The three cultures you find in SNF and senior living

Together With

Good morning.    Recently, CMS confirmed publicly that surveyors do not need to be vaccinated to enter communities.  Furthermore, surveyors can be asked to wear PPE, including respirators but can refuse and must be allowed to enter the community.

Here is an excellent opportunity for us to unite as a group of leaders and support ourselves and each other.

Send a quick email to Evan.Shulman@cms.hhs.gov, Director- Division of Nursing Homes at CMS, and let him know how irresponsible this decision is.  

Elevate your leadership by leveraging the matrix

I've been fortunate enough to work for a couple of great but very different organizations for most of my career.

The "let's wing it" company- The first was a small regional operator that grew in size by nearly 400% in less than a decade.  We were agile and figuring out processes on the fly.  Our owner was and still is one of the most innovative senior living leaders I have ever met.  No good idea or concept was out of reach.  If the company still existed, I would have stayed with them for the rest of my career.  The culture spoke to my entrepreneurial spirit.

The "consistently collaborative" company- The second organization, where I still work, is a large "machine" over 30 years in the making.  The communities bring in over a billion dollars per year in revenue, and for the most part, we have systems and processes for most things you can imagine.  There is no such thing as winging it.  We are built on the framework of matrix-style leadership.  No decision is made alone but rather collaboratively in groups.  We take the phrase "There is no I in team" to a new level.

The "top-down" company- Most of the industry leads with a top-down approach.  Systems and processes are determined at the top and cascaded down with little input from community teams.  Consistency is the key to success, and innovation is on the back burner.

One of these three "cultures" may speak more to your soul than the others.  Chances are you will find yourself working in one of the other cultures, making it harder for you to be successful.

Here are a few things I have learned through working at the rare "consistently collaborative" company that you can leverage to succeed at any of the three.

Know the program and run the program first

A common theme in all three SNF and senior living cultures is that consistency is your friend.  Innovation and collaboration have their time and place.  Still, even at the most forward-thinking companies, 90% of your role will be to operate the systems as established, even if they have room for improvement.  

Don't try to pilot some new innovative technology solution if your organization's QAPI program is not yet fully implemented as processed.  Focus on consistency first.  

Email is never the answer.

Email is the single worst communication medium for leaders communicating with a corporate office or corporate partners in a different geographic location.  When face-to-face interactions aren't possible, always default to picking up the phone.

Now, this doesn't mean you should be calling without an agenda.  Collect your thoughts, schedule the time, and communicate concisely.  

Always have a conversation if you're communicating any message that can be perceived negatively.  It's common sense, but I see solid and well-intentioned leaders get sucked into the role of keyboard warrior.  Pick up the phone and address conflict professionally and head-on.

Default to collaboration

Collaboration is just a fancy word for communication. 

Collaboration= Not operating in a silo. 

When you're facing a situation, decision point, or are trying to accomplish something, always ask yourself and your team, "who are the stakeholders?" and invite them into the conversation.

Stakeholders are all the individuals or leaders impacted by your decisions.  When the group of stakeholders is large, always look to communicate with the individual that best aligns with your level first, whether that be the manager, director, VP, etc.  Ensure you're looking up, down, left, and right on the org chart to consider everyone who may be a stakeholder.

Relationships first, influence second

The most successful leaders in all three cultures lead through influence, not authority. 

When you build trust by consistently running the organization's programs and achieving a baseline of success, you will naturally gain a positive reputation. 

If partners know you will pick up the phone and call them, they will be more likely to consider your viewpoint as part of the decision-making process.

When partners know that you seek to include stakeholders and communicate effectively, they will be motivated to do the same.

Combine all three, and your voice carries more weight.

Webinar opportunity 

Be sure to register for the upcoming webinar from our partners at Base 10.  Your clinical team won't want to miss learning about the role nurses and precision medicine can play in managing cardiovascular disease in the skilled nursing and senior living setting.  I'm impressed with the common sense services Base 10 brings to our industry.  Utilizing a resident's specific genes to determine the most appropriate medication regimen means better resident outcomes, reduced med pass times, and decreased pharmacy spending.- The trifecta.  

Grab your coffee and make it a great day.  We appreciate you and your dedication to your team and residents. -Thank you!