Clear Protocols as Important as Everamid Healthcare Staffing Shortage

By Chris Zuccarini, Managing Director, National Healthcare Practice and Jennifer Negley VP National Healthcare Practice

Staffing shortages have hampered the United States economy since the onset of the COVID-19 pandemic. This shortage is particularly acute for the healthcare industry which faces a growing scarcity of trained professionals.

Healthcare employment has declined by 2.7% since the start of the pandemic. That exceeds the overall workforce decline of 2.3%. Low medical school admissions indicate that the situation won’t improve any time soon. The Association of American Medical Colleges predicts that by 2030, there will be a shortage of between 42,600 and 121,300 physicians in primary and specialty care. To make matters worse, nurses, home health aides, and medical assistant positions also have become difficult to fill. 

The staffing shortage has several causal factors. Baby boomer workers are retiring, with many choosing to retire early due to the pandemic. These exits combined with the shortage of trained professionals has led to numerous unfilled positions. This can lead to employee “burnout”— feeling exhausted and overworked— among those remaining employed. These employees are under greater stress as they have fewer peers to rely on for assistance.

Meanwhile, higher salaries are eating the payroll budget. The talent shortage has also given existing workers the power to demand higher salaries. For workers earning less than $60,000 per year, the reservation wage—the minimum acceptable wage for a job—increased by 26.4% from March 2020 to March 2021. Physician compensation has increased 29% since 2017, almost double the cumulative rate of inflation. Organizations must find creative ways to
enhance recruitment efforts when their payroll budget goes to fewer employees.

Measures to address staffing shortages

Many healthcare organizations enlist help from traveling professionals and clinicians to compensate for the scarce available talent. New employees may need to quickly learn an organization’s processes upon joining. However, rushing training can result in mistakes that could lead to costly outcomes.

All healthcare workers temporary and permanent—need to be thoroughly trained on an organization’s procedures so they adhere to precise protocols. Implementing an onboarding process that makes clear risk and responsibility is also beneficial

The risk of putting profits ahead of patient care

Another factor affecting the healthcare space is the rise in mergers and acquisitions. Some organizations engaging in M&A activity may take measures to cut costs to boost profitability. These measures may include laying off staff and eliminating positions. These organizations may pay the price, though. Scaling down a workforce can result in burnout for those who remain. 

Physician-related studies consistently show a strong association between medical staff burnout levels and errors that result in malpractice suits. Likewise, profit-driven decisions that harm patients can lead to costly lawsuits. Losses incurred in this manner are likely to be excluded from coverage under medical malpractice policies. 

Striking a balance with limited resources

Many healthcare organizations will have to implement creative recruiting techniques and benefits strategies as they struggle to fill open positions. Hiring candidates from outside the area can play a role in this. There is no evidence to suggest that someone from outside a region would be any less competent in their profession. Still, organizations should have firm onboarding protocols to assure that all employees are following standard procedures. Benefits are now an important part of job acceptance decisions. Benchmarking against the competition is a good way to see if some benefits enhancements could help with recruiting.

With creative recruiting and attractive benefits in play, organizations should then prioritize the mental and physical well-being of employees. Limiting hours and encouraging time off can keep employees from becoming overworked. Structuring departments to prevent any one individual from carrying too much stress or responsibility can also reduce burnout. Employees make fewer mistakes when they are rested and focused, decreasing the chances of legal action being taken against them. 

While the interplay between malpractice insurance cost and benefit offerings would not seem clearcut at first glance, we now know one can directly impact the other. Working with an experienced team dedicated to the healthcare space versed in both sectors can make all the difference. 

For more information on this topic and other insurance options, please contact Jenn Negley, Vice President, Risk Strategies Company, 267-251-2233 or JNegley@Risk Strategies.com.

What to do BEFORE considering a private equity transaction

by Marc S. Beckman, J.D.

We have numerous clients who have completed private equity transactions and many more that are considering them. The allure of senior physicians monetizing a practice value together with the promise of fewer administrative headaches can be too great to ignore. Private equity transaction costs are particularly high and many physician practices are not prepared for some of the pitfalls and other surprises that await them. Some relatively simple advanced planning can save a practice a substantial amount in transactions costs, including attorney, accountant and other consultant fees. 

Private equity transactions for physician practices come in many forms. The most common structure involves the sale of the practice’s non-clinical assets to a buyer management services organization (MSO) and the sale of clinical assets to a new buyer professional entity (or the restructure of the existing professional entity) (collectively, the “Buyer”) in exchange for purchase price cash and rollover MSO equity. 

Compliance Audit

Far and away, the most important planning if a practice thinks it might consider such a transaction is to conduct a comprehensive compliance and billing audit. This should be done far in advance of any serious private equity transaction. Allow your counsel to manage this process in order to best preserve attorney-client privilege. The private equity backed Buyer is going to conduct extremely thorough due diligence. This process will involve much more than merely reviewing billing and coding history. This is especially true if the practice maintains ancillary revenue streams that might otherwise make it more attractive for private equity, such as imaging services such as ultrasound, MRI, PET, CT, clinical laboratory and/ or pathology services, radiation oncology, real estate, ASC and/or billing services. 

Among other issues, the due diligence process will undertake a critical review of the practice’s compliance with the highly technical and often misunderstood elements of the federal and state physician self-referral prohibitions (i.e. “Stark Law”). Accordingly, the practice’s historic manner and method of allocating revenue and expenses will be under the microscope (i.e. its compensation plan), including, for example, whether the practice is fully satisfying the myriad of elements involved in the Stark Law group practice and in-office ancillary services exception. Too many practices that do not undergo this self review presume they are in compliance but find that they are not when they are far into the expense of the transaction. Another common example is a heightened review of all real estate leases, particularly parttime and/or block leases with referral sources. Over time, some may have lapsed without executed renewals or the rents have fallen out of fair market value. Same issue applies for independent contractor relationships. 

