Slide

Question 1

Name the differing types of interview questions?

Answer 1

Initiative
Motivational
Attutude
Persona (job related)
Management

Question 2

IN pre employment testing, reliability refers to?
2) in one on ones- what types of questions?

Answer 2

how dependable or consistently a test measures a characteristic
2 behavioral, competency, situational

Question 3

What is onboarding

Answer 3

The planned and executed process of welcoming, orientating and training a new employee

Question 4

Management tasks prior new hire first day

Answer 4

1.send a welcome letter, training dates, where to park, website, early access intranet
2.notify current employees of decision, new schedule and expectations
3. meet with trainers to discuss
4. inform new employee what to bring first day

Question 5

4 c’s Onboarding

Answer 5

compliance
clarification
culture
connection

Question 6

facilitate onboarding with EASE

Answer 6

Encouragment
Align
solve
End

Question 7

What is a reasonable training investment

Answer 7

1-2% of gross revenue

Question 8

Give examples of core competencies

Answer 8

Teamwork
Customer focus
Accountability
Technical skills

Question 9

Employee IDP are

Answer 9

between management and staff
can include ann goal setting
effective training tool-built on positivitiy
used to increase scope of tasks and gives employee fulfillment

Question 10

What are employee improvement plans

Answer 10

plan when employee in line for progressive disciplinment without improvement

Question 11

What is ten minute flex schedule

Answer 11

fastest growing system. 10 minute increments dependant on appt type
Most common due to flexibility

Question 12

What is preferred bonding rate

Answer 12

70% tentured doctors
25% new doctors

Question 13

What is formula for fill rate

Answer 13

booked appt/# apps in day as %
ex. 8 booked- 10 in day=fill rate 80%

Question 14

How often update clients when have emergency

Answer 14

every 5 minutes

Question 15

What are acceptable appt reminders

Answer 15

call
text
automated service
email

Question 16

Name some staff scheduling considerations and timer off requests

Answer 16

limit new employees all at once
staff budget likely guild # staff members
Post schedule consistent deadline in advance
30 days time off requests
keep those request two years like timecards
no verbal agreements
time off policies limit favoritism

Question 17

Key to successful vet practice.. Two words pm too think about

Answer 17

delegate and empower

Question 18

smart system for teams

Answer 18

specific
measurable
agreed
realistic
time bound

Question 19

What does it cost average hosp to be open per minute

Answer 19

$10

Question 20

Step to determine staff if a leveraged correctly

Answer 20

ask them list every task in one week period. are they working below potential

Question 21

Various type task classification “to do lists”

Answer 21

opening
departmental
individual
task specific
time list

Question 22

training meeting considerations

Answer 22

can be as long as needed.
set goals. no matter who speaker it- list notes.. after meeting “you should be able to”
should include tests( ensures quality time -time well spent)

Question 23

What is PM challenge in employee reviews

Answer 23

make them relevant and useful to practice and employee

Question 24

Marsha Heinke’s 3 basic approaches to employee performance evaluations

Answer 24

1. formal performance reviews
2. coaching conversations
3. corrective action discussions

Question 25

What are 4 elements of most successful employee performance review programs

Answer 25

1. regular informal feedback by supervisor
   -day to day observations- even .
   praise– can practice with quarters
   2.performance goals set by employee and supervisor- employees need 5to have active role in review process help with goal setting- timeline and quantificable- give them tools- record and review often, modify is needed

3.Actions plans to address performance or disciplinary problems- e mployee should have input.. help them design plan- will get more buy in and greater commitment. ** review often
4. formal reviews that address big picture (follow through)- has the statements goals been met, have action plans been followed, is team member on right path

Question 26

What is role of 3- corrective action

Answer 26

1. annoyed, take notice
2. second time, mentally note-pattern
3. 3rd-warrants conversation
   three occurrences is justified conversation- examples are helpful

Question 27

ABCDEF formula- for corrective action

Answer 27

Awareness-describe with clarity to employee
Behavioral Expectations-explain improvement employee must make
consequences- what will happen next if behavior repeated
Decision confirmed-ask employee if able to make change=need agreement here
employee involvement-if employee agrees, THEY must write action plan- can use smart goal - help them WHAT NEEDS TO CHANGE TO MEET EXPECTATION
follow up-SCHEDULE a time to follow up employee

Question 28

steps in managing conflict management with employees

Answer 28

1. conflict addressed
2. listen all issues
3. determine real problem
4. exercise control avoid argument
5. avoid delay in decision
6. maintain records

Question 29

Conflict management thougths pm

Answer 29

as pm we need to model way and help them succeed-

Question 30

questions to ask in conflict

Answer 30

1. is this individual problem
2. who is involved
3. does it relate to job satisfaction
4. is patient care compromised
5. is poor service the issue

confirm what you hear with :what i heard you saY is

Question 31

General discipline/discharge employees. 3 steps

Answer 31

1. verbal warning with correction method-documented with supervisor signatures
2. written warning (# decided practice) doc/signed- bjoth parties
3. final waring should state next step termination

Question 32

Pitfalls leading to wrongful termination

Answer 32

1. no regular evaluations
2. unsatisfactory eval… no raise
3. policy manual should stae- employee may be terminated on 2 weeks notice, with or without causse
4. education on policy
5. not related protected class
6. family stessor- give time

Question 33

Immediate termination grounds- no warning

Answer 33

unethical behavior
criminal activity
falsification of records
insubordination
ppe
will violation policy
timecard violation
sleeping on duty
imappropriate computer use

Question 34

What is qualification for Cobra .

Answer 34

20 employees on 50% of the typical business day previous calendar year

Question 35

Session 4

Answer 35

Session 4

Question 36

Preferred Provider PPO

Answer 36

blend of fee for service and HMO- not required to visit primary- do have network of providers and cost more to go outside network

Question 37

Point of Service Plan

Answer 37

like HMO except don’t have to see primary first to see specialist unless the specialist is outside of network

Question 38

Section 125 plans

Answer 38

tax saving both employer and employee. allows employees to pay certain expenses including premium, before taxes deducted

Question 39

IN FSA account- who owns it? can it roll over

Answer 39

FSA acct , pretax section 125 plan, owned by employer, no high deductible plan required. generally use or lose end of years

Question 40

ACA

Answer 40

Affordable Care Acct PPACA of 2010

Question 41

What are stipulations ACA

Answer 41

50+ full time employees or be penalized if not providing health insurance employees, If you are under 50 employees and don’t provide, employee can be penalized. Act also places certain cap/CONDITIONS on HSA and FSA

Question 42

Who enforces ERisa

Answer 42

Dept of labor

Question 43

What is name of act for ERISA

Answer 43

Employee Retirement Income Security Act. Title 1 1974

Question 44

What is SIMPLE IRA

Answer 44

Savings Incentive Match Plan

Question 45

Specifics of SIMPLE ira

Answer 45

established by employers, employee contribute pre tax $- employer required to match or % contribution- simple to administer

Question 46

401 K Plan specifics

Answer 46

Established employer
employer not required to contribute
can have profit sharing component
need professional admin and can be costy]

Question 47

SEP stands for

Answer 47

Simple Employee Pension

Question 48

What are the specifics SEP pension plan

Answer 48

similar profit sharing
funded employer- NOT EMPLOYEES
employer has tax savings

Question 49

Types of employee benefits

Answer 49

Health insurance
Retirement Plans- 401 k, simple, sep
PTO
Sick leave
Vacation
Holidays
Pet Health care
Dues/license- need a policy
continuing education- cost 5% practice(team development)
Disability insurance
uniform allowance
life insurance
dental and vision plans

Question 50

Pay during CE

Answer 50

Practices that require CE are required to pay time incurred for all non-exempt employees. Hours must also be counted in overtime

Question 51

Considerations disability insurance

Answer 51

elimination period
benefit period
non cancelable guaranteed renewal
residual coverage
automatic benefit indexing
waiver of promiums
future insure options
total recovery clause

Question 52

Considerations in creating employee file policy

Answer 52

environmetal protection
access and storage protects confidentiality but remains accessable
what records should be stored separately
retention and disposal guidelines

Question 53

personnel files contents

Answer 53

application-resume-interview notes-background check
job description
offer letter
discipline docs
W4
copy degree, diploma etc
contracts, non competes
action forms- changes
attendance leave of absence-not FMLA
emergency contact-
employment records including date of hire, promos etc

Question 54

Which entity requires detailed payroll records

Answer 54

IRS and FSLA- access limited- stored separately

Question 55

Payroll files should include at min

Answer 55

full name, address, ss
birth date
work schedule- pay rate, earnings record
benefits records
timeclock records

Question 56

What not to keep in the personnel file

Answer 56

docs cannot be legally used to make decisions (protected class)
docs on gender, race, religion , vet status, disabiltiy
Garnishment or credit report
investigation docs for criminal cases

Question 57

What are the 5 potential employee files

Answer 57

1personnel file-job related
2. Security file- docs related garnishment, background results, credit checks, docs no legal role in firing, promotion
3. Medical file
4. payroll file
5. I-9

Question 58

Reasonable time frame to request view employee file

Answer 58

2-5 business days

Question 59

Retention time frame generally employee files from date of termination

Answer 59

3 years- I-9, hiring records, personnel file
4 years-(rolling four years) tax records, pay rate, pension plans
5 years- injury and work comp
30 years- medical exam findings, exposure records, covid

Question 60

Laws that state employee retention rate

Answer 60

Title VII civil rights, ADA, ADEA- require 1 year from termination
FMLA-3 years
I9 -3 years

Question 61

Hard verses soft skills

Answer 61

Hard skills are generally technical skills that can be taught
soft skills are generally inherant—- critical thinking

Question 62

If job descriptions are not legally required.. how are they used legally?

Answer 62

lawsuit, discrimination allegations, some unemployment claims

Question 63

uses of job description

Answer 63

used training-roadmap new hire
performance reviews and expectations

Question 64

Task verses responsibility

Answer 64

Engaged employees are typically seeking more than new tasks, they want more responsibility

Question 65

What three purposes do Manuals serve

Answer 65

1. reference tool for standards of care and practice guideline
   2.training and instructional tool
2. define a standard which employees can be help accountable

Question 66

Considerations creating employee policy (general thoughts not diff. sections) manuals- what should it look like

Answer 66

court may consider contract.. be sure to state.. not a contract
attorney review
large print
positive and not authoritarian, create positive work environment, prevent problems via clarity open dialogue–

think about culture you project

Question 67

HOw to create organizational efficiency with manuals

Answer 67

same directory/file name
network location and file organization
revision date and initials- bottom of revision page

Question 68

Procedures Manual contain

Answer 68

correct way to do tasks as well as benchmark to determine whether employees are achieving stated standards
Checklists are valuable and usually evolved from these manuels- update as they evolve

Question 69

when creating procedure manual, ask yourself 6 things

Answer 69

What is procedure
who is responsible
what resources
optimal outcome
steps to complete
when this created and when reviewed again

Question 70

Name 3 primary function procedure logs such as lab log

Answer 70

1. allow convenient storage of important data
2. improve quality of patient care/client care
3. facilitate charge capture and auditing processes

Question 71

Types of Logs

Answer 71

Hybird logs ex. cremation-paw prints
Patient logs- ex laboratory logs
Procedure logs- task completion-autoclave cleaning

Question 72

Hospital safety manual 3 key points as to why

Answer 72

1. required (federal law) written plan to notify staff how hospital complies with OSHA Hazard communication standard
2. at core is Right to Know law - every employee has right
3. Employer responsibility to be educated about risk, not only to mitigate them but inform employees of risks.

