“The Power Of The Ask” by Dianne H. Timmering

My four-year-old niece Lola was on the phone with my sister Linda recently and was telling her about her day. While they were talking, Lola suddenly stopped and asked my sister how much longer did she want to talk because her favorite show was coming on and she didn’t want to miss princess Sophia’s slumber party with her friends. Linda paused, laughed inside, and then told Lola that they could be done talking so she didn’t have to miss her show.

And I thought about the power of ‘the ask’.

Lola’s ‘ask’ was honest, direct, and specific and yielded her the result she wanted. Do we do that when we are praying? I know I have found myself thinking healing prayers when I pray for someone on the prayer chain, but DO I ask? And I found that my answer was often no, I didn’t.

Joe and I were so honored to be able to present our early research on the power of the ask and frankly since we did that livestream broadcast we have been more aware than ever of the intent of the ask and the power around it.

I am now asking for the healing of a chronic sickness for a resident…

I am now asking for the healing of a motorcycle victim’s broken bone and an ease of pain…

I am now asking that God zap a devilish cancer of a distant friend…

Let us be bold, specific and honest with God as to exactly what our requests are. It might take another few seconds to put our requests or thoughts into the form of an ‘ask’ but take the additional time up-front, in both mind, thought and deed, and see if the result isn’t faster, more complete and fully sustainable.

Ask…for God alone knows the desires of your heart and see if that doesn’t open up special dialogue. “Talk to me” He says, “I will meet you there.”

Dianne H. Timmering, MBA, MFA, CNA
Vice President of Spirituality and Legislative Affairs
Signature HealthCARE Consulting Services, LLC

#shcspirituality; @DHTimmering


Don’t Run: A DON Clinical Revolution Reflection

Recently in November, SHC hosted our first-ever Clinical Revolution, bringing in all of our DONs across the 10 states that we serve. They are beautiful, inclined to think of others with the passion of their hands and the truth of their skill-sets.

In long-term care, we serve the sickest and most vulnerable, and even abandoned in some cases. Our DONs face cruel sickness on a daily basis…angry family members, stakeholders who are broken, fighting it out on a daily basis, taking care of beloved residents while coping with personal issues that sometimes seem like a tumultuous mountain that grows out of the earth – and they can’t keep up.

Our DONs came with fatigue, and maybe even some hopelessness. Our CEO Joe and other greats leaders, like Kathy O., listened with compassion, dissected their survey results, discussed new tools and clinical offerings, that it was, and would be, worth the wait.

God spoke too.

‘I see you,’ He said. ‘I hear you. I know your pains, and your soulful thoughts that only I can hear.’

He said to trust Him, to let go of the past hurts, regrets, mistakes and to let go and be all that was capable within.

“Don’t run,’ He said. ‘I appointed you for such a time as this. You are called.’

Nursing, after all, is a vocation; service to a population who helped build cities and communities, teach and raise us, farm the soil and fight in distant lands.

What if…

What if the power of the spiritual could heal when nothing else could?

What if we could defy pain through compassionate listening and tender music?

What if we could pray over pressure sores and the power to “heal thy wound” is real?

What if we could prescribe the spiritual of scripture and sew it into torment, or the physicality of what hurts?

What if we could stop a fall or prevent a negative act from happening because we encourage a patient to simply use her walker, because she is beautiful doing it and she just needs a little help?

What if.

What if the power of the spiritual and clinical together could reduce hospital readmits because the patient is just scared? And the qualified team of nurses can handle their physical ails, it was just a frightening moment…

What if we could comfort an angry family member, not because they are really mad at the care we give, but simply because they feel helpless to hope their loved one gets better?

What if.

And together that morning, we started to renew, restore, believe. Because a revolution takes a vision and the belief wrapped around it in the possible. Because risk is only failure when there is no risk at all.

So we let go, and we didn’t run, realizing we didn’t have to. A mosaic of peoples, skills, cultures, traditions, beliefs, fitting into the puzzle of a perfect mission, an army linked arm-in-arm on the front line of the care battlefield. Each one a fortress. Each one serving a pivotal role. Each one skilled. Purposeful and fulfilled, not because every day was absolutely easy, but because each day was powerful in the journey of the destiny of a real revolution.

I say we run toward the revolution of the possible now, for we are the future of what the world can only imagine. We are the intervention of hope, the innovation of true change, of really healing, of pioneering our way and shoveling toward figuring it out together.

Maybe turnover is related to fear of failure and not distress of the position. Maybe turnover can be overtaken and combated by simply believing that a new future for our people is worth the fight of a good revolution, and because we have the right tools, weaponry, armor. A new world awakens.