Another common trap for the unwary involves excluded personnel. All medical practices participating with Medicare and Medicaid must ensure that no excluded persons are employed or contracted by their practice (whether as a billing provider or administrative staff person) and regular review of the excluded provider lists must be conducted to avoid utilizing such an individual, even if such person misrepresents themselves. While many practices have a vague familiarity with these issues, most do not engage in critical self-examination to ensure compliance. 

Why is this attorney guided advance review so important? Because the private equity Buyer will typically require the Seller practice to address these issues in the most conservative manner possible. That would include full self-disclosure and repayment of offers to pay penalties. In addition, it may also require significant escrows out of purchase price proceeds to secure future potential payments and indemnification obligations to the Buyer. Further, the advance review provides an opportunity for the practice to control the result based on its own risk tolerance and without being dictated by the Seller. We are aware of numerous instances when highly technical but financially insignificant compliance error resulted in literally millions of dollars of potential repayment and escrowed dollars significantly reducing the benefit of a private equity transaction.

Document/Contract Review
Regardless of whether a practice follows the above suggestion for an audit, a second significant cost-saving measure is for the practice to thoroughly prepare its paperwork in advance of the transaction. A substantial and often unnecessary cost of a private equity transaction is organizing and chasing down so much of the paperwork necessary for the Buyer and its counsel. Among the items most commonly requested is the evidence of admissions of all current practice owners and redemption of prior owners. Third-party payer agreements and vendor contracts are also notoriously hard to track down. Many will need to be terminated or assigned as part of the private equity transaction and therefore it is helpful to know the underlying terms of these documents. Longer term vendor or service contracts that may not be easy to terminate. Similarly, any liens or open lines of credit will need to be addressed. Even a zero balance line of credit needs to be closed so a lien termination can be filed, and this filing may take much longer than it should and hold up the transaction.

Employee census information should be maintained and kept up to date. The practice needs to ensure all contracts with employees and independent contractors are fully executed and maintained. Malpractice policies may need to be terminated, reporting endorsement (i.e. “tail”) may need to be priced and purchased including for the practice entity. If known in advance, some of these transaction costs can be more easily negotiated with the Buyer. There may also be planning opportunities for the practice as it will be terminating its defined benefit and defined contribution retirement plans. 

Another issue often overlooked until late into the process is patient and payer credit balances. This is money that the practice must account for to be refunded or turned over to the state register for unclaimed consumer credit balances. This can be an unpleasant surprise for practices that have allowed these balances to accumulate over a long period of time. A regular and routine process for reducing these balances can save a practice significant headaches and potential cash flow issues during the transaction process. 

Finally, before seriously entertaining a private equity transaction, physician practices are encouraged to have their corporate accountants collaborate in advance with their legal counsel. There are numerous potential tax implications to the transaction as well as the structure of the practice post-transaction that should be understood. Understandably, accountants are frequently concerned about the tax structure of the transactions promoted by the private equity backed Buyer, and will want the opportunity to weigh in before it’s too late.

Some advanced planning and consulting can go a long way toward saving a physician practice significant transaction expenses later. 

Marc Beckman is a member at CCB Law, a boutique law firm focused on providing counsel to physicians and healthcare professionals. He can be reached at 315-477-6244
or mbeckman@ccblaw.com.

TDO: 35 Years of Training for Manufacturing Success in CNY

By: Elizabeth Landry

Celebrating 35 years of support for local manufacturing businesses, TDO (Train, Develop,Optimize) is a not-for-profit in Central New York that provides coaching, consulting and training. The organization’s mission is to help local manufacturing and technology companies grow and prosper through operational excellence. TDO serves as the MEP (Manufacturing Extension Partnership) center for the CNY region, which encompasses Madison, Cayuga, Cortland, Onondaga and Oswego counties. With diverse talent on TDO’s team and a wealth of partners and resources, TDO can provide services to any kind of manufacturing company within the region, from aerospace and defense and precision machine shops to the food industry, medical device manufacturing and commercial manufacturers.

In the time since TDO was created in 1988, the specific needs of the varied manufacturers in CNY have evolved, and the organization has evolved alongside them in order to continue its mission. James A. D’Agostino, CEO and MEP Center Director at TDO, explained how the organization has changed over the decades while always remaining true to its focus on manufacturers.
 
“Over the years, TDO has evolved from an organization that focused mostly on training to an organization that is more all-encompassing in terms of consulting, coaching, training and being a conduit to resources in the community. I like to think that the TDO of today is very well-rounded with assisting manufacturers with their various needs. It really is the natural growth of the center,” he stated.
 
Productivity and Growth Assistance
 
When TDO helps a manufacturer optimize its productivity, there are many options that may best suit the manufacturer’s unique needs. Strategies include Kata coaching (a type of mindset-shift training and coaching aimed at better problem solving, scientific thinking, and daily continuous improvement), Lean Six Sigma training (strategies for waste reduction and project completion improvement) and other assistance with quality management systems, supply chain management, and health and safety systems.
 
D’Agostino expanded on the different strategies that are implemented based on each manufacturer’s goals. “We ask questions like, ‘Where does the company want to be over the next few years?’ and ‘What are their lofty goals?’ We then take those goals and work with managers, supervisors and technicians to break them down into bite-sized chunks and achievable target conditions we can help them strive for. Sometimes, that means we focus on training. Sometimes, training is an obstacle and we need to provide some type of Lean training or quality training to help achieve the next target condition that will ultimately help them get to their lofty goal. Sometimes, it requires us to do a formal, structured improvement event. There are a lot of ways we can help support manufacturers toward their productivity goals,” he said.
 