Question 73

What does specific areas do VET hospital have in OSHA Hazardous comm plan

Answer 73

1. anesthesia and wag
2. accident prevention and response
3. animal handling, bite prevention, noise risk
4. blood borne path and first aid
5. infection control/zoonotic disease prot
6. Hazardous chemical
7. chemotherapy
8. driving/machinery
   9 dentistry

Question 74

What building/staff concerns are also in written plan safety plan

Answer 74

electricity concerns
ergonomics
fire and emergency evacuation
lasers
meals. snacks
nature disasters/weather
radiation
safety training
securuty and violence prevention

Question 75

Right to know

Answer 75

every employee must have access to handbook and told they have right and responsibility to view it

Question 76

CE- if required.. what direction should practice suggest

Answer 76

set CE goals that help support the Mission and Vision of practice

Question 77

Benefits of CE

Answer 77

inspires team to improve quality care
contributes to prevention burn out
important in staff retention

Question 78

Reasons declining interest CE

Answer 78

staff felt CE skills learned were not used
management doesnt place value on ce
management doesnt embrace new ce information
personal family challenges

Question 79

License fees

Answer 79

for rvt,dvm, cvpm practice usualy covers cost of renewal and can amount to 1200 yearly

Question 80

Section 5- law and ethics part 1

Answer 80

Section 5

Question 81

What Act is enforced by the DEA-established 1973

Answer 81

Controlled Substance Act

Question 82

Vets working at two+ locations- what can they legally do

Answer 82

can RX ANYWHERE if registered at some principal place of business.
to administer or dispense, must be classified as employee or registered at the facility

Question 83

Can non vet admin controlled drugs?

Answer 83

yes if agents/employees of registered dvm
yes if performing in reg course of business
yes if acting under direction of Dvm (present)
yes if under the direction of dvm (on premises)

Question 84

Can IC dispense or admin drugs at relief site?

Answer 84

The law is less clear.. they certainly can RX but should maintain their own DEA license to support IC factor-

Question 85

How to get DEA 222 forms

Answer 85

they are sent out by DEA no charge when registration granted.. and appropriate box requesting copies checked

Question 86

Who can sign DEA form

Answer 86

only registered DVM or person with valid power of attorney may legally sign

Question 87

What to do once receive controlled 2 drug

Answer 87

when shipment arrives, date of receipt and the number of containers of each drug docuemtned on copy 3 or original order form used when order placed.. file separately all Schedule II drugs and copies

Question 88

Can a DVM employee rx, dispense and admin-controlled drug

Answer 88

yes if is employee of location registered dvm

Question 89

how many locations can dvm employees rx drugs?

Answer 89

4 different locations owned by the same business owner

Question 90

Can schedule 2 drug records be mixed with other records

Answer 90

no- C2 drugs must be recorded and stored separately from medical record

Question 91

Can C3-5 drugs be stored in medical records?

Answer 91

yes if they can be readily retrievable- common belief is they are not retrievable in quick manner in case of audit

Question 92

To lend C2-C5 drugs

Answer 92

must obtain a receipt signed by registerd vet who received drug and stored with other records of these drugs. These drugs can be returned to same dvm using same receipt records

Question 93

Can lend C2 drugs

Answer 93

yes but use same format as if purchasing drug using DEA 222 form

Question 94

When purchasing vet hosp

Answer 94

accounting must be done- old vet prepares invoice all drugs (dated and signed with time), exact count of Schedule 2 drugs- C3-C5 can be estimated counts unless bottle holds 1000+ tabs- then exact count.
these records must be keep in controlled record keeping book or log

Question 95

How often required to count all controlled drugs

Answer 95

biennially or every 2 years

Question 96

examples controlled drugs

Answer 96

I- las heroin
II- oxymorpphone, morphine, pentobarbital fentanyl
III- hycodan, codeine, buprenorphine, hydrocodone, ketamine, teleazol
IV- tramadol, valium, phenobarbital, butophanol
V-lomitil. robitussinAC

Question 97

What DEA form for loss-theft-breakage

Answer 97

106

Question 98

DEA inspectors must present

Answer 98

ID selves, state purpose, give credentials, written notice to inspect or warrant

Question 99

Questions to ask applicants

Answer 99

Within past 5 years have you been convicted of a crime or within the past 2 years a misdemeanor, or ARE Presently chargge
IN Past 3 years have you knowinngly taken narcotic, amphetamine or barbituarrates not prescribed

Question 100

What title under Controlled Substance Act. What intent and what kind system

Answer 100

is Title II of the Comprehensive Drug Abuse Prevention and Control Act 1970
REgulaates by registration, persons involved in the manufacture, distribution, and dispensing of controlled substances
CSA designed “closed system” for handlers of these drugs to reduce them coming into the illicit drug market.

Question 101

Schedule 1 drugs

Answer 101

Highest abust
lowest potential medical use
heroin LSD

Question 102

Schedule II drugs

Answer 102

High potential abuse-severe dependence
accepted medical use
morphine oxymorphine

Question 103

Schedule III drugs

Answer 103

less potential abuse-dependence
accepted medical use
codeine, hydrocodone, ketamine,telazol

Question 104

Schedule IV drugs

Answer 104

low potential abuse- limited depend
accepted medical use
tramadol, phenobarb, valium

Question 105

Schedule V

Answer 105

lowest potential aboust
accepted medical
Robotissuin Lomitil

Question 106

who can reclassify controlled drugs

Answer 106

DEA and attorney general

Question 107

What is FDA/CVM

Answer 107

Food and Drug Administration Center for VEterinary medicine

Question 108

What is FDACVM responsible for

Answer 108

regulating animal foods/feeds and animal care products

Question 109

What are adulterated drugs

Answer 109

unsanitary, lack of control in manuf, differ in strenght from compendum, mixed

Question 110

What are misbranded drugs

Answer 110

False misleading labels that not have adequante information for manf/packer/distrubute/quantity- NO adequate directions for use

Question 111

What are 3 classifications that qualify a legend drugs

Answer 111

1. For use only under veterinarian
2. in possission person engaged in manuf/storageg sale of vet drugs
3. in possession of a Veterinarian

Question 112

Are medical devices (including syringes, needles. etc) required to get approval by the FDA

Answer 112

no except radiation emitting devices

Question 113

Define Generic Drugs

Answer 113

FDA approved which requires a demonstration of bioequivalence with the safety and efficacy with the orginal pioneer drug

Question 115

Who registers Radiation emitting device with

Answer 115

Center for Devices Radiological Health

Question 116

What is the act that regulates EPA

Answer 116

FIFRA- Federal insecticide, fungicide and rodenticide act

Question 117

Define Pharmacoviligence

Answer 117

the science and activities relating to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problem

Question 118

What catagories are required to report ADE

Answer 118

1.drugs/ medical devices,food and dietary-FDA
2.pesticides-EPA or reporting page provided- Nat’l Pesticide Info Center NPIC
3.vaccines- not required to report- required to record- report to USDS CVB- APHIS

Question 119

The FDA is within what US Department

Answer 119

US Department of Health and Human Services

Question 120

Compounding regulations- what are 4 conditions

Answer 120

1. vet believes need to alter approved drug for non food animal with Dx
2. there is VCPR
3. Pet has medical condition
4. Vet determines compounded drug is needed

Question 121

Adverse Drug reporting- call 888-fda-vets or find form 1932a and include

Answer 121

1. person familiar with event
2. Clinical signs right after exposure
3. Product name and lot
4. Patient or owner

Question 122

According to OSHA and right to know- what items are required for Vet Practices to be compliant in their safety program

Answer 122

1. safety manager
2. ann hazard inspection
3. Safety plan
4. Chemical list- plan for safety
5. SDS
6. Secondary labeling
7. Protocol emergency evat
8. Training program all PPE, monitoring devices and hazards

Question 123

OSHA many standards list include

Answer 123

First Aid Kits
Hazard Assessment
Personal Protective Equipment
Safety and hazard training
sanitation and housekeeping
waste disposal
egress and emergency exits
Fire extinguishers and sprinklers
electricity
stairs
vehicles
ergonomics
indoor air quality
SDS library
container labeling
noise hazards
radiology
chemotherapy
Hazardous Chemical Plan

Question 124

The Hazardous Chemical Plan must have, what are the 5 basic components

Answer 124

1. must be in writing
2. Complete list of all hazardous chemical
3. SDS
4. Secondary labels
5. staff training

Question 125

Admin Requirements of OSHA

Answer 125

1. It is the law poster- state poster if avail
2. Notice of pending inspection
3. Inspection citation 3 days or until fixed- longer
4. warning signs, exits and radiation
5. written plans for

Question 126

OSHA rights for Employer

Answer 126

Set and enforce safety
Be present during the inspection
can require warrant
can request postponement
Trade secrets cant be divulged
consult before, during after inspection before responding inquiry
see complaint
insist staff members interview during off times
right to appeal

Question 127

OSHA Employer Responsibilities

Answer 127

provide workplace-free unnec hazards
set and enforce safety rules
Provide PPE and proper use
provide training hazards

Question 128

Staff member rights- regarding osha

Answer 128

1. workplace free hazards
2. informed rights
3. informed hazards and trained to do job safelyu
4. provided and instructed on PPE
5. view and receive copies OSHA standards
6. access medical exposure records
7. be presnet when safety testing performed
8. present complaints to emplyer or OSHA
9. speak compliance officer privately

Question 129

Staff member responsibilities under OSHA

Answer 129

to comply with all safety rules, regualtion and orders by workplace or OSHA
know that can be discipline up to including termination for violation of safety rule provided given proper instruction or training

Question 130

Addl staff responsibilities OSHAS

Answer 130

1. READ OSHA POSTER
2. comply standards
3. follow safety rules and regs
4. wear PPE
5. report hazardous conditions supervisor
6. report job related injury and seel treatment
7. coorpeate with compliance officer

Question 131

OSHA form 300

Answer 131

11 or more employees!
Log of work related injuries- record every work related injury beyond first aid. also work related illness diagnosed by dr

Question 132

OSHA Form 301

Answer 132

• every business-
  Illness and Injury Indicent Report- within 7 days that you know of recordable work related injury- this form or equivalent

Question 133

OSHA 300a

Answer 133

11 or more employees
Summary Work Related illnesses/injury-
must posted Feb 1 to April 30- displayed even with zero reports

Question 134

How long keep OSHA forms

Answer 134

5 years

Question 135

Section 6 Laws and Ethics part II

Answer 135

Section 6

Question 136

What are three ethical areas affect teams

Answer 136

1. social ethics
2. personal ethics
3. professional ethics

Question 137

social ethics

Answer 137

principles accepted by society codified into law

Question 138

personal ethics

Answer 138

right or wrong on individual basis

Question 139

professional ethics

Answer 139

developed by professionals that create codes of conduct for members of profession

Question 140

What is the purpose of a professional code of ethics

Answer 140

To help members achieve high standards of behavior through moreal consciousness, decision making.

Question 141

What are 4 branches of Veterinary Ethics

Answer 141

1. descriptive-study of ethical views
2. official- professional ethical standards- they develop and enforce
3. administrative- actions by administrative govt bodies- license revoke
4. normative- search for good/bad right/wrong

Question 142

difference in law and ethics

Answer 142

the govt enforces laws, the professional asso develop the ethics and enforce the ethics

Question 143

What 4 types of moral problems does Rollin believe in vet med

Answer 143

1. peers
2. clients
3. animals
4. society

Question 144

What are detailed sections of AVMA Code of Ethics

Answer 144

Professional behavior
VCPR
Attending, consulting, referring
influence on judgment
therapies
genetic defects
medical records
fees and remuneration
advertising
euthanasia

Question 145

VHMA code of ethics include talk of

Answer 145

promote profession
CE refinement skills
equitabel cooperative with fellow members
excellence to clients-pets
Honest, integrity, industriousness above all elese
confidential bus affairs
protect hosp funds
keep hosp records in house- owner of practice soley

Question 146

What are two examples of situation with both legal and ethical considerations in vet med

Answer 146

INformed Consent
Emergency care

Question 147

What constitutes informed consent

Answer 147

1. consent freely given
2. treatment/diagnosis in understandable terms.
3. risk/benefits/prognosis stated
4. prog if no treatment stated
5. alternative treatmetns with risk, benefits cost
6. ability to ask questions

Question 148

what aspect of emergency care has both ethical and legal considerations

Answer 148

emergency care of the pet ,not in owner’s possession.- ethically vet has responsibility to save life or relieve suffering. Without owner, getting paid can be issue. Lact of payment due to lack of consent.
The law of Unjust Enrichment was created to avoid unjust enrichment of one party at expense of another

Question 149

What does legal system look for before considering unjust enrichment

Answer 149

1. more valuable animal, the greater chance recovery
2. More emergent animal’s need, more urgency to provide medical care
3. Vet attempted to reach owner
4. The emergency care was reasonable

Question 150

Ethical consideration in vet med- wilson cautions a dilemna in what is ethical and not

Answer 150

Wilson states, It is the situation, not the act that should be analyzed for ethical considerations because what may be unethical in one scenario, may be acceptable in a different scenario.

