Training the greatest performers on earth - long term care facility administrators

Nursing Homes, Feb, 2001 by Douglas J. Edwards

Long-term care facilities and circuses have much in common. This analogy is certain to raise some eyebrows, but consider the similarities. The ringmaster of a circus oversees separate rings, each with its own actions and activities, just as an administrator monitors nursing, financing, physical plant and other departments in the organization. Like circuses, long-term care facilities attempt to keep all the people--in this case, residents, families, staff, financial resources and the government--happy. But, while a ringmaster usually has performers to help run his show, long-term care administrators are not always so lucky.

Indeed, administrators themselves must be multiskilled performers. Walking the tightrope of regulatory compliance, they must also jump through hoops of customer satisfaction, staffing issues, ethical concerns and negligence lawsuits; dodge the finicky actions of elephants (Republicans) and donkeys (Democrats); and juggle their home and work lives, all the while continuing to chase after up-to-date knowledge.

Thankfully, under the long-term care Big Top, there is help to be found: Several organizations are prepared to help wearied managers gain some measure of control of the acrobatics of administration.

The Assisted Living Federation of America (ALFA) is one such group. "Because assisted living is a new industry," explains Barbara Shoemaker, director of marketing for ALFA University, "many people have not had the benefit of training specific to assisted living. Having the opportunity to take courses developed specifically for assisted living helps explain the 'philosophy behind the practice,' giving administrators a perspective that is very, very helpful." To that end, ALFA University offers many courses for administrators to advance their skills, including a 47-hour "Management Library," a self-study, self-paced course with an open-book exam that, if passed, leads to voluntary ALFA certification in assisted living administration.

The American College of Health Care Administrators (ACHCA) also offers certification for administrators of assisted living homes, as well as for nursing home and subacute facilities. ACHCA even collaborates with ALFA to offer the Assisted Living Boot Camp. "It's like a 101 college course that takes participants through at least a 201-type level of understanding of the assisted living industry," explains Mary Paspalas, ACHCA chair-elect.

Colleges and universities have developed programs that specifically deal with long-term care management. The Wertlieb Educational Institute for Long Term Care Management at The George Washington University has a graduate-level certificate in long-term care administration (Table 1 ),a master's degree in health services administration and various continuing education programs. Other options include an MBA focusing on health services administration, a doctorate of public health and for those with less far-reaching educational plans, three-week intensive courses focusing on specialized topics, such as law and policy and long-term care. According to Nancy Alfred Persily, MPH, director of the Wertlieb Institute and associate dean for Undergraduate and Continuing Education at The George Washington University School of Public Health and Health Services, an undergraduate program focusing on long-term care administration was in development at press time.

Saint Joseph's College of Maine also has a long-term care administration program through its Long-Term Care Management Institute, offering a certificate (Table 2) and bachelor's degree in long-term care administration, in addition to a master's in health services administration. All three can be earned by taking courses online, but a two-week on-campus session is required to earn the degrees. According to Institute Director John Pratt, American nationals living in places such as Saudi Arabia, Guam and Saipan (part of the U.S. Commonwealth of the Northern Mariana Islands) have taken the Institute's online classes; some anticipate returning to the United States to pursue careers in healthcare or long-term care administration.

(The latest academic entry in the field, Johns Hopkins University, is starting its new "Seniors Housing & Care Program" this month; see "NIC on Financing," p. 40.)

Other organizations use the Internet for training, as well. ALFA University anticipates having several courses online by April 1. Paspalas says AGHCA currently does not have courses online, but its Web site offers information on its sessions. The ACHCA site also has a Peer-to-Peer section that allows administrators to communicate with each other, and AGHGA is considering ways for administrators to earn continuing education units (CEUs) online. (Many are eligible to earn CEUs by reading Nursing Homes/Long Term Care Management and taking the test at the back of each issue.)

The Wertlieb Institute, according to Persily, plans to have selected gerontology and long-term care management courses online this summer; students eventually will be able to take most- if not all-courses for the graduate certificate online.