Similarly, TDO’s services aimed at manufacturing growth involve varied approaches based on each company’s individual needs. Lean Six Sigma training and coaching is necessary for more technical challenges. Many times, manufacturing companies want to become ISO 9001-certified or AS9100-certified, which are often required for the aerospace, defense and automotive industries, among others. To help achieve these goals, TDO’s team includes certified lead auditors who can guide manufacturers along the process for certifications that will then allow them to grow their businesses in meaningful ways.
 
Sometimes, manufacturers express a desire for improvement in areas that TDO’s team isn’t fully capable of supporting. In those instances, TDO relies on its robust network of partners and resources in the region. With partners who are sales and marketing strategists, brand experts, HR consultants, accountants and authorities on leadership development, among many other specialties, TDO offers connections with a wide range of support for the manufacturers they serve.
 
“We tell manufacturers that it doesn’t matter what the need is – if they have a question or need a resource, they can reach out to us. If their need doesn’t fall into TDO’s core competencies, we’ll find someone who can help,” D’Agostino emphasized.
 
 
“Anti-consulting” Model for Documented Success
 
After TDO completes a project or a series of projects with a manufacturer, the manufacturer receives a third-party survey containing 10 questions aimed at measuring the efficacy of TDO’s services. The survey asks the manufacturer if TDO’s training helped them retain jobs, create jobs, retain sales or grow sales, make investments and save money. Based on aggregated survey results, TDO receives a quarterly report card with a score out of 100 total points. Over the last 17 quarters, a vast majority of TDO’s scores have been a perfect 100, and D’Agostino attributes this high level of success to what he terms the organization’s “anti-consulting” model that differs from the way traditional consulting firms operate.
“The unique thing about working with TDO is we’re unlike other consultants that can go in and do a job or a project and walk away regardless of actual results because they don’t really have any skin in the game, so to speak. That’s why consulting can sometimes get a bad reputation – employees see these high-paid consultants swoop in, shake things up and ultimately leave a mess,” D’Agostino explained. “We at TDO have skin in the game through the report card metrics. If we don’t deliver on whatever that scope of work is – if we don’t help them grow their business or be more productive – our report card will reflect that. We really have the ‘anti-consulting’ model in a lot of ways because of our well-documented and proven results. The report cards are a testament to the impactful nature of our work at TDO, creating jobs, sales, cost savings and investments.”
 
Along with the report card metrics, another aspect of TDO that contributes to the organization’s proven results and efficacy is the small yet incredibly talented and experienced team. With only seven full-time team members, TDO must remain extremely efficient and effective in its work to support the approximately 2,000 manufacturers in the five-county region it serves.
 
D’Agostino stated this need for efficiency is an important part of the “anti-consulting” model, as well. “We have to be very, very good at what we do for these manufacturers. We have to get them up and running, help them be more productive, grow as quickly as possible and make them self-sufficient so we can move onto the next manufacturer in our region who needs help. Most other consultants have an underlying personal goal of staying there with clients as long as possible in order to keep their revenue flowing, but it’s really the exact opposite at TDO,” he said.
 
 
Although the team at TDO is small, each staff member’s diverse talent and experience is crucial to the organization’s success. Prior to joining TDO in 2018, D’Agostino ran a high-volume automotive manufacturer for several years. Other team members have also held high-level professional roles in various capacities at manufacturing companies, such as plant managers, operations managers and general managers.
 
For D’Agostino, the wide range of skills and experience the TDO staff exhibits is what allows the organization to reach manufacturers on a human level and provide tangible support that matters most. “We love helping everyone from the company owners down to the technicians out on the floor. Sometimes that help means taking a phone call at nine o’clock at night because a business owner has nobody else to talk to and really wants to talk through decision-making strategy. I really pride myself on helping manufacturers, and it’s not just me – it’s the whole staff, because of our background and our professionalism. Everybody brings that same mission and assistance-type mindset to TDO’s work. We wouldn’t exist at TDO, and we wouldn’t be nearly as effective as we are, if it weren’t for our amazing staff,” said D’Agostino.
 
Connecting Manufacturers with Available Funding
 
One of the most important ways the TDO team supports local manufacturers is by helping them secure available funding through several sources. As the regional MEP for CNY, TDO has exclusive access to manufacturing funds through the two local utility companies, National Grid and NYSEG/RG&E, which are very lucrative grants ranging from 40-60% reimbursement for productivity and growth projects. 
Additional funding is available through the Workforce Development Institute (WDI), CNY Works, SUNY workforce grants, capital funds through Empire State Development, tax credits, and the list goes on. TDO has excellent relationships with contacts at these entities and can connect local manufacturers with the appropriate contacts and help guide them through the processes. Importantly, even if TDO can offer the services associated with the funding, manufacturers can choose to work with any consulting organization of their choosing, and TDO can simply serve as the connection to the funding.
 
When D’Agostino was leading a local automotive manufacturer several years ago, he never knew about TDO, nor did he know about the various funding opportunities available to manufacturers. Subsequently, he is very passionate about spreading awareness of the available funding in his role as CEO and MEP Center Director at TDO.
 
“I want folks to know that there’s money out there. If manufacturers are spending money on third-party resources, they should absolutely call TDO if they’d like some support. We serve as a conduit a lot of times, connecting manufacturers to the right folks and becoming a trusted advisor. We’ll make those warm introductions as necessary and coordinate meetings. It’s just another way we support manufacturers in our community,” said D’Agostino.
 
