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What Does a Leader L ook Like?. Leadership S tyle and Methodology within a Skilled Nursing Facility. What is an INTJ?.

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What does a leader l ook like

What Does a Leader Look Like?

Leadership Style and Methodology within a Skilled Nursing Facility

What is an intj
What is an INTJ?

  • The Jung Personality test helps determine whether a person is more of an introvert or an extrovert, more intuitive or sensing, more of a thinker or a feeler, and more judgmental or perceptive.

  • According to the test, I am an INTJ

    11% more introverted than extroverted

    33% more Intuitive than Sensing

    25% more thinking than feeling

    45% more Judging than Perceiving

    Human-Metrics, 2012

Characteristics of an intj
Characteristics of an INTJ

  • Very self-confident, definite, and strong-willed.

  • Before making decisions, INTJs have to do a lot of research and exhaust all available resources and data before embracing an idea.

  • They believe that complex operations involve many steps or stages, and INTJ’s are naturally able to grasp how each one leads to the next, and to prepare alternatives for difficulties that are likely to arise any step of the way (Keirsey, 1998)

  • INTJs believe that thoughts, feelings, responses and behaviors consciously operate in line with some rules, principles or norms

    Human-Metrics-Basics, 2012

So how would an intj design the most important presentation of the semester
So…how would an INTJ design the most important presentation of the semester?

Graphs & Charts?






The most organized and logical option was powerpoint
The most organized and logical option was PowerPoint! presentation of the semester?

Please enjoy the following presentation as you learn

About my current leadership experience

Leadership potential
Leadership Potential presentation of the semester?

  • Like most INTJs, I possess the ability to be a great system builder and to see and seize those opportunities which often go unnoticed.

  • I am also a problem solver and am able to find complex solutions to even the most difficult of problems.

  • I offer positive criticism rather than negative/hurtful criticism because I enjoy encouraging staff based on their good qualities rather than tearing them down and focusing on the bad.

  • My personality type works very hard to create an efficient work environment and will quickly remove or change anything that causes inefficiency.

  • I appreciate and respect rules, procedures, and most traditional authority.

  • I am dedicated to my goals and I like a career that requires me to solve problems and find solutions.

    Keirsey, 1998

Where are my leadership skills being formed and transformed
Where are my leadership skills being formed and transformed? presentation of the semester?

A Skilled Nursing and Long-Term Care Facility with 40 skilled and 20 long-term beds.

Received the Gold Medal Award for State Survey (zero deficiencies) in 2012 and 2013.

A Five-Star nursing facility according to U.S. News.

Our patients
Our Patients presentation of the semester?

  • Stroke and neurological conditions

  • Orthopedic surgeries including knee and hip joint replacement

  • Fractures including hip and femur

  • Injuries related to falls

  • Cardiac-related problems including heart failure

  • Pulmonary impairment including pneumonia and COPD

  • Post-surgery recovery

  • Wound care

  • Tracheostomy (uncuffed)

  • Professional medical teams are capable of also providing these services for specific patients:

  • Intravenous Administrations

  • Total Parenteral Nutrition

  • PCA Pumps

  • Wound vacs

  • PICC (peripherally inserted central catheter)

  • Exclusive LifeWorks Rehab program

    Bayside Health and Rehab, 2013

What is lifeworks rehab
What is presentation of the semester?LifeWorks Rehab?

  • Well-rounded

  • Compassionate

  • Outcome-driven

  • Based on proven clinical pathways

  • Individualized treatment, therapies, services, and recovery tools

  • Carefully planned and supervised by medical professionals

  • Most modern technology available

  • Supportive staff

  • Therapy is offered seven days per week to speed recovery

    Bayside Health and Rehab, 2013

How is the staffing at bayside

How is the staffing at Bayside? presentation of the semester?

Our team
Our Team presentation of the semester?

  • Nurses:

    • Talented and caring group of men and women. Some of the nurses are new graduates and others have twenty years of experience

    • Ratio: One nurse (RN or LPN) to 20 patients during the day and evening shift; one nurse (RN or LPN) to 30 patients on night shift

  • CNAs

    • A group of men and women who are friendly, compassionate, and focused on customer service. Some are newly certified, others have been with the facility for 15 years.

