Mark Koscinski NFP

Memorial Day Musings

Memorial Day Musings

Despite the fact we have had some decidedly “unsummer like weather” in the Northeast, Memorial Day is the unofficial start of the summer.   It is also the start of the real negotiations on the tax bill currently  moving through Congress.  Speaker Mike Johnson has said he would like to get the bill to the Senate for a vote before Memorial Day.   The bill will change as it moves through the Senate and back to conference,  but let’s take a look at how the current provisions in the bill  might impact the not-for-profit  (NFP) world.

Congress appears to be ready to increase the allowable deduction for state and local taxes (SALT) on an individual’s federal income tax return.  This may have a positive impact on NFP organizations. The hike from the current $10,000 cap on SALT deductions  for married couples to $40,000 is substantial.  There is a phase-out for those making more. At the same time, the bill proposes a hike in the standard deduction to $32,000 for a married couple.  On the face of it, these changes could make it more likely individuals can  itemize deductions on their federal income tax returns. This means it will be easier to deduct charitable contributions again.  Previously, the low cap on SALT deductions precluded people from itemizing since the standard deduction is so high. If you live in a “Blue” State, you pay a pretty hefty state income tax and property tax, most of which is not deducible.  Increased charitable contribution deductions may mean more donations to qualified NFPs.  Onc can only hope at this point. 

There have been two other developments in the NFP space worth mentioning.  As I write this, the U.S. Supreme Court has deadlocked on the legality and constitutionality of state  funding of  charter schools. The whole issue of charter schools is a contentious one, with public school unions opposing any funding for them at all, let alone those schools chartered by religious groups. There was no opinion issued by any of the Justices, so it is difficult to determine exactly what their thinking was on the matter. The tie vote was possible because Justice Barrett, a practicing Catholic, recused herself from the case.  The Court affirmed the decision of the Oklahoma Supreme Court that state funding of a religiously affiliated charter school was unconstitutional. In recent years the Court has been very accommodating to  religious groups.  Perhaps there was something about this case that Chief Justice Roberts, the presumed swing vote, did not like. Only time will tell if this ruling will stand. For now, the ban on state funding of religiously backed charter schools  applies only in Oklahoma and not nation-wide. 

The second development is the cost-cutting activities of the Trump Administration.  Many have been blocked by  federal district court judges. The issue of the “universal injunction”  will also be decided by the Supreme  Court in the near future.  I believe some of the cuts will in fact be enacted. Which will survive and which will be blocked is still up in the air, as well as any impact on NFP organizations. 

In closing, I want to wish all of you a wonderful Memorial Day.  And remember to contribute to your favorite charity.  It is the American thing to do.  Even if you don’t get a tax deduction. 

Mark Koscinski NFP

Taking Your NFP From Good to Great

So, you are the executive director of a Not-For-Profit (NFP) organization.  You look around, and think that you have a good organization.  The first question that comes up is: “Is this good enough?” Many people would say no. We want to have a great organization. We all strive for this. The next question is: How do you make it a great organization?  One way is to look at the book “Good to Great” by Jim Collins. “Good to Great” has become a bestseller in the business world, influencing management practices and leadership styles. It can be adapted to the NFP world as well.  “Good to Great” emphasizes the importance of long-term vision, building a strong culture, and having the right people in place for sustainable success.

 The book focuses on how ordinary companies can make the leap from being merely “good” to becoming truly great over a sustained period. The principles Collins puts forth work just as well for NFP organizations as well as for for-profit companies.  Collins identifies “Level 5” Leadership as the crucial factor differentiating good organizations from great ones. A Level 5 leader blends humility and “professional will”, prioritizing the organization’s success over personal success. Great organizations  understand the “Hedgehog Concept,” the intersection of three key circles: what they can be the best in the world at (passion), what drives their economic engine (cash flow), and what truly matters to their clients (passion). Many NFP leaders are not comfortable dealing with the fiscal side of the business, but as one religious leader told me, “it takes money to do God’s work.” Similarly, it takes cash flow to keep your  doors open. 

Collins believes organizations can build a culture of discipline  This is achieved by having:

  • Discipline of People: Great organizations  foster a culture of discipline by employing and promoting talented individuals who embody the company’s core values and principles. This same principle applies to volunteers as well. 
  • Discipline of Thought: Great organizations maintain a culture of thinking and challenging assumptions, fostering a data-driven approach while remaining adaptable. Harold Geneen, the former president of ITT famously said, “the numbers will set you free.”
  • Discipline of Action: Great organizations  translate plans into action with a relentless focus on execution and achieving results.

