IT DOESN’T HAVE TO BE THIS WAY

Occasionally, I receive contacts from Board Members of non-profit nursing homes.  Frankly, I’m not one hundred per cent sure why they bother because nothing ever comes from these chats.  But I never turn anyone away even if it’s a seeming waste of time.  

     These chats nearly always center around the fact that their facility is failing. 

When I prod them for details, their responses are almost comical.  In fairness, Board members are not trained in the intricacies of the long term care industry which is one of the most complex businesses on the planet.  Notice I said “businesses”.  They depend on the professional leaders who they hire to lead and guide the facility (Administrators). 

The problem with this, though, is that maybe 90% of the time, the reason that the facility is failing is BECAUSE of their Administrator.  That may sound like a cruel generality, but after all, the Administrator is the ultimate operational authority.  Like Harry Truman said, “The buck stops here.” 

But, at least at first, I try to avoid this topic.  I try to avoid this for good reason. They don’t want to face up to the fact that as a Board member, they have fiduciary responsibility and liability.  Yes, they are responsible for hiring an Administrator, but, they also have the responsibility for firing the Administrator.  They will desperately try to avoid this and will seek other avenues to “right the ship” (which is nearly impossible since the ship is already on the rocks).

Let me throw in a few other issues that I often hear:

•  We can’t fill our beds, but the Administrator tells us that all nursing homes are having this trouble.

• Ah, no.  Not necessarily.  Many States have web sites that provide this information.  Try to look them up.  Might the census (beds filled) be low because of your poor reputation and poor care? Is the Administrator pushing the staff to fill the beds, or is he or she out golfing again today?

•    Because of the poor census level, our cash flow is suffering.  But after all, we’re non- profit so we’re not expected to make money.  

• Whoa, No!  For profit or non-profit doesn’t matter.  You have to bring in more money than you spend.  Salary and employee benefit costs are on the rise.  Food costs, building repairs, pharmacy costs, insurance premiums, and other costs are always on the rise.  How are you going to pay for all of this if you don’t have the money?

•    We can make up the difference in financial losses through government grants.

• Wait a minute.  From where do you think most of this money comes? It’s tax payers, so you think that it’s okay to have us tax payers subsidize your nursing home’s incompetence? Not only do you have a fiduciary responsibility, I believe that you also have an ethical and moral duty, don’t you?

The sad part of all of this is that it doesn’t have to be this way. 

Believe it or not, there are competent people out there who can correct and Improve facilities. 

But you, as a Board Member, have to find the courage and guts and do what must be done for the sake of your community, and, most importantly for the residents who live in your institution. Or did you forget about that.

I think they’re why you’re there.