What's a 'good' assisted living administrator?

What are the qualities that would exemplify a good assisted living administrator? That is a question that is being asked more and more frequently as the industry continues to grow. Answering it is by no means simple because there are varied models of assisted living programs often requiring a different focus. Nevertheless, in hopes of finding some common ground, Nursing Homes asked some assisted living insiders to name three characteristics that an assisted living administrator should possess.

Christian A. Mason, CNHA, MBA, FACHCA, CALA, Vice President of Operations, Sun Retirement Corp., Salem, OR: "To find the right people we must have a 'recipe' for selecting quality assisted living managers or we'll likely end up with nothing more than half-baked programs.

"When we talk about our favorite recipe, we tend to describe it in terms of outcomes - what it is we like about it. We say it has an excellent flavor or a unique appearance or some other special feature. We talk about the finished product and not the ingredients from which it was made. It seems we do the same thing when talking about successful assisted living managers. We discuss them based on what we like about the overall program they manage and not the specific skills they possess. We say they have created a positive environment, a homey look or a cheery staff. But we seldom zero in on the ingredients of their success.

"To be successful in assisted living management today, every manager must possess three key ingredients: organizational skills, communication skills and people skills. Additionally, they must have a dash of caring, a pinch of flexibility, a cup of knowledge and a handful of experience.

"Organizational skills are central to every good assisted living manager. They must juggle an endless number of details regarding care, personnel, finances, the facility, and families. Successful managers must be able to track multiple systems, respond quickly to changes and allocate necessary resources to optimize outcomes.

"Communication skills are needed to help managers maintain a perceptual parity among the beliefs of residents, families and staff. They must continuously examine residents' perspectives and communicate these perceptions to staff and family to maintain balance within the community. In line with this, they must have good written and verbal communication skills.

"People skills are an essential for every good assisted living manager. Managers must understand the uniqueness of every individual and be able to respond to their needs on their specific terms. They must have a finger on the pulse of organizational morale, and know when to laugh and when to be serious. Good managers have the respect of their staffs, and their friendship too.

"Every assisted living manager should also have: 1) a minimum of four years administrative experience and/or education, 2) completed a state-approved licensing program or a national certification program specific to assisted living, and 3) the ability to put all this together in a recipe for success."

Nancy West, Vice President, Health Care Dimensions, Colorado Springs, CO: 1) "Personal qualifies: Good assisted living administrators share many similar personality and character traits. In order to be effective and successful, an administrator should be a highly compassionate person with a genuine caring for the elderly. They will develop relationships with the residents and must have a high degree of honesty, integrity and self-responsibility. Today's facilities are designed to be as home-like and non-institutional as possible, and an administrator will strive to provide that atmosphere of caring and compassion as residents struggle with the issues of loss of ability and, therefore, loss of independence.

2) "Technical abilities/experience: Because the field of assisted living is growing so rapidly, there are not enough administrators with specific operations experience to match the number of facilities. Therefore, it becomes necessary for sponsors to look to related industries to find administrators with skills that will best translate to assisted living. Individuals with management experience in continuing care retirement communities tend to transition well because more of today's assisted living facilities are based on the social model, i.e., they see their residents as people with social needs who sometimes get sick. Administrators from more highly structured, highly regulated industries tend to operate with the medical model, seeing their residents primarily as sick people.

3) "Financial/marketing expertise: Administrators in the assisted living field must have a strong business orientation and good financial skills because the margins are fairly small. A good sense of bottom-line management must balance the desire with the ability to provide quality services. Most assisted living residents pay with private funds, as opposed to those who are funded by Medicare, Medicaid and managed care organizations; therefore, the marketing effort is directed more toward individual residents and their families."

Linzi Mamstrom, CALA, Director, Carl Weyand Education Center, a division of La Amistad Foundation, Inc., Fern Park, FL: "When asked what the three most important qualifying characteristics of an assisted living administrator should be, I thought, 'No problem. I work with administrators every day, and get to know many from different models of long-term care health.' Once I began to consider these characteristics, though, coming up with three was tougher than I'd expected, mainly because there are vast differences from one model of assisted living to the other. It was hard to generalize the role of the administrator enough to pinpoint just three key characteristics. However, considering that probably the most important feature of an assisted living facility is a home-like atmosphere, I asked myself 'What qualities would an administrator have to have to create such an atmosphere?' The first three that come to mind were that he or she would have to be friendly, trustworthy and understanding.

"The administrator, as the leader, should ensure that the qualities of friendship, trust and understanding are embodied in the facility and reflected to the community. He or she must be able to listen well, as a friend would, and be as trustworthy as a financial advisor when dealing with the residents' financial issues on their behalf. Attentive administrators show understanding to the individual, which allows the resident to feel safe, respected and autonomous.

"How does an administrator cultivate these qualities? Experience and education can be used to shape the assisted living administrator's character. Dealing with our own problems and crises, and considering what we would want, can lay the groundwork for understanding resident needs and lead to a professional application of the golden rule.

"Through education we administrators can begin to advance our professional skills in areas such as management, human services, business planning, and program development, and make it a priority to establish policies and procedures that guide programs that meet resident needs. Advanced continuing education can have a positive effect on how the community views the administrator and the facility. Residents feel more comfortable knowing there is a qualified person overseeing their programs and services, and it demonstrates to family and community members that the administrator is likely to have high standards of practice."

Karen Wayne, President/CEO, Assisted Living Federation of America (ALFA), Fairfax, VA: "The most important characteristic of an assisted living administrator is compassion. They should have a willingness to make direct contact with the residents and their families and have a real love of working with people. As a result, ALFA encourages administrators to promote the dignity and independence of residents through the following 'Philosophy of Care':

* Offering cost-effective quality care that is personalized for the individual's needs;

* Fostering independence for each resident;

* Treating each resident with dignity and respect;

* Promoting the individuality of each resident;

* Allowing each resident choice of care and lifestyle;

* Protecting each resident's right to privacy;

* Nurturing the spirit of each resident;

* Involving family and friends, as appropriate, in care planning and implementation;

* Providing a safe, residential environment;

* Making the assisted living residence a valuable community asset."

For this writer, it keeps coming back to you and your conscience: if you try to do the right thing for the resident/patient/client, you will be successful much of the time.

My thanks to the experts who participated in this article. For more information about assisted living administration, contact ALFA at [phone] and the American College of Health Care Administrators (ACHCA) at 888-88 ACHCA.

Inquiries or suggestions regarding this or future columns should be directed to 2956 Kelton Avenue, Los Angeles, CA 90064. Only those who include their name, name of the organization, address and phone number will receive a response.

Laura Hyatt is the Principal of Hyatt & Associates, Los Angeles, CA.