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Highly successful leaders in long term care are few and far between. Strong leaders must be able to balance the needs of their staff, residents, and the facility all while observing federal regulations and providing quality care. In this article, we will explore some of the essential characteristics of successful leaders and provide examples of how they work best in the long term care industry. Additionally, we will look at current challenges in long term care and how leaders can work to solve them.

Leadership has always been critical to the success of any long term care facility. But that is even more so the case now. The drop in census rates due to the COVID-19 pandemic coupled with massive staff turnover rates have made strong leadership absolutely imperative for the sustainability of the long term care industry.

Highly successful leaders are those who can build a team that works collaboratively and empowers employees, making them feel valued, respected, and motivated. Concurrently, successful leadership facilitates a higher quality of life for residents, resulting in long-term benefits, such as increased facility reputation and higher occupancy rates.

Without proper leadership, facility procedures would be poorly communicated and staff would be disorganized and unmotivated, resulting in many vulnerable residents being unable to receive adequate care. There are about 1.4 million nursing home residents across the United States who are in need of daily assistance from caregivers. It is by way of organized and effective leadership that those needs are addressed. 

Leadership is not only a role but also a duty and a privilege. “We’re all leaders in this industry, which means we get to care for our nation’s senior adults,” said Stacey Pickering, the executive director of Mississippi Veterans Affairs. “And it is a great responsibility that we have.” Pickering talked to Peter Murphy Lewis about the importance of leadership in long term care on the LTC Heroes podcast. In his interview, Pickering emphasized leadership’s role in long term care branding and advocacy.

The 5 Essential Characteristics of Highly Successful Leaders in Long Term Care

Being a successful leader in any industry is difficult, but due to the size and complexities of long term care, leadership in this field is particularly challenging. A highly successful long term care administrator is:

  1. An effective communicator: As in other industries, leaders in long term care must be able to provide clear direction for staff members by communicating goals and expectations on a regular basis. This involves the facilitation of meetings across all departments in order to ensure that everyone in the organization is on the same page. Additionally, leaders should recognize that they are not always correct and must know how to listen to subordinates in order to build trust and obtain new ideas. “In management, there’s nothing wrong with listening to your staff,” opined Pickering. Listening, of course, also entails hearing the concerns and suggestions of residents and family members.
doctor consulting senior people in nursing home
Effective leadership in long term care involves communicating with residents.
  1. Able to resolve conflicts: Conflict resolution skills include being able to foster trust, manage emotions, clarify expectations, negotiate mutually agreeable solutions, and establish ground rules for handling difficult conversations. Highly successful leaders must be able to create an environment where disagreements among staff can be discussed without fear of retribution. The key to conflict resolution is having the previous characteristic, being able to communicate. That means that administrators should hold regular meetings with staff to discuss and solve issues in an open manner. In addition to disputes between staff members, conflicts may also arise between staff and family members who are upset over the treatment that their residents or loved ones are receiving. Again, communication is vital in order to identify the root cause of the disagreement and address it accordingly. Facility administrators should meet each affected party with an open mind and calmly discuss issues to find a resolution.
  1. Skilled in people management: Highly successful leaders require the ability to develop and manage relationships with employees. The long term care industry faces more staff burnout than other healthcare sectors, with a rate of 37% in skilled nursing facilities. It is, thus, imperative that long term care leaders reduce this rate through empowering and supporting staff. To do so, facility administrators should understand what motivates their staff and reward contributions and individual excellence.
  1. A strong decision-maker and problem solver: Long term care leaders must have a demonstrated ability to think strategically about goals and decisively work toward them, avoiding confusion or lost productivity among employees. There are three keys to making any decision in long term care:
    • Data: Highly successful leaders must constantly be analyzing performance numbers and identifying the decisions that have led to the best results in order to establish further steps and goals. “Those of us in long term care and skilled nursing facilities really need to look at the data of making decisions,” said Pickering, speaking from great experience. This process is facilitated by using the most recent advancements in technology: electronic health records. With a customized key performance indicator (KPI) dashboard, your staff can stay on top of all of your residents’ needs;
    • Knowledge of the industry: Long term care is a massive industry with an estimated value of $430 billion, a number that will only continue to grow. As a player in such a large sector, you must be well versed in policies, news, and trends, like a point of care module for your EHR that allows for custom data tracking. Staying informed about such things will allow you to make decisions that are in the best interest of your residents and staff and help you get ahead of competitors;
    • Understanding company values: Therefore, knowing your values prevents you from making decisions that are irrelevant and unhelpful toward overall objectives. Pickering highlighted the benefits of knowing your organization’s values prior to making decisions and the role this plays in establishing and achieving your goals. “I want to be relevant, I want to be modern, and I want to be professional,” said Pickering, when sharing his own values. “If I’m not doing two of those three things on every decision, then I don’t need to do it.” 
  1. Adaptable: The COVID-19 pandemic and negative stereotypes about nursing homes caused census rates to drop dramatically recently. That has forced facilities to change their marketing strategies. The pandemic and alternatives to nursing homes, such as PACE, have also driven nursing facilities to stay innovative to keep up with new demands. That is why Pickering emphasizes the importance of making changes to stay relevant within the long term care industry. “Whether it’s building programs and renovations and modernizations, you can never be static,” he said. “And if we ever are, we’re really in deep trouble at that point as far as leadership in the LTC community.”

