ORGANIZATIONAL ANALYSIS

Organizational Analysis: StoneCrest Behavioral Center

Kritzia M. Rosas-Feliciano
Wayne State University

SW 4020

Abstract
In this organizational analysis the human service organization I will analyze is StoneCrest
Behavioral Health and Inpatient Treatment Center. I will discuss the organization and the
services it provides to the population they serve. I will review the organizations mission and
goals and I will go into detail about how the organization addresses multiple goals and the
influence this has on the organization. Organizational structure and staffing will be mentioned
and the relationships among staff and programs will be discussed. I will go into detail about the
internal and the external environment and the relationship between the organization and the
community and clients it serves. A theoretical construct of the organization will be formulated.
Finally, recommendations will be provided for the organization.

ORGANIZATIONAL ANALYSIS

Attached are the following:

Organizational chart
SWOT Analysis

Organizational Analysis: StoneCrest Behavioral Center

Organization and Services
The organization where I am currently doing my field placement is StoneCrest
Behavioral Health and Inpatient Treatment Center. StoneCrest Behavioral Center is a for profit
agency. Stone Crest is a psychiatric hospital that serves different populations with mental
illnesses and/or substance abuse problems. StoneCrest has 104 beds for acute psychiatric
inpatient treatment provided to seniors, adults and adolescents who are in need of specialized
behavioral healthcare and chemical dependency services. StoneCrest offers treatment for
depression, bipolar disorder, substance abuse problems, schizophrenia, and/or developmental
disorder. StoneCrest is the only treatment center in the state that provides specialized services

ORGANIZATIONAL ANALYSIS

for individuals with developmental disabilities such as autism, Asperger Syndrome, intellectual
disability and sensory processing disorder. Also, StoneCrest offers a Generations Program that
specializes in treating co-occurring and memory disorders, including Alzheimers disease and
dementia for older adults and seniors.

The Generations Program at StoneCrest is a short-term, inpatient treatment program

specifically designed to help seniors deal with emotional problems or stressors they may be
experiencing in life. This treatment program offers treatment for older adults who are suffering
with issues of aging which may include depression, anxiety, mood disorders, grief, coping with
long-lasting illness, adjustment to retirement or widowed life, stress associated with care giving,
and cognitive impairment. Moreover, family involvement is extremely important to the wellbeing of the patient and that is why the Generations Program is partially geared towards
educating the patients family to help them understand what their loved one is experiencing and
how to cope with certain emotional difficulties in the future in order to improve their overall
quality of life. The Generations Program treatment includes individual, family, group and
recreation therapy.

The adult inpatient treatment is called the Restorations Program, which is designed to
help adults with behavioral health issues and severe or life-threatening psychiatric problems.
StoneCrest aims to prevent, support and treat mental, emotional, and behavioral conditions so
that patients can return to their home and community. Some of the treatment includes group,
family and expressive art therapy.

The adolescent inpatient treatment is called the Foundations Program and is for

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adolescents struggling with a number of different behavioral health issues. StoneCrests

treatment program focuses on reintegrating patients back into the community by increasing
problem solving and communication skills, coping abilities, and enhancing their self-esteem.
Some of the treatment methods used include individual, group, family and expressive arts
therapy.

StoneCrest also offers substance abuse treatment that includes medication management
and group and family therapy. Medication management consists of the use of medications to
help alleviate the symptoms of withdrawal or to help treat the symptoms of a co-occurring
disorder. All patients meet with a psychiatrist daily and see a medical doctor regularly in order to
ensure the effectiveness of any medication that is prescribed and to make any changes if
necessary. Group therapy consists of multiple groups held on a daily basis that cover topics such
as social skills, goal-setting, support systems, anger management, and educational meetings.
Family therapy is offered to encourage the involvement of the family of the patient in order to
help the patients be successful in the treatment process. Also families are educated to help them
understand what their loved ones are experiencing and to discover ways that will help them cope
with emotional difficulties. Other methods of treatment that may be used include individual
therapy, expressive arts therapeutic recreation and sensory room interventions.

Mission and Goals

The sated mission of StoneCrest Behavioral Center is to provide advanced care in a
compassionate environment. To set StoneCrest apart from other mental health facilities,
StoneCrest offers individualized, superior care that improves the quality of life for the patients

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and provides a reliable resource for the community. Acadia Healthcare has an active
Compliance Program and Code of Conduct intended to promote ethics and integrity while
completing the mission of helping clients attain their full potential by delivering quality
behavioral healthcare services in a caring, supportive and financially responsible environment. It
is expected of all Acadia Healthcare affiliates to be alert and sensitive to situations that could
result in improper, unethical or illegal conduct. Acadias compliance program is a resource to
help Acadia meet its ethical and compliance obligations.

