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O Administrator, DON, Where Art Thou?

January 1, 2003
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In search of tomorrow's top management By Todd Hutlock, Assistant Editor
O Administrator, DON, Where Art Thou? With turnover rates on the rise, where will tomorrow's administrators and DONs come from?

BY TODD HUTLOCK, ASSISTANT EDITOR The staffing crisis plaguing the long-term care field is already bad enough, but with the baby boomers waiting in the wings, things could get far worse before they get better. Turnover rates among managers, not just frontline workers, are sky-high, and there are fewer and fewer qualified managers interested in entering the LTC workplace. While the lack of nurses, DONs, and other skilled staff continues to be a problem (see sidebar), more and more nursing home administrators are looking to greener pastures and leaving the LTC field altogether. And, with the negative image presently hung around LTC's neck, finding new administrators has proved problematic. This raises some intriguing questions: How do we recruit qualified new people into the field? What can we do to keep them from leaving once they're in place?

One group that has definitive ideas on the subject is the American Association of Homes and Services for the Aging (AAHSA). AAHSA's recently formed New Leaders Task Force program is aimed directly at bringing people into the aging-services administration profession. The task force is collaborating with a number of prominent universities: The Heller School for Social Policy and Management at Brandeis University; The School of Public Health and Health Services at The George Washington University; The Johns Hopkins University School of Professional Studies in Business and Education; the University of North Texas School of Community Service; and the University of North Carolina at Chapel Hill School of Public Health.

"The New Leaders Task Force is part of AAHSA's Leadership Development Initiative, which has been formed because AAHSA has heard from members that attracting, retaining, and developing leadership is one of the most crucial issues they deal with today," explains Susanne Matthiesen, director of business development, Continuing Care Accreditation Commission, AAHSA. "With the challenges facing our field, strong leadership teams are essential to help AAHSA organ-izations prepare for the future.

"The goals of the task force are to ensure the development of an adequate number of outstanding graduate and postgraduate fellowships to facilitate education for capable and qualified professionals interested in aging-services careers; attract potential leaders into graduate education programs relevant to the aging-services field; and to develop mentoring strategies to foster information sharing between established and incoming aging-services leaders."

While the implementation of AAHSA's task force is certainly a step in the right direction, the lack of students interested in a long-term care administration career is already a problem. "In communicating with my colleagues at academic institutions that offer graduate-level programs in health-services administration, business, and public health, there are very few students actively seeking aging services as a field of choice for their career," says Matthiesen. "While some professionals are looking at LTC as an option when seeking a career, many of them find the state licensure requirements, particularly the AIT process, to be barriers to entry, because few provider organ-izations pay AITs a salary while they are working in that capacity at their organization. For students who have loans to repay or professionals who have families to support, it is very challenging to fulfill this requirement."

Another part of the problem is the manner in which the position of nursing home administrator is promoted to undergraduate and graduate students. To cultivate interest in the field, LTC administration needs to be presented to students as a "hot" career choice-and not just at the collegiate level.

"I do not think the aging-services field is being actively promoted as a career of choice to undergrads and grad students, but I really think that we need to expose children in grade school and high school to our field so that they understand what long-term care is and what career opportunities are available to them," says Matthiesen. "Part of this education proc-ess is the responsibility of professionals currently in the field. We need to be actively going into the community and the public education system and talking about aging issues, providing information about nursing homes, and discussing careers in our field. We also need to be talking to young people about the positive aspects of our field, such as making a difference by caring for residents, managing staff, creating innovative programs to enhance quality, strategic planning, and all the other things that are positive career-development aspects of working in a nursing home."

Needless to say, it takes a certain kind of person to become an LTC adminis-trator; this field is not for everyone. Matthiesen suggests that potential administrators should possess the following qualities in order to face the challenges of long-term care: "Creativity, strategic-planning experience, excellent financial skills, comfort with technology (including database and Internet use), personnel-management experience focused on a coaching model, and the ability to communicate and form productive relationships with many audiences- including regulators, the media, and potential strategic business partners."

These qualifications, while impressive-sounding, are not such rare skills that many young people don't possess them already or couldn't readily work toward them; quite the contrary. The difficulty lies in convincing these students that they should devote their skills to a career choice that appears to offer, at the moment, more headaches than happiness.