Leadership Solutions for the Industry’s Biggest Problems

From government regulations and bureaucracy to a global pandemic and changing perceptions about nursing homes, the challenges faced by the long term care industry pose an uphill battle for facility leaders. Below, we will highlight the main challenges that facilities face today and suggest marketing and advocacy solutions that highly successful leaders can take to resolve these challenges.

Improving Branding to Address Low Census Rates

Nursing home occupancy rates fell approximately 13% from February 2020 to December 2020 due, in large part, to the COVID-19 pandemic. Today, as the cases have subsided and vaccinations have been administered, it is less of a threat to residents. Still, the impact that the pandemic had on censuses remains as facilities struggle to return occupancy rates to pre-pandemic levels. The fear of future pandemics, coupled with several alternatives to nursing homes, has caused many families to rethink sending elders to a traditional facility and to look for different forms of care for their loved ones.

social media marketing chart
One of the essential characteristics of highly successful leaders in long term care is knowing how to appeal to the younger generation.

Faced with these challenges, long term care administrators simply cannot grow complacent and count on the growing number of senior citizens in the U.S to increase occupancy. “We think we have a steady pipeline of folks coming in, and while we have the retiring baby boomers aging, at some point that’s going to start dwindling,” said Pickering. “We have to ask ourselves: how do we remain relevant as an organization and an industry?” 

To tackle the pressing issue of insufficient census numbers as a facility administrator, you should take initiative to increase census rates by improving your organization’s branding. In his conversation with Lewis, Pickering suggests that leaders do the following:

  • Appeal to the younger generation: This tip may sound counterintuitive. After all, those entering long term care facilities are senior citizens. However, the people making the choice to register the resident for admission are typically the family members. This is why Pickering stresses the importance of keeping younger family members in mind when making a branding decision: “If I look at my logo, and my branding, and my image looks like grandmother’s quilt, guess what. That’s not who’s making the decision on long term care. It’s the daughter and granddaughter that are making that decision.”
  • Use social media: Because your primary audience should be the children and grandchildren of prospective residents, social media is a great place to share marketing content. “Any long term care facility that is not actively on social media telling their story is totally missing out on a marketing opportunity, but also a family connection opportunity,” said Pickering. 
  • Understand and communicate your vision: Once you know your target audience and where you will share your content, selecting brand content and designs should be next on your list. This comes back to two key characteristics of long term care leadership: communication and knowing your values. As Pickering puts it, branding is “more than just a logo.” It is ensuring that your organization’s purpose, values, and mission are effectively communicated both internally and externally.
social media concept flatplay with keyboard
Highly successful leaders in long term care must learn to use social media to their advantage.

Example: One form of branding that Pickering’s organization chose was to redesign the exterior of all their buses in order to display “transporting our heroes” on one side. By making this change to all facility buses, Mississippi Veteran Affairs was able to demonstrate that supporting veterans is a value that is shared across all its facilities. Another sign of success for this project was how the public reacted to the buses, with passersby giving their approval with honks and waves, showing that the new branding was effective in conveying the organization’s mission to potential residents and their families.

The final step to improving your facility’s branding is ensuring that your message is widely and strongly conveyed. You can announce your branding goals by following these steps:

  1. Call a meeting with your leadership team
  2. Go through all pieces of your current branding
  3. Determine whether branding makes sense given your organization’s values
  4. Make adjustments as needed, keeping in mind values and mission
  5. Share new changes with the rest of your staff
  6. Distribute social media posts and advertisements using the new branding

Advocacy to Address Insufficient Government Support

There is, no doubt, a lack of government support for long term care facilities and their leaders. This is especially the case for long term care administrators in smaller facilities, who may feel as if the government is ignoring important issues and making little effort to improve conditions. Pickering advises that highly successful leaders should actively open facility doors to government officials, thereby paving the way for future partnerships.

Highly Successful Leaders in Long Term Care
A cordial invitation to a government official from a long term care administrator can go a long way toward improving conditions in nursing homes.

One tactic to use is inviting elected officials for dinner at your facility or a restaurant. “If I’ve got a U.S. senator or the governor, I invite their wife to come in, we go to Outback Steakhouse and make it a special night,” he said. These types of dinners allow facility administrators to inform legislators about the facility’s purpose and educate them about the long term care industry. This way, according to Pickering, “When long term care issues do come up, they know who you are. They’re going to reach out to you to ask, ‘Hey, how’s this gonna affect you and our local community?’”

Smaller facility administrators, who may not have access to governors or senators, can still make progress by reaching out to members of the municipal government. It may feel daunting to directly reach out to someone in a high position, but do not be afraid to make that invite. There is a good chance that they will attend because they were elected to serve you, and, as Pickering mentions, such appearances are great for “any politician looking for an opportunity to be relevant in his community, to have that photo op saying ‘I care.’” 


Leadership is an essential trait in the long term care industry, in which constant challenges require keen problem-solving skills and adaptability. While each long term care facility is different in terms of values, size, and mission, all highly successful leaders in long term care are communicative, data-driven, and strategic. These abilities are especially needed today, as low census rates and a lack of government support have forced leaders to rethink branding and advocacy.

To receive more advice from highly successful leaders in LTC, subscribe to the LTC Heroes podcast.