Effective and caring leaders come in all shapes and sizes. And this year’s class of 20 To Watch demonstrates now more than ever that passionate leaders lead from every position.
 
The best leaders lead in the moment they are in and from the place they are in that moment, with vision, authenticity, transparency, and a steadfastness; all of these are key when their calling and work is the health, wellness, and safety of another person.
 
One of the effective leadership attributes shared by all of the outstanding professionals chronicled on these pages is a sense of calling, and each of this year’s 20 To Watch is driven to be the part of the solution that ensures quality care for people in need and thoughtful support and empowerment to the families of the people receiving care.
 
Among this year’s honorees, you will also read of leaders—among them nurses, physicians, administrators, and chief executive officers—who are not only helping residents and patients to be their best, healthiest, and most engaged selves, but who are dedicated to doing it for their colleagues, 360 degrees in their organizations.
 
By honoring these leaders, we are planting a flag dedicated to what could and must be in meeting the health and care needs of an aging America; the best of our best don’t aim for the lowest bar, they reach and stretch over the  highest one.
 
Their stories are uplifting and inspirational, and that’s important because in this age, and with the challenges and opportunities we and the people in long term and post-acute care face, we live in a time when we need as many great leaders as we can get. I encourage you to read, discuss, and share these brief profiles of Provider’s 2014 Class of 20 To Watch with colleagues, friends, families, and people inside and outside the industry.
 
And if you are a passionate leader yourself, I ask you to join me in asking the following questions:
  • What vision do I do I have for a better tomorrow?
  • Who can, and must, I ask to join me, lead me, or follow me in this vision?
  • What action can I take today to make this vision for a better tomorrow a reality?                  
 
–Joseph DeMattos Jr.
 
Joseph DeMattos Jr. is president and chief executive officer of the Health Facilities Association of Maryland, an adjunct professor at the University of Maryland Baltimore County’s Management of Aging Services master’s program, and a leadership consultant.
 

Michelle GiffordMichelle Gifford, RN

Director of Nursing
Atlantic Nursing and Rehab Center
Atlantic, Iowa
 
Being a caregiver is in Michelle Gifford’s roots. Both her mother and grandmother were nurses, and Gifford herself was a certified nurse assistant (CNA) for 12 years, working in both hospitals and long term care, before becoming a nurse. She was motivated to get a nursing degree after tiring of “wanting to do more but not having credentials and education to do it,” she says.

Today she is “a teacher, a mentor, and a leader,” says Kim Jimerson, RN, Atlantic’s administrator. “She seldom hesitates to offer to help out at our buildings or help another director of nursing [DON] figure something out. She does this because she loves to teach and share and work with others.”
 
Gifford, who worked as a charge nurse before becoming a DON, has adopted a motto that illustrates her leadership style: “You never want to tell someone to do something that you wouldn’t want to do yourself,” she says with conviction.
 
Among Gifford’s accomplishments, says Jimerson, are her efforts to reduce turnover among staff at Atlantic, as well as working with local hospitals to reduce rehospitalizations.
 
Says Jimerson: “Michelle has worked very hard to reduce staff turnover within our building. With the support of our corporation she has been able to offer such things as anniversary bonus programs. Michelle works directly with our employees in the nursing department, trying to make sure that our employees are able to earn their bonus check. She listens to what her employees need, and she advocates for that.”
 
The result of Gifford’s work has paid off. Jimerson reports that Atlantic’s turnover within the building has plummeted from “more than 120 percent … to less than 50 percent at last review; we are working on a 34 percent turnover rate currently year-to-date.”

Gifford’s mentoring of staff has earned her additional accolades, while many of her staff have gone on to obtain their registere nurse or licensed practical nurse degrees and returned to Atlantic to work.

“Michelle meets with her staff to discuss such things as hours and what will work for them. She assists them with the ability to juggle their schedules and find replacements, as necessary,” Jimerson says.

“When an employee looks to leave our employment, Michelle will try to find out the real reason for their leaving, and then she will try to find a way to work within their limitations so that the residents have stable staff in our building.”

Gifford’s efforts to reduce unnecessary hospitalizations have brought her additional praise, as well. She utilizes a program known as LTC Trend Tracker—an American Health Care Association (AHCA) software tool that enables users to access reports to track, organize, identify, benchmark, examine, and compare the profession’s data online—to augment her efforts and learn about how other providers are doing.

Jimerson notes that Gifford also takes advantage of multiple educational opportunities available to her. She takes classes through the Iowa Health Care Association and recently became certified as a Resident Assessment Coordinator and as a Nurse Executive, “to get that extra little bit of education,” Gifford says.

