The Right Stuff

Last September, McKnights was kind enough to publish my guest submission on the State Operation Manual and how I felt many administrators in skilled nursing didn’t seem to have much working knowledge of Centers for Medicare & Medicaid regulations. This spurred a burning question: What drives someone into this work; an often thankless, deeply challenging, and moderately compensated profession working with people that our culture tends to keep out of sight and out of mind

What makes an administrator? And even more, what makes a really good one?

This question brought me to an interview with Shaun Dahl, administrator of Coventry Court Health Canter in Anaheim, CA. His 97-bed skilled nursing facility has been servicing the city of Anaheim and surrounding communities for more than 35 years. From its very first time with CMS, Coventry Court has had a 5-Star ranking.

Although he would deny it, a good portion of the success of Coventry Court lies with Dahl as its administrator. During the hour that we spoke, he excused himself to respond to a surveyor that was in the building without missing a beat. Clearly this was an example of the “right stuff.”

Long-term care is a family affair with Dahl. In fact, two of his brothers were Administrators in Training at the same time that he was. He laughs about his Mom having to crack a whip during the holidays to steer the conversations away from census, and surveys, and work in general. His education, like many in the field, was in Business Administration, concluding with an MBA from Pepperdine University. Despite some work in other fields, the family tug brought him to Coventry Court.

Not only did Mr. Dahl enjoy his training experience, it sparked a deep passion for the care of seniors. He gives his preceptor, Paul Duranczyk, a tremendous amount of the credit for both his success in the field and that passion.

Dahl trained at Coventry Court, then went to another facility for a year before returning when his preceptor was promoted to a regional position. A strong understanding of business administration may be a good foundation, but long-term care and rehabilitation are first and foremost about healthcare. Whether someone becomes a resident of his facility to recover from an accident or illness, or as the result of aging and failing ability for self care, these people are among the most vulnerable of our population. In his words, “I think constantly about how I would want my mom or dad treated.” It keeps him humble.

He refers again and again to “his team.” Finding and retaining a great staff is a primary concern. Coventry Court is perhaps a stand-out facility, at least in part, due to low staff turnover. The Director of Nursing, Linda Budy, is a veteran who preceded Dahl at the facility. He affectionately speaks of her as his “at work wife,” i.e. a cherished and respected partner.

To my complete surprise, he refers to his CNAs as experts on the residents. “Who knows them better than the people who care for them every day?” he asked.

I can tell by the way that his talks about his staff that he is accessible to each and every employee. This is not a man who hides in his office.

Dahl is very proud of Coventry Court and the work that they do. His pride shows as he expounds on a pilot infection control program that they spearheaded (with UC Irvine and the Centers for Disease Control and Prevention), or the deep satisfaction he feels when a resident “graduates” from rehab and is able to return home. He talks at length about the privilege of being a preceptor himself, to the tune of 17 AITs in 18 years. His voice goes quiet when he speaks of assuring dignity at the end of life.

I was getting a real handle on how he has the “right stuff.” With 18 years as an administrator, he still loves his job.

I ask the $64,000 question: “Are skilled nursing facilities over regulated?

Well, some of the regs are obviously archaic, but we do our best to stay on top of it,” he said. “Surveyors have their job to do, and we have our job to do. If we’re doing it right, there’s no problem.” I

In addition to the resources that his corporation provides him, Mr. Dahl is a long time subscriber to SAVVY on the SOM, our subscription newsletter on the regulations. Why?

“There’s no such thing as too much knowledge.”

My final question – what advice would you offer someone new to the industry? 

“If you truly have a passion and desire to serve people then this can be an excellent career. While it can be demanding in many ways, the rewards for making a difference in someones life are endless,” he said.

He added, “Folks come to your care in one of the most challenging and difficult times of their lives. We do our best to give them hope, encouragement and dignity.”

While every administrator is different, Dahl’s example is clearly one to follow, and an example of “the right stuff.”

Trish Rodriguez is the Operations Manager for SAVVY on the SOM.