Lesson 13: The Administrator as Leader; the Administrator as Manager
Lesson 14: Functions of Managers
Lesson 15: Communication and Governance
Lesson 16: CMS Survey Process and Marketing
Lesson 13: The Administrator as Leader; the Administrator as Manager
- Explain the difference between leadership and management.
A leader is someone who has the ability to project him/herself as someone who is honest. Precisely, leader encompasses demonstration of qualities, which cannot be written in a list of duties. For example, if honesty is a requirement for recruitment of a manager; how can human resource measure honesty? It takes the manifestation of this virtue in a leader for perceptions of honesty are obtained. Hence, leaders show honest during interactions with staff, clients and the public.
A manager does not have to lead. As such, no qualities such as honesty, competence, inspiration or intelligence are necessarily demonstrated for others to follow. Managers simply administer goals; objectives; strategies and values of an organization. As a leader the manager must act integrity, which can conflict with his/her culture and values. The line of demarcation lies purpose, mission and beliefs in who the person represents as a leader/manager. Leaders have a responsibility to act accordingly to influence growth with the organization an manager works on behalf of the organization irrespective of whether it conflict with personality.
2. Describe the various styles of management that are discussed in the Townsend & Davis text on pp. 301-302. Which style fits best with you, and why?
According to Townsend & Davis (2013) management styles are classified using a hierarchy of models. Autocratic and permissive are the two most contrasting styles, which produce the least and most positive outcomes, respectively. In autocratic management leaders make all decisions and staff are compelled to follow being subordinates. Permissive is exactly the opposite whereby members of the organization are allowed to intervene in the decision making process through surveys and forum discussions. This model is best applied with democratic strategies. In the democratic model apart from allowing subordinates to make decisions these decisions are not shelved. Due to the democratic process attempts are made to implement policies based consensus in voting (Townsend & Davis, 2013).
Laissez-faire management style allows the administrator to be a mentor/stimulator. Every section such as units will manage their division within the organization. The nursing home administrator will validate and make suggestions for adjustments where necessary. Many contemporary management styles focus on management by walking around (MBWA). In walking around the administrator has an opportunity to observe and evaluate from a first-hand perspective. Listening is also facilitated (Townsend & Davis, 2013).
In my opinion a blend of permissive and democratic styles is an appropriate management strategy for a nursing home environment. For example, administration can solicit employees’ opinions on certain issues by conducting a poll. This could be followed by a forum discussion concluding with a vote. This technique facilitates cooperation in execution of goals within the structure since every staff member was offered the privilege of initiating the conditions of service relevant to their need and those of the institution.
Lesson 14: Functions of Managers
1. In a brief essay, apply the five management functions (planning, organizing, staffing, directing, and controlling) to the challenge of supervising a large, diverse group of subordinates who have different interests, explaining how each of those functions might be used in meeting such a challenge.
Planning for diverse group of subordinates with different interests in a large organization necessitates understanding first of the organization’s culture and secondly how this diverse group of subordinates have influenced the its design. Essentially, the organization’s culture displays the values and expectations of these employees if permissive and democratic management is being executed during decision making process. Hence, the key towards resolving this challenge is astute management skills embodied in the democratic process
Organizing and directing could be undertaken simultaneously. The suggested execution process encompasses changing the management style into a Laissez-faire model whereby supervisors are allowed to organize their units initiated by the nursing director, who serves as mentor/stimulator rather than a dictator director. As unit leader are allowed to organize their specific areas management simple validate and make suggestions if adjustment are to be made.
Staffing and controlling are two functions even though is the manager’s responsibility human resource serves as a valuable support through utilizing the services of a subject manager expert (SME) in designing competency requirements and selecting the most appropriate staff. This technique is executing control over the quality and quantity of staff recruited.
- Identify the agency or agencies who license administrators. Are the licensing conditions the same in each state? What are the minimum requirements to be licensed as a long-term care administrator in your state?
The Division of Health Facilities and Evaluation Licensing is the New Jersey agency that Licenses Long Term Care Homes’ Administrators. Licensing conditions in New Jersey include internship approval; official transcripts; three references and $100 application fee. These conditions vary from across the country state to state. Minimum requirements embody completion of 100 seminar or course hours in long term care administration.
- Describe the various styles of leadership that are discussed in the Townsend & Davis text on p. 311. Which style fits best with you, and why?
Townsend & Davis (2013) has identified transformational; transactional and paternalistic are styles a leader could adapt. Transformational leadership encompassed the leader growing past the perceptions of subordinate staff and are not limited by staff opinions instead he/she models the outcomes that are achievable by the organization. This is accomplished through inspiration and opening opportunities for exploring new ideals (Townsend & Davis, 2013).
Transactional leaders operate a distinct system of rewards and punishments as a motivation technique. A great disadvantage of this leadership style is that employees function from the premise of fear and not integrity. Consequently the true qualities of efficiency do not surface. An advantage is forging competition and improvement within the organization (Townsend & Davis, 2013).
