Staffing challenges continue to torment skilled nursing facilities (SNFs), and not just at the caregiving level. Often, broader issues within a SNF are traced back to high turnover at the administrative level.
As a result, SNF hiring managers should be thinking more critically about attracting the right candidates who will positively impact the facility.
“It’s more of a calling than it ever was in the past,” Elizabeth McLaren, associate vice president of healthcare at Covenant Retirement Communities, told Skilled Nursing News. “New challenges in the regulatory environment have made it more difficult to be a strong administrator. Having a ‘system and process brain’ is really critical to understand how to identify opportunities by reviewing data.”
McLaren and Philip Jean, associate executive director at Erickson Living and a member of the American College of Health Care Administrators’ (ACHCA) board of directors, each talked with SNN about the key attributes they look for in a skilled nursing administrator.
1. Sees beyond regulatory compliance
Meeting ever-changing and complicated state and federal regulations is an ongoing effort for SNFs. Just last year, the Centers for Medicare and Medicaid Services (CMS) issued its first comprehensive overhaul of skilled nursing rules since 1991. Though the revisions go into effect on November 28, CMS is offering a one-year delay in enforcement—an acknowledgment of the difficultly of meeting these requirements.
Though SNF administrators must put a great deal of effort into ensuring that regulations are met, Jean suggests that a strong leader will go beyond this minimum standard and “[aim] for the gold standard.”
While government regulations exist to ensure that SNFs are meeting a certain level of quality, administrators should not fall into the trap of merely checking requirements off a list. Rather, they should constantly keep their eyes open for opportunities to better meet resident satisfaction and improve efficiency.
2. Stays current in an environment of constant change
Because the skilled nursing landscape is constantly shifting, Jean stresses the importance of hiring an administrator that knows the environment well and is able to stay up-to-date on the industry.
A strong administrator should “stay ahead of the pack and serve as a change agent,” Jean said.
This means focusing on innovation and establishing best practices to remain successful in the current and future SNF landscape. In light of shifting payment models, that currently means proving that a SNF can provide value within the health care system by achieving good patient outcomes and avoiding rehospitalizations.
3. Provides mentorship to administrators-in-training
With recruitment of administrators being as tough as it is, strong ones will serve as mentors to administrators-in-training (AITs) and newly licensed administrators to ensure that they are building a strong supporting cast.
SNF administrators should share their knowledge of the industry and lead by example to guide their rest of their team.
“Administrators must support and assist leaders through times of change and uncertainty, since that is a real dynamic in the skilled nursing and long-term care profession,” Jean said.
4. Prioritizes a person-centered culture
Additionally, administrators will build their teams up by focusing on employee engagement. They can do this by being visible throughout their facility and promoting a culture of excellence, according to Jean.
“Employee engagement must be a top priority for an administrator,” said Jean. “In order to achieve that result, top leadership must embrace, support, and promote a person-centered culture that will drive quality of care and good outcomes. The fundamental culture of the organization must be woven into daily operations to make it real and achievable for the team.”
5. Implements systems and technologies that streamline workflow
Finally, a successful administrator will put in place systems that will improve efficiency and patient outcomes within the facility.
“Due to the growing diversity of residents, clinical competency and education programs are essential so staff have the skill set to care for people with both acute and chronic needs,” Jean said.
SNF administrators should look into integrated technologies that will improve systems, data, and outcomes, Jean recommends. These may include auditing systems and tools to ensure the integrity of billing and financial data, electronic medical record platforms, and clinical systems that will enhance resident outcomes.
One caveat to this rule is that technology is not a “set it and forget it” solution for administrations, according to McLaren.
“A lot of times we falsely assume that if we’ve put technology in, we’re compliant,” McLaren said. “We can’t have that false sense of security. Once you find the right technology, how are you validating that your system and processes are still operating appropriately?”
Recruiting strong candidates
So, with the knowledge of these traits that make up a strong administrative leader, how do SNF executives find candidates that fit the description?
The best recruitment method, according to Jean, is to hire AITs who can learn the ropes of the industry right in the facility. SNFs can promote the program to employees to demonstrate career advancement opportunities.
“We’ve had a lot of success developing relationships with colleges that have healthcare administrator programs,” McLaren added. “Some buildings need a more seasoned administrator, but we’ve also had success bringing in someone right out of school with a fresh perspective, drive, and enthusiasm.”
Hiring managers can also work with local recruiters to identify known candidates and potential leads, as well as source candidates from local trade associations and professional societies.
The senior living industry presents challenges and variety to health care professionals, from nurses to administrators and everything in between, McLaren noted. It is not always presented as the most glamorous career path, but its benefits should be promoted.
“Senior living has a lot to offer,” McLaren said. “You get a lot of autonomy in senior living because you connect with so many provider types. As an industry, we need to continue to do a better job of promoting what senior living has to offer health care professionals.”
Written by Elizabeth Jakaitis