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Leadership for culture change

May 27, 2016
by Pamela Tabar, Editor-in-Chief
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Culture change is easy to spot after it’s happened. It’s much harder to discern while it’s in progress—when it’s still just a single, bright torch held by a single person.

We all know the business of long-term care has changed a ton, most drastically in the past five years. Some of that culture change has been driven by mandates and initiatives from the Centers for Medicare & Medicaid Services, and some of it has been about smart shifts in business practices. Once the market decided that person-centered care was here to stay, it burst open the door to new ideas—and gave everyone a legitimate reason to reexamine things and to question “why we’ve always done things that way.”

Nursing leadership also has a vastly different face than it did years ago. Now, clinical caregivers at all levels are embracing wellness initiatives and chronic care management services rather than just “taking care of sick people.” Directors of Nursing Services (DONs) are increasingly becoming involved in their organization’s decisions about lots of provider processes in addition to clinical care, and they’re a respected part of decision teams. Many DONs are—and should be—considered members of the executive team, right along with their administrative counterparts.

In short, long-term care has finally gotten the team concept and why it matters, both to quality resident care and to good business.

One aspect of the long-term care industry has always struck me: Where new ideas are concerned, it tends to be a “trickle up” environment, not a trickle down one. Bold, game-changing initiatives don’t often begin as “edicts from on high” from the corporate CEO. Instead, the freshest new ideas often emerge at a single provider site—the pilot idea of a single person, even—and then often end up being rolled out to other sites or across national chains as proof of the success spreads. As others across the industry see the idea’s success, they try it out, too—like a great recipe shared among friends.

When it comes to LTC leadership, size doesn’t matter. No one cares if the idea came from a family-owned stand-alone provider or the biggest chain in the state. It’s not a popularity contest. What really matters is the ability to champion innovative progress and the skill to push others to keep the culture change line moving forward.

Nothing proves that point more than our 2016 Leaders of Tomorrow Award winners, whose backgrounds and work environments are as different as their ideas and passions. We had more than 100 nominations this year, fully three-fold more than last year, and every one of them had excellent merit. Choosing only five winners was the hardest thing the selection committee has done this year, but it’s a good problem to have.

I hope you’ll learn as much from each of these leaders’ stories as we did in interviewing them and learning about their drive and ideas. None of them are famous—they’re just passionate people who have the rare ability to inspire others to achieve things much greater than themselves. But each one of them is standing on the front lines of the senior care quality movement, showing by example what can be done if we all try. None of them would take the credit alone—all told us their colleagues are crucial to the success of their ideas and commended them for refusing to settle for less. And, none of these leaders would rather be doing anything else than what they’re doing in their communities each and every day.



pamela tabar


pamela tabar


Pamela Tabar is editor-in-chief of Long-Term Living. She has worked as a writer and...