Question 151

Define Moral Distress

Answer 151

you know ethically appropriate action to take but you are unable to act on it. You act in manner contrary to personal and professional values, it undermines your integrity and authenticity and causes moral distress

Question 152

What are 4 A’s to rise above moral distress- an ongoing process

Answer 152

Ask-is moral distress present
Affirm- commitment to address moral distress
Assess-Contemplate readiness to act- risk and benefits (4 R’s)
Act-develop a plan-identify resourcess inside and out

Question 153

When assessing Moral distress- what 4 r’s can help

Answer 153

RElevance- impact
risk- what about not acting
reward- when acting
roadblocks- identify struggles

Question 154

Define Ethics exhaustion

Answer 154

fatigue, emotional distress, and lack of will to act in a way consistent with the belief of what is right. It isn’t a lack of compassion, but prevented from acting in a way you feel is morally right. Prevention is key- minimizing moral distress ahead of time

Question 155

What are the most common complaints to the board

Answer 155

Unsatisfied Experience
lack of communication
Unexpected Death
Conduct, record keeping, premises, and Pharmacy issues

Question 156

What is the most common premise complaint?

Answer 156

the surgery room is not separate room

Question 157

Common pharaceutical complaint

Answer 157

vet not honoring request to prvide written rx

Question 158

What SOP should be created in area of ethics/law for many aspects hospital

Answer 158

*Hospital policy for shredding
*Develop liability release volunteers, interns
*follow AVMA updates Fairness to Pet Owners Act and Compounding
*Develop medical records standards (SOAP format, abbrev. data entry, password protect
*SOP for client communication, conflict, and complaints
*Ensure practice meets state requirements

Question 159

Law is broken into two sub-categories, what are they

Answer 159

civil law and criminal law

Question 160

What two sub categories fall under civil law

Answer 160

tort and contract

Question 161

Four elements of a contract

Answer 161

Offer
Acceptance
Consideration
Intent to contract
(Today, more emphasis is placed on what a reasonable person would conclude from the conduct of the other)

Question 162

3 situations where capacity to contract exists

Answer 162

Minority
Mental Disability
Intoxication/substance abuse

Question 163

In law of agency- what are two most common situations

Answer 163

Agency and consent for care- best practice - contract owner for confirmation
Agency and Consents for Euthanasia- when someone other than presents a pet for euthanasia- request owner come in to sign form

Question 164

Statute of Fraud

Answer 164

requirement for written memorandum before courts will enforce certain contracts

Question 165

What contracts require written memorandum as per statute of fraud

Answer 165

1. contracts for sale of real estate.
2. leases longer than a year
3. contracts not performed within year
4. contracts to answer debt of another
5. contracts over a certain price

Question 166

define parol evidence

Answer 166

any agreement not contained in written contract– under parol evidence rule, these agreements are inadmissible

Question 167

What is Guardian Ad Litem

Answer 167

person appointed to protect interests of minor or legaly incompetent person. In vet med- if pets become guardians, what is potential issue- who determines best interest pet
wrongful death civil lawsuits?
no pain meds- neglect lawsuit?

Question 168

Session 7- Laws and Ethics part 3

Answer 168

e

Question 169

What does EEOC protect when it comes to unfair Tx

Answer 169

unfair tx cuz of race, color, religion, sex (including preg/gender identity/sex orientation) national origin, age, disability or genetic info.

Question 170

What does EEOC protect when it comes to Harrassment

Answer 170

Harrassment because of race, color, religion, sex (including preg), national origin, age, disability or genetic info

Question 171

What does EEOC protect when it comes to work accomodations

Answer 171

Denial work accom needs becauseof religious beliefs or disability

Question 172

What does EEOC protect when it comes to retaliation

Answer 172

protects employee who complained about job discrimination or assisted in job discrimination case

Question 173

Immigration Reform and Control Act- who does it apply to

Answer 173

EMployers although specific count is unclear
Law seeks to preserve jobs for American citizen and immigrants who are authorized to work

Question 174

Immigration Reform and Control Act- what does it do- EEOC enforces

Answer 174

Amended Immigration and Nationality ACt- make unlawful to hire alien knowing person is unauthorized to work without verifying- or continuing to allow to work knowing unauthorized
Established I9 system (EEOC)- required to attest on form made by Attorney General that docs have been verified- the worker also attested he is authorized- keep records for 3 years

Question 175

Fair labor Standards apply to ?

Answer 175

all business- Fundamental Employee Act

Question 176

What are minor regulations in FSLA

Answer 176

14-15- permitted with work permit- 3 hours school days- 8 hours non school- hours must be between 7a ma -7 pm- except 9 pm summer break

Question 177

Exemptions ovetime

Answer 177

salary 455 week
cannot be reduced quality or quantity work
job duties under these:
executive- 2+ direct reports
administrative
professional- dvm

Question 178

Who enforces FLSA- ( FaIR LABOR sTANDARDS aCT)

Answer 178

WAge and Hour Division of US Dept Labor- inspections can be random after complaint

Question 179

Civil Rights Act 1964- Broad umbrella cover in addition to discriminaton- what are different classes outsude of act

Answer 179

SExual Harassment
Preg Discrimination
Amer with disabilities
Age discrimination

Question 180

What is Civil Rights Act 1964 Title 7

Answer 180

Unlawful for employer to refuse to hire any individual or discriminate with respect to race, color, religion, sex or national origin

Question 181

EEOC

Answer 181

EEOC was created to enforce the anitdiscrimination law

Question 182

Sexual harassment- what are three area of discrimination focus

Answer 182

gender based discrimination
sex discrimination based on pregnancy
sexual harrassment

Question 183

What are two types sexual harassment

Answer 183

Quid Pro Quo
Hostile environment

Question 184

What is sexual harrassment-hostile environment

Answer 184

unwelcome conduct sex or not directed because of gender and interferes with work

Question 185

Pregancy Discrimination ACt - amended title 7 Civil rights- who does it protect

Answer 185

based on pregnancy, childbirth, related medical conditions

Question 186

Pregnancy Discrimination ACt What does it say

Answer 186

Preg women must be treated same as other empoyees on ability or inability to do work
Preg worker must be allow to work at all time as long as she can perform duties

Question 187

Americans with Disabilities Act 1990- what employer does it apply too

Answer 187

emplyers 15+ who are on payroll at least 20 weeks
expanded to include persons with mental disabilities
** be sure jjob description includes essential task including physical, time, stress requirements

Question 188

Age Discrimination ACt 1967- 20 emplyees

Answer 188

Can’t discriminate based on age- special rules pertainning to pension and other benefit plans

Question 189

ERISA - Employee Retirement Income Security Act- who

Answer 189

employees in qualified benefit programs (retirement, stock, group medifcal insurance, prepaid legal services
ERISA provides safeguards for employee interested in these plans

Question 190

ERISA -what are in 3 Titles

Answer 190

Title 1- reporting and disclosure- fuduciary standards- enforced DOL
Title 2- IRC enforced IRS
Title IV- Administered by Pension Benefit Guaranty corp
all reports must be filed, DOL,IRS. PBGC annually and to participants and beneficialy]

Question 191

Equal Employment Opportunity Commission

Answer 191

enforces feral laws, prohibiting discrimination- protect employees and job applicants against discrimination- 15 or more employees- wrk at least 20 calendar weeks last 2 years

Question 192

COBRa- what is it

Answer 192

Consolidated Omnibus Budget Reconciliation Act

Question 193

Who does Cobra apply to

Answer 193

employers 20+ employees .. for employees who leave under certain circumstances

Question 194

What does COBRA provide

Answer 194

Qualified individuals are allowed to enstend th3eier coverage on a self pay basis for 18 months to 36 months after end of employment- lentgth of time determined by type of event
COBRa has numerous notice requirements on employers, plan administrators, and covered employees

Question 195

HIPPA

Answer 195

Health insurance portability and Accountability Act

Question 196

Who does HIPPA apply to

Answer 196

all eligible employees

Question 197

What does HIPPA do

Answer 197

protects employees health inusrance coverage when they change jobs, limits exclusions for preexisting conditions, and prohibits discrimination against employees and dependents based on their health status.
Also deals with privacy concerns regarding health care and some tax implecations

Question 198

Mental Health Parity Act

Answer 198

all eligible employees

Question 199

Mental Health Parity Act

Answer 199

Provides for fairness and consistency between medical and surgical benefits .

Same annual $ benefits medical.mental

Question 200

Employee Polygraph Protection Act 1988-

Answer 200

prohibits most private sector employers from directly/indirectly requiring lie detector test
employers cannot discharge, discipline or discriminate against any employee who refuses lie detector test
EPPA does permit on some job applicants9 stringent requirements)

Question 201

Name the 7 required posters employment

Answer 201

1. Fair labor standards and min wage
2. equal opportunity provisions
3. Family and Medical leave act
4. OSHA Job safety and Health Protection requirements (right to know)
5. Employee Polygraph Protection ACT
6. Uniformed services employment and reemployment rights act
7. Right to join/form unions and asso

Question 201

define confidentiality

Answer 201

duty of keeping private information pertaining to patient health obtained dur8ng formation of diagnosis (more than medical records)

Question 202

Do all states require confidentiality?

Answer 202

Not all states specifically recognize veterinary-client-patient confidentiality but ethical considerations remain the same regardless

Question 203

What entity specifically requires confidentiality

Answer 203

the Principles of Veterinary Medical Ethics of the AVMA require vets to protect the personal privacy of clients and patients and clients. All records are considered privileged and confidential and should not be released except by court order or consent of patient’s owner.

Question 204

Does PVME has force of law?

Answer 204

In most states it does not

Question 205

what is the concern regarding confidentiality in abuse cases?

Answer 205

Some states require vets to report animal abuse or neglect to child protection/welfare authorities due to some studies suggesting a correlation between animal abuse and child abuse

Question 206

If reporting the abuse… is there protection

Answer 206

States that have abuse reporting requirements will protect reporting vet from civil lawsuit providing report done in good faith

Question 207

Who owns the confidentiality, the client or vet?