    • Ratio: One CNA to 12 patients during the day and evening shift and one CNA to 20 patients at night.

Our team1
Our Team presentation of the semester?

  • Administrator

  • Human Resources Director

  • Dietary staff and management

  • Housekeeping staff and management

  • Maintenance Director

  • Activities Director

  • Admissions Director

  • Finance Director

  • Dietician

  • Discharge Planner

  • Receptionist

  • Therapy staff (manager, Speech, Occupational, Physical, assistants)

  • Director of Nursing

  • Associate Director of Nursing and Unit Manager (two roles, one person)

  • Two shift supervisors and two weekend supervisors

  • Staff Development Coordinator & Infection Control Nurse (two roles, one person)

  • Minimum Data Set Coordinator

What role do i play at bayside
What role do I play at Bayside? presentation of the semester?

Staff Development Coordinator


Infection Control Nurse

Most of my duties revolve around education, in-services, orientation, antibiotic monitoring, isolation precautions, and training.

Common to most nursing facilities there are many ethical and legal considerations at bayside
Common to most nursing facilities, there are many ethical and legal considerations at Bayside…

Ethical considerations
Ethical Considerations and legal considerations at Bayside…

  • Respect for persons (autonomy and self-determination)

  • Beneficence (doing good)

  • Non-maleficence (avoiding harm)

  • Justice (fairness, equitability, truthfulness)

  • Veracity (telling the truth)

  • Fidelity (remaining faithful to one’s commitment)

  • Sometimes the nurses, CNAs, managers, and doctors have a difficult time making ethical decisions. At all times, they attempt to be respectful, fair, truthful, faithful, and harmless to the patients. Everyone tries to respect the wishes of the patient and family.

    Arch Intern Med, 1996

Legal considerations
Legal Considerations and legal considerations at Bayside…

  • Advance directives

  • Competence and decision-making capacity

  • Decisions about life-sustaining treatment

  • Resident abuse

  • Restraints

  • Psychotropic medications

  • Risk management

  • Participation in research

    All patients are encouraged to have an advanced directive, living will, or POA so that the medical personel are not overwhelmed by the ethical or legal situations which may occur while the patient is residing at the facility.

    Arch Intern Med, 1996

Bayside s culture of care and customer service

Bayside’s and legal considerations at Bayside… Culture of Care and Customer Service

What sets bayside apart from other nursing and rehab facilities
What sets Bayside apart from other Nursing and Rehab Facilities?

  • Person-directed setting: resident-directed care and activities

    • An example of this is “Resident Council” which is held bi-weekly and it enables the residents who attend the meeting to make important decisions about activities and allows them to share thoughts, opinions, and complaints

    • Another example is care plan meeting. During this meeting, the patient can make changes to their care and can voice compliments, complaints, and opinions. They can also ask questions and receive education when necessary

  • Home-like environment for long-term care residents

  • Staff tries to build relationships with the family, resident and community. Staff Empowerment; all staff are encouraged to answer call-lights. Staff Meetings and Opinion surveys.

  • Collaborative and decentralized decision-making. Ex.) Morning meeting, Staff meetings, QA meeting quarterly.

  • Systematic processes that are comprehensive and measurement-based, and that are utilized for continuous quality improvement

  • The Culture is one of customer service. This attitude is directed towards residents, family, co-workers, management, doctors, transportation services, phlebotomy services, other departments, and anyone else who steps in to the building.

Bayside philosophy
Bayside Philosophy Facilities?

  • “We believe that giving the best care requires more than just treating patients…it requires knowing them as people. It’s more than just caring for people–it’s caring about them.”

  • “People who not only care for you but care about you and take the time to get to know you personally–makes all the difference in the world. That’s the cornerstone of our philosophy.”

  • “Our unique, inclusive approach creates the perfect environment for healing, and translates to better outcomes and a more personal, rewarding experience for our patients.”

    Bayside Health and Rehab, 2013

Compassion quality safety customer service
Compassion, Quality, Safety, Facilities? Customer Service…

Coaching and motivating is an ongoing process at Bayside. Staff is encouraged to perform at their best at all times and in all circumstances!