The visual operative goal is to treat mental and behavioral health as well as addictions so
patients can regain a healthier life. StoneCrest Behavioral Centers vision is to redefine the way
mental health care is delivered. StoneCrest continues to be the leader in creating distinct
effective mental health disease management through partnerships with physicians and other
clinical professionals; the application of technology; and most important, the extension of
services from the hospital to the home. With a vision to remain an ever-improving care center,
StoneCrest strives to redefine the way that mental health treatment is delivered. By focusing on
reintegrating patients back into the community by increasing problem-solving skills,
communication skills, coping abilities, and enhancing their self-esteem, the compassionate staff
is committed to providing a safe, supportive environment for those who trust StoneCrest with
their care.
Goal displacement occurs randomly in the organization. At times documenting becomes
the main priority rather than the actual care of the patients. Most of the influences that impact
goal displacement are management and the need to have all documents in the patients chart up
to code to meet the standards of the state surveyors and other organizations that conduct

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inspections at the facility. These influences are necessary to maintain the good prestige of the
organization, but at times it can affect the client because staff members would be more focused
on documentation that providing the physical care to the patient. It can also be beneficial for the
patient, because it increases knowledge of the patients status on an actual document and it can
be used and tracked more easily.
Organizational Structure and Staffing
The organizations structure influences the distribution of power and control in the
organization rather evenly. Acadia Healthcare Inc. is over the StoneCrest Governing Board and
under the governing board is over the CEO, Steve Savage. The CEO is in charge all of the
discipline directors and COO, CNO and CFO. The Administrative Assistant also works with the
COO. The COO is in charge of the Clinical Service Director, Pharmacy, Facilities Manager,
Dietary and Security. The CNO is also in charge of the Pharmacy and is in charge of the ADON,
Nurse Supervisors, and Unit Clerks. The CFO is in charge of the Business Office Director,
Billing, Assistant Controller, HIM Director, and Purchasing Manager. The Medical Director is in
charge of medical Physicians and Psychologists. The Quality Director is in charge of the
Quality Manger and the assistant. The Recipients Rights Director, the Business Development
Director and the Admissions Director oversee their own staff. The Human Resource Director
oversees Administrative Assistant. The Facilities Manager oversees Housekeeping and
Maintenance. The Assistant Controller oversees Purchasing, Payroll, Accounting, and IT.
Finally, the Clinical Service Director, Paul Anderson, is in charge of many departments and
mainly the Social Work Department. Paul works directly with Utilization Supervisor and her
staff, Social Work Manager and her staff, Document Specialist, Activity Therapist staff and Court
Liaison. Paul also oversees Interns, the Social work manager works directly with the interns as

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well. A well functioning hospital requires many professionals in order to operate effectively and
efficiently. As an Intern, I follow orders from the Clinical Service Director and the Social Work
Manager. I have also had the opportunity to experience the activity therapist staff work with
clients. The organizations structure influences the distribution of power and control in the
organization evenly, because each discipline has a manager and/or director who supervise them.
These Managers and directors are constantly involved with the staffs work and improvement.
StoneCrest Behavioral Center best fits as the organismic analogy. The organismic
analogy refers to organizations working much like the human body where every organ has
different functions to reach a common goal (Netting, Kettner, McMurtry, &Thomas, 2012, p.
141). In this organization all the disciplines have different functions to reach a common goal.
According to Netting, Kettner, McMurtry, and Thomas 2012, the community as a whole to
function effectively and for the community members to agree on what needs to happen (p. 141).
Conflict is kept to a minimum as long as workers play by the rules in this agency. The directors
and management often talk to staff about certain changes or new policies and procedures that
they must follow and they often ask for the staffs opinions. As long as the staff members
opinions are by the rules and facilitate the work for the staff members, management and the new
policies, their opinions and ideas will be considered valid and will be taken into consideration for
implementation.
The extent of diversity at different levels within the organization is shown in the
organizational chart. Both, men and women, are represented in director and management
positions. Most of these individuals in management positions are Caucasian and very few are
African American. Greenhaus, Parasuraman, and Wormlet 1990, conducted a study that
examined relationships among race, organizational experiences, job performance evaluations,