By doing this culture of discipline, your organization will achieve The Flywheel Effect. Your NFP will  build momentum through the flywheel effect, where sustained effort in core areas like people, strategy, and operations reinforces each other, leading to continuous improvement.

To be sure, there are some criticisms of this book. A common one is its treatment of an organization’s development is simplistic, and doesn’t deal with root causes. Nevertheless, “Good to Great” offers valuable insights for NFP organizations aiming to achieve long-term excellence. It highlights the importance of leadership, culture, and a consistent focus on core principles for achieving sustainable success.  It can be a roadmap for taking your organization from being merely “good” to “great”!

Mark Koscinski NFP

NFP Budgeting Tips

As the month of June comes to a close, many NFP organizations will have to close their books and begin their next fiscal year. This may also begin the dreaded budgeting process.  Many budgets are of dubious worth, often out of date before they are published.  In an effort to help NFP financial management,  I thought it would be worthwhile to discuss some often overlooked aspects of the budgeting process.  The inspiration for this blog comes from Gary Cokins, a prolific author and expert on the subject of managerial accounting.  He has some wonderful insights into the world of budgeting. 

Cokins states there are two general parts of the budget.  The first is demand driven.  This portion of the budget will take into account the expected activities of the organization for the year.  For instance, if the NFP has received a grant to perform certain services it must budget for those activities.  It will take into account the grant funding and any costs associated with it. The second part of the budget is the expenditure portion of the budget.  By expenditure portion we mean those expenditures driven by the mission, vision, and strategic plan of the NFP.  While these concepts are outside the scope of this article, any decent management book will cover these topics in sufficient detail. 

Cokins divides these expenditures into four types:

  • Capex–Capital expenditures needed to achieve the plan for the year and the strategic plan over a number of years;
  • Riskex–Expenditures needed to measure and control risk. Again, any management textbook will tell you that risk and reward can be two sides of the same coin;
  • Opex–those expenditures needed to actualize the operating budget for the year: and 
  • Stratex–Expenditures required to advance the strategic plan. 

Cokins believes by taking into account the demand driven requirements of  operations and the various types of expenditures required by the operating budget and the strategic plan, an organization can put together an insightful  budget that will also tie into the strategic plan. 

Some other words of advice on doing your budget:

  • Don’t just budget to continue operating your organization as you have in the past.  Remember, standardization can often reduce costs.  It has been my observation that organizations treating each individual transaction or activity on an ad hoc basis will be inefficient and will often make mistakes; 
  • Remember the power of technology.  Where can you leverage your operations and make them more efficient by automating your process flow? 
  • Try to use the principles of activity based costing.  Funding sources often do not like to fund “overhead”. To the extent you can trace costs you can turn them into direct costs and more palatable to the donors and funding organizations.  

So, with these tips  in mind, I wish you good luck on your budget preparation for the year.  If you have any questions, please feel free to contact me!

Mark Koscinski NFP

The Strategery

Many NFP organizations do not understand how to construct a strategic plan, or even know why one is needed. In this little article, I  discuss how to start your strategic plan.  First let’s start with why a strategic plan is necessary.  Without one, the organization could be likened to the Biblical Israelites wandering in the desert for forty years.  I have seen NFP organizations lurch from one activity to another, often without any guiding principle.  The strategic plan will often eliminate that problem by focusing the actions of the organization.  It guides the management in its daily decision making.  One famous management consultant used the phrase “sticking to your knitting” as the focus an organization needs to have to succeed, preventing it from losing its way and undertaking activities that are not core to its mission. 

The strategic plan is a communication tool as well.  It aids in fundraising and procuring bank loans.  Donors have a vast array of potential organizations they can contribute to. Your strategic plan tells them why they should give their scarce resources to your organization at the expense of all others. The strategic plan also has signal value, showing management is capable and will not fritter away funds secured from  lenders and patrons.  Finally, the strategic plan can also aid in budgeting.  