Preparing Manufacturers for the Future
 
Looking ahead to the next 35 years for TDO, the staff plans to continue carrying on the mission of the organization and spreading the word about the resources and funding that are available to manufacturers. “When people say that we’re the best kept secret, it’s a compliment, but it also shows we have a lot more work to do. There are still startups and mature organizations who are unaware of all that’s out there,” explained D’Agostino.
 
Additionally, D’Agostino hopes to help prepare manufacturers for the way the local technology landscape will change when Micron is established in the community. This change certainly presents new challenges for manufacturers, but it can also present new opportunities.
 
“All manufacturers need to prepare for the big Micron growth in the region,” he said. “Most are experiencing workforce shortages now, and that’s only going to accelerate when Micron starts its expansion. We’re starting to get manufacturers to think about ways they can automate, be more productive now and work on employee retention strategies by giving employees a reason why they would never think of leaving. We’re really trying to help manufacturers not get pushed to the sidelines and left behind.”
 
No matter how manufacturing continues to evolve in CNY, though, it’s certain that D’Agostino and the team at TDO will continue to be a trusted resource to help support manufacturers through it all. “We love what we do. Every one of us comes to work with a smile,” said D’Agostino. 
 
“We’ve made great relationships in the community, and it’s really rewarding to see the growth of the region and to know we were able to play a part in that.” Jim D’Agostino, CEO/MEP Center Director 

In Pursuit of Happiness

By: Pierre Morrisseau, CEO, OneGroup

As business leaders facing new and evolving workforce challenges, we must focus on what research has been telling us for many years: Happiness at work increases productivity, creativity, and superior problem-solving abilities. It is also a solution for the attraction and retention of talent, which remains a high priority as most companies are working hard to find, develop and keep their employees. Easier said than done.

Consider these research statistics from data compiler, Gitnux:
• Worldwide, just 13% of employees reported being engaged at work.
• In the U.S., only 38% of employees reported being engaged at work.
• 56% of employees in the US feel that their employer is or could be doing more to prioritize happiness.
• 63% of employees believe that companies should offer mental health benefits.
With so few employees feeling engaged in their work, there appears to be a disconnect between employers and their employees. Our own internal surveys bear this out. These statistics are at direct odds with employers’ goals for hiring and retaining employees let alone employee productivity.

Why happiness in the workplace matters:

• Companies with happy employees outperform competition by 20%.
• 67% of employees say they are more productive when they are happy at work.
• Employees are 48% more likely to give excellent customer service if they’re happy at work.
• 60% of employees are attracted and stay at a company due to a better work-life balance.
• A happy employee is 31% more productive than an unhappy one.
• Employees who feel valued are 15 times more likely to report job satisfaction.

These statistics show that when employees feel fulfilled and happy in their work, their productivity increases significantly as does that of those around them. This points to the fact that investing in employee happiness is beneficial to both the employee and employer. We are acutely aware of the need to dramatically increase employee engagement and have undertaken a number of small- and large-scale initiatives to improve individual wellbeing and happiness. I will share this one significant effort in the hopes it might aid you in your own strategies.

For the second year following the pandemic, we closed all offices from Massachusetts to Florida and invited all employees to join us at the Turning Stone for a major event we dubbed Day of Learning. Actually, it turned into two days filled with events, breakout sessions, sidebars with various experts in finance, management, health, wellbeing and more. The entire focus was to show employees that they are important to themselves and to OneGroup. We planned the event around personal growth, fulfillment and achieving happiness—seeing the positive vs. the negative. Our post event surveys indicate we are truly moving the needle in the right direction.

Many of the concepts came from a book our management team recently read called The Happiness Advantage by Shawn Achor. His years of research into what happiness is and how one finds it is fascinating. At the heart of his work with humanity, the happiness formula is in reverse: that happiness leads to success and not the other way around. His research shows when you are happy, you see things in a positive light, you recognize opportunities and ultimately achieve greater success than those who are unhappy and negative. Achor posits societies instill a belief at an early age that happiness is your reward for success, but in fact, positive psychology research shows that happiness creates success.

We have taken this to heart at our company and although change is never easy, by focusing on happiness first, we are seeing steady improvement throughout the company as well as in our relationship with our clients.

Author Daniel Pink in his book Drive, explores motivation, a key element in achieving happiness. His message is that motivation today is acquired through autonomy, mastery and purpose—purpose over profit. He further recommends using a “now, that” method of rewarding vs. “if, then” (the historic carrot and stick process). He proposes approaching employees with: “Now that you’ve executed this work so well, you deserve a reward.”

There are many employee engagement ideas and processes for sure but the most important one is recognizing the importance of taking action—of beginning with achieving our own happiness in order to lead others.

As always, I am most interested in learning about what others are doing to solve business challenges. I would love to hear your thoughts.

The 3 Pieces of Secure Act 2.0 You Need to Consider NOW

By: Jason D. Nickerson, CFP®, EA, President & Chief Operating Officer, John G. Ullman & Associates

The Secure Act 2.0 clearly focuses on the belief that there is a real shortfall between what we have saved for retirement and what we need to have saved to retire. The new law has opened up some great opportunities for you to impact the financial decisions you have made in the past, influence decisions you can make now, and plan other decisions for the future. Here are the three key provisions you need to discuss with your advisor now to implement in your plan right away.
 
