At which point during the PLC will the income statement indicate that it’s time to consider strategic changes?  What would you recommend?

At which point during the PLC will the income statement indicate that it’s time to consider strategic changes?  What would you recommend?

Reference

Swayne, L.E., Duncan, W.J., & Ginter, P.M. (2013). Strategic management of health

care organizations (7^th ed). Hoboken, NJ: Wiley