How do we coach at bayside health and rehab
How do we coach at Bayside Health and Rehab? Staff is encouraged to perform at their best at all times and in all circumstances!

Coaching and mentoring
Coaching and Mentoring Staff is encouraged to perform at their best at all times and in all circumstances!

  • Trust is developed by encouraging open, two-way communications

  • Leaders share personal experiences and offer guidance

  • Each team member is respected and appreciated for his/her individuality. All judgments and opinions are suspended. Good leaders see and appreciate different perspectives

  • Leaders display patience with new employees because they have a learning curve to overcome. Long-standing employees do not receive as much grace when they make a mistake because they are expected to “know better.”

  • Leaders must demonstrate good listening/follow-up skills and provide constructive feedback and advice.

  • Mentors must have great listening skills. Their focus should be completely on the mentee, his/her words, non-verbals, and agenda.

  • Good mentors ask powerful questions. These questions are short in length, open-ended, deep, and encourage the employee towards a goal.

  • Leaders also challenge the mentee to become better and to advance in his/her skills and knowledge.

  • The mentee is held accountable for his/her actions.

  • Mentees receive encouragement, support, and acknowledgement

  • Good mentors do not ignore their intuition. They realize that their “gut” feeling is usually trustworthy.

    ASHA, 2013

How do i coach as the staff development coordinator
How do I coach as the Staff Development Coordinator? Staff is encouraged to perform at their best at all times and in all circumstances!

  • By conducting orientation for all new nursing staff

  • By providing training and skills fairs so that staff can learn new skills or refresh their knowledge of a rarely used skill

  • Through utilization of the skills validation checklist, which helps me to assure that the new employee has learned about all important aspects of their job and has hands-on experience with each skill

  • By having an open-door policy and encouraging staff to discuss their concerns and questions with me at any time.

  • Through accountability and follow-up with each employee

  • By correcting errors in a positive and encouraging manner

  • By listening to staff and trying to meet their needs in the best way possible

Accreditation regulatory agencies

Accreditation & Regulatory Agencies Staff is encouraged to perform at their best at all times and in all circumstances!

Regulatory agencies
Regulatory Agencies Staff is encouraged to perform at their best at all times and in all circumstances!

  • Center for Medicare and Medicaid Services (CMS)

    • Congress has legislated minimal standards such as Prospective Payment System for facilities using Medicare.

    • The standards created by Congress “govern minimum participation requirements and an inspection process to review a facility’s compliance” (Markenson, 2004)

    • CMS has established the Medicare Statutory Operational, Statutory Reimbursement, Regulatory Operational, and Regulatory Reimbursement Requirements as well as the Medicaid Statutory Operational Requirements.

    • These requirements are closely assessed during the facility’s annual survey.

  • Virginia Health Department (VDH)

    • Coordinates with CMS to develop State Statutory Operational Requirements, along with State Medicaid and Medicare Statutory and Regulatory Reimbursement Requirements.

    • The VDH has also developed regulations about physical environment, administrative services, resident services, and support services as they relate to Skilled Nursing Facilities

What is state survey
What is State Survey? Staff is encouraged to perform at their best at all times and in all circumstances!

  • Nursing facility surveys are not announced to the facility.

    • States conduct standard surveys and complete them on consecutive workdays, whenever possible.

    • They may be conducted at any time including weekends, 24 hours a day. Random inspections occur at times as a result from a complaint against the facility.

    • Bayside has a survey window of 5 months, so management is prepared every day until the surveyors finally arrive

  • All nursing facilities are subject to inspection or survey by virtue of their certification to participate in Medicare &Medicaid, and/or their licensure by the state in which they conduct their services.

  • State licensure standards usually follow Federal guidelines. Most surveys are conducted by state personnel who simultaneously assess compliance with both licensure and certification requirements.

What is state survey1
What is State Survey? Staff is encouraged to perform at their best at all times and in all circumstances!

  • The standards set by CMS are reviewed during the facility’s annual survey

  • When a facility is surveyed and found to not be in compliance with one or many of the standards, a deficiency or deficiencies will be given to the facility

  • Any deficiency cited against the facility will result in regulatory and/or monetary penalties to the facility. It will also become a part of the public record about the facility.

