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Why I stay in the game: A determined nursing home administrator

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Michael Hotz, LNHA, CNHA, FACHCA
Michael Hotz, LNHA, CNHA, FACHCA

There has been a lot of buzz generated by Julie Boggess' piece on leaving the profession from at least a bit of burnout. I have heard from people ranging from the CEO of the American College of Health Care Administrators to educators of administrators to my protégé in the ACHCA mentor program to my past and current interns to seasoned pros.

This article has created a lot of discussion and that is a good thing. My own reaction has evolved. Here is my current take.

Julie, I am sorry that the current environment led to your needing a sabbatical. I am choosing something different. I am choosing to make a difference in the profession, teaching the leaders of the future and doing my best to implement this stuff in my building.

These new regulations are of our making. Resident-centered care is now required because we failed to do it ourselves. Fire safety and disaster planning are way up the compliance food chain after Hurricane Katrina, Sandy, and those patients who died in Florida, in no small part due to inadequate generator coverage of HVAC.

Facility Assessment exists to make sure that we have the resources to implement the care that we claim we offer. We have allowed those regulations by not jumping in to best practices.

And we have not educated ourselves enough to get ahead of the regulations. When we do the right thing, some regulations become unnecessary and we are ready when they do come.

I understand that some need to take a step back, but I continue after 35 years in to work on our future leaders. I know the key to success is joining and more importantly participating in associations. Whether it is AHCA, or Leading Age or the American College of Health Care Administrators, we need to be involved in changing our practice and environment. We need to be brave and bold.

When my former governor cut my Medicaid Rates 20% several years ago, my company president surgically reduced expenses and went to the vendors to contribute to the cause. The impact on residents was unperceivable.

I know an owner who is a former AHCA chair who proves everyday that quality care brings a quality bottom line. I have a former protégé in the ACHCA Mentor program who is inspiring people, even as a new administrator of record. Of my over 30 interns in my career, most are successfully running buildings and doing a great job. These people inspire me.

I remember Michael Duffy's speech accepting his administrator of the year award banging the podium declaring, “Ladies and gentlemen, we are in a noble profession!”

Make a difference.

John Pratt asked me to give a seminar at St. Joseph's College Summer Symposium several years back, and we chose model AIT/Preceptor Programming. That seminar inspired Phil DuBois to approach the NAB and we worked with task forces from ACHCA and NAB to create the model AIT/Preceptor program that is now available in most states.

Professor Doug Olson recognized that many newer administrators struggled to be successful. Therefore, he created a formal mentor program for the ACHCA where seasoned administrators mentor newer administrators. (Full disclosure: In mid-April, I will become the chair of that program.) AHCA and LeadingAge have created talented communities to examine regulations and propose modifications, suggestions, and feedback to regulators.

We need people to step forward and improve our environment and our practice. We all do better together.

My response to all these myriad of challenges is to get busy. Create new leaders as we are leaving the field faster than people are entering. Inspire and help the leaders of the future.

Trust me: Those you think you are teaching will inspire you. I have been on the front lines as a practicing administrator for 35 years. My peers inspire me. My interns inspire me. My proteges inspire me. My associations inspire me.

We have come a long way in my career. We have a long way to go. What frustrates us seasoned folks is the normal for the new leaders. Let's inspire them. Our residents, their families, our staff and we deserve the best. Get involved, get inspired and make the difference.

Isn't that why we all got into this crazy field — to make a difference? Never forget why you started, and if you feel like you need inspiration, spend some time with a resident, with your peers and with our associations.

We will never regret making a difference.

Next week, I rotate off the board of the ACHCA after eight years. I did what I could and I am proud. I thank everyone who inspired and taught me and I leave the college in great hands.

I will continue to pay it forward as so many have helped me in my career.

How about you? Are you ready to tackle the challenges of the future and get ahead of the regs with best practices? I challenge you to aspire to be like your leadership heroes in our chosen profession. I know you can do it!

Michael Hotz is the Administrator of Northern Manhattan Rehabilitation and Nursing Center in New York City. He is the Immediate Past Chair of the American College of Health Care Administrators and a member of the AHCA Survey and Regulatory Committee

Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.

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