The client is a nonprofit organization specializing in services and support for individuals with disabilities. The organization operates an Article 16 clinic providing psychiatric, podiatry, nutrition, speech, social work, assessment and testing, and physical and occupational therapy services. The clinic spans 13 locations across five counties and serves approximately 1,300 patients.

At the time of engagement, the clinic was experiencing declining operational performance and increasing regulatory risk. Leadership identified challenges related to staffing alignment, high appointment no-show and cancellation rates, and significant compliance exposure following a recent Electronic Health Record (EHR) migration from Accumedic to eClinicalWorks.

In addition, the clinic lacked consistent operational discipline, up-to-date policies and procedures, and clear accountability structures, all of which contributed to financial pressure and heightened oversight risk. As a result, the client engaged ProNexus to stabilize clinic operations, mitigate compliance risk, and implement a sustainable operational framework—without disrupting patient care.

ProNexus Solution (How We Helped):

ProNexus was engaged to conduct a rapid operational, clinical, compliance, and financial assessment and to lead an immediate stabilization effort across the Article 16 clinic.

To begin the engagement, ProNexus requested and reviewed comprehensive operational, clinical, compliance, and financial documentation. ProNexus then conducted structured interviews with clinic leadership and staff, both individually and in group settings, and collected qualitative and quantitative data over a two-week period.

Based on assessment findings, ProNexus developed a detailed Plan of Action addressing the original engagement objectives as well as additional operational and compliance risks identified during the review. The Plan of Action was reviewed and approved by the client, and implementation began immediately.

Key areas of focus and impact included:

• Staffing Optimization:
  ProNexus identified overstaffing equivalent to three full-time employees and redesigned the staffing matrix to align clinician coverage with patient demand while maintaining continuity and quality of care.
  • Annual financial impact: $312,000 in cost savings (exclusive of fringe benefits)
  • Recommended inter-agency agreements to appropriately allocate and charge for non–Article 16 billable clinician time
• No-Show and Cancellation Reduction:
  With no-show and cancellation rates exceeding 30%, ProNexus implemented a multi-pronged strategy that included activating automated appointment and paperwork reminders within Healow/eClinicalWorks, revising and enforcing discharge policies, and establishing weekly monitoring and rapid rescheduling protocols.
  • Projected reduction in no-show rate to approximately 15%
  • Forecasted annual revenue impact: $483,000 in additional revenue
• EHR and Compliance Risk Mitigation:
  ProNexus identified incomplete patient record migration and the absence of a compliant treatment plan workflow following the EHR conversion. ProNexus led a full review and correction of all 1,300 patient charts and worked directly with the eClinicalWorks technical team to redesign treatment plan workflows to meet operational and regulatory requirements.
  • Corrective actions significantly reduced ongoing compliance exposure and mitigated risk related to prior $1.2 million in Medicaid paybacks
• Operational and Infrastructure Improvements:
  ProNexus modernized outdated policies, developed standardized operating procedures, restored active use of the agency’s compliance plan, verified clinician licensure and credentialing, completed overdue audits, strengthened the quality assurance plan, and worked directly with the EHR vendor to resolve platform issues and implement the patient portal.

In addition to technical and operational improvements, ProNexus established leadership and communication infrastructure to support long-term stability, including defined supervision and accountability structures, regular leadership and staff meetings, and clear internal and external communication channels.

As a result of the engagement, the clinic achieved immediate financial savings, identified meaningful revenue enhancement opportunities, significantly reduced regulatory risk, and is now positioned with a clearer, more disciplined operational framework to support its mission and long-term sustainability. ProNexus assisted in the onboarding of and knowledge transfer to the newly hired Director, ensuring a sound handoff and smooth transition.