About the Author

David Farrell, M.S.W., L.N.H.A., is Director of Organizational Development and Regional Director of Operations for a private nursing home management firm in California. He has served as a licensed nursing home administrator in the long-term care profession for 25 years. As a nationally known leader in quality improvement and culture change, Farrell has documented the business case for providing a positive work environment and translated research about good leadership into daily practice. A published author and former board member of the Pioneer Network, he has delivered inspiring presentations to long-term care leaders at state conferences and corporate training events in nearly every state. While working for state Quality Improvement Organizations, he played a lead role in the National Nursing Home Quality Initiative. Farrell also served on the faculty team for the national Improving the Nursing Home Culture project involving QIOs and national nursing home corporations in 21 states. He has advised the Centers for Medicare and Medicaid Services on quality improvement and culture change. Cathie Brady, M.S., is co-owner of B&F Consulting, Inc., which facilitates nursing home improvements by developing leadersâ abilities to nurture their staff and help people work better together. Brady has more than 30 years of experience providing services and advocating for older adults in a variety of settings, including serving as Executive Director of the Department of Aging Services for the city of Bristol, Connecticut, and for 10 years as the Regional LTC Ombudsman for eastern Connecticut. Brady has an M.S. in Organizational Management from Eastern Connecticut State University. She served as faculty for a national 22-state pilot with Quality Partners of Rhode Island on Improving the Nursing Home Culture and co-produced a four-part Webcast series for the Center for Medicare and Medicaid Services entitled â From Institutional to Individualized Care.â? Brady has directed several initiatives in Connecticut, Massachusetts, and Maine to support workplace learning and culture change and she co-developed a curriculum for Nurses as Mentors for a Robert Wood Johnsonâ funded Jobs to Careers initiative in Connecticut. For 3 years, she worked with the New Orleans Nursing Home Staffing Project, which helped nursing homes recover from the aftermath of Hurricane Katrina, and co-produced a film with Louisiana Public Broadcasting called The Big Uneasy: Katrinaâ s Unsung Heroes. A frequent speaker at state and national conferences, Brady specializes in working with leaders who have the right instincts but who are overwhelmed by the challenges of being in nursing homes in need, special-focus facilities, critical access nursing homes, or otherwise challenged care organizations. Barbara Frank, M.P.A., is co-owner of B&F Consulting, Inc., a business that facilitates nursing home improvements by developing leadersâ abilities to nurture their staff and help people work better together. She worked for 16 years at the National Citizensâ Coalition for Nursing Home Reform in Washington, D.C., where she directed the landmark 1985 study â A Consumer Perspective on Quality Care: The Residentsâ Point of Viewâ? and helped establish the national network of state and local ombudsman programs. She facilitated the Campaign for Quality, through which providers, consumers, practitioners, and regulators developed consensus on what became the OBRA 1987 legislation that refocused nursing home regulations on individualized care. Frank facilitated the first Pioneer Network gathering in 1997, and in 2005 she facilitated the St. Louis Accord, a national gathering of providers, consumers, regulators, and quality improvement organizations that came together to improve clinical outcomes through staff stability and culture change. Co-founder (with her colleague and co-author, Cathie Brady) of B&F Consulting, she works directly with individual nursing homes to improve their stability, care outcomes, and quality of life. As faculty to the Quality Partners of Rhode Island Improving the Nursing Home Culture pilot, she helped 254 nursing homes improve staff, resident, and organizational outcomes, and co-produced Quality Partnersâ Staff Stability Toolkit and the four-part CMS Web series â From Institutional to Individualized Care.â? Frank also led a team in the New Orleans Nursing Home Staffing Project, which helped nursing homes recover from the aftermath of Hurricane Katrina. Frank co-produced a film with Louisiana Public Broadcasting called The Big Uneasy: Katrinaâ s Unsung Heroes. She coauthored Nursing Homes: Getting Good Care There (1996). Frank serves on the board of the Pioneer Network and has a masterâ s degree in public administration from the Kennedy School of Government.