529 Conversion to Roth IRA 
 
You’ve done well in saving for your child’s college education utilizing a 529 plan. You have done so well that you have (or are projected to have) some left in the plan. In the past, we have typically talked to clients about what to do with those funds. Would you want to support your child’s advanced degree? What interest do you have in pursuing advanced personal education? What type of support would you want to give to grandchildren? Now, we can add a whole new layer of planning. What support would you want to give your child’s retirement savings? Under a new law, 529 assets can be converted by the beneficiary to a Roth IRA.
 
Pros 
• Up to $35,000 can be converted from a 529 Plan to a Roth
• Tax-free growth in the Roth IRA
• It can be an early start for your child’s retirement savings.
 
Cons 
• The conversion is taxable. You must pay tax on the accumulated earnings in the 529 when converted to the Roth.
• Limited to $35,000, lifetime
• The account must be open for 15 years.
• The conversion is subject to the annual Roth IRA contribution limits.
 
Opinion 
This is one of my favorite tax changes in recent years; however, there is much room for improvement. None of these thoughts should keep you from considering this opportunity now. Key areas that can be improved in future laws: 
 
•Eliminate taxation of the conversion. If the funds in the 529 would come out tax-free if used for education, they should be allowed to transfer to a Roth tax-free. As long as the Roth owner abides by the rules, the funds can come out tax-free.
•Eliminate the $35,000 limit, or change it to allow for more conversion.
 
Higher Catch-Up Contributions 
 
Most of us are probably already aware that when we reach the BIG 5-0, we get to make additional contributions to retirement plans. Hopefully, those of you reading are doing that now. In the new law, you need to take advantage of a major expansion of this concept. Starting in 2025, those between the ages of 60-63 can make even higher catch-up contributions of $10,000.
 
Pros 
The law is recognizing that we either need or want to work longer. We can supercharge our retirement savings in those later working years.
 
Cons
None. As an advisor, one of my key objectives with clients is to get them to save more money. 
 
Opinion
I would like to see the age decrease to 50, like the current catch-up rules. I don’t see the magic of 60-63. We know how this math works. The earlier you save, the more compound earnings can work for you.
 
Required Distribution Age increased 
 
The age for required distributions from retirement plans was increased in 2023 to age 73. That age will further increase in 2033 to age 75.
 
Pros
More tax-deferred growth and more opportunity for tax planning opportunities around required distributions
 
Cons  
Nothing comes to mind at the moment. Remember, these are required distributions we are talking about. You are still able to access funds at 59 1/2.
 
Opinion 
If people are working longer, then this change supports that by not requiring distributions until the later years. I think pre-retirees can now plan to save money in other ways (not in tax-deferred plans with a required distribution) to support cash flow if they retire before RMD age.
 
As you can see, this new law has been really focused on retirement savings. This article touches on three of the key provisions that can benefit your overall financial plan. If you want to learn more about these and how you might be able to implement them, join my free webinar on July 20th at noon for a little “lunch and learn.” Visit jgua.com/presentations to register.

What Our Customers Can Teach Us About Supplier Management

By: Don Lynch, Senior Project Manager, TDO

Are you struggling with increased component lead times, price increases, and quality issues? You’re not alone.  The COVID-19 pandemic has caused interruptions in staffing all over the world.  This has led to late supplier deliveries, increased commodity prices, and unpredictable transit times.  Some of these supply challenges are trending back toward pre-pandemic levels, but many challenges remain.
 
So, what can we do to improve the performance and predictability of our suppliers?  The answer will depend on each business’s unique needs; however, there may be a rich source of ideas within our midst. Please think for a moment about what makes a great customer.  Your list may be different than mine, but here are some of the things that have defined great customer relationships for me:
 
1. Clearly documented requirements.
2. Predictable demand.
3. Few expedite requests.
4. Collaborative approach to resolve delivery and quality issues.
5. On-time invoice payment.
6. Opportunities to win new business.
 
 
These attributes create and maintain relationships that are built on openness, collaboration, and trust.  Great customers not only allow our businesses to grow in revenue and profitability, but they also help us to improve our operations so that we can become even more competitive.  Keeping in mind that every buy-sell relationship has a customer and a supplier, how do your suppliers perceive you as a customer?
 
• Do our purchase orders and specification documents clearly provide all the information that your supplier needs to meet your expectations?
 
• Is our component demand predictable?
 
• Do we often ask suppliers to deliver within their stated lead times?
 
• How do we engage with suppliers to resolve delivery and quality issues?
 
• Do we pay our invoices on time?
 
• Do we invite our best suppliers to help us develop new products and services?
 
If great customers can help our businesses grow in revenue and profitability, are there similar opportunities with our suppliers?  Can our suppliers’ expertise help us become a great customer?  Will becoming a great customer help improve our suppliers’ performance?
 
This all sounds nice, but what about getting the best (lowest) price?  My list defining a great customer doesn’t include paying more than other customers.  Great customers want best-in-market value from their suppliers.  This helps them earn acceptable margins so that they can continue to make investments to innovate, improve, and grow.  We want the same thing for our businesses, and so do our suppliers.
 
Being a great customer doesn’t mean that you pay more than best-in-market value for products and services.  Instead, investing in supplier relationships can lead to maintaining best-in-market value while fully leveraging our suppliers’ capabilities to help us improve. Are you less than satisfied with your suppliers?  Consider asking yourself how becoming a great customer may improve their performance.
 
If you are a small or mid-size manufacturer and would like to further the discussion, TDO’s team is fully certified to help. Reach out today to learn more and schedule a free consultation!