  • Thankfully, Bayside has not received any deficiencies over the past two years

How do you feel about state survey
How do you feel about State Survey? Staff is encouraged to perform at their best at all times and in all circumstances!

I have to admit…it is VERY stressful!

How does bayside prepare for survey
How does Bayside prepare for Survey? Staff is encouraged to perform at their best at all times and in all circumstances!

Infection control precautions

Locking of supply doors and medication/treatment carts

Equipment only on one side of the hall

Completion of crash cart logs

Verbal orders

Pain assessment

Error corrections

Initialing and signing of orders

Informed consent

Advanced directives and DNR form completion

Approved abbreviations

Documentation of timely and consistent care

Customer service

  • Continuous education about:

    • Control & security of medications

    • Expiration of medications and labeling

      of boxes

    • Labeling of multi-dose vials

    • High alert medications

    • Use of at least two patient identifiers

    • Proper documentation of medication


    • Bedside medications

    • Hand washing guidelines

    • Eating/drinking at the nurses’ station

    • Storage of sterile/non-sterile items

    • Patient/staff food storage

  • Mock Surveys

  • Daily chart and order audits

  • Infection control rounds

  • Employee file auditing

  • Skills fairs for CNAs and Nurses

  • The Joint Commission, 2013

Quality and safety
Quality and Safety Staff is encouraged to perform at their best at all times and in all circumstances!

  • Regulations help to assure that the healthcare environment is constantly improving in quality and safety

    • The survey process helps the leaders to know the areas in which the healthcare facility needs to make improvements or the areas in which the facility is striving. The agencies provide clear guidelines and initiatives based on evidence & research which guide leaders as they seek to provide the safest and highest quality care for the patients.

  • Safety is ensured through provision of leadership, recognizing human limits in process design, promoting effective time functioning, anticipating the unexpected, and creating a learning environment

  • Quality occurs when there is:

    • adequate staffing

    • a positive collaborative environment

    • a supportive nursing culture

    • resources that encourage ongoing learning

  • The quality of healthcare is improving as a result of evidence-based practice, electronic medical records, dashboards, increased nurse staffing, reduction in medication errors, and peer review

    Sullivan, 2012

Accrediting agency
Accrediting Agency Staff is encouraged to perform at their best at all times and in all circumstances!

  • Bayside Health and Rehab is not accredited. The Administrator does not think it is necessary to become accredited by the Better Business Bureau or the Joint Commission. According to the Administrator, the state survey accounts for the facility’s accreditation.

  • The management is not pursuing accreditation because Bayside has a great reputation and is well respected by the state and Center for Medicare & Medicaid Services.

Leadership theory

Leadership Theory Staff is encouraged to perform at their best at all times and in all circumstances!

Leadership theory1
Leadership Theory Staff is encouraged to perform at their best at all times and in all circumstances!

  • Most of the leaders within the facility are participative or transformational theorists:

    • The leaders at Bayside value the thoughts and opinions of others. They encourage participation and contributions from group members and help group members feel more relevant and committed to the decision-making process.

    • The transformational leaders appreciate the connections formed between leaders and followers. These leaders motivate and inspire people by helping group members see the importance of their work and tasks and encouraging them to fulfill their potential.

    • I have high ethical and moral standards, so I tend to lead in a transformational style. I try to provide direction for each employee in a way that is most beneficial and understandable to them. Each employee learns differently, so I try my best to be cognizant of their individuality and learning style.

    • The Administrator of Bayside utilizes the transactional leadership theory style. He focuses on the role of supervision, organization and group performance. When employees are successful, they are rewarded. If they fail, they are reprimanded or punished.

      Sullivan, 2012

Forcasting Staff is encouraged to perform at their best at all times and in all circumstances!

What is the five-year outlook for Bayside Health and Rehab?

Finarelli johnson 2004

“Healthcare Staff is encouraged to perform at their best at all times and in all circumstances!forecasting is a prediction about the future of healthcare. The purpose of a successful forecast is “to identify the key variables that underlie demand for healthcare services within a particular service area and to understand how and why these variables might change over time.”

Finarelli & Johnson, 2004

Cloudy with a chance of obamacare
Cloudy with a chance of… Staff is encouraged to perform at their best at all times and in all circumstances!ObamaCare?

