Corporate leaders express their resolve to facility employees by:

·          stressing that caregiving excellence drives profitability, not vice versa

·          making company decisions based upon the inspiration that drew them to elder care

·          recognizing that a company's reputation is earned one facility at a time, and that the collective achievements of many over time can be tarnished overnight by a few    

·          treating facility staff with equal reverence in organizations in which nursing homes are not the major source of income

·          placing proven management talent within the facility and streamlining corporate operations

·          structuring lines of accountability where nursing directors, business office staff, and facility-based managers report to the administrator only, and the administrator reports to one corporate executive. Solving management problems at the facility level, rather than micro-managing day-to-day operations from afar

·          hiring facility-based clinical talent (i.e., therapy, dietetics, social services, and recreation) whenever possible, rather than rationing these services from independent contractors

·          granting facility management the autonomy to influence the destiny of their operation

·          de-emphasizing one-size-fits-all,  per-patient-day decision making, and cookie-cutter approaches to caregiving

·          designing staffing levels based on periodic caregiving studies and resident outcomes, not  regulatory (survey) tolerance

·          enabling facility management to hire, schedule and retain quality personnel

·          structuring employee wage and benefit programs to foster longevity

·          promoting facility and corporate talent from within the organization

·          approaching staff education as a wise investment, not a cursory compliance exercise

·          communicating business challenges to company employees on a timely basis

·          making periodic facility appearances to interact with residents and front-line staff. 

·          funding sufficient levels of facility supplies and replacing worn out equipment and furnishings before they become problematic

·          making timely repairs and improvements to the physical plant, including periodic renovation and cosmetic upgrades.

·          achieving a bottom line by exhausting revenue opportunities and culling non-essential company resources before slashing caregiving expenses (i.e., labor hours, benefits)

·          designing facility budgets with realistic, attainable benchmarks

·          reinforcing caregiving expectations through a variety of communication vehicles, while recognizing that spoken words and actions carry more meaning than words on paper

·          rewarding facility employees for their caregiving contributions from a corporate platform

·          designing executive bonus plans that do not undermine caregiving excellence

·          promoting the philosophy that corporate offices are designed to support facility operations, not vice versa

·          posturing corporate field staff to serve as company mentors and facilitators, not enforcers

·          scrutinizing the bureaucratic paper trail between corporate offices and facilities

·          ensuring that resident representatives receive an accurate and timely accounting of facility charges, whether generated by facility staff or third parties

·          reminding corporate staff that the era of order taking has passed. Census development is now determined by competition; competition is determined by caregiving excellence and caregiving excellence is determined by company executives.

·          remembering that facility employees are the instrument of a company cause

·          not conceding a "cause" to defeat due to government reimbursement challenges 

·          possessing the business wisdom and perseverance for a facility to remain prosperous

·          being forthright with facility staff about business decisions affecting their employment

·          treating each facility as a unique caregiving community, not as a link in a chain   

·          Recognizing the far reaching ripple effect of adverse facility decisions to residents and staff, their families and friends, facility business relationships, and the surrounding community.