow the straps of the mattress to secure to the frame of the bed. The second time I learned that there was enough space between the plywood and the frame that I could slip the straps through without the extra holes.

Conclusion
It works. As soon as my clients lay on the new surface they noticed an immediate improvement. Considering a long history of never quite making these two clients happy, a smile and a thumbs up were all the proof I needed that the modification worked. The mods are almost a month old now and we haven't heard a single complaint.

If you need a quick and inexpensive solid sleep surface, this is a good alternative. We happened to have a sheet of plywood in the warehouse, but for the cost of paint ($5-10), bolts and nuts ($3.50ish unless you have a good junk drawer), plywood ($12-15), and some cobalt drill bits ($3.50 ea) you can upgrade a standard sleep surface to a solid pan very effectively.