ObamaCare Staff is encouraged to perform at their best at all times and in all circumstances!

  • Currently, the only worries for Bayside Health and Rehab are the potential changes that may result from ObamaCare.

  • The fear is that the facility may eventually have to drop-out of Medicare practice because reimbursement will be greatly reduced, administrative costs will be higher, and the rules and reporting requirements will become increasingly complex.

  • According to a report from the Congressional Budget Office (CBO), “Obamacare will reduce Medicare reimbursements by $716 billion over 10 years.”

  • These cuts will greatly affect the majority of skilled nursing facilities. Bayside Health and Rehab will more than likely be amongst the majority of nursing facilities that are negatively affected by Obamacare.

    Moffit& Sneger, 2013

A brighter forecast
A brighter forecast? Staff is encouraged to perform at their best at all times and in all circumstances!

  • Apart from Obamacare, the outlook for Bayside is positive.

  • More staff is being hired so that there will be minimal staff shortages (this will increase employee and resident satisfaction)

  • Many of the nursing employees are furthering their education so that the facility will have a greater number of RNs and Bachelors level nurses.

    The forecast looks bright for Bayside!


Marketing Staff is encouraged to perform at their best at all times and in all circumstances!

Marketing plan
Marketing Plan Staff is encouraged to perform at their best at all times and in all circumstances!

  • Create a list of what Bayside has to offer and then compare to the competition. What makes Bayside the best option for the customer?

  • Anticipate customer needs.

  • Assure reliability, quality, and safety place to live.

  • Staff must be friendly, compassionate, and encouraging

  • Provide many exciting and variable patient activities

  • The environment should be home-like and comfortable

  • Match customer needs with Bayside’s services and benefits.

  • Markey Bayside’s special awards, qualified staff, unique extracurricular activities, and successful LifeWorks therapy program.

  • Develop advertisements for the target population (ex. television commercials, newspaper ads, one-page handouts and flyers). The website for Bayside includes success stories from family members and clients who have come to Bayside for skilled nursing or therapy services.

  • Word of mouth is still one of the most effective forms of drawing clientele.

  • The Admissions Director markets Bayside to hospitals, surgeons, and other doctors offices. Many of the patients choose Bayside because of its good reputation and because the facility has been recommended to them by a doctor, nurse, or friend.

Employee satisfaction and retention
Employee Satisfaction and Retention Staff is encouraged to perform at their best at all times and in all circumstances!

Methods to increase employee s atisfaction r etention
Methods to increase employee Staff is encouraged to perform at their best at all times and in all circumstances!satisfaction & retention

  • Demonstrate leadership commitment and accountability

  • Create a work environment in which employees want to establish careers rather than just jobs.

  • Ensure that employees from all backgrounds feel accepted, respected, and fairly treated

  • Provide on a fair and equal basis the support and opportunities its employees need to reach maximum potential

  • Conduct employee opinion surveys and 360 degree evaluations.

  • Offer a competitive benefits package that fits your employees’ needs. Providing health insurance, life insurance and a retirement-savings plan is essential in retaining employees.

  • Provide some small perks: free bagels on Monday and dress-down (jeans) Fridays.

  • Use contests and incentives to help keep workers motivated and feeling rewarded.

  • Conduct “stay” interviews. In addition to performing exit interviews to learn why employees are leaving, consider asking longer-tenured employees why they stay.

  • Promote from within whenever possible. And give employees a clear path of advancement.

  • Foster employee development. This could be training to learn a new job skill or tuition reimbursement to help further your employee’s education.

  • Create open communication between employees and management. Hold regular meetings in which employees can offer ideas and ask questions. Have an open-door policy that encourages employees to speak frankly with their managers without fear of repercussion.

  • Get managers involved. Require your managers to spend time coaching employees, helping good performers move to new positions and minimizing poor performance.

  • Offer financial rewards. Consider offering stock options or other financial awards for employees who meet performance goals and stay for a predetermined time period, say, three or five years. Also, provide meaningful annual raises.

  • Make sure employees know what you expect of them. If they don’t know exactly what their jobs entail and what you need from them, they can’t perform up to standard, and morale can begin to dip.

