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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 he’s-so-incompetent-how’d-he-ever-get-his-job, and finally the smile-to-your-face-while-they’re-sticking-a-knife-in-your-back boss.  A common denominator that most of the former bosses had was that they make quick decisions, usually bad ones, had a 1-track, tunnel-vision way of doing things, and managed their employees with fear and intimidation like a fierce emperor that everyone was afraid of.  They did not care about their employees and their only goal was to make themselves look good.

So, how do you deal with these people.  Well, there are usually several options that you have to tackle this problem:

  1. Quit – Find a new job that doesn’t require you to deal with this type of person.
  2. Put up with it and just be happy you have a job – Not one I’m really fond of but many people take this option because finding a new job is a scary endeavor for them.
  3. Confront your boss directly – Usually goes badly because these types of bosses don’t take criticism well and it puts you on their short-list of employees that they need to get rid of.
  4. Go over their head – Telling your boss’s boss or the HR department may be beneficial and actually prompt them to fix the problem…..unless they don’t do anything about it except tell your boss you’re lodging complaints against him.  This one can backfire on you and you end up on that list again.  Tread carefully here.
  5. Manage upward.

What’s managing upward?  Well, it’s kind of like creating a script for your boss to follow.  Your actions can define the actions your boss will take.  This will keep you off their radar and allow someone else to deal with their bad behavior.  You stay in good graces while your boss continues their own self-sabotage elsewhere.  It takes time but can be accomplished successfully.

Some points to remember when managing upward:

  • Don’t outdo your boss.  If there is something that your boss has hand their hands on, don’t make it your own.  Do your best and, if you are very successful with it, share that credit with your boss.  Make them a partner.
  • Give positive reinforcement.  This is not just for subordinates.  It works on bosses, too.  I’m not saying become a yes-man or yes-woman or a behind-kisser, I’m saying find something positive that you can acknowledge that your boss did well.
  • Keep calm even when under fire.  You must practice emotional maturity even when being inundated with someone else’s out-of-control behavior.  Keep a strong, positive, and calm tone of voice and don’t let them “get your goat.”
  • Exceed their expectations.  It sure is easier for them to ride you when you’re not producing results.  And it sure is easier for them to ride someone else when you’re producing results that make them look good.
  • Be a problem-solver.  No boss wants more problems.  So, when you have a problem, brainstorm a couple of possible solutions so you don’t become just the Problem Guy.  At least you’ve made the effort to find the answer.
  • As hard as this may be to do, protect your boss’s back.  Make sure that you remain ethical and don’t throw your boss under the bus to the other employees or his coworkers.  If there is something that develops and he needs to know, tell him.  When he finally moves on or is let go, you can have a clean conscience.
  • When attempting to get permission to do something, think of the potential barriers that your boss may throw in your way and have a response ready.  Offer it in a non-threatening way.  Be knowledgeable, back your position up with facts and regulations.

Hope this helps!

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Clock on wall

One of the first things I learned in the nursing home industry is that when you receive a referral, you’ve got to act quickly to capture it.  A typical scenario is that a discharge planner at a hospital either faxes out a referral to multiple facilities or uses an email referral distribution service such as e-Discharge to distribute the referral to multiple facilities. 

From the time you get this referral, you are competing with other facilities to see who can generate an answer the fastest.  What usually happens is the admissions director gets the referral off the fax or email and does the following:

1.  Takes the face sheet to the business office manager to check the insurance.

2.  At the same time, gives a copy of the referral to the Director of Nursing so he/she can determine if the facility can take care of the the patient.

That’s really all that’s needed.

Yes, you need a chest x-ray and yes, you need a pre-admission evaluation completed in some states, but all that can be taken care of AFTER you accept the referral and prior to admission.

If there is an issue with the insurance the BOM may mark “No” on the referral.  Or, if the DON identifies expensive medications or equipment needed, we may have to do a cost-out, especially on a Part A referral.  Any denials or barriers to admission should come directly to the administrator who should have the final decision.  The administrator has to enforce this process with the team.  Referrals can never take a back seat on the bus.

The referrals can NEVER sit on someone’s desk for hours at a time.  You have 15 minutes to get an answer to your discharge planner.  That’s it.   The answer isn’t always Yes or No.  It may be, “We’re interested, but we need a little more information – the last few days of nursing notes…”

If you snooze, you lose.  I have seen some one facility with an average turnaround time of 9 minutes.  That’s outstanding!  Make it easy on your discharge planner and on your team.  Make processing referrals quickly and smoothly a priority in your building.

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In the past week, I have had a unique opportunity to observe a facility with another company fall to the pressures of survey.  The facility had a rough history – staying out of compliance more than in.  A few IJ’s later, CMS has pulled the plug on their Medicare/Medicaid provider agreement.  They lost their certification.  What this means is that they have to discharge all their Medicare and Medicaid residents.  They have 30 days to do such.  They can keep their private pay residents as long as they keep their state license.  A State monitor is in the facility daily to ensure the residents are being cared for properly and the discharges are happening as ordered.