Imagine we control the regulatory world around us. When an adverse event happens, we can begin the “four step process.” Now.

What if.

That’s the song of a revolution: controlling our world, not waiting for it to sword our gut with the skewer of the sting so that we can’t fight anymore because the fight has left us.

That is our calling. Together, we are the future of what is possible now.

The Spirituality Framework in a Corporate World

The essence of the spiritual is within. It means that you can be your own spiritual entity of light. We have brought God inside the workplace, inside our for-profit culture, and have been blessed with significant essence of that which is about the presence of what is real, in the light of matter.

Many people ask about and yet fear the spiritual realm in the workplace for real reasons, although through education and the deliberate intention of respect for another’s practice or faith tradition, we have created an environment where we can thrive in the roundness of who we are, un-watered down, spiritual skin intact, just not rubbed off on someone else, so to speak. Simply said, it is a modeling of dignified compassion. It is a new awakening of what being spiritual means with discernment and decision-making in the realm of profit, where humankind and profit-making find themselves inside the same sentence, and a spiritual injection into the fabric of a culture begins to look at the co-worker as a neighbor, a colleague and a friend, someone to care about, to rejoice with, to pray with, to cry for, all wrapped up in the thumb of life, because life flows at work and need never stop, and kindness has its place, and a profit is stewardship, the best of its kind, so that people have purpose and place together in market-borne demands.

Money is good. Unabashed courage of the inner life is even better. Mastering one’s own solitude is boundless.

But most companies are just not ready for God in the workplace. The misnomer that God cannot live where we spend so much time making critical decisions based on profits and margins and people, while untrue, has a well-tuned media life in that the fear is real even though the cause is often based on the assumption that spiritual air cannot come through the door from 9 to 5 because the world says it can’t. But the First Amendment allows the free practice thereof, as does Title VII of the Civil Rights Act, where religion has its place of consideration in the workplace. So, we have opened the door to the experience within a framework – and why not? The rules of the workplace operate within policies and plans, systems and processes, so why not spirituality? Our framework around the model has given it the freedom to flourish and everyone within the walls of employment the right to worship or not to worship, but the freedom to choose.

But even if simulating our model is not happening for you any time soon in your workplace, remember this and weld it to your heart: the spiritual resides in you. The spiritual essence is in you, even in the workplace, where you can practice in the crevices and taffy of the soul who you are in thought and mind, and in deed. While faith can be a sensory experience, faith is a decision, and you can make that decision right there at your work table or office desk. Attach affection to reasoning. Reduce hatred with the practice of forgiveness. Embrace your religion, respect a non-believer. Love those in the world because they are worth it – many in the challenged matrix of life where noise pounds like incessant drums. And they can’t hear. Hear for them and help battle the weapon of dissonant beats, for the world is full of noise and booby traps. God guides around and through. The Divine is fearless. No one can take the Spirit from you; no one can hide your light, for brilliance is made up of quantum particles which seep through any darkness and the thickness of battle. Shine forth, and Seek. Knock. Find.

“God: A Quantum Physicist?” by Dianne H. Timmering

Is there a miracle formula? Is faith always enough? If God were a physicist, would He be a quantum physicist, dissecting the universe in nanoseconds of time which go away and never come back? Would He say, “Live, rejoice, have peace because I’m holding what hurts you.” He pinches it between his fingers and it disintegrates into space and it doesn’t exist and then there is no hurt or pain or even heartache of mourning which can linger with a longing of dotted suffering on a landscape of flat terrain.

Is God a God of patterns and systems, process and notion, formulas that we may or may not see, we may or may not understand? A quantum theory is a formula with enough probability of certainty that something happened, that something is real. But it is not exact science, it is a science based on the probable. Is the probable the quantum leap of the unknown, a leap of trust that His hands are wide in the universe of your existence? Inside His formulas of time is His notion of mystery, the mysticism of His essence, His character inside your miracle of need, hope of presence. This mystery He gives to us because it is His way to stay attached to His people, His ironclad tentacle to you, His heart coiled with yours, His soul embedded in your dreams. If we could crack His code, would we still need Him anymore?

I say God likes the power of quantum physics; He is the probable in the likely of time. He is the unknown in the leap of faith; He is the hands in the universe of your existence and even if you can’t see Him, He sees you. His mystery is His pursuit of you; the quantum is our pursuit of Him.

In our efforts to reveal some of God’s limitless activity in our service here at Signature HealthCARE, we have challenged our chaplains to develop case studies on their work. You can see examples of these case studies here.