Answer 207

For states that do have regulations, the client owns the confidentiality

Question 208

When do state statues’ regarding confidentiality, not apply

Answer 208

1. Client or agent consents to release
2. law requires disclosure
3. animals health at stake
4. legal dispute has arisen in court conflict
5. board investigation exists against vet or owner
6. suspected or actual abuse
7. vet served with subpoena

Question 209

Who reviews social media postings

Answer 209

they all should be reviewed by the social media manager

Question 210

What type of social media postings need to be supervised

Answer 210

all potential confidentiality breaches both on the practice and staff need to be addressed. Employees can create legal problems for vet posting unauthorized photos or confidential text

Question 211

Can employers dictate what staff can post

Answer 211

Practice cannot dictate what staff post on personal site but can establish professional guidlines with disciplinary consequences when violated

Question 212

What are some social media confidentiality rules the hospital might want to create

Answer 212

1. all post on practice websites taken with hospital camera-never personal cell
2. cell phone policy prohibits any and all recordings while on duty
3. only authorized staff can post
4. all photos/detailed text must have client authorization
5. statement any negetvity caused may result in disciplinary action up to and including termination
6. inappropriate posting include- remarks, harassment, threats, unprofessional comments

Question 213

Why to have a identity theft program

Answer 213

federal/state laws obligate us to protect sensitive info
written policy/training

Question 214

Name some identity theft considerations to apply to employees when thinking about theft

Answer 214

Perform reg background checks all
limit keyed access
computers password protected
shred all personal/financial paper
red flag rule

Question 215

What should identity theft training include

Answer 215

how to gather and store personal info
what can and cannot be discussed over phone./internet/fax, 3rd party
leaving records unattended
keep staff phone lists/computer codes out of public view

Question 216

Identitiy theft and verfiication- red flags regarding controlled drugs

Answer 216

inabiliity to provide govt ID
handwritten credit card numbers
photo doesnt represent previous records
presents altered or forged medical records-drug seeking

Question 217

What are risks of breaching confidentiality and may be in policy documents

Answer 217

Sharing w/o consent may result in disciplinary actions. this even includes kennels, trainders
**Unauthorized disclosure of information may lead to client claiming invasion of provacy or breach of duty to maintain confidentiality

Question 218

Session 8 Financial Part 1

Question 219

Chart of accounts

Answer 219

systematic listing of all account names and numbers by company. Recommended use only chart of accounts needed

Question 220

Profit and Loss statement

Answer 220

income statement, PL, covers specific period of time. reports revenue less expenses to show net income during that period of time

Question 221

Balance sheet

Answer 221

shows financial condition of practice listing assets, liabilities and owners equity. - does not forecast- no historial data. can use to create accounting equation

Question 222

Basic accounting equation

Answer 222

Asset=liabilities + equity

Question 223

Cash flow statement

Answer 223

shows were cash in practice comes from and how used

Question 224

Net Income

Answer 224

expenses subtracted from income-

Question 225

What is AVMA net average profit goal is

Answer 225

10-12%

Question 226

INtangible property

Answer 226

nonphysical property that has value- goodwill, non-compete, copyrights

Question 227

Assets

Answer 227

everything of value owned by practice (intangible and tangible)

Question 228

What two subcategories are included in assets

Answer 228

Current assets and fixed or long term assets

Question 229

current asset

Answer 229

items consumed within a short periof of time often a year. ex inventory

Question 230

fixed or long term asset

Answer 230

assets that extend longer than a year ex building, land equipment, software

Question 231

liabilites

Answer 231

debts. can be short term like accts payable or long term like mortgage

Question 232

equity- another name and formula

Answer 232

asset-liabilities. it shows the net worth of practice. sometimes referred to as net book value

Question 233

cost of goods sold

Answer 233

products used to produce a service for client or products sold to client- variable expense

Question 234

What are four main theoritical areas when understanding financial statements- the 4 ideas behind them

Answer 234

The theories
the purpose
the practicality
the effect

Question 235

what are the two theories of accounting methodologies

Answer 235

Cash based accounting
accrual based accounting

Question 236

what is cash based accounting

Answer 236

recognized revenue when cash received and expenses paid. Allow more clear vision of day to day operations. important bills paid on time.
majority of practices use this
shows many peaks and valleys

Question 237

What is accrual based accounting

Answer 237

required in corporations with gross > $10 mil
recognizes revenue when it is earned and expenses when they incur. Goods received and services are performed. As general rule, considered more accurate.
more complex
poor job tracting cash
better at matching

Question 238

what is differnet in straight line depreciation and MACRS (modified accelerated)

Answer 238

straight line - cost asset evenly distributed over useful life
MACRS- cost distribulted accelerated, more cost at first couple years then reduced

Question 239

Purpose fo Financial Reports

Answer 239

enable ownership and management to properly review what has happened in period

Question 240

Who should be part of the monthly financial review

Answer 240

key employees and department heads

Question 241

Practicality of Financial statements

Answer 241

Identifies trends and recognized problems that need attention. beneficial and necessary.

Question 242

The effect of Financial statements

Answer 242

Helps to make sound and thoughtful business decisions. Enables performance of practice to be measured in historical and prospective terms so that decisions can be made

Question 243

Income Statement- basic thoughts behind this statement

Answer 243

Most important of financial statements
important detailed as possible to help with inconsistencies
correct categories
stating expenses as % valuable tool to compare historial data. % give more accurate picture than numbers

Question 244

What is an expense and name 2 types of expenses

Answer 244

any outflow of money owed to another company. fixed and variable

Question 245

what are fixed expenses

Answer 245

set cost that don’t fluctuate with busyness of hospital. ex dr on salary=fixed expense

Question 246

what are variable expenses

Answer 246

will change with amount of business. ex vaccine, dvm on production, staff payroll

Question 247

What to do when expenses dont look right on pL

Answer 247

compare percentages
ask questions of percentages
implement change

Question 248

Possible issues when PL shows inconsistencies

Answer 248

invoice paid late
income drop signficantly
expense misclassified

Question 249

Do we need to manage profit centers

Answer 249

***If center is not managed, it cannot be improved

Question 250

What are steps or things you will look at to evaluate profitability of service when it comes to sq footage

Answer 250

1. gross revenue per month for service
2. square footage used by service
3. fixed cost practice
4. fixed cost per square foot for service

Question 251

How to determine if profit center can be improved- what is formula

Answer 251

got to look at numbers ex;
Revenue from profit center- fixed cost of sq footage(including dvm/eqt)/facility) -variable cost staff= net income for that center

Question 252

What is balance sheet

Answer 252

also called- Statement of Financial Condition of Practice
summarizes assets, liabilities, and equitites at time-no historial
although real estate could be increasing in value, this increase not represented on balance sheet

Question 253

What is cash flow sheet

Answer 253

illustrates cash generated minus cash flowed out rendering cash total end of year
Snapshot of checking- but not necessarily correct because could have inventory not sold that was purchased, account receivable,
b

Question 254

What are some financial reporting process considerations for the PM in delivering to owners

Answer 254

1. timeliness- 5-10 business days end of month
2. accurate- often times cpa audit not feasible. manager does self audit
3. Simplicity
4. sufficiently detailed - so non acct can understand
5. analytical- information worthy of analysis- benchmarks/budgets

Question 255

What are some practices to consider when analyzing finances and looking to grow- how do grow your financial condition

Answer 255

1. safeguarding assets
2. pricing/fee structure- is it adequate
3. cost evaluation- consider cost of services
4. procurement of capital- assuring owners ROI
5. incremental performance- CASH FLOW, PROFIT, CHANGE IN COST, INVESTMENT
6. accountability via departmentalization- what are profit centers doing
7. profitability analysis- two different number- profit for owners and profit for tax purposes
8. return on capital analysis-

Question 256

What are key ingredients of incremental performance to make it happen- four short words

Answer 256

change in cost, cash flow, profit, and or investment

Question 257

what should you take into consideration when measuring true profitability- true value of practice

Answer 257

depreciation of assets, owner compensation, rent to owner, other owner discretionary expenses

Question 258

What is formula for return on capital percentage?
EBITDA

Answer 258

income divided by average total assets= return on capital %
usually measured before interest, taxes, depreciation, and amortization

Question 259

What are KPI’s

Answer 259

basic statistics used to measure preformance, compare benchmarks and identify changes. Usually entered in spreadsheet compares over previous year

Question 260

Common KPIs

Answer 260

*Total revenue and total trans per month
*average trans per month
*new clients and lost clients by month
*revenue transactions, and average transactions per DVM by month
*revenue by category
*accts receivable by aging classification

Question 261

Net profit margin

Answer 261

practice profit/practice revenue- measures simple profit. A higher value indicates more revenue falls to the bottom line instead of being consumed by expenses

Question 262

Why should you use % statement analysis

Answer 262

% make it clear how practice is doing

Question 263

What is variance analysis

Answer 263

Identifies the variance of financial metric and may help explain why

Question 264

Gross Profit Margin

Answer 264

Gross profit/revenue- measures how much profit is in service

Question 265

Average Transaction charge

Answer 265

practice revenue/practice transactions.
Ideally number should increase

Question 266

Revenue Per full time DVM

Answer 266

practice revenue/full time DVM

Question 267

What is a full time DVM

Answer 267

DVN who spends 100% of their time with clients

Question 268

Accounts receivable turn-over

Answer 268

credit sales/average accounts receivable- higher number better, indicates acct receiveable converted to cash more often

Question 269

What are the 3 types of payroll methods

Answer 269

Manual- employers liable for error- highest risk errors
Automated in house- quickbooks- more efficient manual, can schedule regular reoccuring deductions
3rd party- convenient, expertise, savings

Question 270

What are different types of payroll periods

Answer 270

Weekly- 52
biweekly- 26- problem: difficult to make specific historical comparisons since quarters inconsistent year to year 2 quarters 6 and 2 qts 7 pay periods
semi monthly- 24
Shift differential- wage premium used in 24 hr facilities- less desireable shifts more rewarding

Question 271

What if FICA

Answer 271

Federal Insurance Contribution Act

Question 272

What is FUTA

Answer 272

Federal Unemployment Tax Act

Question 273

State payroll tax

Answer 273

vary often include state income tax and unemployment tax- THERE MAY BE OTHER TAXES DEPENDANT ON STATE

Question 274

What should written employee payroll policy include- long form

Answer 274

definition of part time - full time
how and when PTO is accrued and if rolls over year end or is paid out at termination
segregate duties for up0dating personnel data from duties of payroll accumulation, recording, and reporting
require manage approval changes payroll records or personnel info
restrict access as need to know basis
mandatory direct deposit
process new hires timely
personal records
when using 3rd party- compare records
monitor timeclock- cant clock in for other employee
track advances- signed auth from employee and payback asap via payroll deductions

Question 275

what should personal records include regarding payroll

Answer 275

date orf hire
PTO jpaid vs used
tardiness

Question 276

What if you dont issue 1099

Answer 276

Can be liable for back taxes, interest, penalties

Question 277

Accounts Payable considerations

Answer 277

watch that not spending more than making
must develop a plan if getting out of control

Question 278

How to mitigate large accts payable or not enough $ bottom line)- WHAT YOU CAN DO TO DECREASE

Answer 278

decrease spending-increase revenue
hold employee accountable waste’
consider reevaluation fee structure
review charges be sure charged correctly and not missed
if line of credit needed- have plan to pay back asap

Question 279

What is account receivable

Answer 279

monies owed practice for services rendered that not paid at time of service

Question 280

What is acceptable AR Balance

Answer 280

no higher than 1.5% gross rev

Question 281

What is AR problem %

Answer 281

AR over 3% should get focus entire team

Question 282

What can you do to reduce Ar while still helping clientele that is hurting

Answer 282

If it is high, should look at AR policy and
Institute Flex or Indigent acct financially sustained by client contributions or fund raisers. Team develops guidllines for eligible cases

Question 283

What are choices when check NSF

Answer 283

take loss, try to capture by self, turn over 3rd party

Question 284

How to avoid NSF

Answer 284

check verification machine- either verifies or immediately captures funds . Real time transfer is most cost effective- make sure always get DL

Question 285

Why ask for DL when accepting check

Answer 285

Part of best practice plan to prevent fraud

Question 286

How many basic ways of accepting payment on AR accts

Answer 286

Manually or Computerized AR system

Question 287

what are some precautions in manually accepting AR check

Answer 287

want to prevent internal embezzlement. Usually finance fees are added. When payment rec’d, a receipts provided and the copy of receipt forwarded to AR manager who will update ledger. Aged acct can be flagged different colors and appropriate notices sent

Question 288

what are some computerized AR systems perks over manuel systems

Answer 288

All calculations of interest and fees are automatically added. Eliminates errors and decreases embezzlement

Question 289

How to: creating and enforcing AR policy- basics

Answer 289

OPost sign at practice,
estimates to all clients
signature required from the client
50% required all services- all employees must be okay with this

Question 290

Hold Checks

Answer 290

accepting check with current date but depositing later- not recommended.
Problem with tracking and depositing on right date.
No guarantee of funds
If mistake, usually hospital has to pay service fee

Question 291

Are post dated checks legal

Answer 291

Illegical in some if not most states

Question 292

Collection Procedures- when should AR be due

Answer 292

Should be paid within 30 days

Question 293

What is benefit of aged acccounting AR

Answer 293

It offers the PM a more accurate review of AR

Question 294

When are AR statements sent

Answer 294

Immediately after service

Question 295

What to do if no payment in over 60 days

Answer 295

handwritten note on stateemetn
overdue sticker placed on statement.
Fair Debt Collection Practices Act says stickers cannot be placed on outside envelope. Also, return address is okay but cannot put Debt Collector name on outside envelope

Question 296

What about collections over 90 days- strategies?