Reviews

AALTCN commends the authors for this important contribution to the advancement of LTC leadership.--American Association of Long Term Care Nurses"Reviews" (09/14/2011)

David Farrell was fired by the first nursing home administrator he ever worked for. His intolerable indiscretion? Visiting facility residents because he enjoyed their company, while not "on the clock" as a nurse's aide.Farrell has now been a licensed nursing home administrator for twenty-five years, and he is a recognized leader in improving quality and creating change through positive example. Together with Cathie Brady and Barbara Frank--also veterans in improving nursing home quality and culture--Farrell has produced an unusually practical and encouraging guide for nursing home administrators and directors of nursing. Farrell calls them "the unseen, hands-on leaders who mentor 1.3 million workers in the art of caring for older adults." He provides a range of insights for anyone interested in the ins and outs of long-term care.The stage is set by a personal journal--it makes up about one-quarter of the book--documenting a year during which Farrell oversees the transformation of an unnamed dysfunctional and disheveled facility. He candidly records the strategies he employed (each is fully described in later sections) and the enormity of the changes produced. Among them were signs of progress that every survey team and chief financial officer want to see, including major declines in staff turnover, drops in patients' pressure ulcers acquired in the facility, and substantial increases in the occupancy rate and profit margin.But the important message in the journal isn't so much that objective measures of success were achieved, but how. In the authors' view, they flowed logically from transformations in working relationships, guiding values, and key processes. Beginning at the top, changes created what the authors call a "positive spillover" effect.Grounded in a combination of clearheaded observation and research, some changes were consistent with accepted practices, like implementing employee recognition programs and making sure not to assign work shifts during people's scheduled absences. Others overturned deeply held but ultimately counterproductive "wisdom," such as paying aides more when they were covering for absentee colleagues (actually a perverse incentive to miss one's own shifts) and ignoring personal circumstances outside the workplace (they can affect job performance, and the employee assistance program might help).Meeting the Leadership Challenge in Long-Term Care provides straightforward, no-nonsense guidance for nursing home leaders and will help corporate officers to whom they report--and many others--appreciate their true value.-- (10/06/2011)

Meeting the Leadership Challenge in Long-Term Care provides straightforward, no-nonsense guidance for nursing home leaders and will help corporate officers to whom they report--and many others--appreciate their true value.--Health Affairs"Reviews" (10/06/2011)

To anyone familiar with culture change, the names David Farrell, Cathie Brady and Barbara Frank are well known. These leaders have helped to cast a vision for enlightened approaches to transforming nursing homes into dynamic centers for residents and employees alike. They now have pooled their wisdom in a new book that helps NHAs, DONs, and other leaders to improve their performance. Meeting the Leadership Challenge in Long-Term Care: What You Do Matters combines practical experience with current leadership theory to offer a guide to addressing major challenges that nursing homes face. Practical approaches are offered on staff recruitment and retention, team development, leadership development, quality improvement, and satisfaction improvement. AALTCN commends the authors (who also have been good supporters of the association!) for this important contribution to the advancement of LTC leadership. To learn more or to order the book visit: www.healthpropress.com-- (09/14/2011)

Farrell is director of organizational development for a private nursing home management firm in California. Here, he offers a practical field guide for administrators, directors of nursing, corporate regional staff, and other long-term care leaders, emphasizing that managers must connect to the human needs of staff. The book begins with Farrell's account of a year of transformation in one nursing home, based on his real-life journals. The second part of the book gives detailed, practical techniques for preventing absenteeism and high staff turnover and for rewarding staff for stability and dependability. The third section gives suggestions for integrating quality improvement, individualized care, and workplace stability practices, using leadership examples from real nursing homes. A final chapter explains the negative impact of common practices such as 'drive-by consulting.' An appendix offers a method for tracking absenteeism. (Annotation (c)2011 Book News Inc. Portland, OR)-- (06/08/2011)