Inspired to Help Others: Celebrating Long-Term Care Administrator’s Week

While he was in college, Brandon Upshaw’s great-grandmother became ill and needed to live in a nursing home. It was a difficult time for him and his mother and grandmother. This inspired Brandon to want to help families who need answers and support when choosing a skilled nursing care center for their loved one.

Brandon is now Administrator of Cherry Hill Rehabilitation & Healthcare Center in Birmingham. As part of Long-Term Care Administrator’s Week, Brandon takes us through a “typical” work day.

By Brandon T. Upshaw, NHA

One thing you quickly learn about long-term care is that no day is ever the same. Expect the unexpected. Each day has its own challenges and rewards. It’s not your typical 8 to 5! I work nights, weekends, holidays and often spend the night during bad weather. Plus, I am always on call. I like to see my building function during waking hours all the way until resting hours. You never know when you’ll see me in the building.

8:30 a.m. Each morning I arrive and head to the dining room where I usually greet many of my residents while I get my morning coffee. Afterwards, I make my morning rounds on the halls to greet my staff and make sure the building looks its best. Then, I proceed to my office where I briefly check email and gather information that needs to be shared.

9:00 a.m. I meet with my Interdisciplinary Care Team every day at this time. We reflect on the previous day and establish new goals and plans for the current day. All members of my core team share information and the status of projects. This makes sure we’re all on the same page and provide the best continuity of care in all departments. I enjoy providing team building exercises for my core team in this meeting to better establish rapport and boost the moral to carry out positive energy onto the halls. Depending on the day, this meeting usually lasts for 30-45 minutes.

10:00 a.m. We begin our Rehabilitation Meeting to discuss the patients and residents who are receiving therapy. This entails their level of progress, goals and plans to get short-term residents back to their highest level of functioning. This sometimes includes scheduling home visits to ensure patients will smoothly transition back to their homes without a high risk of hospital readmission. We try not to exceed 30 minutes in this meeting. However, the length of time truly depends on the current caseload which is increasingly growing! As an administrator, it’s fulfilling to see patients in our therapy program thrive and regain independence.

11:00 a.m. I prepare for “walk and dine” which is prompted when the music comes on the intercom speakers. This is when all staff members assist residents who are coming to the dining room for lunch. This gives me more time to spend walking the halls encouraging residents to eat in the dining room while providing them assistance to get there. The accommodations we provide along with the jazz music gives our residents a fine dining experience.

11:30 a.m. I finally sit at my desk and review information collected from the morning meetings.  I’ll check my emails again, return phone calls and handle routine office items.

12:00 p.m. Time to check some tasks off the to-do list. I review all pending purchase orders and sign my approval for needed items within the building. Since the building has a budget, I try to check it daily to make sure that we are being efficient with funding. This is also a time where many of my staff come in and ask questions as it relates to their departments. I also read information pertaining to regulation changes from the Centers for Medicare and Medicaid Services. This helps me to know what to look for through implementation and stay in compliance. I also approve and sign off on all schedules submitted to maintain proper staff coverage within the building.

1:00 p.m. At this point, it’s time to follow up with my residents to gauge whether they enjoyed their lunch. I enjoy their feedback as it helps me to know how we could better accommodate them through their meal service. This gives our residents an opportunity to voice their likes and dislikes which produces better results. Next, I visit our inpatient and outpatient therapy gyms to encourage rehab recipients and give them accolades on their progress. The outpatient therapy program serves individuals who live elsewhere and come to Cherry Hill for services. Lastly, I spend time on our cognitive care unit to interact with residents who have Alzheimer’s or dementia. Cherry Hill can care for up to 117 residents or patients. It takes a lot of time to visit with each one, but it is time well spent.

1:30 p.m. My goal to eat lunch by 1:30 p.m. each day…but it’s not always set in stone. I enjoy eating the meals provided by my dietary department. It’s essential for me to eat the food so I know my residents are receiving a well-balanced, delicious meal that has great presentation. I intentionally to eat in the dining room with my staff to fellowship with them. The workplace is where we spend most of our time, and I want to create a family like atmosphere. Grabbing food on the go is always a last resort.

2:00 p.m. This time is set aside to meet with families for initial admission meetings, care plan meetings and impromptu meetings with pertinent members of the Interdisciplinary Care Team.  While I like to meet with families as a team, there are some who prefer more individual meetings to discuss the expectations for their loved one. Depending on the day, I may use this time to facilitate staff in-service meetings on topics such as behavior management, nursing and quality assurance. I also use this time to follow up on concerns brought before me by the resident council.

3:00 p.m. At this hour, I like to reach out to each person on the Interdisciplinary Care Team and provide any guidance they may need. Managing a staff of more than 135 people, I must stay up-to-date on employee evaluations, see to it that they are given timely manner and in process for review. I make rounds again because it’s shift change time and the evening shift employees are arriving. While walking, I’m always looking at the building to make sure it presents well from the floors, the artwork, the neatness of the nursing station, making sure there are no housekeeping carts or laundry bins on the halls and that the air is fresh across the building. We strongly believe in a clean, homelike environment.

4:00 p.m. Now’s the time to review complicated admissions with my Director of Nursing and Admissions Director. I believe in finding more ways to say “yes” than “no.” With that being said, it is my job to make sure we are able to meet all the medical and safety needs of a potential resident while maintaining the health and safety of our current residents. I receive updates on all confirmed admissions for the day. We must confirm we have all needed equipment and materials to care for a new resident or patient. Towards the end of the day, I try to prepare for the next day by gathering materials to present to the team at tomorrow morning’s meeting. My administrative assistant briefs me on newly scheduled meetings and keeps me up-to-date on changes or cancellations.

5:00 p.m. Things are beginning to calm down and now I turn my attention to corresponding with our corporate staff. I review all submitted paperwork and sign off on it. Though the building has federal and state guidelines, I must also stay in compliance with our corporate guidelines and follow all recommendations. I usually stay at the building completing paperwork until I tire out…or my wife calls and says it’s time to come home!

Cherry Hill hosts many events outside of normal business hours. I attend quarterly family council meetings usually held between 6:00-7:30 p.m., back to school carnivals and health fair. If you’re ever in the neighborhood in December, be sure to attend our “Christmas on the Hill” program.

While no day is the same, I wouldn’t have it any other way. My job is rewarding, and I know I’m making a positive impact on the lives of my residents, patients, staff and their families. I encourage you to pursue this as your career.

In closing, Happy Long-Term Care Administrators Week to my fellow administrators!