Waiting for the silver lining - Guest Editorial - Editorial

Nursing Homes, Feb, 2002 by Daniel W. Farley

Recently in a variety of long-term care publications, information app eared relative to the decline in availability of nursing home administrators in the United States. According to the National Association of Boards of Examiners of Long Term Care Administrators (NAB), in the last three years, there has been a 36.5% decrease in the number of persons taking the national examination. Different writers have wondered why. According to Richard L. Peck in an editorial appearing in the July 2001 issue of Nursing Homes/Long Term Care Management, the reason is fear....Who in his right mind would want this job?"

In the August 2001 issue of the same publication, an attorney whose firm represents nursing home administrators offered an additional opinion pertinent to NAB's reason for the decline in candidates to take the test. Annaliese Impink, Esq., identified a variety of "shoulds" to prepare administrators for their work.

For seasoned colleagues the offerings made sense, but the challenge of staying in the field of long-term care might require more to lure and keep the best and the brightest practicing in our profession. Experience is a grand teacher, when one is open to change and recognizes that progress in any endeavor comes with a price. In this writer's opinion, the key question is, "Are we willing to pay it?"

As one struggles to understand this question, various factors come to mind. What drives a person to choose long-term care administration? Is the objective to have a job, earn a living and go home at day's end with no thought of returning until the next workday? Or, might the reason be that which has been mentioned, plus development of skills in the quest for a career that hopefully moves one to become professionally and financially secure?

In days past, it was not uncommon to hear role models say, "Administrators must come early and stay late in order to succeed in chronic care." Obviously, this meant investment of time far beyond a 40-hour workweek. In assessing where colleagues find themselves today, it might be reasonable to ask, "Is today's new breed of administrator ready, willing and able to adopt such a philosophy at a time when other options for work and professional life might be less demanding and potentially offer the same, or better, financial opportunities?"

Demographics show our population is aging. In all probability, the result will be an increase in demand for chronic care services, and people and facilities to provide those services. With fewer persons electing to seek a career in chronic care administration, those who have adjusted their outlook and can see the opportunity will likely reap the rewards -- financial and otherwise.

There is little doubt that we are living in a time when leaders in long-term care--principally nursing home administrators--have been placed under the gun, sometimes appropriately, for failure to offer quality service, but more likely than not for falling victim to subjective surveys, inadequate reimbursement and the threat of litigation, both corporate and personal. With increased exposure to such hazards has come the question for many as to whether long-term care administration is what they want to do as their life's work.

Being at a crossroads will cause some to take the path of least resistance. Those who are more insightful will step back from the situation, read the sociological signs and conclude they have what it takes in aptitude, commitment and willingness to stay the course and make a difference. When this occurs, these persons will likely see the light of the "silver lining" surrounding the cloud that lingers over our profession today.

Daniel W. Farley, PhD, CNHA, is president/chief executive officer of GlenWood Park Retirement Village, Princeton, West Virginia.