 Okay, so you understand why you need a strategic plan. Now it is time to build the plan. Unfortunately, many organizations do not even know where to start. They fear that this could be a massive undertaking. It is precisely this fear that prevents many organizations from building a strategic plan.  My suggestion would be to start with some core elements of the plan and then successively build on that model.  Let me try to demystify the process a little, by starting at the top.   You need to define the mission and vision of your NFP.  In broad terms, The mission of the organization is what you are doing now.  The vision of the organization is where you want your organization to be and what you want it to do. The mission and vision statements should be short, no more than a few sentences as most. They will become the mantra of the organization.  All the metrics you set up to measure the plan performance will flow from them. 

Sadly, the next step is sometimes not taken in the strategic planning process.  That is, how do I get from here to there?  What steps do I need to take to undertake that journey? Many NFPs will just spin their wheels in attempting to cross that gulf. The strategy map is your plan of how you will  do that. It is the general plan of action.  The strategy map was the brainchild of Robert S. Kaplan and David P. Norton, and came out of their work on the balanced scorecard. I have written about balanced scorecards already and can be found in another section of this website.The strategy map  is a visual representation of a company’s strategy, laying out the key objectives and how they connect to each other. It  usually includes  four key perspectives:

  1. Financial Perspective: This perspective focuses on the financial outcomes the organization wants to achieve through its strategy.  The annual budget will need to tie into the strategic plan.  That being said, management must be careful not to overemphasize the financial perspective, since by definition it is working in a not-for-profit environment. Objectives related to financial sustainability include funding operational expansion  and required human capital growth. 
  2. Constituent Perspective: This perspective identifies how the company will create value for its constituents and do it well. Objectives might relate to customer satisfaction and service  innovation.
  3. Internal Processes Perspective: This perspective shows the internal processes the company needs to excel at to deliver its value proposition to its constituents. Some common objectives would be  operational efficiency or process improvement.
  4. People/Learning & Growth Perspective: This perspective focuses on the human capital and knowledge required for successful strategy execution. Objectives might include employee and volunteer training, talent development, management succession or fostering a culture of innovation.

The strategy map is a tool ensuring everyone understands how their role contributes to the overall strategy. They can see how their actions contribute to the success of the program.   Above all, It’s a dynamic document that can be revisited and revised as the business environment or the company’s strategy changes.

Oh BTW. For those of you who don’t know where the term strategery comes from….

Mark Koscinski NFP

NFP New Year’s Resolutions

As the New Year has passed, it is time to get back to business.  Before we get lost in the day to day activity cluttering our calendars, we need to think about how we are going to do things differently this year. This takes time: time to think about what we would like to change and time to actually implement what we want to change. However, if we never take the opportunity  to plan and improve our current situation we are doomed to live a Ground Hog Day existence, repeating the same day (and probably the same mistakes)  over and over again. 

  Perhaps our New Year’s resolution will be to undertake at least one of those projects this year we have been putting off.  Need help thinking about this?   Here are five potential resolutions for NFP managers:

  1. Take the time to do formal planning.  No matter how large or small your organization is, this is a good time to formalize your planning process. Any organization can profit from organized, systematic planning. Look at the vision and the mission of your organization.  Think in terms of strategy maps ( example here) to put your plans into action. Budget in greater detail to get a deeper understanding of where the money leaks out. 
  2. Enhance your human capital.  Perhaps this is the year you start that graduate degree you have been thinking about. Larger organizations may offer tuition reimbursement, a cost effective way to compensate employees.  Even if your organization is too small to offer this benefit, look at using the various tuition tax credits that might be available to you.  Look around for colleges and universities  that offer discounts to employees of tax-exempt organizations.  Remember, an investment in your education will benefit not only you, but the organization you work with. 
  3. Be open to new points of view.  Effective leaders are willing to listen, to learn to get different points of view, even if they disagree with their own. As John Maynard Keynes is alleged to have said, “ When the facts change, I change my mind. What do you do?”
  4. Update the organization’s Social Media presence.  Perhaps it is time to refresh that website or even more importantly, look at new social media applications. What worked last year, or even yesterday for that matter may not work today.  Are you trying to reach a younger audience?  Maybe it is time to use Instagram or, perish forfend, TikTok.  Do you want to engender a lively discussion?  Perhaps Discord is the way to go.  You get the idea. 
  5. Look at new technology.  You don’t have to be on the bleeding edge of technology to benefit from the use of technology. Used correctly, it is a labor multiplier, not a labor divider.  What processes in your office can be automated?  Maybe something as simple as learning Quickbooks can cut down on your accounting fees. Investigate AI.  I have learned that even the free version of ChatGPT can provide insights to operational issues and extensive information we can use to run our organization. 

