Purdue University Long Term Governance and Leadership Questions

in knowing that ing in mistakes were the fault of others, and to give credit to others, even when the leader might properly deserve some of the credit. Being unselfish requires that a leader have t you know that should be enough. patience with those who do not know as much as she or he does. There is a good feel- Forward-Looking People expect their leaders to be forward-looking. We have already said that they are not prescient, nor do they have special visionary powers. People expect leaders to have a sense of direction and a concern for the future of the organization. They must (Kouzes & Posner, 2007). A leader is not satisfied with the status quo. know where they are going going if they expect others to willingly join them on the journey Inspiring Individuals want their leaders to be inspiring. The term inspiring is not used here in the r P religious sense, although most religious leaders are indeed inspiring. Rather, it means that a leader takes people where they did not think they could go. The leader makes them believe they can do things they had previously thought they could not. They -breathe life into people’s dreams and aspirations, making those people much more willing to enlist in the movement” (Kouzes & Posner, 2007, p. 34). To better under- stand inspiring in this context, readers are urged to look the term up in a thesaurus (it can be done very easily online). It matches terms such as invigorating, enlivening, encouraging, motivating, energizing, and stimulating. It to nd if- se nd Competency Leaders are expected to know what they are doing—to be competent. Their fol- lowers must believe in them and their ability to lead. In a field such as long-term care, there are two kinds of competence. First, the leader must be competent in the profession being practiced, such as nursing, rehabilitation, or management, That does not mean that the leader has to know as much as all of the technical professionals supervised, but he or she must know enough about them to “speak their language” and know whether they are performing well or not. A leader must an- Its. inis 03, gle ncy pod the quickly and lose respect. know what he or she can do and what she or he cannot. He or she should not show off (as opposed to demonstrating competence). Others will see through it A second kind of competence is leadership competence. As we discuss later, there e specific leadership skills, and a person’s ability to practice those skills is all too observable to subordinates or followers. These characteristics are only a few of those common to successful leaders, but are the ones most often cited. ead- 403 hose they Common Characteristics of Leaders mistakes were th might properly Leadership Is a Matter of Control ing in knowing patience with th There was a time (long ago) when managers were taught that they had to control those | supervised could not be trusted to do what is right. That is not leadership. Leader they supervised, meaning to dominate, manipulate, or rule them. It implied that those converts followers to leaders” (Bennis & Nanus, 1985, p. 3). ship means getting those others to want to do what is needed. A leader “is one who Forward-Look People expect t are not prescien have a sense of know where the (Kouzes & Pos Leaders Are Remote and Distant subordinates; they must be remote and distant. The idea was that they had to be s Another outdated management belief is that managers must be detached from their just the opposite-that leaders be seen as approachable by their followers. as superior and could not break down the barrier between them and their employees. Actually, all that demonstrated was the insecurity of the managers. Leadership requires Inspiring Common Characteristics of Leaders Individuals wai religious sense that a leader ta them believe ti “breathe life in willing to enlis People look for certain things in their leaders, whether they are in long-term care or some other business. Research by Kouzes and Posner (2007) demonstrated that the top characteristics they look for are honesty, forward-looking, inspiring, and competency. stand inspiring (it can be done encouraging, 1 Competency Leaders are e lowers must care, there ar the professio Honesty Honesty goes beyond simply not committing crimes (although that is important). It also means being sincere. Followers want their leaders to be genuine. They want to know that what they see is what they get, and they reject phoniness, artificiality, and hypocrisy. Honesty means being fair and treating all equally. If some are treated dif- ferently from others—or are perceived to be treated differently—the leader will lose his or her followers’ respect. If the leader is seen as honest, followers will understand it even when things do not go as they might wish. Honesty also implies being trustworthy. It means saying what you mean and mean- ing what you say. Leaders should be willing to admit their mistakes and their faults . Followers must know that they can trust their leader. As leadership icon Warren Bennis puts it, “Leadership without mutual trust is a contradiction in terms” (Bennis, 2003, p. 131). Such trust takes a long time to develop but can be lost in an instant. A single failure of trust can invalidate many prior successes. Engendering trust is a competency that can be learned, applied, and understood. It is something that you can get good at, something you can measure and improve, something for which you can “move the needle.” You cannot be an effective leader without trust (Covey, 2009). That does nc professionals their languag know what I show off (as quickly and A second are specific lo Another aspect of honesty that is sometimes overlooked is being unselfish. Lead- even when those observable to These ch they are the 402 CHAPTER 15 Leadership in Long-Term Care 2 com- nt that does for nursing care facilities, home care agencies, and hospice agencies, most likely resulting from the fact that they were written at different times by different people. However, they essentially require the governing body (1) to be legally responsible for e facility licensing regulations go into much more detail concerning the require the operation of the facility or agency and (2) to hire a qualified administrator. Some efer to state ments for governing bodies. -term cs. For Ous or anized everal enting wners. Governing Body: Responsibilities The governing body, or board, of any organization has a number of specific respon- sibilities. The following discussion was compiled from several sources (Furr & Furr, 2013a, 2013b; Pozgar, 2010; Singh, 2010) using portions from each to develop a comprehensive list. It applies to long-term care organizations, whether for profit or ferences. Where such differences occur, they are explained. nonprofit, and, generally, to public organizations, although there are occasional dif- rgani- tment nd the IS. Organization 1. Develop and Maintain the Mission and Operational Strategies of the Because the board has overall responsibility for the direction of the organization, it is vision, goals, and operational strategies. critical that the board be directly involved in establishing the organization’s mission, • The mission identifies and defines what the organization is all about and what it does. • The vision identifies and defines what the organization would like to be. • The goals are benchmarks by which progress toward the vision can be measured. • The strategies are the way the organization sets about achieving those goals. In