When You're Not Aligned With Your Boss

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Good afternoon.

You ever walk out of a regional check-in thinking, “We’re totally aligned…”
Only to get your budget cut, your census goal bumped, and zero green lights on your latest project?

You didn’t miss the assignment. You missed the real assignment.

A few months ago, I was on the phone with an NHA who pitched a new scheduling platform—one that would’ve streamlined agency use and boosted staff morale. Smart move. But it got no traction. Why? Because her company had just entered acquisition mode. What her RVP really needed from her community was 5% occupancy growth—quietly, quickly, and without friction.

No one said it out loud. But that was the real scoreboard. And she was running the wrong play.

Let’s talk about how to get in sync with your boss when they aren’t spelling out the game plan—and how to manage up like a top-tier operator.

Elevate Your (Managing Up) Leadership

We've all been there where you feel like there are hidden priorities your leader isn't quite filling you in one or when you feel like you can't get your boss to see the concrete wall you feel your community is driving towards. Misalignment when managing up is never good and it negatively impacts you the most. Here's how to avoid it or fix it when it happens.

Decode the Real Assignment

As Melody Wilding writes in Managing Up, bosses communicate their expectations in subtle ways—through what they repeat, react to, or reward. It’s your job to listen between the lines.

If your organization is trying to acquire new communities, leadership’s bandwidth is locked in on growth. That means your RVP isn’t just focused on your building’s performance—they’re looking at how your census supports the company's leverage.

They may never say, “I need you to increase occupancy by 5% or this growth strategy falls apart.”
But trust me, it’s buried in the conversation.

In moments like this, don’t pitch a new initiative. Lead with the scoreboard that matters most:
“Here’s our plan to grow occupancy 5%. I’ve mapped out three key strategies, who owns each one, and when they’ll move the numbers.”

Action Step: Wilding recommends developing what she calls a “clarity loop”—a recurring touchpoint where you echo back what you heard as the priority:
“To make sure I’ve got our priorities right—growing occupancy 5% is the core focus right now, correct?”

This creates alignment through confirmation, not assumption.

Build a Dashboard That Speaks Their Language

Ethan Evans offers a killer framework in his Be Your Boss’s Boss article: use the 5-by-5 rule—no more than 5 bullet points in any report, and no more than 5 minutes to digest. Give the facts, make the ask, show what you’re already doing.

Let’s say 5% occupancy growth is the mandate. Don’t bring a narrative. Bring a scoreboard:

Your Lead Measures Dashboard Might Include:

Hospital Outreach: 3 in-person visits/week
Lead Response: Video/text follow-up daily
Retention Push: Biweekly family touchpoints with leaders

Now, track those. Show weekly performance against these lead indicators. You’re not just managing up—you’re creating transparency and trust.

Action Step: Format your dashboard in 5 bullet points. Use Evans’ R-A-D method (Recommend, Ask, Do) when reviewing it:

Recommend: “Extend this plan for 60 days.”
Ask: “Can I present it at the next regional call?”
Do: “I’ll send you a snapshot weekly.”

When Your Boss is Out of Touch: Lead Anyway

From the EntreLeadership YouTube session: Even if your leader is checked out or unaware, you can still lead the relationship by reducing risk and demonstrating traction.

Let’s say your RVP is skeptical of a new staffing retention approach. Here’s how you build their trust:

Step One: Frame the Plan with Guardrails
“We’ll launch a 60-day pilot. At 30 days, we’ll review turnover, OT cost, and team engagement scores. If it’s not working, we pivot fast.”

Step Two: Insert Data Checkpoints
You’re not just saying “Trust me.” You’re saying:
“You don’t have to. The data will tell us together.”

Action Step: EntreLeadership emphasizes using metrics as “confidence bridges” for hesitant bosses. Schedule built-in review points that de-risk your initiative for them—and accelerate approvals.

Keep Your Front Porch the Cleanest—and Make Sure It’s Seen

Ethan Evans’ top advice for visibility: make your wins replicable and reportable. If it’s not visible, it’s invisible.

In senior care, your “front porch” is your tour path, your team culture, your first impression. Keeping it spotless is step one. Making sure it gets seen is step two.

Host your RVP during high-performing shifts
Invite them to shadow a referral call
Send a monthly recap: “Here are 3 systems that moved our metrics this month. Happy to share with the region.”

Action Step: Wilding recommends acting like an “executive translator”—turning local execution into regional impact. Be the model community everyone else gets measured against.

Alignment Is Your Only Leverage

If you’re not aligned, your best ideas stall. Your team burns out. And you get frustrated by decisions that don’t make sense.

Managing up isn’t politics. It’s performance.
When you start thinking like your boss, solving for their pain points, and reducing the friction in their day—you don’t just move your building forward. You move everything forward.

So this week, ask yourself:
What’s the unsaid priority I need to lead toward?

Because once you see it—you can own it.

Let’s lead from the top—whether the top asks you to or not.

Take the survey: How do you manage up? Let us know!

Don’t see it the same way? That’s fair. This is just one perspective—and we’d love to hear yours. Reply back with your take, and we might feature it in an upcoming issue.

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Together with TapestryHealth

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Kevin Goedeke, Publisher and Founder