Good luck everyone, and once again, Happy New Year!

Mark Koscinski NFP

Shoutouts

The coming end of  2023  and the beginning of 2024 means it is time for shoutouts to some extraordinary people and organizations I have had the pleasure of working with this year. Higher Education and students have been taking a lot of hits lately.  Despite all of the negative press there has been a lot of good going on at campuses around the country.  Let’s look at just a few examples of that on the Moravian University campus: 

Dr. Sonia Aziz–a wonderful scholar and academic, whose work in health economics has helped reduce the sum total of misery in the world.  She was recently named Dean of the Moravian University School of Business and Economics, a well deserved appointment.  For more information about her work, click here.

The Moravian University Craft Club, Stitches– The members of this club crocheted and sold Christmas ornaments and collected donations for  the Bethlehem Emergency Shelter this holiday season. It was a great experience for me as their faculty advisor to watch their camaraderie develop from week to week as they worked toward their worthwhile goal. 

The Moravain University Catholics on Campus–Another remarkable group of students, who spent time every week learning and practicing their faith. It takes courage to say you are religious if you live on a college campus these days. These students are proud of their faith and aren’t afraid of saying so. 

Moravian University Chess Club–Members practiced the Game of Kings, not over the internet, but in person.  It was great to sit over the chessboard and once again hit the time clock….

And of course, let’s not forget all of the Moravian students and groups that participated in the annual Christmas Vespers. To listen to this truly majestic service, please click here.

And what about in the broader world? 

Bethlehem Emergency Sheltering– In Luke 3:11 we hear, “John answered, ‘Anyone who has two shirts should share with the one who has none, and anyone who has food should do the same.’” Need I say more?

All the volunteer workers, employees of not for profit organizations, and clergy tirelessly working for a better world–Although we are all sure you could work for a higher wage somewhere else, please do take the time to remember Matthew 5:12, “ Rejoice and be glad for your reward is great in heaven…”

Wishing you all a wonderful Christmas and a Happy New Year. 

Mark Koscinski NFP

Being Tone Deaf, Part 2

Last week I began reviewing the Annual Report of the Diocese of Metuchen, NJ (the “Diocese”). In that entry, I concentrated on the seemingly devastating loss in its investment portfolio. Just as a reminder  I want to emphasize the phrase “seemingly devastating” since there is not enough information in the Annual Report to make that determination. I also want to reiterate that I am in no way being critical of the management of the Diocese except for how it didn’t address the unrealized losses in the mailing.  I am “picking” on the Diocese  to make some points.  If anything, its marketing arm is tone deaf to how some of its materials might be received by potential donors. 

 This week I want to focus on some of the other concerrs I have with the Annual Report: 

  •  The Annual Report was issued almost a year after the period end.  I received it in May 2023, eleven months after the period being reported on ended. By itself, this gives you some pause.  By comparison, public companies issue their financial statements within 90 days of year end.  Obviously,  a Catholic diocese isn’t a public company and doesn’t have the resources or the legal requirement to issue such a report that quickly.  However, taking so long to issue a financial report  is  often taken as a sign of weak financial management.  This is particularly important when you are sharing bad news such as the unrealized investment losses the Diocese incurred. 
  • There is no indication of an outside accountant’s review or audit of the financial data. The financial statements seem to be in good form so there is obviously  a capable financial team in place. Nevertheless, there are some very complex accounting issues involved.  For instance, the Diocese self-insures and has an Incurred But Not Reported (IBNR) liability of $22.5 million.  Similarly, the clergy retirement and post retirement obligations amounted to $24.5 million. I don’t know about other potential donors, but I  would feel much better if  an outside reviewer could provide me with some comfort about  these balances.  How would a donor know the correct actuarial assumptions were included in the computation of the liabilities and the accounting principles are correct? 
  • Donating should be made easy.  The Annual Report doesn’t say where to send donations and what they will be used for. Perhaps a QR code or a Paypal address would be helpful. Why make potential donors search for where to send their hard-earned money?

With all of that being said, I truly applaud the Diocese for hitting the “Abuse” issue head on.  It did a great job of outlining its programs to control and eliminate such a terrible plague. The importance of this can’t be underestimated as the now disgraced former Cardinal Theodore McCarrick was once the Bishop of the Diocese.  Finally, I wish the Diocese well in its activities for the upcoming year.  It has been a tremendous force for good in Central New Jersey.  With the help of its donors and parishioners, it will be for many years to come.