Paternalistic leaders adapt a parenting style whereby the interactions are design to loyalty to the administrator. A major disadvantage of this leadership style lies in destroying the innovation of employees since they simply have to comply with all decisions made by the leader. The relationships employees have with the organization are focused on the leader. If he/she is removed there could be a sudden collapse. With this leadership style there are solid relationships between the leader and staff (Townsend & Davis, 2013).
In my opinion transformational leadership is most beneficial because it offers scope for expansion in both the leader and staff by building strength against criticisms. Employees have the freedom of speech, but the leader does not become offense neither defensive when opinions are shared. Instead these comments are used to modify polices and address issues before they escalate into problems. Importantly, employees are allowed to participate in the decision making process.
Lesson 15: Communication and Governance
- The communication process is defined as having seven steps: ideation, encoding, transmission, receiving, decoding, understanding, and feedback. Give an example of communication, identifying each of these steps, and show how each step occurs in your example.
An example of communication identifying the seven steps relate to communicating a change of working hours among nursing staff. Ideation begins by asking employees what they think about a change in the working hours. Encoding encompasses gathering ideas received from the first communication level and displaying them in a chart as suggestions received pertaining to change of working hours. Transmission entails distributing in pamphlet form or mounted in a prominent location for all staff to review.
In demonstrating the receiving communication mechanism it means evaluating the encoded information responses by conducting a mini poll gathering reactions as to how the message was received. Once the response rate is acceptable decoding of this information occurs. Charts are removed and pamphlets destroyed. A discussion forum is then organized to share the response rate regarding the suggested change in working hours. At this forum staff members express how the information is understood. A facilitator records perceptions and evaluates understanding levels in determining whether the message regarding changes in working hours was interpreted correctly. The forum discussion will end y sharing understanding and clarification made. A feedback evaluation form is distributed in determining the percentage of employees in favor of the change.
- Governing boards hire administrators to manage, yet board members often involve themselves in the internal management of the facility, which is damaging both to governance and to management. Using examples (other than the one in the text), discuss ways in which the board might get involved in internal management and the damage that can be done by such involvement.
Board members are not always health care professionals. When they find themselves in that capacity the tendency often is to supersede their authority in forcing administrators to comply with their goals, which may be inconsistent with prevailing conditions. For example, the function of a governing board is to ensure that the organization functions according to policy, but conflict of interest can occur when board members misinterpret organizations’ doctrines.
It may become necessary for a nursing home administrator to execute more financial prudence due to reduction in income. The administrator presents a framework to the directors through which this project is expected to be implemented. In their function to ensure that the nursing home delivers quality care they reject the plan forcing the administrator to continue operations as usual. This decision could be crippling to the organization because when resources are fully absorbed it would be impossible to pay utilities and staff.
Another example entails purchasing supply polices within the organization. The administrator purchases wheelchairs from a particular company because the organization benefits through a 30% cost reduction. Board members know of a merchant who offers the same services and negotiates with this agency for supplying the nursing home with a similar deal on wheel chairs. These suggestions are brought to the administrator urging him/her to change suppliers. The administrator is reluctant to do so, but responds to the Board’s demands only to find that the wheel chairs were faulty and endangered residents ‘safety.
Lesson 16: CMS Survey Process and Marketing
- Explain the survey process. In your explanation, compare the old “standard survey process” with the more up-to-date “QIS” survey process. Please be specific.
The quality indicator survey (QIS) is a computerized long term care institution survey related to standards evaluation. It is used by state survey agencies and Center for Medicare Services (CMS) for evaluating whether nursing homes adhere to Medicaid/Medicare guidelines in the according to Federal regulations. There are three distinct stages to the process. Stage 1 encompasses random selection of 40 nursing home residents. Quality of care and life are evaluated based on specific criteria standards out lined in the project document.
Stage 11 has to do with the admission sample whereby 30 recent admissions are evaluated regarding readmissions; death and functional loss. A focused chart review is captured and documented. In stage 111 entails gathering MDS data, which is used to create a resident pool in selecting samples for stage 1 of the survey. The old standard survey contained the exact objectives as the contemporary model. Quality of care/life indicators are revised after the second phase is completed; However, the old system was not a computerized survey. Paper documents were utilized for storing data and the process required more resources because the survey were manually performed.
- Write a paragraph or two describing how a nursing facility might go about marketing itself and the services it provides to the community. When might management use a public relations firm? Please give examples.
One of the most inexpensive ways of marketing any product or service lies within the values of service/products itself. It has been said that actions speak louder than voice. When residents can voluntarily speak about the high quality of care to family and friends this creates more credibility than placing an advertisement in a healthcare magazine, internet or newspapers. The twenty-first century viewing audience is bombarded with enough ads on the internet; television and media generally.
The current perspective of consumers is that many advertisements are just that. No guarantee of high quality services when the product is bought. Therefore, in allowing residents to invite friends, family, members and visitors to view/explore the facility during events and when daily activities are in process is the most profound marketing twenty first century strategy in my opinion because the public does not trust advertisements.
References
Townsend, J., & Davis, W. (2013). The Principles of Health Care Administration. Publicare.