ORGANIZATIONAL ANALYSIS

and career outcomes for black and white managers from three work organizations (p. 64). The
employees that are unaware of the constant oppression that minorities are subjected on a daily
basis might over look some of these findings. According to Greenhaus, Parasuraman, and
Wormlet 1990, compared to white managers, blacks felt less accepted in their organizations,
perceived themselves as having less discretion on their jobs, received lower ratings from their
supervisors on their job performance and promo ability, were more likely to have reached career
plateaus, and experienced lower levels of career satisfaction (p. 64). The majority of the staff
members at Stone Crest are Caucasian, there are some African American, and very few Hispanics
or other races. There are more female employees in management positions and more male
workers in the areas of nursing and mental health assistant. The majority of the people of color
are in clerical positions, nursing, mental health assistant, dietary, and housekeeping. There are
persons with disabilities that work in dietary and housekeeping positions as well.
Relationship with Community
The relationship between the organizations internal environment and the shifting macro
environment in which it operates is welcoming, because everyone is treated with dignity and
respect. Being a behavioral center, StoneCrest is a gaited facility and has very high security for
the protection of the patients.
StoneCrest Behavioral Center achieves legitimatization in its external environment by
their location in Detroit where the surrounding area is made up of people prone to have substance
abuse issues and mental illnesses. StoneCrest also accepts all insurance in order to be able to
provide help for those that needed without being discriminatory of their health insurance.
During treatment clients are given tools they can use in the external community, such as a crisis

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plan. A crisis plan helps the client and anyone who reads it find information to help the client
and seek the correct support system, hospital, and even medications according to the client
desires. StoneCrest treats their clients in terms of biographical space. According to Lefton and
Rosengren 1966, treating clients in terms of biographical space means that the organization has
an extended interest in the client as a product of and participant in society (p. 805). Crisis
planning helps the client prevent a crisis, or in the case that it happens it helps their wishes to be
met. The best way to ensure that clients will choose to get help from the facility whenever
needed is to strengthen the relationship between the staff and the clients. According to Lefton
and Rosengren 1966, there is a need to codify the relationships between clients and
organizations (p. 802) in order to see the effectiveness of the organizations with their clients;
this can also be very beneficial to the organization.
The clients at StoneCrest Behavioral Center come from all over Michigan, depending on
the availability of psychiatric hospitals in their area. Clients who are at risk of harm to self or
others, struggling with psychiatric illnesses, substance abuse concerns, degenerative cognitive
disorders, or any Autism disorder can be admitted to StoneCrest Behavioral Center. Clients
facing a crisis can also call or go to the facility for self/voluntary-admission.

StoneCrest also has well-established guidelines for those requiring involuntary admission
and collaborates with outside resources and community agencies to ensure that any and all needs
are met. On an effort to provide a collaborative approach to fighting mental health disorders,
StoneCrest Center works with medical professionals in the community. Physicians and
multidisciplinary teams focus on providing accurate assessments, thorough medical
management, and complete therapeutic interventions for clients.

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Theoretical construct of organization

The organizational theory that best describes StoneCrest Behavioral Center in terms of its
overall functioning, management structure, decision-making practices, and organizational culture
is the Management by Objectives Theory. According to Netting, Kettner, McMurtry, and
Thomas 2012, management by objectives theory suggests, organizational goals and objectives
should be made the central construct around which organizational life revolves (p. 223). The
Directors and management staff are constantly reinforcing the importance of achieving the
objectives at hand. Participative management is used to promote understanding throughout the
organization by discussing different approaches to the same task as long as the objective is met
(Rogers & Hunter, 1992, p.27). Protocols and procedures are constantly changing; management
ensures that their staff is aware of the new changes and that the objectives are met by the end of
the day. According to Rogers and Hunter 1992, goal setting in MBO programs involves the
continuous review and revision of objective (p. 27). Different ways that the management at
StoneCrest achieves these objectives are by auditing charts. Charts are audited randomly weekly
and also at the end of every month 40 charts are audited at random as well. Any new rules that
were implemented must be reflected in every chart for every patient in order to ensure 100
percent compliance. Management is very meticulous about documentation on patients and
making sure every single expectation from the state is met. The management by objective theory
helps an outsider understand my agency better, because they will know what is expected of them.
They will understand the importance of always documenting everything on patients and doing so
correctly. Having the right documentation will not only increase profit, but it benefits the
patient. The patient benefits from full and correct documentation because their rights are sure to
be protected and also documenting increases staff knowledge on the patient which helps them

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provide better care to the patient.