The lesson to be learned for any NFP organization is to stop and  ask what the perception of its stakeholders is.  Management needs to scrutinize its communication strategy to see if the proper message is being conveyed. Alternatively, can the message be misconstrued by the public?  Sometimes management is too close to the issue to see how this information is being  received.  

Mark Koscinski NFP

Being Tone Deaf

Sometimes, we don’t really appreciate what some of our marketing material can do to our fundraising.  The NFP world relies on fundraising as its lifeblood but we sometimes don’t pay enough attention to how the world sees us. Let’s look at a case in point:  The 2022 Annual Report of the Catholic Diocese of Metuchen. This is the first of a two part blog on things that I quickly picked out from its  annual report. For those of you not familiar with this organization, the Diocese of Metuchen (the “Diocese”)  is a very large Central Jersey Catholic diocese responsible for 90 parishes, 26 schools and a hospital, among other things. The Diocese does an amazing job in  four NJ counties.  It has a strong financial condition, with net assets of about $125 million and a strong positive cash flow.  Nothing in this article should be construed to be a criticism of how the Diocese operated. The Annual report itself is  a very fine piece  of marketing material, but was tone-deaf to fundraising concerns. There are several reasons for this, but for this week  let’s start with the 800 pound gorilla in the room. 

The Diocese reported unrealized investment losses of $51.2 million during the year, resulting in a decrease in net assets of $36 million dollars for the same period.  To put this in perspective, the decrease  was approximately 18.1% of  ending total assets and 25% of the ending total investment portfolio. At the same time, the Diocese reported positive net cash flow.  In short, a very creditable performance in managing operating cash flows in a tough economic environment was swamped by what appears to be a cataclysmic decrease in the investment portfolio. 

How could this be?  Unfortunately, the Annual Report does not disclose the reasons why, nor does it disclose the composition of the investment portfolio.  So, let’s make the assumption (and it is only an assumption!) the investment portfolio had a heavy element of fixed income securities. What happened to interest rates over the year? The Fed discount rate (the marginal cost of borrowing for a bank and therefore the rate that drives other other interest rates) was .25% at the beginning of the fiscal year (June 30, 2021) and 1.75% at the end of the period. The prime rate also increased from 3.25% to 4. 75% over the same period. Interest rates were rising as the Federal Reserve was trying to deal with inflation.  As interest rates rise the value of fixed income securities fall. Such a large increase in interest rates is presumably the reason why at least part of the investment portfolio took such a beating.  The stock portfolio also could have taken a beating in the same time period.  For instance, the Dow Jones Industrial Average was 34,292 on June 30, 2021 and 30,824 on June 30, 2022 a decline of about 10%. Again, there simply isn’t enough information provided to see how the various components performed. 

Why is this disclosure important?  If the investment portfolio is heavily concentrated in fixed income securities there will be no loss if the securities are held to maturity.  The loss will turn into unrealized gain in subsequent periods. As the investments securities near maturity the market value of those securities will begin to approach the maturity (par) value of the securities.  On the other hand, there is no assurance that a stock portfolio will ever recover its value.  It seems to be that any donor would be vitally interested in knowing this information.  Financially responsible management of a fixed income investment portfolio will lead to zero unrealized gain or loss over time.  However, if the loss was due to a stock portfolio, would you want to donate to an organization that  could blithely lose such vast amounts of money?  And heaven forbid such a loss could be due to speculative derivative securities…. Based on what I have seen, I find it highly improbable that the investment portfolio includes such problems.  I am only using this Annual Report to make a point. 

I will readily acknowledge what happened may not be completely the responsibility of the Diocese.  For the life of me I can’t figure out why the Financial Accounting Standards Board (FASB) would require fair market value accounting if the NFP organization could demonstrate it has the ability to hold the securities to maturity.  Clearly the Diocese does.  Even more unfortunate is the fact that a business entity incurring such unrealized losses might be able to mitigate the losses by recording deferred taxes, thereby reducing the impact to the “bottom line”.  Since the Diocese is a NFP organization there is no tax effect for such losses.  Nevertheless, the Diocese needs to do a better job of explaining what happened. 

In the next installment, I’ll examine some of the other issues contained in the Diocese’s Annual Report. Stay tuned. 

