One of the mistakes that many of us make when our facility is census-challenged is to begin taking and admitting whatever referrals we can get.  This can create tons of problems in your facility.  Obviously, a good rule of thumb is to ensure that clinically you can take of the patient, that financially they have a payor source, and you’re not going to lose money on them.  However, there are other factors to consider.  Namely,...

For the past few years, everytime I took over a new facility, one of the first things I did was to distribute my BASICS MEMO to each and every employee and go through it with them in my first inservice.  Then, every new hire orientation had time set aside for me to personally sit down with new team members and go over the basics with them, too. The BASICS MEMO was compiled after having to troubleshoot many facilities and seeing the same...

So you want to become a great nursing home administrator.  But you find yourself not quite attaining the level of success you aspire to.  Have you asked yourself one simple question:  What am I doing wrong? You want to accomplish great things in this long term care industry we call home.  Here are 10 points to consider.  If you’re doing any of  these, it could very well be the roadblock on your highway to success. 1.  Not...

I recently encountered an issue with the way employees are being paid in one facility.  It seems that at one point, the Nurse Administration team members other than the DON - ADON, RN supervisors, MDS, support staff, etc. were all paid hourly.  That’s fine.  They simply need to manage their hours to avoid unnecessary and unapproved overtime.  However, one of the Nurse Admin team members ended up having to work the floor in a...

Almost everyone has one and at times they can be a royal pain!  Bosses!  How do you deal with a boss that has a completely different mindset and personality than yourself?  I have had several real winners in my career ranging from the immature-and-explosive, to the better-than-thou, to the raving psychopath, to the drunk pill-popper, to the always-has inappropriate-relationship-rumors-flying-around-him, to the...

One thing I try to do is to learn from my mistakes.  So, I’ll share some of my mistakes in this section called Lessons Learned so hopefully you can learn from them, too.  The lesson we’ll talk about today is about family members coming to take your resident out of the facility. This incident happened to me several years ago when I was first starting out. I was a new nursing home administrator working in one of my first...