    U.S. EEOC, 2013

How does bayside retain employees
How does Bayside retain employees? Staff is encouraged to perform at their best at all times and in all circumstances!

  • Dress-down Fridays

  • Monthly staff meetings and Skip-Levels (both meetings allow staff to voice their concerns and opinions in a non-threatening group setting

  • Employee satisfaction surveys and employee evaluations. This helps management to assess the climate of the workplace and make changes to increase employee satisfaction.

  • Competitive benefits packages

  • Staff Development Contests: the team that wins the contest and finishes their monthly education on time wins a small party

  • Employee development and tuition reimbursement

  • Regular, monthly meetings are held and employees are encouraged to share opinions and ask questions.

  • My open-door policy and a lot of the employees come to me before going to the Associate Director of Nursing or the Director of Nursing because they know that I will offer advice and guidance without repercussion.

  • Weekly in-services to correct errors and help fix problems before they become commonplace or habit. This prevents employees from receiving warnings or suspensions for making the same mistakes repeatedly

How does bayside retain employees1
How does Bayside retain employees? Staff is encouraged to perform at their best at all times and in all circumstances!

  • At Bayside, leadership is encouraged and rewarded. Those CNAs and nurses who perform their duties to the best of their abilities are given the option to be a star CNA or a nurse preceptor. Continual education is mandatory and encouraged.

  • CNAs are encouraged to become nurses, LPNs are encouraged to become RNs and RNs are encouraged to earn their BSN or MSN. Other team members such as therapists, social workers, and human resource managers are encouraged to further their schooling as well.

  • The company offers financial assistance for those who desire to further their education. Not only does MFA offer reimbursement up to $1,500, but they also offer 20 scholarships of $1,000 or more to those employees who are eligible and who apply for the scholarship.

  • Bayside encourages leadership by helping their employees to find other job opportunities within MFA if/when an employee is looking for a manager/leader role. For example, if an RN is interested in becoming an MDS, Bayside provides the RN with a list of facilities that are seeking an MDS. As long as employees stay within MFA, Bayside Health and Rehab is very supportive of employees wanting to transition into a leadership position.

Human resources
Human Resources Staff is encouraged to perform at their best at all times and in all circumstances!

  • The nurse managers meet with HR on a daily basis if there is a nursing staffing need. When they meet, they discuss applications, phone screening, upcoming interviews and opinions about the applicant. More importantly, they discuss the type of applicant that the nurse managers desire so that HR can more easily sift through the applications.

  • The nurse managers are responsible for the in-person Interview and HR is responsible for recruiting, phone screening, and making the job offer after the department head has made a decision.

  • The nurse managers rely on HR to choose the best locations at which to do mock-interviews (job fairs, colleges, tech schools, etc.).

  • The nurse managers rely on HR to find and attract the widest and most diverse applicant pool. Recruitment policies and practices are regularly reviewed to assure that they are finding the best applicants.

  • Human Resources is encouraged to observe the exit interviews and look for patterns of discontent so that she can report it to the department heads and they can make changes where necessary.

Accountability at bayside health and rehab
Accountability at Bayside Health and Rehab Staff is encouraged to perform at their best at all times and in all circumstances!

Organizational chart
Organizational Chart Staff is encouraged to perform at their best at all times and in all circumstances!

President & CEO of Medical Facilities of America

Regional Director


Director of Nursing Minimum Data Set Coordinator

Staff Development Coordinator Assistant Director of Nursing



Accountability Staff is encouraged to perform at their best at all times and in all circumstances!

  • I am accountable to the Director of Nursing, Assistant Director of Nursing and Administrator

  • We all meet on a daily basis and talk about the issues within the facility that are most important.

  • The Director of Nursing looks through my documentation, educational in-services, orientation data, and infection control records to make sure that I am not doing something wrong.

  • The Administrator comes to me on occasion to discuss in-services and infection patterns. He shares his opinions about what he sees and what he thinks I should do in the upcoming week (s).

  • The Assistant Director of Nursing keeps me aware of problems amongst the nursing staff, either as individuals or as a group. She is also a great resource whenever I have a question about skills or job duties.

Disaster preparedness
Disaster Preparedness Staff is encouraged to perform at their best at all times and in all circumstances!

