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Success Story

Achieving 5-Star Ratings

Client interview with Diane Geis, Chief Personnel Officer.

As the Chief Personnel Officer of TSG Resources, a management company for long term care and rehabilitation centers, Diane Geis works hard to uphold organizational values of quality of care, customer service and customer satisfaction. Diane credits Relias for improving their quality of care. Her proof? Their 5-star ratings for all 20 facilities.



Altercare began in 1973 as a single nursing facility. This family-owned business now owns and operates twenty skilled nursing facilities in Ohio and one in Michigan, delivering quality care to their shortterm rehabilitation, long-term nursing, and residential patients. Longterm healthcare is the organization’s passion. Over the past forty years, Altercare has worked hard to fulfill its mission of putting patients’ needs and goals first, and their long record of AHCA Quality Awards proves it.

They have received a total of 35 National Quality Awards over the past 11 years and have been awarded two Gold (the only in the State of Ohio), thirteen Silver, and twenty Bronze awards. In addition, eighteen of their twenty one facilities have achieved a 5-star CMS rating. How have they done it? The organization prioritized the education and training of their employees to focus on quality of service. The results speak for themselves.



Prioritizing education and training is one thing, but actually delivering it is another. Altercare needed to deliver, manage, and track training for over 2,000 employees across 21 facilities. In the early days, this meant scheduling four different training sessions on one day, which still didn’t reach everyone. Follow up sessions were needed, creating additional cost. This method of training was cumbersome, costly, and inconsistent. As the company expanded, it was clear that in-person training was no longer an efficient or effective option.

Diane Geis, Altercare’s Chief Personnel Officer, explains: “Someone would send out volumes of paperwork.
These were extensive piles – 10 inches high! The training lacked consistency because the material was being presented by many different people: managers, nurses, and even human resources.”



When in-person training no longer sufficed to get staff up to delivering the desired quality of care, Altercare looked for an automated training solution. Altercare identified Relias* as their eLearning solution of choice. In 2012, they began utilizing the Relias learning management system (LMS) to create an interactive and progressive training program that standardized care and aligned with quality measures. Orientation curriculums were implemented to introduce new staff to Altercare’s continuum of care. Employees were also assigned a monthly curriculum that is easily distributed and tracked within the Relias LMS.

“Our philosophy is that when surveyors are in the building, we expect all staff to be able to understand and respond to queries. Everyone, from the housekeeper to the Nurse Manager needs to be able to answer questions of surveyors.”

These expectations have been easily applied and readily accepted amongst the staff. Altercare put laptops in their facilities and encouraged staff to utilize Relias’ mobile app and BrainSparks®, digestible “content snacks” that trigger key learning elements. Altercare found that creating a culture of learning and giving employees easy access has not only impacted the quality of care they provide, but also added to employee satisfaction.



Altercare has shown what can happen when an organization fully embraces what the Relias Learning Management System offers and uses it to put its own mission into action. The organization and, perhaps more importantly, its residents have reaped the benefits. Across Altercare’s twenty one skilled nursing facilities, eighteen hold a 5-star rating and the remaining three hold a 4-star rating.

Not only have their ratings improved, they have also seen their re-hospitalization rates improve, dropping from 18% to 12.4% as a direct result of better training and education. With the average re-hospitalization rate in the state of Ohio at 17.4%, Altercare is far ahead of many other organizations.

“We have seen an overall improvement in moving up on the 5-Star Ratings, and we attribute some of that success to the consistent training curriculums we have identified and structured in Relias.”

Altercare made a conscious choice to invest in their employees and their company when they purchased Relias’ innovative technology, and they continue to experience the return. Their managers customize content to suit the needs of their department and/or a specific employee.

“Facility supervisors can ensure that when they have compliant surveys or when they have an internal problem they want to address, they will look in the Relias courses and find a module that fits their purpose and assign it out to that specific facility” says Geis.

Altercare also uses Relias courses from the Advanced Leadership library to develop their leaders and managers. They assign specially designed curricula to leaders and combine it with additional leadership training initiatives within their organization. Geis has found that the combination “is a wonderful support mechanism that can take good leaders and make them really great in their role.”

Quarterly reports, provided to the Altercare CEO, demonstrate a significant cost savings, noting that in-service hours now come in under budget.

“Even though we must pay a fee for Relias, I feel it is still less than the time it takes a nursing manager to present three In-service Trainings each month at all staff meetings at every site,” says Geis.

Relias has enabled Altercare to offer consistent, relevant, and up-to-date training across their organization. Altercare can now guarantee that all employees receive uniform training that keeps the organization compliant, employees engaged, and provides the utmost quality care to their patients.


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