Construction Career Aspirations Are Achievable

By: Earl Hall, Executive Director, Syracuse Builders Exchange

Long before governmental entities began to focus on “inclusivity” and other “workforce development” initiatives targeting minority, women and “disadvantaged” groups of people who may not have had a presence in particular segments of the economy, construction industry employers have tried for decades to include all people into the industry, including immigrants.
 
The United States of America provides all people equal opportunity to participate in the economy, including the regional construction industry.  Determination, self-motivation, hard work, perseverance, and the will to succeed are human attributes necessary to be successful in life and business.  Gul Ahmad Hamidi is an example of how an Afghanistan immigrant successfully entered the local workforce and pursued a career in the construction industry.
 
Hamidi was born in Afghanistan, earned a degree in Civil Engineering in New Delhi, India, and was a civil engineer and a construction project manager in Kandahar, Afghanistan.  While his career accomplishments were impressive and his future full of opportunities, it all ended on August 31, 2021, when he escaped Afghanistan on a United States military C-17 cargo plane, leaving his family behind.  
 
As an interpreter for the United States military, Hamidi was taken by the United States military and hidden for the month of August, before being rushed to one of the final C-17 cargo planes leaving Afghanistan.  While on board, he assisted pilots by communicating important instructions and information to those on the plane, which was headed for Germany.  Hamidi would spend the next several months at United States military bases in Germany and in Philadelphia, preparing to begin his new life in the United States.
 
In March of 2022, InterFaith Works of Central New York introduced Hamidi to me via an email.  He expressed a strong interest in working in the construction industry as a project manager.  After meeting Hamidi during two different interviews, it was apparent that he had all the characteristics necessary to not only become a successful employee, but a productive member of society as he embraced the United States’ way of life, freedom, and culture.  
 
After interviewing with local construction companies and having nothing more than the clothes on his back and documents from the United States government, Hamidi was hired by one of the area’s premier general contractors.  Today, Hamidi is enjoying the infancy of his construction career and the many wonderful benefits of living in central New York.
 
Hamidi is a shining example of one’s ability to pursue the American dream by applying the human attributes necessary to be successful in life and in one’s career.  He escaped Afghanistan on the very last day before the Afghanistan government collapsed, now controlled by the Taliban.   Arriving in central New York with nothing, Hamidi today has a car, an apartment, clothes, and money to enjoy the many entertainment opportunities central New York has to offer.  He continues to send money back home to his parents in Afghanistan and saves money to someday own his own business or to buy a home.
 
Hamidi’s story reinforces the notion anyone can be successful in entering and participating in the construction workforce.  Being successful in a career is not a right – it is earned.  It is earned by self-motivation, hard work, perseverance, and the will to succeed.  Overcoming adversity is something most people experience at some point in life, whether it is personal or career.  
 
Hamidi’s story is compelling and is a prime example of how citizens in New York who really desire to enter the construction industry workforce can do so, if they have the drive and commitment to be successful in life and with their chosen career.

Design Specialists: Thinking Outside the Box to Better Design Inside the Box

By Tami S. Scott

When you first walk inside Design Specialists—a Syracuse-based independent design firm established in 1988— expect to be greeted by at least one of three small dogs with big personalities. Buck, Addie, and Gretta are experts at creating smiles and welcoming guests.

Much like the business’s founder and president, Krista Taskey.

Not only does Taskey have a knack for interior design, but she also has a gift for making people feel at home and building lasting connections. So, it’s only logical that, based on those two attributes alone, her 35-plus-year career has climbed to what it is today, where 90% of her business is repeat or referrals.

“We started out as an interior design firm specializing in commercial, fee-based work, but I also sold product, such as furniture, window treatments, artwork and accessories. We realized that our clients were thrilled to have a single source for their design and procurement,” she said. “Gradually, the procurement part of the business just grew and grew, [and] now we have two businesses here—the interior design business and a window treatment business.”

The window treatment business started about 15 years ago.

“We received a call from a local general contractor who noticed that we are a certified WBE business in NYS and City of Syracuse and asked if we would consider submitting a bid for blinds for a dormitory project that they were bidding on,” Taskey said. “At that time, we had never bid window treatments to any contractors.”

The contractor convinced Taskey to try—and they won the project! Today, at any given time, two to four employees dedicate their time bidding and project managing work in the window treatment side of the business.

The concept of “thinking outside the box to better design inside the box” is the way of life at Design Specialists. “I don’t ever say no to a customer,” Taskey said. She explained that if a potential client asks for a specific service or product that they haven’t yet done, she will research the request before responding either way.

The interiors library at Design Specialists is most likely the largest commercial library in all of Central New York. It consists of samples for carpet, tile, specialty flooring, wallcoverings, paints and fabrics for upholsteries and window treatments, and other specialty product.

“One of the things that’s important about our library is that we can typically design pretty fast. Probably 99% of what we need to design a space, is right here at our office,” Taskey said. “If we need larger samples of specific items and/or additional options, we simply reach out to our vendor reps who will then ship things directly to us.”

 

Currently, Design Specialists purchases product directly from more than 100 vendors. “We only team up with vendors that will support us and our clients when issues surface, which we all know that happens more than we like!” she said.

Taskey credited a large part of the business’s success to “our great staff and our liaisons with other businesses.” 

“Some of the partners we collaborate with take care of fabricating and installing soft window treatments, framing and hanging artwork, and other specialty services.  We have long standing relationships with these businesses,” she said.

In terms of the window treatment business, “we have our own installers, they are on our payroll, they are not subcontractors. This allows us to control the quality of the work and the scheduling. Our installation team, led by Dave Reid, is top notch! Dave always watches out for us while putting the customer first. We have received many compliments that are a testament to the entire team.”