Dianne H. Timmering, MBA, MFA, CNA
Vice President of Spirituality and Legislative Affairs
Signature HealthCARE Consulting Services, LLC

Twitter: @Dhtimmering

Faith and politics intertwine as Timmering drives LTC change by leading legislative efforts

It’s no secret that sweeping change is taking place in health care, with both delivery and payment models in a state of upheaval and uncertainty, demanding that health care operators not only take note, but take action.

Signature has long worked to build relationships with lawmakers, with Director of Legislative Affairs Kathy Gallin making considerable headway during the past few years. Gallin has drawn numerous local, state and national officials to Signature events, helping residents and stakeholders voice opinions about pertinent issues to their elected representatives and exercise their ability to push for positive change.

Now the company is expanding its government relations efforts, a process that is being helmed by Dianne Timmering, now Vice President of Spirituality and Legislative Affairs.

“We are more than 80 percent funded by the federal and state government – they control our reimbursement stream,” she said. “We have to be involved.”

Signature has quickly aligned itself with other providers in the fight for an improved and more efficient health care system, and a friendlier climate in which those providers can operate. The company has joined or has plans to join various state and national health care organizations, including the American Health Care Association this year and the Kentucky Hospital Association in 2015.

“We’re not just skilled nursing anymore, and we’re not just long term care,” she said. “It’s next-level integration.”

As further evidence of the need for deeper involvement in the political process, she points to several examples, such as the shift away from a fee-for-service model and toward a bundled payment system, along with states transitioning to a case-mix system and legislation that would pave the way for a site-neutral payment system between inpatient rehab facilities and skilled-nursing centers.

“Being on the forefront of a good site-neutral bill, for example, could tip the reimbursement quotient,” she said. “Not overnight, but in a couple year period of time.”

Given her background, Timmering is more than equipped for the job. She spent several years in Washington, D.C., as a policy enthusiast and political fundraiser, even working for Bob Dole and later serving as a lead advance representative and messaging expert for Pres. George H.W. Bush.

During this time she traveled the world, developing messaging on policy impact and creating events for the president. Timmering worked with local embassies and met with global political leaders alongside the president as he worked to strengthen diplomatic relations between warring nations, among other efforts.

An entrepreneur first, she later became a self-proprietor and worked as a fundraiser – helping drum up millions of dollars in support for various political and trade organizations, associations and not-for-profits – before venturing into the private sector.

Dianne joined Signature (HQM at the time) late in 2005 and co-created, alongside Signature President Joe Steier, what would become the company’s Spirituality Pillar. The unit now employs more than 100 chaplains and support staff, operating a $4 million annual budget.

Timmering, who holds Master’s degrees in Fine Arts (Writing) and Business Administration, vows that while her new role is demanding, it does not come at the expense of the Spirituality Pillar – and that the two are more intertwined than they might initially appear.

Her policy vision is to take the outcomes of several qualitative studies now being conducted by her chaplain army in the field, and to show CMS within five years the efficacy of spirituality in the integration of overall care where it has reduced anxiety and depression, or the power of prayer over a stage 3 pressure sore.

“There is a spiritual essence to the political piece, and that is ensuring the survivability of an industry to take care of the most vulnerable, the sickest and the least among us as good stewards of our people and the government funding provided.”

“Spirituality is such a movement now within the company and embraced by so many,” she went on to say. “It’s not because of any one person that it’s successful at this point. The power of spirituality is the freedom to choose to be, to plug into individualized spirituality, whatever that means to them. That’s the culture and climate we’ve been able to create here.

“And now it’s this explosive effervescence that we live and breathe as a company, and therefore spirituality kind of walks around the halls with us. And that’s exciting.”

“Terezin: A Concentration Camp” by Dianne H. Timmering

Terezin, a former military town and fortress, an hour north of Prague in the Czech Republic, was built during the 18th century when the Austro-Hungarian empire ruled the majestic lands of Bohemia and Moravia, where peaceful moats and sturdy encampments never saw battle until the Nazis found it and decided on its fate.

The Terezin Ghetto, where battalions once lived, where a sleepy town of 7,000 Czechs lived in the 1930s before the Germans conquered the lands, where these civilians were forced to leave, because the Jewish populace of the Czech lands was coming. Terezin, re-designed by the Gestapo as a deportation center for the Jews of Prague and the elderly Jews of Berlin, who were transported there with the hopes of a “spa” like life, to live out their days, protected from war, instead of going into the soul of it. Many elderly paid for what they thought was the opportunity to live there, to be transported, paying the Nazi war purse maximum sums inside the treachery of what they could never have conceived. Worse, it was a place for deportation to Auschwitz and Buchenwald where, of the 155,000 who lived in and/or faced deportation from the Terezin Ghetto, there were only 3,200 known survivors. Toward the end of WWII, Terezin built its own crematorium to extinguish death faster, so that in ash to ash and dust to dust scattered into the molecular world of shriveled seed, a person could no longer exist.