What this means to me is that there will be around 140 residents that will need a new home.  Unfortunately, the facility is about an hour away from my own.  However, I decided to pay them a visit anyway.  Knowing what survey and high pressure situations can do to nursing home staff, I decided to take them some cookies.  :-D   I previously talked about marketing with cookies here and making sure that this tactic is used only a tool. 

But…bringing cookies works!  Let me tell you what happened.

When I arrived at the facility, as expected, there was a ton of activity.  I managed to catch the social worker in the hallway and quickly told him who I was and why I was there.  I asked if he had a few minutes to allow me to show him how I could assist with their many discharges.  Of course, he was too busy at the moment.  “No problem,” I said.  I tucked my business card and facility brochure into this large bag I brought in with me.  I told him I understaood how busy he was and to give me a ring when he had a chance to review my information.  I handed him the bag and left the building.  What was in this bag?  The items I mentioned as well as a sheet of laminated paper with 4 unique selling features of my facility:

1.  Number of male and female beds I had available for both ICF and skilled residents.

2.  VA Contract – I have a VA contract which is not common for many of the facilities in the area.  I could help this facility with the placement of any residents who may have veterans benefits.

3.  We love wounds!  My facility routinely accepts patients with complex wound care issues including negative pressure and IV antibiotics.  These types of residents are often more difficult to place and a facility asking for them stands out.

4.  We’ll give you your residents back when you’re ready!  This is the one that gets a lot of attention.  Why would I make this offer?  Well, for many reasons:  It’s a huge incentive for a facility in the middle of decertification to send as many residents to me knowing when they get their certification back, their residents will be waiting.  Rebuilding census will not be as hard.  Many of the families will not continue to drive for an hour and will move the resident anyway.  Some of the residents will like my facility and decide to stay anyway.  The facility I’m getting them from has already proven to have survey compliance issues and will most likely have more in the future even if they do get recertified.  It makes sense to build relationships in this industry for future business. And, it’s all revenue for me!

Also in the bag were the cookies I had bought earlier from Wal-Mart and put on a nice-looking plastic plate, wrapped with a clear decorative wrap, and tied off with a ribbon.  Now, I’m not the most creative guy and certainly don’t know how to make bows or how to make fancy goodie baskets; but anybody can do this and make it look good.

I was in the parking lot about to drive off when the social worker called me and asked me to return to the building.  He told me to come to the Admissions office.  When I arrived, I found the social worker, the admissions director, the administrator, the regional director of operations, and the regional director of clinical services.  They asked if I was the cookie man.  “Yes, I am,” I replied.  “They said that no one else (out of the multiple facilities that had representatives there) had brought them anything to eat.  For that reason, they allowed me to stay in the office with them as we discussed the unique selling features I had listed and dropped in the bag.  Every other facility’s rep had landed next door in the conference room waiting to be allowed to look at referrals.

I went back the next 2 days to review the charts and see the potential referrals.  I made sure that I brought the facility’s team snacks each morning.  All-in-all, I received 50 referrals from this building in 2 and 1/2 days.  Not too shabby!  Not all wanted to go an hour away and not all did I accept for admission to my facility.  But, it was definitely worth the effort and it reinforced the point that you should use the tools you have available when marketing to stand out.  You never know where it will get you!

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Cookies for marketingI recently discussed different sales and marketing strategies for nursing homes with a friend of mine.  One strategy that I always see is the practice of dropping off cookies, candy, doughnuts, and other goodies at potential referral source locations.  Many “experts” advise against this practice as the referral sources may come just to see you as the candy-lady or the cookie-man and forget the whole reason you’re dropping by.  And, they’re absolutely right.  This CAN happen.  I have seen many times a marketer go into an account and the individuals in that office ask where the candy or cookies are.  Are they thinking about where your referral is?  Probably not.

However, some very successful marketers still utilize this tactic very effectively and manage to produce referrals.  How is that?  It’s because they don’t use the candy or cookies to replace the communication that should be taking place – the reason you’re actually there.  The candy or cookie drop-off is used as a tool, as a supplement to their visit.  It’s a reminder they were there and serves to produce a positive experience for the customer, the referral source.  We don’t do candy drop-offs; we do sales calls.  Never forget the reason you’re going into an account.  It’s NOT to drop off cookies.  It’s to strengthen your relationship with that referral source and assist them with referral placement.  The cookies are just a tool like business cards or brochures.

Are candy and cookies necessary to conduct a proper sales call?  No.

Is it wrong to use this tactic?  Not as long as you are still communicating effectively.

Can it be an effective marketing tool?  Absolutely, but only as a supplement.

Look at some of the most successful marketers in your company and I’ll bet they have learned to use this tactic as a tool to get them past gatekeepers or to make themselves stand out from the competition.

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