Mark Koscinski NFP

The NFP World

As the Spring semester grinds to a close, and the burden of grading, the bane of all professors’ lives comes inevitably to an end, it is time to get back into the world of blogging.  Today’s topic comes courtesy of an assignment I gave to my Not For Profit Accounting class. Municipal and NFP accounting constitutes approximately 20% (give or take for any particular year) of the financial reporting section of the Uniform CPA exam so students are intensely interested in it.  They are often amazed how municipal accounting differs from the previous accounting they have learned.  That is a story for another day though.  

We sometimes need to stop and remind ourselves how important the nonprofit segment of the economy is.  I assigned a short paper to my class on the importance of the NFP segment to the entire economy.  Ashley Robinson, one of my students who earned two bachelor’s degrees in four years and will be employed by Pricewaterhousecoopers, summarized  what a powerful economic force the NFP sector is.  Ashley reported, 

“As of 2022 there are about 1.5 million not-for-profit organizations in the United States,and over 10 million worldwide. They employ about 10% of the workforce, but worldwide they employ about 7.4% of the workforce. About 5.7% of the United States GDP comes from not-for-profits. This is the third largest workforce in the United States just behind retail and manufacturing. These entities make money off donations, and in 2021 about 56% of people in the United States donated to charity, and 45% of those people donate in a monthly program. There is about 10% of the overall revenue that comes from individual donations. 80% of their revenue comes from government grants.”

These are truly staggering numbers in many respects. I am continuously amazed by the number of NFP organizations, the often underpaid and overworked employees who keep at their jobs because of their personal values, and the number of Americans who donate to a charity on a monthly basis.  This continues to show the United States and its citizens are and have been a generous nation.  There were times when I served on the board of an NFP organization that I felt as if no one cared. I would quickly come to my senses though and realize I was wrong.  Perhaps this little reminder that the vast majority of Americans do care will provide a little lift to those involved in the NFP world.

Another student made some interesting comments about the geographical  dispersion of NFP organizations.  He posited that there are more NFP organizations located in capital cities and in the eastern part of the United States. The former assertion seems reasonable to me and the latter he suggests occurs because of legacy wealth in the United States.  I think that bears additional research though.  If any of my readers have any insight into that, please let me know.  

Mark Koscinski NFP

Nurses

May 6 is Nurses Day in the United States and May 12 is International Nurses Day.  I just wanted to stop and give a shout out to the nurses both here in the United States and around the world. Medieval thinkers reckoned there were only three noble professions:  divinity (clergy), law, and medicine. You may perhaps notice the first two on that list have fallen out of disfavor in recent years for circumstances that I won’t discuss today but may be apparent to many of my readers. 

Nursing constitutes  the largest group of medical practitioners. How many people are involved in the nursing profession?  Just to give you an idea, the American Association of Colleges of Nursing reports:

“Nursing is the nation’s largest healthcare profession, with nearly 4.2 million registered nurses (RNs) nationwide. Of all licensed RNs, 84.1% are employed in nursing. The federal government projects that more than 203,000 new registered nurse positions will be created each year from 2021-2031.”  (1)

 The nursing  practitioners of all stripes generously give of their time not only to their patients but also to many volunteer and not-for-profit groups. Do nurses volunteer?  You bet they do.  Just ask the Red Cross or other agencies handling disaster relief. The National Association of Free and Charitable Clinics report 14,700 volunteer nurses took part in their clinics in 2021.  This is a phenomenal record of charitable activity.   

INursing is  among  the most highly regarded professions in the United States. Along with firefighters and doctors, nurses have been held in high esteem by the general public for many years. Perhaps my profession (certified public accounting) should take a hint from this. 

I  am proud  Moravian University, where I hang my mortar board and doctoral hood during the academic year,  granted over 100 bachelors’ degrees in nursing and many students with masters degrees in 2023. 

Whether working for pay or doing charitable work, stop and think about the number of times a nurse brought a smile to the face of someone facing a tough medical situation or their loved one. How many times has a nurse made you smile when you were facing uncertainty? It is no wonder nurses come to the top of the most respected charts. 

A happy International Nursing Day to one and all!

  1. Source: Nursing Fact  Sheet.
https://www.aacnnursing.org/news-data/fact-sheets/nursing-fact-sheet#:~:text=Nursing%20is%20the%20nation’s%20largest,84.1%25%20are%20employed%20in%20nursing.&text=The%20federal%20government%20projects%20that,each%20year%20from%202021%2D2031.