Saluting today’s (and tomorrow’s) LTC administrators

Today marks the beginning of Long Term Care Administrators Week. During this holiday, the American College of Health Care Administrators honors and celebrates the important role the administrator has in providing leadership for the delivery of quality, resident-centered care and a supportive work environment for staff.

As society grapples with wars, political standoffs, natural disasters, economic instability, unemployment, union challengers, layoffs, threats to social welfare programs—the list goes on and on—long-term care administrators of 2012 face many challenges of their own. Having to deal with such challenges comes with the territory, but the number and magnitude of these issues have reached new heights. LTC administrators must focus simultaneously on internal matters involving residents and staff as well as external pressures that often threaten their ability to perform their jobs.


Internally, administrators strive to provide care that is of high clinical quality, assures optimum quality of life and meets the needs—and, when appropriate the, desires—of those whose care is entrusted to them. This responsibility can be intimidating, but is welcomed by successful administrators. They understand that they are lucky to have this profession, that there are many opportunities to focus on all that is good and not let bad news run their lives.

One of the rewards of managing an LTC facility or organization that is often cited is the opportunity to “get close” to the residents and know them better than is possible in some other parts of the healthcare system. It gives added incentive to serve those residents well.

A second internal constituency for LTC administrators is their staff. These employees are notably loyal to their charges, hard working and often underpaid. Leading them involves helping them perform the best job possible. It also involves meeting their needs and treating them with respect and compassion. These dual responsibilities are not mutually exclusive; indeed, they are complementary.


While providing leadership within the organization, administrators must also deal with a variety of external factors. Doing so is not nearly as much fun as addressing internal responsibilities but is of equal importance. External factors include regulations, financing and changing demographics.

Regulations determine nearly every aspect of long-term care delivery. Few administrators will deny the need for regulations to control the quality of care provided (except perhaps in moments of extreme frustration). However, keeping abreast of ever-increasing regulations can seem like a full-time job, particularly with the arrival of the Affordable Care Act, commonly referred to as “Obamacare.” The uncertainty of what is included or will be included as time goes on makes it very difficult to plan or even to function. This insecurity is not likely to improve in the near future.

Another area of concern for LTC administrators is financing. Like it or not, they must balance revenues and expenses if they are to remain solvent and provide the services they want to. As the national economy continues to struggle, their usual sources of revenue become increasingly unreliable. The largest source, Medicaid, is threatened as state governments struggle to balance their budgets and more people have to rely on it. Medicare’s future is equally tentative and uncertain.

Lastly, administrators must recognize that the demographics of their residents are changing with the coming of the baby boomers. They represent a huge influx of potential customers and bring with them a whole new set of expectations. They want more say in the care they get, in the types of services they are provided and in their ability to refuse those services. Customer service is more important than ever and often makes the difference between organizational success and failure.

Given all of these demands on LTC administrators, it is remarkable how well they have performed. While the media tend to sensationalize any shortcomings—and there are some—the preponderance of care is excellent, even outstanding.

This is due, in large part, to the dedication and expertise of the administrators of long-term care organizations and facilities. For that, the American College of Health Care Administrators salutes them.

Marianna Kern Grachek, CNHA, CALA, FACHCA, is President and CEO of the American College of Health Care Administrators. For more information, visit

Topics: Advocacy , Articles , Facility management , Leadership