The path to leadership

Marianna Kern Grachek, CNHA, CALA, FACHCA

John Pratt, MHA, FACHCA

All nursing home administrators and many assisted living administrators must be licensed by their state licensing agencies, most of which require documentation of a prescribed number of continuing education (CE) hours for licensure renewal, and many states provide oversight about the acceptability of administrator CE within the state. The National Association of Long-Term Care Administrator Boards (NAB) offers a list of approved providers of CE programs that are primarily designed for long-term care (LTC) administrators. Approval by such an organization ensures quality in education and training programming. The American College of Health Care Administrators (ACHCA) is an approved provider of both NAB/NCERS (National Continuing Education Reviewers Service) administrator continuing education, and nursing CNE under the Virginia Nurses Association/ANCC (American Nurses Credentialing Center).

While licensure requirements are a powerful stimulus for administrators to obtain continuing education, it is not the only reason they do. Successful LTC administrators/leaders understand the value of an ongoing program of education to maintain and improve their skills for better organizational and clinical performance.

This is particularly true of leadership skills. A position paper titled “Effective Leadership in Long Term Care: The Need and the Opportunity,” commissioned by ACHCA in 2007, noted that “Studies have evolved in long-term care that clearly link effective leadership practices with organizational performance. While these LTC studies support the broader research on leadership, there are some nuances that make LTC leadership unique. Among other things, these nuances can relate to the need for a compassionate perspective, the high interaction of people, the regulatory-driven environment, a predominantly non-professional workforce, a flat organizational structure, the frequent change in leadership positions, and a lack of understanding and sensitivity of governing authorities.”1 Because of the complexity and dynamic nature of long-term care, its leaders must rely heavily on continuing education to keep up with its demands.

LTC leaders share several characteristics that affect how they approach their ongoing education. They tend to be:

  • highly motivated. They are not kids, studying because they have to, but they understand what they want and take the initiative to get it.

  • goal-oriented. They have set goals and know what is required to achieve them.

  • self-directed. They take responsibility for doing their work and achieving their goals.

  • demanding. Given the above characteristics, it is not surprising that they can be demanding. They want value for their money and efforts.

These LTC leaders are not looking for the same education that works for traditional-age students (18-21 year olds). They want education that:

  • values their experience. They have years of general work experience and expertise on which to build.

  • treats them as equals. They are often as old as-or older than-their instructors and do not want to be treated as children.

  • is relevant to their work. Because they are goal-oriented, they want education that they can put to use right away.

  • allows some element of control. They want to manage their education, at least to some degree.2

In other words, they tend to manage or “self-direct” their continuing education. Self-directed training includes the learner initiating the learning, making the decisions about what training and development experiences will occur, and how. The learners select and carry out their own learning goals, objectives, methods, and means to verifying that goals were met.3

Using learner evaluations of the self-study programs, learner survey results, applicable identified trends, and new LTC research results, ACHCA identifies future educational programming needs. The ACHCA Education Committee, made up of industry volunteers, assists staff in recommending educational products or programs that they believe to be pertinent, timely, and quality information for learner-directed programs.

Once educational needs have been established, ACHCA provides continuing education in several formats to meet these needs:

  • National conferences and meetings (live presentations). The educational activities for ACHCA’s meetings and annual conferences include the Annual Convocation and Exposition, Winter Marketplace, and Summer Leadership Conference, which are organized as a series of educational presentations and workshops. Each session in a conference is scheduled for a specific length of time, with learner objectives, teaching methods, and continuing education credits/units conforming to agencies’ requirements. Attendees may choose their educational programs from a list of concurrent sessions.

  • Webinars. ACHCA, in partnership with redilearning, provides educational webinars on topics pertinent to LTC administrators and multidisciplinary leaders. These webinars build on the business model for e-learning including knowing our market, including how to embrace learners; value learning; market with pricing to a critical customer base, promoting the cost savings to members; meet customer needs; market to the appropriate customer base; and advance leadership excellence.

  • Learner-directed educational activities (self-study programs). ACHCA has affinity partnership agreements with numerous organizations, providing online continuing education as identified by the learner.

In addition to national ACHCA supported CE activities, its chapters provide continuing education that is approved individually by their states. This chapter-provided education can be found on chapter websites through

Leadership development is essential in any business field, but it is particularly important in long-term care. Continuing education is one of the most popular and effective methods by which leaders are able to pursue that development.

Marianna Kern Grachek, CNHA, CALA, FACHCA, is President/CEO of ACHCA. John Pratt, FACHCA, Director of the Long-Term Care Management Institute at Saint Joseph’s College of Maine, has served ACHCA in several positions including membership on the Board of Directors, the Board of the Academy of Long Term Care Leadership and Development, and as Chair of the EducationCommittee. For more information, visit


  1. Dana B, Olson D. Effective Leadership in Long Term Care: The Need and the Opportunity. Alexandria, Va.:American College of Health Care Administrators, 2007.
  2. Pratt J. Education Options for Adult Learners. Standish, Maine:Saint Joseph’s College of Maine, 2008.
  3. MacNamara C.(Strong Value of Self-Directed Learning, 2008. Available at: Free Management Library:

Long-Term Living 2011 May;60(5):34-35

Topics: Articles , Facility management , Leadership