I recently asked a director of rehab at a skilled nursing facility if she was doing anything to prepare for the Patient-Driven Payment Model

“Of course I am,” she replied, “My boyfriend and I are planning to open a Chick-fil-A franchise. That’s how I’m preparing for PDPM!” 

A bit drastic? Maybe, but when trust levels within an organization hit a low point and people get pessimistic about the industry as a whole, this is what we start to see. 

Maintaining your organization’s cohesion as you transition into PDPM will be a test of true leadership. Especially during times of change, successful organizations are powered by the strength of the relationships they build with employees, customers, and investors. 

As we gear up for PDPM, it’s instructive to look at how other industries went through their own disruptive changes, and how great leaders in those industries responded.

In the wake of the dot-com bust and 9/11, the hospitality industry experienced its worst downturn in 60 years. During those years, Chip Conley, the CEO and founder of a San Francisco-based hotel management company, had some of the roughest times of his life. 

In spite of the odds, Conley’s company doubled revenues, and reduced its employee turnover rate to one-third of the industry average. Conley went on to write about his success in his book Peak: How Great Companies Get their Mojo from Maslow. 

So how did he do it?

He called his approach the ‘Maslow-inspired management philosophy’.


You probably recognize this pyramid representing Abraham Maslow’s iconic hierarchy of needs. Starting at the base, we need to satisfy our survival needs. Once these are covered, we can move to higher needs, such as love, belonging, and a feeling of accomplishment. At the top of the pyramid, “self-actualization” represents the sense of achieving one’s deepest life-purpose.

50 years later, thought leaders are now applying this framework to how we lead and manage organizations. They distill the hierarchy down to its core principles: survive, succeed, transform.


Think of an important decision that was made at your most recent budget meeting. From what level of the pyramid was that decision motivated?

With the current industry uncertainty, there’s no doubt that pragmatic decisions need to be made. The lower levels of Maslow’s pyramid absolutely must be satisfied, but Conley’s point is that it cannot stop there. Organizations driven primarily by fear for survival tend to enter a downward spiral of declining employee morale, customer satisfaction, and financial performance.

With PDPM, facilities have two broad challenges to solve for.

The first is about managing resources and setting up processes to ensure survival and profitability.     

The second is about ensuring that whatever you do for PDPM will maintain the strength of your organization’s relationships. This is where Maslow-inspired management philosophy plays an important role. 

It begins, as Conley says, with an understanding that “people long for a connection to others and something bigger than themselves. They want to make an impact. They want to transcend the base of the pyramid.”

Conley’s insight is that if an organization is able to create these “peak experiences” for its employees, customers, and investors, it will lead to “peak performance” for the organization as a whole. 

Imagine this dynamic at play during a care transition meeting, when cross-disciplinary teams of therapists, nurses, and social workers work through each patient’s functional, chronic, and psychosocial factors to determine the best set of goals and optimal length of stay.

The potential for facility-wide participation in patient outcomes can go even further. A session at the NARA spring conference recounted how at one facility, a member of the maintenance staff built a rapport with a patient. When this patient’s function declined, it was the maintenance worker who noticed it, and flagged it to the care workers.

Setting up the right processes is critical, but in order for these processes to do their magic, you need wholehearted buy-in from the human beings that make up your organization. Maslow-inspired leadership holds some key lessons for any leadership team that wishes to nurture this level of staff engagement. 

For those interested to learn more about Maslow-inspired leadership, I heartily recommend Conley’s book, Peak: How Great Companies Get their Mojo from Maslow.

Here’s to renewed purpose, inspired leadership, peak experiences, and organization-wide success!

Mark Evin is the CEO at Jintronix.