“I always say that I’m lucky for working with my peers, I always say it’s not me it’s them,” Gifford says. “I love talking to elders and learning their stories.”
 

Andrea RathboneAndrea Rathbone

Administrator
D’Youville Senior Care
Lowell, Mass.
 
As administrator of a 208-bed skilled nursing facility, Rathbone’s first priority is helping both residents and staff to achieve their full potential, says Ann Marie Antolini, vice president of administration for the Massachusetts Senior Care Association (MSCA).
 
“Each employee and resident is supported in their endeavors with respect, dignity, and compassion. Whether encouraging an employee to apply for a scholarship to support their educational goals or interacting with a resident in the facility’s Learning Center as they expand their knowledge, Andrea provides an unrivaled level of enthusiasm, passion, and energy in her support of employees and residents,” says Antolini.
 
Rathbone’s take on her recognition as one of this year’s 20 To Watch is much humbler, indeed. She admits that she doesn’t understand why she was chosen for the honor, but those familiar with her work have nothing but praise for her accomplishments. From being instrumental in the development of a Dedicated Education Unit at D’Youville to her prominent roles in achieving AHCA’s Bronze and Silver Quality Awards, as well as being responsible for the construction, development, and implementation of an orthopedic recovery unit within a skilled nursing center, Rathbone’s modest response speaks volumes about her dedication and compassion.
 
For the past two years, under Rathbone’s leadership, D’Youville Senior Care has participated in MSCA’s Statewide Initiative to Safely Reduce the Off-Label Use of Antipsychotic Medications.
 
What’s more, according to Antolini, “staff have successfully adopted and implemented a unique, person-centered approach that helps staff understand and respond to the individual needs of each resident in order to develop and refine strategies that will improve the resident’s quality of life and job satisfaction for staff.”
 
As a result these efforts, D’Youville achieved a 15 percent reduction in atypical antipsychotic drug use for long-stay residents over the past two years, Antolini reports.
 
Of her center’s accomplishments, Rathbone notes that “at the end of the day we’re here for one reason and that’s [to be here] for residents and staff, and I try to make that part of my day,” every day, she says.
 
What motivates Rathbone is knowing that every day she can make a small difference in someone’s life. “I think in life it’s all about the small differences we make. And in life all those small differences build, and you realize you’ve done a good thing for a family member or a resident,” she says.
 
Rathbone’s experience with long term care reaches back to her elementary school days. Her mother was a scheduler for a large nursing home. Rathbone would go to the home after school and wait in the lobby until her mother was finished with her day. Once in high school, Rathbone worked at the home answering phones in the evenings. “It was all that I knew,” she says. “I went to college knowing that I would major in health care administration, although I wasn’t sure about long term care. But midway through college, I knew I wanted to be in long term care, and I shifted my work and studies to elders.”
 
Rathbone is emphatic about serving elders and remembering that they come first. “Something I say to staff every day is you have to remember we’re not the ones going through the transition, it’s the residents who are going through transitions. They may have just lost a spouse or just moved in or just recovered from surgery; they have a whole lot of transition, and we can’t forget that,” she says.

Wendell Anderson

Wendell Anderson

Certified Nurse Assistant
Maravilla Care Center
Phoenix, Ariz.
 
Having worked in long term care as a CNA for nearly three decades, Wendell Anderson is highly regarded at Maravilla Care Center, where he has worked for the past 11 years. Anderson’s supervisor, Virginia Krueggel, extols his virtues without hesitation: “He is amazing with the residents—and we deal with some of the most difficult people in the psychiatric population—and he can walk into a room and bring this calmness and deescalate a potential situation,” she says. “He’s awesome, great, amazing—the way he’s grown and taken opportunities that he’s run with, and he’s amplified it to the nth degree.”
 
Anderson was inspired to become a CNA after seeing how well his grandfather, who suffered from cancer, was cared for in a Veteran’s home. Working as a caregiver was his way of giving back, he says.
 
“I love taking care of the neighbors [his term for elders]; I love being there to help with my neighbors’ quality of life and being a part of their family. Every morning I get up and look forward to being with my family,” he says.
 
His love for elders is reflected in Krueggel’s testimony: “Residents feel safe and secure with Anderson, and he works well with almost everybody—a huge asset to our team here,” she says, adding that Anderson has “grown beyond leaps and bounds for the past 11 years that I’ve been working with him.”
 
Krueggel notes that Anderson started on the floor and showed great leadership skills. So much so that he moved up to a lead CNA position and “has been my right and sometimes my left hand,” she says.
 
