As administrators of two long term care facilities, Executive Directors Hal Garland and DeAnn Walters have successfully managed CMS Five-Star buildings—Golden LivingCenter - Greenville in Greenville, N.C., and Golden LivingCenter - Fresno in Fresno, Calif. They know that one of the important parts of their job is to build relationships.
When asked about the challenges of long term care and why they work in this field, they had similar responses revolving around building relationships and how to keep them strong in a long term care setting.

What gets you excited about going to work?

DeAnn Walters: This is the best job that anyone can have, so who would not be excited about coming in each day. It is definitely the people that keep this career exciting. The residents with their vast and colorful history, the staff with their challenges and dreams, and they all come together under one roof at GLC - Fresno. It is a business, a business about caring for people that makes it exceptional.
Hal Garland: There is never a dull moment from the time I come in to the time I leave. We have 35 admissions/discharges each week, and we get to meet the new residents and families. We always wish the discharged residents well and miss them.

What is one thing you have learned about this work?

Garland: It’s all about personal relationships and how to keep them strong, whether the relationship is with a staff member, resident, patient, patient’s family member, physician, referral source, or corporate employee. It’s personal, and it is more personal than ever with cell phones and technology to connect us 24/7.
Walters: There is never one thing to learn about this work. Each day has new experiences, new challenges, and so many new rewards.

How do you inspire and motivate your staff?

Walters: I believe our teams are motivated to provide excellence even if I am not present. For me, I feel that I add a certain amount of focus. As the leader, I help them decide upon and begin the journey to a specified goal. Through this process I keep the team focused and help brainstorm ways to overcome challenges. I want to ensure that they are recognized for their hard work and accomplishments achieved. 
Garland: My goal is to raise the team’s energy and make things as fun and enjoyable as possible. Recognition goes a long way to increase energy, morale, and teamwork. We surprise people with awards, such as the monthly top smiler, Golden Star, and associate of the month. 

Name a challenge at your LivingCenter.

Garland: The challenge was in creating short-term neighborhoods and long-term neighborhoods within the LivingCenter where short-term residents who did not make the necessary progress were moved to long-term neighborhoods. These residents did not want to move because they enjoyed being with short-term patients. We held open discussions with the residents and families, highlighting the advantages of moving to the long-term neighborhood. These advantages included roommate compatibility, fewer admissions and discharges, and easier resident care routines. Once their concerns were addressed, they were happy to move, and staff worked to ensure their comfort and care needs were met.
Walters: One challenge for our team was to move our LivingCenter from a Four-Star CMS rating to a Five-Star CMS rating. The team reviewed our quality measures resident by resident to see how we could affect them positively. We already had a great survey outcome, and our staffing exceeded requirements, so for us to move up in our rating, we looked at individual experience and quality outcomes. Through process improvement and root cause analysis, the team began to make individualized changes that improved our patient experience and outcomes. It took well over a half of the year, but the outcomes improved, and in that time, the LivingCenter achieved a Five-Star rating.

DeAnn Walters, executive director, has worked for Golden Living as a licensed nursing home administrator since 1998. She has also worked at Golden LivingCenter - Country View, also in Fresno, and Golden LivingCenter - Clovis. She has held the position at Golden LivingCenter - Fresno since January 2012. She served on the Board of Senior and Master Examiners for the American Health Care Association/National Center for Assisted Living National Quality Awards in 2012 and 2013. Hal Garland has worked for Golden Living for 32 years and has served as executive director for Golden LivingCenter - Greenville since 1988. He is a member of the Exam Writing Committee with the National Association of Boards and a member of the East Carolina University Masters of Public Health Program Community Advisory Board.