Answer 296

Harder to collect beyond 90 days
Client should be notified will be turned over if not made
Team member calls cleient to discuss status and attempt to collect or make arrangements
Once all attempts exhausted, turn over to collections

Question 297

• waht happens at collection agenfcy

Answer 297

turn over to agency, if they cant collect, amt reported to credit bureau and credit affected 7 years

Question 298

Is small claims court possible

Answer 298

Yes but need to weigh options, costly to go small claims with fees and time lost, maybe only for larger amounts

Question 299

What to do with delinquent accounts

Answer 299

flag them in PMS to avoid further services

Question 300

What does the Fair Debt Collection Practices Act regulate

Answer 300

regulates collection procedures of past due accounts to protect public from unethical collection procedures against all collectors

Question 301

What is stated in Fair Debt Collection Practices Act

Answer 301

cannot subject client to harassment, oppressive tactics or abuse
cant make false statements, claiming to be lawyer
cant call client work if client objects,
cleints cant be called before 8 am or after 9 pm
Acct details only discussed with client

Question 302

What are guidelines when calling client with overdue acct

Answer 302

use caller ID
Counsel team not to take personal
keep conversation focused on acct collection
team member introduces themselves
Team member confirms who speaking with to avoid disclosing personal info. never leave voice message with details, just leave name and practice name and phone number
Conversations should be documented in PMS

Question 303

-Collection letters- when given and how should they be worded

Answer 303

at 30, 60, 90 days
letter short and polite, simple words
make sure date, amt and client info correct
provide specific date client must respond
provide a date when action will be taken
include a thank youi

Question 304

Employee AR considerations

Answer 304

Written policy
Best practices says employees should not be allowed to charge
May not be able to collect employee leaves
practices can loose money with discount
balance should not be greater than 100
mandatory monthly payments
if deducting payments from check- check state law
must have signed document employee authorizes payroll deduction
federal law prohibits money being withheld that would take wages lower than min wage

Question 305

Collection agencies- info needed

Answer 305

client full name, address phone
balance due
client occupation
cleint employer address
driver license
copy of client info sheet and signature guaranteeing payment
they charge 40-60%

Question 306

formula average AR

Answer 306

beginning AR+ending AR/2

Question 307

AR turnover

Answer 307

credit sales/average AR

Question 308

days in AR- what is it and what is formula

Answer 308

indicates how many days clients acct sits in AR before being collected
# of days in period/AR turnover

Question 309

How to analyze AR or how practice is doing

Answer 309

AR turnover and # days in AR important to see how practice is performing

Question 310

Two most common ways of analyzing AR

Answer 310

used to help determine liquidity, solvency, and profitability. Two most common formulas is AR turnover and days in AR ratios

Question 311

What does days in AR tell us

Answer 311

how many days of working capital to maintain the practices cash flow needs.

Question 312

Alternatives to extending credit

Answer 312

Pet insurance- studies show pet insurance means more visits, HIGHER cap on treatment, spend TWICE AS MUCH OVER PET LIFETIME- 3 types are major medical, accident, wellness

cARE CREDIT

HELD CREDIT CARD PAYMENTS- consider adding fee to cover costs - be sure read credit care agreement- surcharges may not be allowed
WELLNESS AND PREVENTATIVE PACKAGES-to encourage to accept highest level of care- allow clients to spread out payments ADDing admin fee is reasonable

Question 313

What are the two causes of action- risk of liabiltiy in necropsys

Answer 313

Tort of outrageous conduct
right not to have one’s sensibilities shocked

Question 314

Financials part 2

Question 315

Define Budgeting

Answer 315

process of planning expense and revenue and measuring values against actual financial results which provides knowledge of how operational plans are being executed

Question 316

Reports necessary to start budget process

Answer 316

1. last 3 yrs PL
2. all lease/loan docs
3. fee schedule
4. list op changes expected next few years
5. list major capital expenses expected next few years
6. employee rooster and recent W2

Question 317

what is economic cycle (aka business cycle)

Answer 317

Predictable long term pattern changes in national income. Has an impact on consumer confidence, labor market, inflation and therefore impact on practice revenues

Question 318

name traditional business cycles 4 stages- short fancy answer

Answer 318

expansion, prosperity, contraction, recession

Question 319

Name 2 things outside issues that can influence vet service demand

Answer 319

technology- ex telehealth
interest rates and access to credit

Question 320

Name 6 steps of budgeting

Answer 320

1. determine financial results- where do want to be- $ dollar amt profit
2. analysis financial statements- how have you been doing
3. normalizing the revenue and expenses
4. budgeting revenue
5. budgeting expenses
6. combining budgeted revenue and expense - making adjustments

Question 321

How do you determine financial results

Answer 321

specify goals of practice, usually profit and/or earning to gross- amount of profit on every dollar

Question 322

Step 2 What to look at when doing analysis of financial statement

Answer 322

Revenue- historical trends by profit centers- which centers have the greatest potential
RR says Breaking down revenue by profit centers and taking the time to understand the main sources of practice draws income and which areas possess the greatest potential.
Expenses- can be reorganized in 4 categories

Question 323

What are categories of Expenses

Answer 323

personnel expenses
variable expenses/cost of goods- related revenue
occupancy/facility expenses
fixed/administrative expenses-leases dues interest

Question 324

how to normalize revenue and expenses

Answer 324

remove any one time item from financials or use average last 3 yrs to normalize

Question 325

Step 3. How to budget for revenue

Answer 325

can look at patient volume (key driver)
look at schedule and # procedures poss day
look at fee schedule

Question 326

what are some considerations estimating revenue when estamating patient patient volume in future

Answer 326

adding or subtracting services
adding or losing vet
economic conditions
advertising
fee increase
demographics in area
what are some constraints

Question 327

How to estimate revenue looking at schedule, tp project income

Answer 327

average time dvm appt
average time dvm procedure
average number appt/procedures in day
look at 5 day work week and 48 weeks to project practice potential
ex. 48 weeks year X 24 appts day X 5 days week= 5760

Question 328

what are some consideration in increase your fees

Answer 328

can increase client loss
best to project revenue on per profit center basis for more accurate projection.
When introducing new service be conservative and conduct market research
*** RR like profit centers

Question 329

How to budget expense- easier because not having to consider the overall economical factors as in revenue

Answer 329

normalize figures by add last three years growth rate to base expense figure
* doesnt work unless practice established, expenses stable last 3 years, and expect to continue

Question 330

How to calculate budgeted anticipated expense categories, explain each category

Answer 330

personnel wages- estimate raises and potential staffing adjustments. add benefits package expense
occupancy/facility-look at mortgage/lease docs and increase utilities by consumer price index
variable expense/cost of goods-use historical %
fixed/admin expense-typically grows consistently with last three years data

Question 331

When do you need to make adjustments after completed budget

Answer 331

once subtracted expense from revenue and got profit, determine if addequate- if not adjust with
increase reveneue
decrease expense
adjust profit

Question 332

What to do with completed budget

Answer 332

use as guideline for daily operational and financial activities. If large variance, thorough analysis is in order- create action plan

Question 333

Client Credit policies-not recommended but at times we have reasons. when would you create client credit policy

Answer 333

long term dependable clients and goodwill- it can also increase compliance for high dollar tx.

Question 334

What are two sub-policies to extend credit

Answer 334

cleint credit policy
charge account policy

Question 335

What is client credit policy

Answer 335

establishes pre qualification necessary to open charge account

Question 336

what is client charge account policy

Answer 336

establishes credit limits, payment due dates, payment methods, invoice procedures

Question 337

Charge acct policy should include

Answer 337

all pre-qual procedures, process of flagging, invoice amount, % bill must be paid at discharge, procedure for managing aging account and collection overdue AR

Question 338

What would your charge acct information form include on the form

Answer 338

client info
amt unpaid
credit service fee
total financed
terms-day mon payment due and penality if not paid
interest rate and timing
client signature in agreement

Question 339

What other steps should be taken if creating credit policy- when it comes to your staff and the policy when it comes to clients

Answer 339

train employees (no exceptions or will lose team trust)
post written guidelines about providing estimates so everyone informed and know to request if concerned about payment.
talk to clients about payment options when scheduling new appt

Question 340

give 2 simple pre-qualifications procedures

Answer 340

call phone number, is disconnected-no or very little credit
call employer to verify employment and length

Question 341

Annual fee schedule review- what is min you should do

Answer 341

markup remains consistent when practice costs increase
be aware of Consumer Price Index and increase prices annually to reflect the cost of living at minimun.

Question 342

What is formula for deterimining cost of service fee

Answer 342

((Fixed cost/min + staff cost/min X length of procedure) + (DVM cost/min X length procedure) + (direct cost X 2) + profit)

Question 343

fixed cost per minute- how do you get formula

Answer 343

=fixed cost for month/ # minutes practice open month

Question 344

staff cost per minute formula

Answer 344

= staff cost per month/# minutes practice open mon

Question 345

Fee setting considerations for new and current pricing- some things to think about for your customers

Answer 345

avoid sticker shock with single large increase
be aware shopped/non shopped
fee setting determined by type practice
dont be too far off competitors unless value component

Question 346

What are some value components that add value to your hospitall

Answer 346

location and appearance
practice history in community
staff training. client relationships
competition

Question 347

What are some clues to persons embezzlement possbility

Answer 347

sudden wealth
talk of money problems
call at work creditors
complaints bookeeping errors
declines vacation
gambling
lift stress divorces, family illness

Question 348

what are some actions to take when you suspect theft

Answer 348

proceed caution
notify owner/leaders
secure important records. backup offsite
second copy attorney
inform insurance- what are insurance policy theft
contact accountant/attorney advice
reassign duties concerning money
on attorney advice, contact police but no accusattions
do not talk about dollar amount

Question 349

Session 10

Question 350

What is quote by stowe regarding Marketing

Answer 350

Marketing is how we tell people what we promise to give them each and every time they visit our practice

Question 351

Stowe believes Marketing needs to be redefined from the 4 P’s product, price, place and promotion. What are they

Answer 351

Emotion-comfort
Value
Virtualtechnology always changing
Excel-every experience
Expeerience- - treat people well

Question 352

When looking at marketing and situations, we often look at demographics, what kind of demographic questions should you consider

Answer 352

breaking down demographics into segments helps you define the needs within each segment
what is economic environment
what is the demand for vet services
what is competition for animal care dollars
what is the median age of the population
know your market segments

Question 353

what is client segmentation in BW?

Answer 353

A marketing term refers to the aggregating of prospective buyers into groups (segments) that have common needs and will respond similarly to a marketing action. Market segmentation enables businessess to target different categories of consumers who perceive the full value of certain products and services differently from one another.

using the client profile data to categorize existing clients into groups with smaller characteristics- (that is the goal)

Question 354

what are some broader environment marketing demographic characteristics?

Answer 354

Rate of movement of the population
rate of growth or decline?-
Municipal government influences
Industrial influences
Income levels
Single families vs multi-family housing

Question 355

marketing considerations within competition- assess them by asking what is differnet

Answer 355

distance from practice
# of Doctors
Impression of facility
# of clients
Gross revenue
strengths
differences in fees- what sets us apart

Question 356

What marketing objective or goal in terms of smart goal is defined

Answer 356

specific
measurable
achievable
realistic
time-dependent

Question 357

Looking at marketing, what are some goals you might look at, visits, cleints, #?