Anderson’s leadership skills have been on display in his work with the National Association of Health Care Assistants (NAHCA). Having served on NAHCA’s National Steering Commission for three years and currently holding the position of vice chair, Anderson helps plan and execute activities within the association, such as the annual CNA conference, and is active in the group’s advocacy efforts in Washington, D.C.
 
“He has spearheaded NAHCA programs and activities at Maravilla Care Center that bring recognition, education, and leadership to his fellow team members, resulting in enhanced teamwork, reduced turnover, and enhanced morale—all of which ultimately positively impact the neighbors being served,” says Kathleen Collins Pagel, executive director of the Arizona Health Care Association in her nomination letter.
He even played the superhero “NAHCA Man,” complete with costume, in a YouTube video encouraging positivity and teamwork.
 
“With Wendell’s leadership, Maravilla Care Center’s NAHCA Leadership Team received the NAHCA Leadership Team of the Year Award in 2011, a national honor,” Collins Pagel wrote. Anderson’s efforts at Miravilla and with NAHCA also earned him the 2013 NAHCA Member of the Year award.
 
“Wendell Anderson is a shining example of a leader from the frontline with compassion, capability, and unlimited potential. He is an outstanding and articulate advocate, with a proven track record on Capitol Hill. But it is Wendell’s passion and fierce devotion to those he cares for, along with his belief in the power of CNAs, that make him a ‘person to watch.’ He truly represents the very best of our profession in every way. It is an honor to be his colleague.”

Bernadette LedesmaBernadette Ledesma, MPH

Administrator
Pearl City Nursing Home
Pearl City, Hawaii
 
Bernadette Ledesma is a hands-on administrator, involved in the day-to-day activities of Pearl City Nursing Home, policy development and education, and communication with residents and their families.
 
Ledesma is often seen making rounds through the building and stopping to encourage residents to participate in their plans of care, talking to families to resolve issues, and observing staff to ensure that the facility is meeting the needs of residents.
 
Through her professional work and service, Ledesma exemplifies what it means to be a champion for the aging. She does so as a provider of care, a leader in improving policy, and an active community member who helps others achieve their goals. She is acknowledged throughout the health care and broader community as a leader.
 
Ledesma provides excellent care for older persons, advocates for improving Hawaii’s capacity to care for residents across settings, and shares her experience and expertise throughout the community. Ledesma is always generous with her time and knowledge, and she is patient and calming even during times of duress. As one Healthcare Association of Hawaii staff member who has worked with her for years shares, “[She] has a wonderful personality; is always supportive, creative, and fun to work with; and gets along with everyone she meets.”
 
Ledesma has been a tireless champion for long term care in Hawaii for over 30 years, and she has done so with grace, humor, and a generosity of spirit that is contagious.
 
Her supporters note that Ledesma has contributed to the welfare of the elderly throughout her 30+ years in geriatric health care in Hawaii. She is very involved in statewide and nationwide initiatives related to long term care, including legislation, regulations, and guidelines that affect the long term care community in general and nursing homes in particular.
 
Ledesma incorporates her wealth of knowledge, providing direction for the operation of Pearl City Nursing Home, and openly shares her knowledge with other nursing home administrators and people interested in geriatric health care. She effectively educates national and local elected officials on policy and regulatory issues and continually mentors new members and colleagues. She makes connections along the continuum of care, across the health care delivery system and community health.
 
Colleagues say that Ledesma exemplifies the spirit of aloha. Here are three recent examples:
  • At Pearl City Nursing Home, Ledesma is an advocate for Culture Change and the Namaste philosophy of looking beyond the surface into the true nature of every resident. The culture change movement in long term care strives to change the way frail people interact with their surroundings. Namaste programs also are focused on individualized engagement and the embrace of each resident’s needs and preferences.
  • Under Ledesma’s leadership, Pearl City Nursing Home joined a nationwide CMA Partnership to Improve Dementia Care in Nursing Homes, which included training staff and emphasizing nonmedical interventions for behavioral health issues faced by long term care residents.
Keith Ridley, chief of the Hawaii Department of Health’s Office of Health Care Assurance and head of the Dementia Care Improvement task force, called the results “remarkable.” Already a leader in the nation for utilization, Hawaii has reduced its rate of antipsychotic medication for dementia residents from 19 percent last year to 11 percent this year.
  • To address the ongoing challenge of transitions of care, Ledesma has spearheaded communication between transferring facilities in her region to promote sharing a list of federally-required and facility-specific documents.

Alicia SeaverAlicia Seaver

Executive Director
Bridges by EPOCH at Hingham
Hingham, Mass.
 
On the job at Bridges by EPOCH at Hingham for two years, Executive Director Alicia Seaver says she sought the assisted living facility out, knowing that it was moving into the area of memory enhancement, which is a field she has been heavily involved in for 25 years.
 
