Reference no: EM133782590

Ms. Denicola had been the administrator at Field Nursing Facility for 30 years. She was retiring and leaving behind many departmental managers that had worked with her for many years. Ms. Denicola was well respected, if not liked, by all that worked at Field Nursing Facility.

She was seen as a tough but fair leader who always had the resident needs as paramount in her decision making.

Some of the departmental managers saw Ms. Denicola departure as an opportunity change some of the things "wrong" with the facility policies that would make things "better" for all those at Field. The new administrator, Mr. Lewis, much younger in years and experience than Ms. Denicola, wanted to get off on the right foot with the administrative staff. He called a meeting and told the departmental managers he respected their experience. Mr. Lewis stated he was not dictatorial and trusted the departments could work out their issues out democratically among themselves. This would give him time to work on the financial issues and put together a 3 year plan for the facility.

It did not take long when some of the "democratically" determined decisions made by the departmental managers began to effect resident care. The Director of Nursing, with a much more aggressive personality, talked the Housekeeping Director into agreeing that nursing would not be cleaning up any spills when they occurred. It would be housekeeping's total responsibility. After all, the nurses and CNA time was better spent on direct care to residents. The Activities Director got a reluctant Building Services

Director to agree to breakdown and set up the multi-service rooms before and after every activity. Previously this was done by the activities staff. The Director of Therapy stated her therapists were to busy to attend morning report and would get the information about from nursing "as needed".

The administrator was now getting complaints that spills on the floor were going unattended until someone could find a housekeeper. This was dangerous situation for everyone. Activities were being delayed and residents and families were complaining. Maintenance issues throughout the facility became backed up with leaky sinks, lamps not working and wandering systems not being attended to in a timely manner. Therapies were late in doing evaluations on potential rehabilitation admissions and this was causing problems with being compliant with the MDS timelines.

What is wrong, if anything, with the new administrator's "leadership"? How should policy issues be handled when they are between different departments?