Recommendations
The SWOT analysis conducted with the COO of StoneCrest was very helpful. The
strengths for this hospital are their specialty programs for each of the populations they serve.
Not only are patients receiving treatment according to their age group and condition but tall of
their treatment is client centered and family is encouraged to participate in the care of their loved
ones in such critical time in their lives. The weaknesses of StoneCrest hospital was managing
patients with medical comorbidities, or more than one disorder. I understand how comorbidity
can be a challenge for StoneCrest because they are a behavioral center not a medical center,
which can be a challenge to help those patients who need medical and psychiatric assistance
conjointly. I would recommend StoneCrest to add an emergency room for those who may need
immediate medical in the psychiatric units and also for those patients who might have attempted
suicide or experience any psychiatric trauma to be able to be assisted in a more efficient manner
and to expand to their many great services. Opportunities in the future for StoneCrest include an
expansion project to add 21 beds in the year of 2015 and 2016 and creating 120 PTEs. Some
threats affecting StoneCrest Behavioral Center is the IMD exclusion. According to Rosenbaum,
Teitelbaum, and Mauery 2002, the IMD exclusion is limited to persons ages 21-64, federal law
exempts adults ages 65 and older who receive services in institutions for mental diseases and
children under age 21 (p. 2). This IMD exclusion affects the adult population that StoneCrest
serves. The adult population at StoneCrest is the most abundant and the ones who often need
the assistance more often. This IMD exclusion is not only a threat to the organization, but also a
huge threat to adults who suffer from mental illnesses. The IMD exclusion has an exemption in
the case of institutions with less than 17 beds (Rosenbaum, Teitelbaum, & Mauery, 2002, p. 2).

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Many attempts to narrow its scope or eliminate the exclusion entirely have been rejected. More
studies are to be done in order to see what the states use this exception and the barriers to its
greater use for mental illness and substance abuse. Knowing that the IMD exclusion is such a
threat to the organization I would recommend the COO to appoint one of the social workers to
advocate for the adult population in need of mental health services. In the perfect world all these
recommendations would work, but in reality it would be difficult to implement an emergency
room to a psychiatric hospital. If there were an Emergency Room to be added to StoneCrest,
more staff would need to be hired and trained which might cause organizational resistance. If the
business side of the idea shows higher chances of making a profit it would be the only way that
can drive the organization to go forward wit the plan. The recommendation about appointing a
social worker to advocate for the population in need would be more realistic to accomplish and
beneficial to the organization.
Conclusion
In conclusion StoneCrest Behavioral Center has specialized treatment for different age
groups with different specific mental illnesses or substance abuse issues. StoneCrest offers many
different types of therapy and medication management in order to help their patients with their
recovery. The organizations mission and goals is to provide advanced care in a compassionate
environment. Focusing on the documenting aspect of the patient care can sometimes displace
this goal. The organizational structure and staffing are well distributed with a manager or
director guiding the staff members every step of the way throughout their workday.
Relationships among staff and programs work as an organismic analogy. The internal and the
external environment at StoneCrest Center provide a sense of safety for those in need of
psychiatric assistance. The theoretical construct of the organization is Management by

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Objective. Finally, recommendations were provided to add an emergency room to StoneCrest

and also to have one of their social workers advocate for the change of the IMD exclusion. The
only realistic recommendation would be the IMD advocacy recommendation.

References
Greenhaus, J. H., Parasuraman, S., & Wormley, W. M. (1990). Effects of race on organizational
experiences, job performance evaluations, and career outcomes. Academy of
Management, 33 (1), 64-86.
Lefton, M., & Rosengren, W. R. (1966). Organizations and clients: Lateral and longitudinal
dimensions. American Sociological Review, 31 (6), 802-810.
Netting, F. E., Kettner, P. M., McMurtry, S. L., & Thomas, M. L. (2012). Social work macro
practice (5TH ed.). Allyn/Bacon.
Rodgers, R., & Hunter, J. E. (1992). A foundation of good management practice in

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government: Management by objectives. Public Administration Review. 52 (1), 27-39.
Rosenbaum, S., Teitelbaum, J., & Mauery, D. R. (2002). An Analysis of the Medicaid IMD
Exclusion. GWU School of Public Health and Health Services, 1-18.

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