Terezin, a place for the vulnerable to perish under the stomp of treachery, lives stolen, legacies obliterated, invisible to new birth lines of being. A place for children, many orphaned during the war where those few brave adults left to tend them, offered secret lessons with hidden Readers. The children painted and contributed to the world of art, allowed (“allowed” because of a predetermined fate by their captor) to design the horror around them, brutal sufferings of sickness, doing without, staying firm within, tapping into the frail memories of warm homes remembered, and sleigh rides in snow. Their artwork, now preserved and poignant on the walls of the Terezin museum, behind glass, fragile, an easy rip to the touch of a human hand or maybe sturdy, after so much toiled turmoil in the memory of one child 10 years old. No legacy, no bloodline, no being.

Let us then be a legacy for life.

A legacy of life; let us jostle open into newness and fresh awakening that life is worth living. Let us live in our greatness — God’s focused creation in each of us. Let us live for loss in past war, even now in bitter feuds centuries old, and the innocence of life that never has a chance.

Still. Seek a new point of awareness. Let us live a legacy of life and maybe the lost won’t be so lost anymore. They will find their way on the shoulder of our breath and in the humanity of memory, in the molecule of new chance, no matter our age, no matter the time, no matter the moment. Your life has started, with every chance still for great purpose. We will always pound out against the walls of time, but don’t let time steal yours.

Life has begun; live, begin, start…Now. Who am I?

Dianne H. Timmering, MBA, MFA, CNA
Vice President of Spirituality and Legislative Affairs
Signature HealthCARE Consulting Services, LLC
Twitter: @Dhtimmering


CNA Appreciation Week Video

Below is the complete footage from the CNA Appreciation Week video:

Why did the Revolution finally join AHCA and become a CPAC Member?


In his latest blog post, Signature President and CEO Joe Steier explains the importance of Signature’s recent move to increase its involvement with the legislative process as it relates to long-term care and health care.

Why did the Revolution finally join AHCA and become a CPAC (Conservative Political Action Conference) Member?

I hate to pull a clichéd David Letterman Top 10 list, but it will tell you the real reason we did…

1 – Former Kansas Gov. Mark Parkinson’s leadership and team depth as AHCA President and CEO is exceptional. The improving quality data, combined with being part of the solution and providing tireless education over half a decade already has made our case worth hearing and supporting!

2 – The amazing work by FHCA (Florida) leadership, headed by Emmett Reed and team. We were supporting through Florida Promise but not at the level they deserved! Florida was a throwaway state 15 years ago, and now it is becoming a model of collaboration and compromise.

3 – We finally launched our own Signature PAC, ‘Protect Seniors Now,’ led by Vice President of Spirituality and Legislative Affairs Dianne Timmering and Director of Legislative Affairs Kathy Gallin, which allows us to become a driver of grassroots advocacy with deep participation alongside our engaged leaders who really want to be part of the conversation. Before I felt so much pressure to fund important healthcare legislators, and if we joined without a growing PAC, I was worried we could not keep up.

4 – So many industry leaders have made huge, selfless contributions to the current evolution, the new solution-based vision and the strong network that has been built. I felt our seat at the table was not really needed based upon the excellence I witnessed by leaders such as Paul Diaz, Neil Pruitt, Norman Estes and many others.

5 – Our legislative lady, Kathy, kept going for 8 years, bootstrapping it, always showing up, building real relationships and partnerships, etc. She educated me to take a fresh look at more resources, adding Dianne Timmering as a partner because of her background in policy and ability to build strategy. We all work better in teams and need to become a larger voice in the changing world. Kathy made many of our team members believers with her relentless pursuit of a voice for the Signature revolution. She convinced Dianne, me and our board that it works, but you have to show up, engage, share and believe, and sometimes will things through.

6 – My thoughts were that we could raise the bar in other meaningful ways, like expanding the role of spirituality in LTC, funding our research center or our InnovateLTC (a collaborative immersion model), developing post-acute hospital forums, and building market intelligence systems to help predict and share it. All of these initiatives made me feel we were already contributing to the body of work that our industry has achieved – but was it enough?

7 – We were mainly concentrated in three states: Kentucky, Tennessee and Florida. I felt we were helping lead and fund some of the costs and energy in the bloody medical panel fight in Kentucky that ran most of my friends off, while in Tennessee there were still some ideology gaps that I just had not become comfortable with, and I knew we were helping in Florida in a different, non-member way. However, with new regions in Ohio, Indiana and North Carolina, and progress by many of our state leaders, it was a great time to make the bold move.