How does Bayside handle a disaster situation? Staff is encouraged to perform at their best at all times and in all circumstances!

Disaster preparedness at bayside
Disaster Preparedness at Bayside Staff is encouraged to perform at their best at all times and in all circumstances!

  • Natural disasters include floods, hurricanes, earthquakes, landslides, mudslides, wildfires, epidemics, and pandemics.

  • Man-made disasters can be accidental or intentional and include accidental structural collapse, industrial spills, power outages, explosions, mass casualty shootings, snipers, release of toxins, and arson fires.

  • Medical Facilities of America and Bayside Health and Rehab have established disaster preparedness techniques:

    • All employees are educated during orientation so that they can easily recognize the different codes that may be called over the intercom.

    • Monthly system “down-times” occur so that the nurses and other staff know how to go about their daily duties without the use of technology, computers, and the eMar system.

    • The facility has the appropriate equipment including a generator, extension cords, battery operated lights, and other necessary supplies.

    • At Bayside, periodic mandatory drills are conducted so that all employees receive “refresher” training about the different codes and their specific duties during a disaster.

  • There are few disaster situations in which the building is planned to be evacuated. Management does not think that evacuation is plausible because the resources to evacuate rarely exist. Bayside Health and Rehab chooses to shelter rather than evacuate unless there is a fire or other disaster within the building for which patients must be evacuated.

    Covan& Fugate-Whitlock, 2010

Disaster preparedness1
Disaster Preparedness Staff is encouraged to perform at their best at all times and in all circumstances!

  • After a disaster, Virginia Department of Health and Environmental health services focuses on providing basic services such as food protection and salvage, restoration of septic and well service, rabies control, and epidemiologic investigations.

  • The Office of Emergency Management promotes a comprehensive emergency management program to lessen the community’s impacts from manmade or technological disasters and potential catastrophic incidents by utilizing mitigation, preparedness, response, and recovery strategies. The City’s emergency management system is outlined in the State Code and within Local Ordinance. The City Manager is the Director of Emergency Management and the Fire Chief is designated as the Coordinator of Emergency Management. Day-to-day operations and activities are coordinated by the Deputy Coordinator of Emergency Management.

  • A Regional Hazard Mitigation Plan was developed with FEMA funding, as part of a mitigation planning requirement of the Disaster Mitigation Act of 2000 (DMA 2000). The DMA 2000 charged localities with the responsibility of identifying, assessing, and mitigating the risks within their communities to ensure that critical services would continue to function if a natural disaster were to occur.

  • The Hazard Mitigation Plan was approved by the Virginia Department of Emergency Management (VDEM) and the Federal Emergency Management Agency, and adopted by City Council.

    VBgov.com, 2013

Retirement plan
Retirement Plan Staff is encouraged to perform at their best at all times and in all circumstances!

I plan to retire at an age later than 65 yrs old. After age 65 I would like to do a job that is very easy and enjoyable. Currently, I am planning for my retirement by:

  • Having a 401K Plan through my employer

  • Paying off my husband’s student loans as quickly as possible

  • Planning to roll my 401K over into a Roth IRA if I ever leave Bayside.

Succession Staff is encouraged to perform at their best at all times and in all circumstances!

  • The facility is not currently expecting any successions because a number of nurse leaders have taken on the positions of Staff Development Coordinator, Evening and Night-shift supervisors, and weekend supervisors. All of the leaders are fairly young in age and are pleased and satisfied in their positions, so there is no expectation for a succession.

  • When a succession is anticipated, Bayside plans by:

    • Identifying current challenges and those that lie ahead

    • Determining the corresponding leadership qualities that are needed to navigate these challenges successfully

    • Identifying leadership development opportunities for staff and board members to expand their leadership skills so that the organization will have a better selection of future leaders

    • Cross-training of current staff so that disruption from unexpected staffing changes is minimized

      Covan& Fugate-Whitlock, 2010

Issues and networking
Issues and Networking Staff is encouraged to perform at their best at all times and in all circumstances!

  • Some emerging issues at Bayside are:

    • Staff not following protocol for post-fall assessments.