some cases, particularly with public organizations, the mission may be well defined by legislation and difficult to change. In such cases, the role of the board is to make certain that the current goals of the organization and the policies created to ne are Or the eaning iew of before long- zation ing its S, may implement the goals, are within the scope of the legislated mission. Usually, the board The planning process by which the mission, vision, goals, and strategies of an still has opportunities to determine what kinds of services the organization provides. organization are determined is dynamic and ongoing, not static and set. Each piece must be reviewed, evaluated, and (if necessary) changed on a periodic basis. Although ultimately the responsibility of the board to ensure that it happens and that it is effec- the CEO and other administrators may coordinate much of the planning effort, it is tive. A study of board members from a variety of businesses and industries showed strategic planning, plan implementation, and evaluation (Furr & Furr, 2013b). It can the purpose of the organization. Strategic management/planning is fundamental in be a very time-consuming task, but it gives everyone involved a much better grasp of beginning to realize that they need to take a much more active role in that boards are 7 have vhat it 383 Governing Body and Administration: Roles and Responsibilities other organizations. does for nursin resulting from However, they the operation state facility li ments for gove a bit more difficult to put percentages on because many of them are combined with munity they serve, and the governing body is made up of individuals who represent the The owners of nonprofit long-term care organizations are the members of the come a municipality or geographic locality. The service community of a particular long-tem community. It should be noted here that the term community does not always refer to care organization may be determined by a variety of demographic characteristics. For example, one nursing facility may have a mission to serve the members of a religious et ethnic group and tailor its services to meeting their needs. Another may be organizat I segment of a large city. The governing body of a nonprofit organization may be chosen in any of several or a small ways, depending on its mission; however selected, that body is charged with Governing The governing sibilities. The 2013a, 2013! comprehensiv nonprofit, an ferences. Who the community served, just as the board of a for-profit corporation represents its owners Public Organizations Public is simply another term for government owned. Public long-term care organ- zations are owned and operated by city, county, or national (e.g., the Department of Veterans Affairs) entities. Their owners are the voters in that jurisdiction, and the governing body is usually made up of elected or appointed government officials. 1. Develop a Organizatior Because the b critical that t vision, goals, • The mis it does. • The vis Governing Body and Administration: Roles and Responsibilities The governing body and administration have numerous responsibilities. Some ar independent, meaning that the responsibilities are assigned to either the board or the administration. However, most of their responsibilities are codependent, meanin . The god • The str that they are shared between the two groups. This discussion begins with a review of the responsibilities of the governing body, and then goes to the administration, before In some defined by le to make cert implement t moving on to how they interrelate. Governing Body term care, is the group of people legally responsible for the way The governing body of any organization, including those engaged in providing long functions. They determine its overall direction by establishing and maintaining is mission. They represent the owners, and in the case of for-profit organizations, may that organization still has opp The plas organization must be revi the CEO an ultimately t! tive. A stud that boards strategic pla actually be the owners. Medicare and Medicaid require that organizations receiving funds from them how a governing body. There are separate definitions of the governing body and what Governing Body: Regulatory Requirement be a very tir the purpose 382 CHAPTER 14 Governance and Administration hose directly be quite different. overseeing of the orga A the admin- partnerships, ning body, rganization st governing ard of direc- For-Profit Organizations duties of their governing bodies are essentially the same, although their makeup may For-profit, long-term care organizations are those companies owned by individuals, complex and the demands on providers have Historically, individuals or families owned many long-term care provider organiza- or corporations that generate (hopefully) a profit for those owners. given way to corporations. tions, particularly the more traditional nursing homes. As the system has become more The term corporation refers to a legal form of ownership. It means that the owners divide the profits of the organization among them. They are investors or stockholders (even if no stock is traded publicly), and their financial liability is limited to the extent of that investment. Even if the organization should go bankrupt, the individual inves- cussion, the providers have grown, such organizations have largely hat the title tion. She or ees, includ. he accepted r, executive or national corporations owning many facilities, and they are indeed becoming a more manage the ries out the ration such e organiza- fors would lose only the amount they had specifically invested. When we think of long-term care corporations, we usually think of large regional common form of ownership. However, the two or three owners of a small corpora- tion have the same governance responsibilities as the stockholders of a much larger organization. So how does this difference in size affect the nature of the governing body? In smaller for-profit long-term care organizations, the governing board may include all of the owners. In a large corporation, the board is generally elected by all of the owners, or stockholders, to represent them. administra o supervise nagement is ore simply. evels of the Nonprofit Organizations Nonprofit (also called not-for-profit) organizations exist to serve a community or sometimes a religious group. No individuals receive any share of the profit from the activities of the organization. All such profits (called “return on assets” in financial parlance) are reinvested in the organization. This form of organization has long been The most common in some other segments of health care, particularly acute hospitals. supervisors , g how they ract. a This is mostly the result of the way those facilities developed, quite differently from the way long-term care developed. There are, however, a significant number of non- Association, an organization representing nursing care facilities, reported that in 2013, ment owned. Fifty-five percent were owned by national, multifacility chains (AHCA, 2013). Similarly, the majority of assisted living facilities are owned and operated by for-profit organizations. A 2011 study found that approximately 82% were for profit and the remainder were not for profit or were owned by government entities (Park- Lee, 2011). Ownership of home healthcare, hospice, and adult day care agencies is ation, let us Sanizations dies. There public. The 381 Organization Types and Who Governs Them

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