When Taskey talks about her crew, the admiration and respect she feels toward them is palpable.

It’s all about trust

When Taskey moved her business from Rome, NY to Downtown Syracuse, her first office was located in an old firehouse, which is now the beloved Wolff’s Biergarten on Montgomery Street. She moved a second time before settling 13 years ago in her current location on Joy Road in East Syracuse.

“Part of the reason I bought this building is because it has a receiving area for the window treatments,” she said. “An 18-wheeler can just pull up with the product and we can get it unloaded directly into our warehouse. Once the product is checked in by our team, we can arrange installation with the general contractors and/or clients.” 

Design Specialists serves clients within a 3-hour radius, with the majority in Buffalo, Orchard Park, and Albany. Yet, Taskey says that her company is still kind of ‘under-the-radar.’

“Not a lot of people know about us,” she said. Those that do, however, keep coming back.

“Some of our clients are at a point where I send them a quote and they don’t even want to see the finishes or the colors anymore,” she said, paraphrasing one customer who told her that ‘in all these years, you’ve never disappointed me so just do what’s right.’ “There’s a trust factor. The longer you work for a client, you build that trust and they pretty much sign the check and send it to you.”

For instance, senior living properties and continuing care communities that have independent living, assisted living, skilled nursing, and memory care are very familiar with the firm—and very satisfied.

“A lot of those clients, we do everything—finishes, lighting, furniture, window treatments—the whole soup to nuts,” she said. “At this point, really all of our business is referral or the same people over and over again—I don’t have to look for work anymore.”

Other clients include those in the healthcare, corporate, education, and hospitality markets. It’s noteworthy to mention that safety, accessibility, and ergonomics are always built into the designs.

Customer service

Imagine contacting a business that has a 24-hour callback/email policy, that doesn’t have voicemail but rather takes messages with handwritten notepads. You might ask why in this advanced technological age, but that’s how Design Specialists rolls — its relationship driven and aims to provide the best customer service for its clientele.

In fact, the DS staff knows where Taskey is, so if she’s on the road and a painter needs her guidance to move forward on a project, he can pick up his phone and call her cell. “In our business, accessibility for our clients and our contractors is really important.”

How it all started

Taskey’ s path to interior design first began by earning a degree from a community college in Ontario, Canada. Though she always felt this work came naturally to her, it was finding the right employers to teach her the industry ropes that really put her on the right path forward.

Taskey’s first job was with a dynamic interior designer in Williamsville, NY.  The move to this area found her working for a large architectural firm in Utica.  Then finally, in true Mary Tyler Moore fashion, she threw her hat in the air (figuratively speaking!) and decided to try to make it on her own.

What may surprise you is … “I never had a business plan,” she said. Rather, Taskey learned through trial and error. By making mistakes or doing it right, the business organically evolved.

When asked what her favorite part of interior design is, she said it’s making the client happy; hearing that we did a good job; hearing they’re thrilled with the results: “Servicing people,” she said. And while money is a motivator, it’s not what most attracts her to the world of design. Rather, the work is rewarding. “I think 99% of what we do here every day is positive.”

“The nursing home environment, where about 80% of our workload is, that’s even more important because for the people that live there, that is their home. I feel very blessed that I can make those spaces beautiful for the residents and the staff,” Taskey said.

The present and the future

When you walk inside the open space facility, there are three large portraits of Buck, Addie, and Gretta that adorn the left wall. The quarters are bright from the natural sun, and the walls are bedecked with bold, rich colors. Multiple work rooms are home to stacks of samples, fabrics, furniture, and artwork. And the comforting and stimulating smell of coffee brewing in the kitchen permeates the air. There’s no slowing down in sight at the DS office. 

As for Taskey’ s retirement, which she’s been asked about on occasion: Put your fears to rest, there’s no plan for that, either.

 “I still love what I do for work,” she said, “and as long as I still have that passion, I don’t see me retiring in the near future.”

For more information about Design Specialists, visit their website at designspecialistsinc.net or call 315.479.1551.

Rising Interest Rates and the Impact on Your Business

Kaitlyn H. Axenfeld, CPA/CFF, CFE, Dannible & McKee, LLP

As we move further from the height of the COVID-19 pandemic, we are seeing a drastic hike in interest rates. Over the past fourteen months, the prime rate has increased by 5.00% (3.25% in 2022 to 8.25% as of May 2023). Today’s high rates are expected to stay, if not continue to increase, which means financing is more expensive, and projects are less affordable. Interest rates should be evaluated and considered in all aspects of your business – the cost of equipment, estimating and bidding, cashflows and backlog.

When considering financing or leasing machinery and equipment, it is imperative to look at the interest rate implicit in leasing and financing agreements and compare the cash flow in the short and long term for all available financing and purchasing options. The days of 0% interest rates are gone. Implicit and stated interest rates for equipment financing now typically range from 7% to 20%.

For example, a contract that requires a piece of equipment that costs $500,000, leased or financed over five years with an interest rate of 10%, would require cash flows for interest payments of approximately $42,000 in the first year. It would be approximately $137,000 over the five years. While the average savings account earns 0.39% APY. The $500,000 of cash in a savings account, with compounded interest over the same five years, would earn approximately $16,000 in interest income. The cost of financing the equipment is almost $120,000. It is crucial to evaluate these decisions and consider the best use of available resources and the impact on short- and long-term operations and goals.