As a CNA in a nursing home, Seaver met her first person with memory impairments at 18 and “fell in love,” she says. “It’s something that I have a passion for.
 
“When I get into my car in the morning, I know where I’m going. And when I get into my car every night, I know that I’ve made a difference.”
 
Seaver is arguably the foremost expert in memory care in all of new England. Co-workers say her dedication and passion are beyond anything they have seen, that she sets the bar high for herself and encourages other staff to do the same.
 
Seaver is a memory-impairment specialist certified by the National Institute on Aging. In addition to running the memory care program at Bridges by EPOCH at Hingham, Seaver regularly leads educational presentations about memory impairment for caregivers, nurses, social workers, and family members.
 
She presents about the different types of dementia, coping tips for caregivers, understanding dementia from multiple perspectives, and more. She offers these presentations in part because of a personal passion to educate, support, and help people who are affected by memory loss. By regularly sharing her knowledge of and experience with memory impairment and caregiving, Seaver continuously supports her residents and staff, as well as members of the larger community.
 
For example, Seaver leads a monthly support group for her residents with early-stage memory impairment. These residents have a working memory and can articulate how frustrating it is to deal with their memory loss on a daily basis. The support group offers a safe environment where residents can articulate their frustration and receive support and encouragement from their peers. Ever sensitive to the needs and emotions of her residents, Seaver encourages them to drive the group. Sometimes, that means they ask her to discuss common types of dementia; other times, it’s a simple check in. Seaver has said that the most important thing is that people have a venue to talk openly about their feelings, because talking leads to healing.
 
Seaver and her staff hold resident council meetings every month, encouraging residents to offer any suggestions or ideas they have. These meetings have helped residents thrive, inspiring them to participate in a number of volunteer projects, including car wash fundraisers and bake sales for the Alzheimer’s Walk and a carnival to benefit the Hope for Caroline foundation.
 
An ardent believer in the power of support groups, Seaver also hosts a group for spouses of individuals with memory impairment. What’s really special about this program is that she invites and welcomes spouses to bring their loved ones with memory impairments along. While caregivers attend the support group, their spouses participate in activities taking place in the community. This has allowed many family caregivers to receive the support and encouragement they need from people who have walked in their shoes—often, spousal caregivers are hesitant to attend such support groups, not wanting to leave their loved one home alone. Seaver has eliminated this worry.

Melanie Lite MatthewsMelanie Lite Matthews

Vice President of Operations
Prestige Care
Vancouver, Wash.

Quality care is in the spotlight in the long term care community, and Melanie Lite Matthews is doing her part to promote, implement, and practice quality throughout her organization and in Washington state’s long term care community.

Taking the lead by motivating her colleagues to apply for and achieve Bronze and Silver Awards through the AHCA/National Center for Assisted Living National Quality Awards Program; participating on the Quality Improvement Committee for the Washington Health Care Association (WHCA); and promoting quality care through projects, initiatives, and efforts of the association through her board position are just a few of the ways that Matthews is helping Washington move the dial on quality.

Matthews is a rising star in long term care. Large organizations have sought to employ her because of her energy, drive, understanding of long term care, and her sincere passion to improve outcomes for residents.
Currently the WHCA Board vice chair, Matthews believes in working together with legislative, regulatory, and other state entities to achieve common goals.

Matthew’s enthusiasm for a focus on quality is contagious, and her efforts are having an impact. She has helped put quality at the center of WHCA’s legislative priorities and worked with the Department of Social and Health Services and other policy-making entities in Washington in an effort to connect providers with oversight agents to achieve quality outcomes together.

Matthews works tirelessly with the Washington state Quality Improvement Organization on the Collaborative Project, designed to help providers learn from one another. She spends time with the Medical Directors Association in an effort to work on the goal to safely reduce unnecessary readmissions to the hospital.

It is under Matthews’ supervision, training, and example that many of the communities she oversees have earned national recognition for AHCA/NCAL Quality Initiative goals achievement. Her efforts and those of her communities made had a direct impact on the reduction of the off-label use of antipsychotic medications, the reduction in staff turnover, the improvements in resident satisfaction levels, and the safe reduction of unnecessary readmissions to the hospital.

Matthews is continuously looking for ways to improve. She spends time with administrators, DONs, caregivers, residents, legislators, and others who can help to improve the quality of care for seniors in Washington. She motivates her own organization to have legislators in for facility tours and she encourages other organizations to do the same.

While busy in her public role, Matthews does not diminish the time she spends or the attention she gives to making quality the center of her everyday operations.

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