Answer 357

Average Transaction Fee- set targets
number of transactions- begin with 5000/dr
# of visits per client- set goal 10
# of active clients- aim 1000/dr

Question 358

Marketing is about communicating the passion and value behind products- what to think about when chatting with clients

Answer 358

non verbal communication
listening
sequencing- logical chain of thought
scripts- not prepared - define points to follow as looks guidelines

Question 359

Indirect marketing

Answer 359

client education
consistent message
clean office
professional clean employees
professional warm relationships

Question 360

Direct marketing

Answer 360

centers on bringing new clients into practice expanding services to current clients and is delivered in many ways

Question 361

What is key to increasing compliance and retention

Answer 361

client communication

Question 362

Internal marketing

Answer 362

focus on retaining current clients
includes
recalls, reminders, newsletters, postcards,
telephone etiquette, always running on time, staff enthusiasm, pets by name, anything that makes client experience better

Question 363

External marketing

Answer 363

aimed at potential clients- key to determine prospective cleints and determine best method to attract them ex social media, website, signage, open house, community classes, office tours

Question 364

what does a website do in relation to marketing

Answer 364

allow for direct, indirect, internal and external marketing, Hire a co. to develop but make sure it is unique

Question 365

What is target marketing?

Answer 365

reaching a specific group determined from your demographic and segment research- where to concentrate efforts.

Question 366

what does the reading tell you in regards to target marketing- who should we be directing our efforts towards

Answer 366

to target our marketing to the majority of pet owners in the community.

Question 367

What does Stowe say is the 16 but 3 main considerations when considering a retail space- VIS

Answer 367

Your vision- retail fit with your vision
Image-
Space

Question 368

What are the many considerations in retail space. what are the 16 sections

Answer 368

ASSIGN a designated driver
staff training- manager should spend 30min week reviewing selling with team
needs of facility- traffic flow
veterinary recommendation- vet needs to know and agree with what on shelf-
Assumptive sale- One number way to sell
advertising/promotion
unique retailing- blend medical vs product- feliway
active marketing - dont just place on shelf
accomodate children
show products
return policy
know price advantage
display strategy

Question 369

What does stowe say is budget target for advertising retail products

Answer 369

1-3%

Question 370

What is the number one way to advertising

Answer 370

word of mouth- testimonials is a great tool

Question 371

what are other ways to promote retail space

Answer 371

increase traffice flow
name mascot
gues # biscuit
open hourse
* stowe notes- DONT TAKE time away from more important vet servcies

Question 372

What are 4 basic strategies for pricing advantage under retail marketing?

Answer 372

Unique
value-added- extra size
value - based- rawhire dental chew enzyme
volume

Question 373

Name some ideas in display strategies

Answer 373

products not above 5’ and lower 1 ft
group products for convenience comparision
displays open
keep in view of receipt for theft
keep stocked
display near checkout-impulse
put prices on products
create product reviews
consider seasonal

Question 374

What is the Resistance Principle

Answer 374

Says for am y price, there will be resistance

Question 375

What does Resistance Princple say

Answer 375

if one person complains, you too low
If every client, you’re too high
Price products to have 15-20% resistance, and accept the fact always some resistance.This % appropriate for business to push the envelope for profitability.
If no complaint, consider raising prices Aim for 1.5-2 people out of 10 to complain

Question 376

What is SEO

Answer 376

Search engine Optimization- the process of affecting the visibility of a website . Client searches with key word,The goal is to have practice at tiop of listed results

Question 377

Keywords

Answer 377

keywords chosen potential clients should be woven into webiste and more often they appear, the higher the SEO

Question 378

Internal Hyperlinks

Answer 378

linking other pages within your website

Question 379

External Hyperlinks

Answer 379

linking other successful businesses on your website

Question 380

what is goal of website

Answer 380

to promote, to bring people in and keep them coming back with portal, educaiton, forms, blogs social media links

Question 381

what should be on practice brochure

Answer 381

mission, doctors, services
doctors with photo and bio
hours
contact info
website address
map QR code

Question 382

What are the 5 specific objectives of practice brochures **

Answer 382

1. provide essential information to new clients
2. compel new clients to consider loyalty
3. establish relationships new clients
4. Establish a sense of trust
5. establish a sense of partnership- the hospital works with me rather than something else

Question 383

Name some marketing strategies or options to market your practice

Answer 383

social media
client education materials
business cards
magnets
on hold messaging
donations- develop a budget
gift certificates

Question 384

what does prendergast say aobut marketing marketing programs

Answer 384

marketing techniques will not overcome effects of poor client relations within practice

Question 385

How to train staff for marketing to clients- where it happens

Answer 385

1.exam rooms- where cleint relationshops are built- marketing in exam rooms important
2. recommendations- train staff use assertice marketing techniques that give clients the information they need to accept services
3.Client perception- tour the practice, what looks good or bad- secret shop

Question 386

When managing negative reviews, what to do

Answer 386

1.take time investigate, create planned response that will be positive
2. response should be empathetic and apologetic, invite to discuss. try to reach clinent and if cannot, reply to post that trying to reach
3. promote good reviews
4. be proactive and create positive culture in practice to avoid client experience that creates negative review.

Question 387

Name the four basic steps to a succesful marketing plan

Answer 387

1. gather data- perform a SWOT-what are target groups
2. define your goal
3. Implement strategy-what when where why and how will plan work
4. create a WRITTENwritten plan- time line and budget what is predicted ROI- execute and measure

Question 388

What is the most critical step to consider when measuring results of marketing plan

Answer 388

a critical step- creating a plan without measuring and adjusting strategy is likely a waste of time- always measure the results

Question 389

What are some kpi or formula to consider when measuring results of marketing plan

Answer 389

1. cost per client
   2.revenue per FTE vet
2. net income
3. income per client
4. shopper call conversations
5. net new clients
6. service and inventory sales

Question 390

what is cost per client formula

Answer 390

gross revenue/ # of clients X % of cost

Question 391

what are the two formulas for measuring revenue per FTE

Answer 391

average transaction fee X invoices per year (DVM specific)
average expenditure per client per year X # of active clients

Question 392

What is net income profit for the owner according to stowe

Answer 392

stowe defines profit as what the owner gets to take home end of day

Question 393

what does stowe believe the number to reach for achievealbe net income

Answer 393

It is challenging but achievable to aim for a profit of 39-40%-ACHIEVEALBE IF- gross rev high, expenses controlled, efficient

Question 394

What are the stats on shopper call conversations

Answer 394

13% directly concerned about price
87% looking best vet- train team turn calls into appt

Question 395

what ideal metrics does stowe offer to measure growth in new clients

Answer 395

6:1 ratio indicates significant growth in new to lost clients per monthly
5:1 or 4:1 needs investigation
3:1 or 1:1 indicates poor growth nad agressive research

Question 396

Define Advertising

Answer 396

creates and places paid media message- best strategies if need immediate results- beign boastful can backfire. at best can persuade your target to try you once.

Question 397

Define Marketing

Answer 397

matches products/services to c onsumer needs. Attempts to forecast products should be agressively promoted, has 5 basic components

Question 398

What are the 5 basic component of marketing **

Answer 398

1. product/service attributes
2. marketing communications
3. market research
4. customer service
5. sales management

Question 399

Define Public relations

Answer 399

art of developing reciprocal underrstnading and goodwill between a business and the public
paves way to sale but more imp increases moral, productivitiy, job satisfaction
provides early warning system because you built a relationship with community, avoid disruptions should jsingle surprise issue arise
protects long develped reputations when org is under attack- no shame in promoting
WHEN PLANN9NG YOUR PUBLIC RELATIONS STRATEGY, TAKE A LONG TERM APPROACH AND USE THE TOOLS TO ESTABLISH CREDIBILITY, INCREASE AWARENESS, AND BUILD COMPETITIVE DISTINCTIONS.

Question 400

How does fear free relate to marketing

Answer 400

tells clients that we are concerned with not only physical but also well being of pet and their emotional well being

Question 401

What are key concepts of Fear Free

Answer 401

Communication
considerate approach
gentle control
touch gradient

Question 402

Define customer experience

Answer 402

sum total of all following ingredients that clients experience as they interact with practice

Question 403

How are some ways you can improve customer experience

Answer 403

client loyalty-know your top 20%-overwhelm
reputation- positive practices are more profitable
make client active partner
improve communication
demonstarte love of animals
develop pet loss strategies- help with grief
create bonds clients
personalize experience
great last impression]
evaluate image

Question 404

Have a plan to create memorable experience with framework each step of way- what happens if dont wow client

Answer 404

if you dont consider each step, can loss to another practice

Question 405

What steps does stowe suggest we focus on to create best experience at the phone call / reception counter level

Answer 405

Create memorable with:
phone call–answer 3rd ring-give name- not on hold, recept is credible, confident, competent,
Reception counter-eye contact, warm smile, greets by name, likeability in 90 secondds, pre-prepare forms, refreshments, uncluttered desk
facility-

Have a motto- if cleint calls… fill that need

Question 406

What are the 7 categories where, according to stowe can create memorable experience

Answer 406

phone call
reception counter
faciltiy
service provided
patient care
meeting needs
follow up

Question 407

What is number of female to males that visit practice

Answer 407

majority is female with 1.5 children- they welcome distractions for children

Question 408

Give some examples of other services that you can provide

Answer 408

pickup drop off services
large print materials
house call- transporation
pet school
extended hours
multiple ways to contact hospital
pet adoption
self service bath area

Question 409

How to increase patient care visit

Answer 409

personal possession in boarding
treats
comfort hospitalized pets with blankets, close circuit video
boarding as a Band B
cats not cages, have condo and sunshine
doggy day trips

Question 410

Give some ways to meet needs of clients

Answer 410

large holding cages reception room
compl cat carriers
comp leashes
water bowls
pet sitting, dog walking
new client kits
through discharge instructions

Question 411

What are some follow up marketing tools

Answer 411

email photo of pet and discharge\
immediate response to questions
medical surgical call 48 hours assess progress

Question 412

What is customer experience management

Answer 412

proactive process of creating experience positive and memorable

Question 413

What is customer relations management

Answer 413

proactive marketing tool like salesforce, process of gathering data on client prefeerences and activities to better target to meet client needs
CRM can be used to enhance CEM

Question 414

what are some examples to consider in improving your customer service standards - do these things over and again- train staff- think about

Answer 414

consider virtual tours including patients
mood, odors, smile, noise, uniforms, client library

Question 415

Six c’sto client relationship management

Answer 415

consistency-
customer service-cost 5x more to get new client than retain existing
competence
cost-value driven
compassion
convenience

Question 416

Name a couple of unique practices

Answer 416

high touch
high tech

Question 417

what is high touch practice

Answer 417

refers to high quality service and ambiance leaves lasting impression- retains more clients, offer client options, comforatlbe space, respectful

Question 418

How to increase key performance indicator, cleint retention

Answer 418

must exceed client expectations every time
in general small animal hosp will lose
10-15% clients every year
goal is retain 70-75% over 3 year period

Question 419

What are 3 R’s client retention?

Answer 419

recall, reappointment, reminder for each client, each visit

Question 420

Name some aspects of client education- what they remember

Answer 420

clients retain only 20% hear and 30% read- average client needs to hear 5 times

Question 421

Aspects of client education material

Answer 421

handouts should be professional and have practice ontact info on it.. all clients should be sent home with at least 1 piece, document when handing out documents

Question 422

Why is cleint education inportant

Answer 422

person in exam may not be person who cares for pet
reflects professional competent team
ensures the same infor sent every client
pateint care and compliance is increased
giving information in writing and documenting in records helps protect practice liability

Question 423

Name some client education tools

Answer 423

info sheets specific diseases
on hold
practice brochures or newletters
brochures by vendors
business cards
exam room power point
models body systems
videos

Question 424

Session 11

Question 425

define Procurement

Answer 425

act of obtaining and buying goods

Question 426

Supply and Demand

Answer 426

Relationship between the product availability and the need of the consumer to purchase it

Question 427

Inventory

Answer 427

all goods owned and held for sale or use in the regular course of business

Question 428

shrinkage

Answer 428

decrease in on-hand inventory that is caused by use that is not recorded or invoiced

Question 429

Replacement cost

Answer 429

The price that will have to be paid to replace an existing inventory asset with the same or similar product

Question 430

Medical supply inventory

Answer 430

Sometimes called Professional inventory- items used in the course of providing vet medical and surgical services

Question 431

Inventory Control

Answer 431

process whereby the need to maintain sufficient inventory to meet operating demands is weighed against the monetary cost of carrying the inventory. Optimal inventory control ensures that frequently used items are always available and that the return on investment for carrying and managing inventory is at the highest possible level.