When estimating and planning jobs, it is also important to consider borrowing requirements and the impact of interest. As an example, $1,000,000 over five years with an interest rate of 3.25% would result in a monthly payment of approximately $18,000 with a total interest expense of approximately $85,000. This same loan with a rate of 8.25% would result in a monthly payment of approximately $20,000 with a total interest expense of approximately $223,000. In a little over a year, the cost of financing $1,000,000 changed drastically, with an increased monthly payment and interest over the period increasing $138,000. This is important to consider when planning and estimating jobs. What is the expected timing of purchases and outlays compared to billing the customer? Is there an option to bill for significant upfront costs? What is the timing of incurring costs and subsequently receiving billings?  If cash flows are such that borrowings from a line of credit are unavoidable, interest expense would need to be considered into account to ensure coverage of capital outlays. Streamlining payments and billings will help ensure the project stays on track and decrease the chance of liens, delays and unnecessary interest and penalties.

Not only is the contractor affected by rising rates, but interest rates also impact the buying power of investors, businesses and property owners. It’s common to rely on short-term or long-term loans to pay for construction and improvement costs. Rising rates impact the availability and qualifications lenders use to evaluate financing. The overall scope of projects increases as costs increase, but the amount of funding may not. Over time, the number of new projects may start to decrease, and existing projects may be delayed due to higher financing costs. This could lead to increased competition as there are fewer available projects.

Rising rates have a significant impact on daily operations. To remain successful, contractors must ensure that projects are estimated using anticipated interest rates and that projects are profitable enough to cover any increased financing costs. With the uncertainty of continued rate increases, contractors have to re-evaluate their thoughts on financing, specifically cash flow stability as debt becomes more expensive and implement a cash management strategy to ensure the best use of resources during this time.

Dannible & McKee, LLP, is a public accounting firm with offices in Syracuse, Auburn, Binghamton and Schenectady, New York.  The firm has specialized in providing tax, audit, accounting and advisory services since its inception in 1978.  For more information on this topic, you may contact Kaitlyn at (315) 472-9127 or visit online at www.dmcpas.com.

Understanding Workers’ Compensation Insurance Rates

Steven Bell, Vice President, Underwriting & Sales

On May 15, 2023, the New York Compensation Rating Board (NYCIRB) filed with the Department of Financial Services, a 2.6% decrease in the overall loss cost level in New York State, to be effective on October 1, 2023. The proposed loss cost decrease was determined by NYCIRB applying their standard ratemaking methodology.

This marks the seventh consecutive year where NYCIRB has filed for a loss cost decrease. While insurance costs have been on the rise across most lines, Workers’ compensation loss costs have defied inflationary pressures. Since 2017, loss costs in NYS have decreased on average nearly -45%.

 

During the same time, the average weekly wage increased nearly +31.6%.

There are many factors that have been driving the rate decreases such as improved loss experience and development, lower loss frequency, lower loss severity, higher wage trend factors, modest growth in loss adjustment expenses, higher benefit levels, lower catastrophe and disaster premium, and modest industry differentials. While all these factors play a role, calculated future wage trends appear to have had the most significant impact on loss costs during the last seven years. Conceptually, if the entire potential cost of losses for NYS is $5 billion, then loss cost must be set to raise $5 billion in premium. In this example, if wages are expected to increase 5%, and losses remain the same, then loss costs must decrease to generate the same amount of premium.

Loss Costs, Rates and Premium
In New York State, workers’ compensation pricing begins with the creation of what is known as a loss cost. NYCIRB collects payroll and loss data divided into approximately 580 classes of businesses such as plumbers, electricians, and painters. The loss cost is created by determining the total losses and payroll for those in a similar class of business. The result is a loss cost, which is an average unit of cost that can be charged for each one hundred dollars of payroll exposure. Carriers in NYS then apply a loss cost multiplier to the loss cost to create their rate. The multiplier, generally greater than one, is based upon each carrier’s expenses and loss experience and covers the carrier’s expenses and profit. Workers’ compensation premium is then determined by multiplying the amount of payroll (divided by 100) for each class code/business type by the carrier’s rate.

There are many factors that drive your final premium. In addition to manual rates, the final cost you pay is affected by your experience modification, the size of your payroll, the construction premium adjustment program, the payroll limitation, scheduled rating and the carrier discount. The experience rating modification is designed to adjust the manual rate to better fit an individual employer’s loss experience compared to all other employers in their class. You may have seen a larger credit or debit on your renewal due to NYCIRB’s recent change to the methodology for determining your experience modification. The construction premium adjustment program (CPAP) develops a credit for those employers who pay higher hourly wages for construction operations. Its purpose is to address premium differences between high–wage and low–wage paying construction employers. In addition to the CPAP program, employers performing commercial construction are also eligible to apply a payroll limitation equivalent to the NYS average weekly. Schedule rating credits and debits along with carrier discounts are also applied in many cases but are subjective and applied by your carrier based on their assessment of your operation. The maximum schedule rating credit/debit is 5% and private carriers can also apply a premium discount, which generally ranges from 1-15% of premium based on premium size. NYSIF can apply discounts and differentials based on their assessment of each individual insured. Policies that perform poorly may be debited and employers who are performing better than average, such as employers in a NYSIF safety group, receive as much as a 30% upfront discount.


If Loss Costs are Down 45%, Why Aren’t My Premiums?

The likely answer to the question is a combination of many of the factors noted above. Given the yearly increases in other lines of insurance, you may not be looking hard at your workers’ compensation costs as your premium may not be increasing. This is human nature, as we tend to focus on those items that are increasing in cost. However, it is wise to periodically market your insurance. If your payrolls have not gone up significantly and all other factors are equal, then your workers’ compensation renewal may be a place where savings awaits you!

For more information on workers’ compensation, contact Lovell at 1-800-5 LOVELL or visit online www.Lovellsafety.com.