The American College of Health Care Administrators (ACHCA) has had its ups and downs over the years. I’m happy to say, having just returned from the College’s most recent convocation in Cincinnati, that it appears to be back on the upswing. Membership is growing and affiliates are developing, and the overall attitude in Cincinnati was upbeat. But even in its lowest days, there was one message ACHCA has always gotten across to me: long-term care administration is a complicated, challenging, demanding, and no game for amateurs or the faint-hearted. This year was no different, with that message ringing strong and true in at least a couple presentations I attended: Long-time medical director Dr. Steven Levenson’s discussion of the Administrator’s all-encompassing role in advancing the skills of geriatric medicine in the facility. As a former editor of the clinical publication Geriatrics, I had never heard the fields of geriatrics and long-term care married so firmly before—and all under the auspices of the Administrator—because, with all due respect to physicians and DONs, Dr. Levenson noted, only the Administrator has responsibilities for facility departments across-the-board. Similarly, the well-known, highly regarded LTC consultant Leah Klusch offered an alarming overview of the liability litigation trend and the Administrator’s central responsibility for MDS accuracy. It was alarming in that she noted the growing number of liability cases using slipshod MDSs as the basis. Administrators occupy the bulls-eye, she noted, when nursing staff and therapists go astray. Leah also noted that attorneys order more copies of the MDS Manual than providers every year. Some fun! I promise to follow both these stories more completely in the magazine in coming issues, but for now I feel only reinforced in what, thanks largely to ACHCA, I’ve known all along: Administrators can’t survive simply by reacting defensively to government regulation and reimbursement shortfalls. They have to aggressively step up to the challenge of running their facilities from top to bottom, and run them. They have to seize the day every day.