8 – I closely watched the Alliance Defending Freedom, with Alan Sears, for years, seeing the importance of their approach to really pushing for a targeted voice and getting the conversation with the power brokers, and did not see a way to be active in both. We were just too small, a new organization that was making a headquarters move across the country, so we tried to get stronger first, and get centralized so we could grow. During this period, I heard a merger was likely. The combined organization has taken best practices from both groups and made it a true standard of excellence that has impressed me.

9 – I want my team to have the best learning experience possible. We have one of the coolest learning pillars anywhere in the U.S., but once AHCA shifted to real rigor, data analytics and developing real, unbiased arguments based upon evidence, the new day began. It was time to enhance our SHC team with some of the best learning I have seen in years.

10 – Lastly, as good as AHCA and CPAC are, I think they need us like we need them. We bring great energy, an innovative platform, new ideas and a very talented team that should be part of the new solutions.

Isn’t that what great partnerships are about anyway?

To read more, visit Joe Steier.com<http://joesteier.com/2014/07/15/why-did-the-revolution-finally-join-ahca-and-become-a-cpac-member/>.


Meetings On Capitol Hill – June 25 and 26, 2014

Joe Steier, Dianne Timmering and Kathy Gallin attended a meeting with the American Health Care Association on June 25th and 26th, discussing so many of the issues that we as providers are watching unfold- i.e. bundled payments, site neutrality, Medicaid Managed Care, etc.

Read the whole story on Kathy Gallin’s ‘Legislative Lady’ blog: 


“My Mama’s CNA” by Dianne H. Timmering (with Video)

Being a CNA. What it feels like is truly beautiful, challenging, exhausting, special, hopeful…

Katy walks in with a smile and my mama has to “go” to the restroom; nervous energy trembles an already trembling leg filled with the demon of Parkinson’s, the ghost in her body which she can no longer control. Katy gently taps her hand, given frailty by slender bones; and with a quick squeeze of calm, Katy lets her know not to worry. Katy helps Mama equalize as she raises her from the bed, slips the gait belt around her waist and offers her the handle bar of her walking “driver”. They ambulate toward the bathroom. Mama stubs her socked toe; Katy slows, steadies, holds.

They are patient with each other because the relationship is not one-sided — it is the valuation of respect and love, compassion and belief that life is still worth living maybe because they are connected friends, united in a common purpose of need and conviction. They are special together like a posse of graceful gazelles leaping along a grassy patch in union of leaps and dance, walking together like Katy and my Mama, a glide and scuffle across the floor. They arrive at the bathroom door and they pirouette around so that my Mama can use the toilet. This too is a delicate dance of caution and support, one function cannot, without the other.

Katy leaves for privacy and dignity; Mama asks her to wait just outside the door. Katy does. Patient, a burden to carry for her people, because she’s filled with the jewels of unique compassion. Katy looks around the room decorated in pictures of a life once lived; she fights through the fatigue and a sleepless night before, her son sick with a stomachache, her daughter troubled with a 3rd grade math test.

When Mama is finished, Katy helps her up, tells her about her daughter’s issue with math. It pleases Mama to hear about the world living around her; Katy knows this. Inside these seconds, they are normal friends.

They wash hands, Mama cleans her teeth — she likes to brush her teeth. A crooked hand steadies as Katy places the toothbrush in Mama’s hand, helps her where she misses and washes it out when Mama is done.  An anxious calm fills a body that belies a once active “jitterbugger” and a lover of endless parties. They can talk now, Mama only anxiously calm; her body once a school teacher’s. Her once dominant voice now a raspy sound in a peal of a help offer: she whispers, “I can help your daughter with that math problem.”

Katy nods, grateful for the kindness because she knows Mama can’t really see much anymore, the light still of a life no longer refracts in the eyes to decipher a word or a number on the page. Katy smiles into Mama’s soft wrinkles and Mama taps a pure cheek that held a private tear only an hour ago; and both are fulfilled in the moment of space and time.

Mama tells her a quick story, and they center their giggles one inside the other. Revived with a little new air in four lungs—two that are old and two that are young.  Need and purpose: a synergy of the dance, a CNA and her patient, a friend and her confidant, a mother and her child.

CNAs, we celebrate you — the crown jewel of the industry, the divine beauty of our healthcare nation. God bless you always. Psalm 91.  – Dianne

Dianne H. Timmering, MBA, MFA, CNA
Vice President of Spirituality and Legislative Affairs
Signature HealthCARE Consulting Services, LLC