Question 432

Just in time inventory

Answer 432

receiving a product just as needed vs storing the product- pros and cons
pro- low holding cost, no expired product
cons-high ordering cost, stock outs and back orders

Question 433

define inventory purchaser

Answer 433

identifies product needs and places orders using the suppliers chosen by the inventory ressearcher. Also know as PROCUREMENT

Question 434

inventory receiver

Answer 434

trained to unpack, account for, and stock the shipments

Question 435

Inventory documenter and tracker

Answer 435

documents the receipt of inventory, transfers of inventory, hospital use, shrinkage, etc. in order to maintain accurate and up-to-date data in the practice management software.

Question 436

When it comes to inventory, there should be a division of labor- what should be divided

Answer 436

**the inventory purchaser should be separate from the inventory receiver and inventory documenter tracker to avoid theft.

Patterson says: the inventory counter and the bookkeeper roles should be handled by someone other than the purchaser

Question 437

What are some areas to consider when
setting up inventory goals

Answer 437

*inventory roles are filled
*products are available to treat and clients can get refills
*quantities are controlled to min expenses
*accurate inventory reports
*regular evaluation of preferred pharmaceuticals and supplies to avoid redundancy
*Employees can efficiently order and dispense items (there are diff types of ordering-call in- online- through pms) should not pull staff away from patient care
* controlled drugs properly mant
* security and safeguards exist to ensure proper use
*employees well versed communicating value of products
*fees adjusted regularly and profit margins are set and accomplished

Question 438

Losses due to poor inventory management

Answer 438

• too much product
• not enough product shelf
• too freq ordering
  *shrinkage
  *theft
  *back orders
  *expired products (print list and use first)
  *incorrect products ordered or received
  *high cost of overnight
• shipping costs with smaller orders

Question 439

unit cost/product

Answer 439

total amount paid to vendor divided by number of units

Question 440

replacement cost

Answer 440

price that will be paid to replace the inventory with the same or similar item

Question 441

ordering cost

Answer 441

labor related expenses such as employee compensaton, including benefits, and taxes paid to perform the various duties ass. with ordering-receiving- managing records

Question 442

holding cost

Answer 442

cost invested in keeping the inventory on premises while waiting to use or sell. These costs incldue personal property tax, insurance, pharmacy licensing/DEA fees, utilities, loss due to expiration/waste/spoilage. OSHA relautions regarding safe handling of inventory and routine product maint

Question 443

holding cost range from

Answer 443

8-15%

Question 444

combined ordering and holding costs account for

Answer 444

25-35%

Question 445

DVM costs to inventory

Answer 445

If DVMs are paid on production and inventory is included, then allocation of a portion of their pay is considered an actual cost to inventory

Question 446

What are the 5 steps for getting your computer inventory under control

Answer 446

1. print your code and product list- delete or inactivate, look for duplicates, are consumables being counted?- make adjustments
2. reprint- have you cleaned up list
3. Create a list of unconsolidated products - its important not to carry more than top 2 brands of same type item. (prepare a report that shows profit/loss of each and make some decisions) FINISH THIS STEP BEFORE PROCEEDING
4. count inventory
5. begin to enter/receive inventory accurately as it is delivered to the practice

Question 447

Name some control function items and describe

Answer 447

control functions -prepare and distribute written policies and procedures create and maintain security and safety protocols, and regularly monitor the system via counts and accountability. Need to be flexible to change- if incorrect- investigate- what happened- breakage?
written policy on procedures
written safety procedure
counts

Question 448

perpetual inventory

Answer 448

one that can provide an accurate idea of inventory quantities at any time.

Question 449

periodic inventory system

Answer 449

uses data from manual product counts at the end of every financial period

Question 450

internal controls

Answer 450

all measures, systems, and protocols used to prevent errors, waste, and fraud

Question 451

What is the difference when counting inventory and the numbers do not match

Answer 451

a variance

Question 452

what amount of variance indicates a weakness

Answer 452

a 1-4% variance on high turns items can be acceptable
the more signficant the variance, the more signficant loss
controlled items- issue!!
expense items- issue!!

Question 453

Give a simple formula for finding the re-order point

Answer 453

average daily use X lead time

Question 454

What is the forecasting function

Answer 454

the ability of inventory system to signal when an item needs to be reordered to avoid an outage. It should account for the estimated delay between ordering and receiving
items with longer delay should be given a high re-order level or amt

Question 455

things to consider when looking at lead time

Answer 455

if you order weekly, consider the shipping.. if it is one day shipping, you lead time is 8 days (with weekly ordering)
WHEN factoring in lead time, start with the longest potential lead time
Round up rather than dow based on expected growth or items that can have a run (ex fluids all sudden used up)

Question 456

calculating re-order quantity (how much to order)

Answer 456

The amount to order once the re-order point has been reached.

Question 457

Formula for re-order quantity

Answer 457

average daily use X turnover goal in days

** turn over goals shouild try to match the vendor’s billing cycle to sell before the practice has to pay

Question 458

What are some of the inventory selling (profits) responsibility or functions

Answer 458

Price setting
tracking profit margin
compare inventory and supply expense to revenue generated
gross profit is the difference between $ product to client and cost of product to practice

Question 459

Give an back up example for inventory ordering to prevent stock out

Answer 459

red tag system

Question 460

What is red tag system (system for manuel inventory or even back up system)

Answer 460

tag inventory with red tag that contains all necessary ordering informaton on it. The tag represents the point at which a reorder should occur. When that product is opened or sold, the team member is responsible for placing red tag in box.

some cautions- tags fall of, packages get out of order, team mmeber loses or forgets to place in box

Question 461

Name 2 important inventory organization techniques

Answer 461

zoning and central supply

Question 462

What is the zoning system

Answer 462

Like creating A MAP where you store products
* begin with inventory team leads creating list of supplies they are responsible for
*helps ensure inventory will not float which makes difficult to track
* create a stocking list with min re-order amounts of each item
* team leads can spot check by referring to stocking list
*great for mobile trucks

Question 463

Give another name for central supply system and define

Answer 463

also known as Ration Based Inventory
supplies and inventory are stored in main highly secured area and systematically rationed out to other areas of practice. used main in large practices

Question 464

describe steps of central supply

Answer 464

*used to control internal theft or waste as aid in tracking
*location for primary9majority) and secondary storage
*access limited 1-2 people
* keyed lock or electronic key pad- dont hid keys
* physical removal requires sign out reports iwth quantities
No person should have control over the asses and the record of the assets movement

Question 465

inventory optimization is obtained through what in two words

Answer 465

Efficient turnover

Question 466

what are the 3 important factors that help drive optimal turnover and therefore inventory efficiency

Answer 466

re-order point
re-order quantity
effect of billing cycles

Question 467

What is selective inventory control

Answer 467

profit based management system that prioritizes inventory based on value and importance. uses the pareto 80/20 rule

Question 468

When can central supply and zoning together be used

Answer 468

in large hospital where they carry all the basics like cotton balls but check out inventory as needed by using their pin to gain access- then another person records the numbers logging in the product to the zone. two peolple in mix

Question 469

What is Pareto 80/20 rule

Answer 469

sya 20% of items account for 80% of sales, that 80% of costs exist in 20% of items, and that 80% profit can be predicted to come from 20% from the products sold

**also 20% client base accounts for 80% income

Question 470

what does selective inventory system suggest

Answer 470

suggest investing the most time in in manage those products in the 20%.

Minimize # times orders are placed per week. Ideeally order top 20% monthly

Question 471

formula average inventory on hand

Answer 471

value BI + value EI (DMSP)/2

Question 472

formula for calculating inventory turns

Answer 472

DMSP/Average inventory= DMSP/AI

Question 473

what is average turnover in companion practices

Answer 473

6 times a year- in general the higher the turnoever ratio, the tighter the controls

Question 474

how to calculate average shelf life (ASLD) and what is it good for

Answer 474

365=
/ annual turnover rate (ITR)

• useful calculation in determine efficiency of inventory management

Question 475

what is the goal for turns per year

Answer 475

8-12

Question 476

There are generally two types of formulas to determine cost to client for a product sold, what are they

Answer 476

Mark-up
Margin

Question 477

what is mark-up pricing

Answer 477

common in vet medicine historically
multiply acquisition cost by a factor
100%=doubles = product $ X 2
200%= triple= product $ X 3

Question 478

What is Margin pricing

Answer 478

predetermines the amount of profit desired and adds that to the acquision cost. Can be useful when there are large dfifferences in resulting pprice based on the size of patient. Margin priceing decreased the rate at which the price increases for the client when compared to mark up pricing

Question 479

What is basic difference between margin and markup

Answer 479

margin is = sales minus the cost of goods sold
Markup=amt by which the cost of the product is increased in order to derive that sales price

Question 480

what is break even point

Answer 480

amount of revenue that covers all fixed and variable cost without generating either profit or loss

Question 481

what is breat even sales price equation + profit formula

Answer 481

SP= FC + VC + P

Question 482

what are the definition of SP

Answer 482

sales price

Question 483

what is FC

Answer 483

fixed cost (unit cost, estimated ordering and holding cost

Question 484

what is VC

Answer 484

variable cost (DVM production % and asso payroll benefits/taxes)
can include almost any liability

Question 485

what is P

Answer 485

profit- aim for 12%

Question 486

What does equipment budget include

Answer 486

maintenance of existing equipment and purchase cost of new equipment.

Question 487

What should you consider when purchasing new equipment

Answer 487

is it new to practice or replacement- if replacement, what benefits does it have over existing equipment
* how will equipment be paid
* what will cleint be charged, and where is break even point?
* cash is smartest, most economical
* perform breakeven analysis prior to purchase

Question 488

define break even analysis

Answer 488

analysis that is used to determine when your business will be able to recover all of its expenses and begin to make a profit

Question 489

When performing a break even analysis, how do you determine # of times service must be performed to break even- what is formula

Answer 489

price of equipment/
client invoiced cost - cost to actually produce the service

Question 490

What is the % to invest back into your equipment yearly

Answer 490

1 % gross back into new equipment or maintenance

Question 491

How can you make equipment investment equitible regarding taxes

Answer 491

Use tax act of 2003

Question 492

What does section 179 say

Answer 492

you can write off in the first year 139,000 (2012)

Question 493

What does section 168K says

Answer 493

after used section 179, this section gives you an additional deduction of 50% of remaining balance of equipment that is purchased above the 139,000 amount already written off

Question 494

what additional deductions can you use

Answer 494

after taken 179 and 168K, you can depreciate the remainder on a straight line depreciation schedule- doesnt allow you to write off the whole thing but reduces the cost even further

Question 495

what is MACRS

Answer 495

Modified accelerated cost recovery system - established by IRS as formulaic table to calculate depreciation

Question 496

What are common examples of license board violations

COMMON PROBLEMS WITH RECORDS

Answer 496

*lack of complete patient and client identification
* lace of complete system by system description with annotated exam notes
*lack of tentative diagnosis
*lack of treatment specified and especially lack of clients informed consent or waiver or denial of recommnedation
*illegible entries and alterations or deletions of record after a reasonable contemporaneous period
1) NOT COMPLETED REASONALBE TIME
2. LACK OF SUFFICIENT DETAIL
3. LACK OF READABILITY

Question 497

give some medical record consideratons

Answer 497

if treatment or diagnosis is not documented it is presumed to not have happened
medical record violations are part of the majority of investigations by state licensing boards
although a client complaint is rarely about records, it is the records that the board will investigate to rule on complaint
even if vet are acquitted, they could still be cited for medical record violations if they do not meet the min standards
Being illegible is same as no medical record

Question 498

What is the POMR (problem oriented medical record)

Answer 498

most common medical record format.