    • CNAs refusing to complete some of their assigned duties due to lack of time

    • Short staffed, call-offs, unable to find coverage for the weekends

    • Behavioral medications: the state survey this year is going to put a big emphasis on antipsychotics, antidepressants, hallucinogens, etc. They will be looking at behavioral monitoring, use of PRN behavioral medications, and proper diagnosis for behavioral medications. Bayside has put some strict policies in to place so that we are adequately prepared for survey.

  • I network by:

    • Keeping informed weekly about OSHA news, Virginia Department of Health news, local health department updates, MFA news and updates, and issues that are discussed on the top nursing websites.

    • Attending morning meetings, skip level meetings, QA quarterlies, staff meetings, and staff training at the corporate office

    • Communicating through email with other staff at Bayside and the executive officers at corporate headquarters.

In conclusion
In Conclusion… Staff is encouraged to perform at their best at all times and in all circumstances!

  • My experience at Bayside has taught me a lot about:

    • The business side of health care: knowing the “what” and “how” of an action is required as a nurse; but, since I took-on the management position, I am learning the “whys” and now all of the “whats” and “hows” make sense

    • The importance of good coaching and mentoring

    • The need for continual education, in-services, quality analysis, and auditing

    • The value of each employee and the importance of making them aware of the fact that they are appreciated

    • How to work as a team interdepartmentally and the importance of each department

    • The importance of good, fair, and experienced leadership

    • Promoting from within, encouraging staff to pursue higher education and leadership roles, and providing opportunities for staff to enhance their skills and abilities

    • The benefits of regulatory agencies and the need for continual analysis of quality and safety standards within the facility

    • The importance of being prepared for any and all situations including disasters, successions, and man-made emergencies.

References Staff is encouraged to perform at their best at all times and in all circumstances!

  • American-Speech-Language-Hearing Assiciation. (2013). Mentoring and coaching skills. Retrieved from http://www.asha.org/students/ gatheringplace/coach/

  • Bayside Health and Rehab. (2013). Skilled Nursing. Retrieved from


  • Covan, E.K. & Fugate-Whitlock, E. (2010). Emergency planning and long-term care: least paid, least powerful, most responsible. Health Care for Women International. 31:1040.

  • Finarelli, H. & Johnson, T. (2004). Effective demand forecasting in 9 steps. Retrieved from http://www.hfma.org/Content.aspx?id=1944.

References Staff is encouraged to perform at their best at all times and in all circumstances!

  • Hayley, D.C., Cassel C.K., Snyder L., Rudberg M.A. (1996).

    Ethical and legal issues in nursing home care. Retrieved from


  • Human-Metrics. (2012). Jung Typology Basics. Retrieved from http://www.humanmetrics.com/hr/you/personalitytype.aspx# Section_JungBasics

  • Human-Metrics. (2012). Jung Typology Test. Retrieved from


  • Keirsey, D. (1998). Rational: The Portrait of a Mastermind. Retrieved from http://www.keirsey.com/4temps/mastermind.asp

References Staff is encouraged to perform at their best at all times and in all circumstances!

  • Markenson, A. (2004). Nursing homes: Overview of federal and state regulations. NYSBA Health Law Journal, Volume 9, Issue 1. Retrieved from http://www.nysba.org/Content/NavigationMenu13/ HealthLawLawsRegsandOpinions/NursingHomesArticle.pdf

  • Moffit, R. & Senger, A. (2013). The Obama medicare agenda: Why seniors will fare worse. Retrieved from http://www.heritage.org/research /reports/2013/05/the-obama-medicare-agenda-why-seniors-will- fare-worse.

  • Sullivan, E.J. (2012). Effective leadership and management in nursing

    (8th ed.). Upper Saddle River, NJ: Pearson Education, Inc.

  • U.S. Equal Employment Opportunity Commission. (2013). Tips on employee retention. Retrieved from http://www.eeoc.gov/federal/retention.cfm

References Staff is encouraged to perform at their best at all times and in all circumstances!

  • VBgov.com. (2013). Regional mitigation plan. Retrieved from



  • The Joint Commission. (July 2013). Survey activity guide for healthcare organizations. Retrieved from http://www.jointcommission.org/ assets/1/6/2013_Organization_SAG_July.pdf