Stepping into Chaos? Why Re-Establishing Chain of Command is a Crucial Step

Walking into a new building as the Administrator can feel like stepping onto a moving train. Maybe the facility is running smoothly, but often, especially if you're replacing someone after a short tenure – or worse, following a series of predecessors – you're stepping into a degree of operational chaos. Systems and processes are often broken, and the team might be looking for stability but unsure where to find it.

As administrators, we know the feeling. The weight of responsibility lands squarely on our shoulders from day one. Residents need care, families have concerns, staff need leadership, and the survey window is always looming. Where do you even begin rebuilding?

Based on my own experience, both as a permanent LNHA and during interim assignments, and through coaching fellow administrators facing these exact scenarios, I can tell you this: one of the most critical foundational pieces you MUST reconstruct immediately is a clear, respected chain of command.

The Revolving Door Effect: Broken Systems and Bypassed Managers

When leadership changes frequently, established structures inevitably erode. Staff, trying to get answers or solve problems, may have learned to bypass their direct supervisors. Perhaps a previous administrator encouraged everyone to come directly to them, or maybe department heads felt disempowered and stopped being the effective first point of contact. Whatever the reason, the result is the same: inefficiency, confusion, and undermined managers.

You walk in, and suddenly, CNAs are bringing scheduling issues directly to you. Dietary aides are complaining about maintenance requests in the hallway. Nurses are asking you for supplies. While it’s tempting to jump in and fix everything instantly to show you're responsive, you're inadvertently perpetuating a broken system.

My Foundational Tool: The "Open Door, But..." Policy

I believe wholeheartedly in an open-door policy. Staff need to know they can approach leadership. However, my door comes with a crucial first step. When a staff member comes to me with an issue that falls under their department head's purview, my very first question is always: "Have you discussed this with your supervisor/manager?"

If the answer is "no," my response is polite but firm. I redirect them back to their direct supervisor. I might say something like, "Okay, please take this to [Supervisor's Name] first. They are responsible for managing this within your department. If you've spoken with them and the issue still isn't resolved, please let me know, and I will follow up with [Supervisor's Name] to support them in finding a solution."

Why is this redirection so critical?

1. It Reinforces Structure: It immediately begins rebuilding the proper operational flow. Problems get addressed at the right level.

2. It Empowers Your Managers: You hired (or inherited) department heads for a reason. They have specific responsibilities and expertise. Bypassing them tells them, and their staff, that you don't trust their ability to manage their own department. Redirecting empowers them and holds them accountable.

3. It Prevents Your Burnout: If every single issue, big or small, lands on your desk first, you will drown. You cannot be the frontline problem-solver for every department and still effectively manage the entire operation, focus on strategic goals, and maintain regulatory compliance.

4. It Sets Clear Expectations: Staff learn quickly who to go to for what, leading to faster resolution of everyday issues.

Understand, this isn't about refusing to help or support your team. If a manager needs guidance, resources, or intervention on a complex issue, absolutely step in alongside them. But the routine practice must be to channel issues through the designated leader first. Don't cut your managers out of the loop – coach them through it.

A Caution for Corporate and Consultants, Too

This principle doesn't just apply within the building's four walls. I extend this same caution to Regional Directors, VPs of Operations, corporate support staff, and external consultants who visit or interact with the facility.

During periods of instability or high turnover, it's natural for staff to reach out to anyone they perceive as having authority or the ability to fix things, including corporate visitors. However, once a competent Administrator and management team are in place, these higher-level leaders and consultants must respect the building's chain of command.

If a staff member approaches a Regional VP directly with an operational issue, the response should mirror the Administrator's: "Have you discussed this with your Department Head? Have you brought this to the Administrator?" Redirecting the issue back down the established chain is vital. Intervening directly, solving the problem on the spot without involving the building leadership, might feel helpful in the moment, but it fundamentally undermines the authority of the NHA and their managers. It sends a confusing message to staff and can inadvertently set your building leaders up for failure by signaling that their authority is conditional.

Support, mentorship, and providing resources when requested by building leadership is invaluable. Direct intervention in daily operational issues, bypassing the established leadership, is counterproductive.

Building a Stable Future

Re-establishing the chain of command isn't always easy, especially if bad habits are deeply ingrained. It requires consistency, clear communication, and unwavering support for your management team.

• Train It: Make the chain of command crystal clear during new hire orientation.

• Reinforce It: Consistently redirect staff and gently remind them of the process.

• Support It: Equip your managers with the training, resources, and authority they need to succeed.

• Model It: Ensure you follow the chain of command in your own interactions.

Ultimately, a well-defined and respected chain of command is essential for operational efficiency, timely problem-solving, and sustainable leadership. It ensures staff know where to turn, managers are empowered to lead, and you, the Administrator, can focus on the bigger picture of steering the ship. It’s not just bureaucracy; it’s the bedrock of a well-run facility. Don't neglect it – make it your priority from day one.

#TheAdministratorsDilemma #LNHA #NursingHomeAdmin #Leadership #LTC #SNF #SkilledNursing #NursingHome #NursingHomeLife #AssistedLiving #MemoryCare #Healthcare #HealthcareConsulting #ChainOfCommand #OperationalEfficiency #EmpoweredManagers