Question 499

What sections are in the POMR medical record

Answer 499

• defined database
• problem list (AKA master list)
• plan
• progress section

Question 500

Where is the SOAP format found

Answer 500

the progress section

Question 501

name the SOAP format

Answer 501

subjective- most CRITICAL information for support staff
objective- info collected via physical exam, diagnostics, interpretation- this section is FACTUAL
assessment- a conclusion reached multiple or tentative diagnoses can be documented here with use of rule ins or rule outs
plan- developed according to assessment and includes any treatment, surgery, medication, intended diagnostics and communication with the owner. Need to be accurate for next vet

Question 502

What is the Source orientate medical records (SOMR)

Answer 502

Data is entered in the medical record and then grouped by the information source and then organized chronologically by date of patient encounter.

Question 503

Name some information sources that divide the SOMR

Answer 503

client oral history
physical exam findings
imaging studies
laboratory results

Question 504

Are SOMR records effective

Answer 504

they can be if well organized but depending on the doctor, the date to date history may be very disjointed.
Use of check lists can increase the probability of doctor capturing necessary data

Question 505

Combination SOMR and POMR records.. Aspects and divisions

Answer 505

Probably the most effective way to orgainze the record from the private practice perspeitive. It would include

*major problem list
*vaccine history
* exam uses the SOAP format with major problems entered using the POMR source orientated format

Question 506

What is the goal for manager regarding technology

Answer 506

To develop effective automated information and processing systems that can evolve with practice growth and that will be able to take advantage of new technology as it developed

Question 507

Name some applications in vet med that use technology

Answer 507

online CE
computer appt system
consultation with specialist
digital photographos
digital radiongraphs
email reminder
electronci medical records
supply purchases
webpage design

Question 508

Software implementation considerations

Answer 508

think about low tech staff and their anxiety- provide time
new software should come with onsite team training, no less than 1/2 day-
appts should be kept at min so team can concentrate on learning
if multiple applications or modules purchased, consider implementing them in phases
if new software is intended to take you to paperless, gradual training transition is recommended.

Question 509

give the timeline for software training when going to paperless

Answer 509

purchase and implement new hardware
implement new software for 6-12 months
begin final phase of going paperless

Question 510

what is the strategy behind having a ongoing liaison relationship with attorney

Answer 510

avoid the urgent and crisis oriented circumstnaces and maintains more of a preventativve relationship for the practice.

Question 511

what might an attorney help with

Answer 511

min liability exposure
review consent forms, handbooks, letter of intent
conduct practice risk audits and form reviews two to three times a year
buy sell agreements
shareholder agreeements

Question 512

name three types of services from an CPA

Answer 512

audited- very detailed- lengthy-highest level to present fair documentation of bus financial position
review- less detailed than audit focused on confirming fin statements in conformity with GAAP- CPA will identify modification to confirm
compilation - most basic- cpa should determine if any obvious departures from GAAP

Question 513

define reservoir

Answer 513

place where an infectious organism survives and replicates

Question 514

define host

Answer 514

living organism provides environment for the maintenance of the organism but may not be necessary for the organisms survival

Question 515

define direcdt transmission

Answer 515

requires close contact between the reservoir of the disease and the susceptible host

Question 516

define indirect transmission

Answer 516

more complex and involves intermediaries that carry the agent of diseeasse from one source to another

Question 517

define vector

Answer 517

living organism that transports

Question 518

zoonotic diseases # and cross-species

Answer 518

1400 exist and 60% know to cross species

Question 519

define vehicle

Answer 519

mode of transmissio of infection from reservoir to host, usually air or dirt, non living

Question 520

when it comes to risk managegment for zoonotic disease what basic should the staff know

Answer 520

zoonotic disease is disease that may be directly or indirectly transmitteed to humans from wild or domesticate animals

Question 521

Can the vet be held liable for failure to education on zoonotic diseases

Answer 521

the vet can be held liable for tansmissio of zoonotic disease. Teams should received extensive training on issue and each employee receives training should sign docuemnt

Question 522

what is vet role in education of zoonotic diseases and name one recommendation

Answer 522

the AVMA code of ethics, many state boards, and regulatory agencies require vet to educatio public regarding zoonotic diseease

One reomminded standard of care is to deworm all puppies and kittens on first visit and educate client on zoonotic potential of parasites and alwasy document conversatoin in medical record

Question 523

What area are zoonotic treatment programs generally focused

Answer 523

on reservoirs and hosts when implementing control methods for zoonotic disease

Question 524

What should zoonotic disease prevention program look like- what does preventiobn look like

Answer 524

these programs require a thorough knowledge of the disease and how it is maintained in order to break the cycle of the idsease. Examples of preventio may include vaccination, water filtration or superior hygiene.

Question 525

what is most common bacteria present in dog or cat

Answer 525

Pasterella

Question 526

common symptom of pasturella

Answer 526

fever, septicemia, menignitis, endocarditis, septic arthritis

Question 527

what to do if bitten

Answer 527

wash area well warm soapy water for at least 5 min, apply dilute betadine solution, then rinse with strong stream of water and consider seeking medical attention

Question 528

what if employee declines to seek medical attention

Answer 528

a form should be singed and placed in their medical file to protect the practice form workers compensation case

Question 529

Name the two different types of insurance coverage

Answer 529

Liability coverage
Property insurance

Question 530

what is liability coverage

Answer 530

covers damages that the vet (or any employee )causes to other person, pets, or proptery. A liability policy will contain multiple provisions, with separate limits, for personal injury and property damage caused to others

Question 531

what is property insurance

Answer 531

covers damage to insured own property

Question 532

Is there specialized forms of liability

Answer 532

yes, malpractice which is clasified legally as a tore that requires proof of foure essential elements and if any of the elements cannot be provided by a preponseerance of the evidence then the cause of action fails

Question 533

waht is a tort

Answer 533

a civil wrong or wrongful act, whether intentional or accidental, from which injury occurs to another.

Question 534

What are the four essential elements required to prove malpractice?

Answer 534

1. duty of practice within the standard of care is typically established at hte creation of a VCPR
2. breach of duty- failure to act in accordance with the standard of care
3. proximate cause- the connection between the negligent act of the practitioner and the harm to the patient or client
   4, damages- harm incurred to patient or client as a direct result of the negligent act of the practioner.

Question 535

Is there a duty of vet to treat

Answer 535

There is no duty to treat until a valid VCPR is established- not even emergencies

Question 536

Once a VCPR is established treament must continue until:

Answer 536

1. animal recovers
2. vet has completed all the treatment that was agreed upon
3. animal dies
4. client terminates the VCPR
5. responsibility for treament is transferred to another practitioner iwth the consent of the client.

**termination is difficult wiithout client consent

Question 537

What is contributory negligence

Answer 537

when defendant in malpractice action may be able to show that the client was also negligent in the care of their animal

Question 538

what is comparative negligence

Answer 538

similar to contributory negligence, except the cleint’s recovery is determined by the percent of negligence on the part of the client. If the client is found to be 25% negliigent, then they will recover only 75% of the total damage. Tyupically, if the client is found to be over 50% negligent the client cannot recover any damages

Question 539

How to avoid malpractice suits

Answer 539

continuing education- hard for vet to win if client can show vet unaware fo facts that reasonalbe vet would do
*medical records- details are the most important evidence in malpractice case
*informed consent- client must be given sufficient data to make informed decisions regarding health of their pets
* staff training- staff properly trained in medical knowledge and have proepr communiciaotn skills
* referral- general vet should be careful to make cleints aware of plethiora of speicialist having high level of specialized care than they can provide

Question 540

What is the business life cycle?

Answer 540

Introductory-vision, innovation and energy- before doors are open- REPEATEDLY THIS COURSE HAS PROMOTED MISSION VISION AND VALUES
Growth- efficiency, discipline, and talent development are critical
Maturity- manage risks, problem solve, search for continuous opportinity for growth- TEAM SHOULD BE RUNNING PRETTY GOOD HERE- KEEP TEAM VIBRANT-
decline- decreased demand for services. Revisiting the strategic plan for revitalizing the practice is vital.

Question 541

What are 4 stages for Strategic planning

Answer 541

Formulation
Development
Implementation
Evaluation

Question 542

What are 3 phases of Formulation phase of strategic planning

Answer 542

1development of Mission, vision and values- represents how every decision is made. every member must embrace MVV of practice
2SWOT analysis- strengths. opp etdc (IMPORTANT PROFESSIONAL AND PERSONALLY)
3Gap Analysis- compare current performance with potential or desired performance. This will lead to development phase of plan.
DEEP DIVE WHAT IS GOING ON AND WHERE WE WANT TO GO

Question 543

what are questions to ask in Gap analysis

Answer 543

What services are delivered today and what services are desired to be offered in future?
What skills, knowledge, and abilities does the team need to get to goal?
What is employee retention rate and are there true career opportunities?

Question 544

What overall aspect make up the development phase of strategic planning

Answer 544

Uses all those things found out in formation phase to create strategic intent to acheive desired goals. HOw you get form point A to point B

Question 545

What things to consider in development phase

Answer 545

Deep dive on where we want to go

Team members- skill level, training, retention
clients- who is target market, how to find them
Patients- what equipment or tools are needed to reach patient care goals
Budget- what investments are needed to reach goals and how will practice obtain those funds

Question 546

What is outcome of development phase

Answer 546

to create a strategy that has a “strategic fit” where the practices activities interact with and support the strategy and each one optimizes the other to reach the goal.

Question 547

What happens in the Implemetation phase of strategic planning

Answer 547

the strategic intent in translated into specific plans of action. There should be allocation of resources, communication to team members, management of team, education and staffing to achieve goals

Question 548

How to implement plan of action in learning organization

Answer 548

incorporate “System Thinking” where consideration is given to how each department affects another
list objective and how to measure
how will objections be obtained and what resources
what is time frame.. WHAT METRICS

Question 549

What is the evaluation phase of strategic planning

Answer 549

Time to think about original objectives created in the Development phase. Evaluate the success of those. There should be check-in points for KPI’s that were discussed.
Might consider a balanced scorecard

Question 550

What is a balanced scorecard

Answer 550

A tool that illustrates the state of the practice in regards to client satisfaction, financial status, learning and development progress. The scorecard metrics can show the side effects of your strategy and its successful implementation, as well as whether the changes have affected other areas of the business.

Question 551

OUtside of the business lifecycle, there are organizational systems that can apply to strategic planning. What is Organizational Design

Answer 551

The methodology that identifies aspects of workflow, procedures, roles, and systems and aligns them to fit current business realities and goals.
Organization design clearly defines roles within the practice and should empower team members due to clear responsibilities, clear goals, and effective communication.

Question 552

Organizational Development is different from Organizational Design in it looks at the process of enhancing effectiveness within practice. What are the four compoinents of organizational development?

Answer 552

1 Define the problem
2 Design a solution
3. Implement phase
4 Follow through

Question 553

What is Learning Organization

Answer 553

Characterized by the ability to adapt to change and respond quickly to environmental/consumer changes

think covid

Question 554

what are 3 areas to evaluate and consider where change might be indicated in learning organization

Answer 554

client services
patient care
TEAM DEVELOPMENT

Question 555

WHAT ARE SOME common reasons for failure of Organizaiotn Development

Answer 555

leadershiop dod not support or commit to change
wrong message or message did not resonate with the team
chages were forceful instead of collaborative
lace of clear communicaiton
change does not align with MVV

Question 556

What does a Learning Organization Do

Answer 556

Uses System Thinking as it relates to being a learning organization

therefore
every team member must generate ideas and create solutions for all parties involved
MVV critical element to systems thinking
team members need to know that leadership readily embraces charge and accepts recommendations
failures create learning opportunities and empower team members to continue being engaged in the process

Question 557

What is order of events if your information tells you there is fraud

Answer 557

1) notify owner
2) secure important data- badckup
3) inform insurance agency
4) contact attorney/accountant
5) Reassign duties so they are shared
6) on attorney advice, contact policy
7) Do not talk about numbers $