Cornelia Nixon Davis: The Right Fit
Corporate Spotlight
Written by Jill Rose   
Tuesday, 01 January 2008
Cornelia Nixon Davis: The Right Fit - Health Executive - RedCoat Publishing
Charles Long’s lengthy tenure with this independent senior-care company helped him put teamwork back into its lexicon.
Between a shortage of geriatricians, a nationwide average nursing staff turnover rate of more than 100%, and a sometimes hard-to-handle attitude from the next generation of workers, running a long-term care campus is a demanding job, to say the least.

Cornelia Nixon Davis: The Right Fit - Health Executive - RedCoat Publishing
Charles Long, CEO
But Charles Long, executive director of Cornelia Nixon Davis Inc., has been with the company for 20 years, and he’s seen it much worse. Long started with the company as office manager and was quickly promoted to comptroller and, later, to CFO. He never intended to run the company, but after other options for management were exhausted and an extensive search concluded without finding a good fit, Long was persuaded to take the head position.

This was in 2003, and the discord among the staff was palpable. Fortunately, the newly promoted administrator had been with the company long enough to know what it needed. Long began working with the nursing department leadership on a new approach to scheduling and management. After much coaching, it became clear that it was time for some necessary turnover, and then things began to look up.

“Shortly thereafter, on a Saturday, I came in to make sure things were okay,” said Long. “People were much happier and working together, and the supervisor said she was getting calls from nurses offering to come in on a volunteer basis to help. That hadn’t happened in a long time.”

Since then, Long has worked consistently with senior staff and other managers to make sure everyone works as a team and that the lines of communication are wide open. As head of Cornelia Nixon Davis, he oversees the administration of the 200-bed Davis Healthcare Center (a skilled nursing home) and the 148-apartment Champions Assisted Living. The facilities are located about 500 feet from each other on a 29-acre wooded campus in the Porter’s Neck area of Wilmington, NC.

The turnaround led by Long has been a major success. When he first became executive director, families and staff were frustrated with senior management and were turning to state agencies and the labor board, respectively. Today, a family atmosphere prevails, and complaints are being resolved inhouse.

“Everything we do here is based on relationships—with staff, residents, and families,” said Long. “We learned that when we built those relationships, we opened the lines of communication and allowed them to talk to us. If they had a problem, they would come to us and give us an opportunity to fix it.”

Shrinking pool
Another problem Long and his team face is the shrinking pool of geriatricians. There were 9,500 such licensed physicians in 1995; today, there are less than 6,500. Taking a proactive approach, CND has partnered with its Area Health Education Center (AHEC). Doctors in training with AHEC for a hospital position also do a rotation at CND. “The hope is we will be able to get some of these physicians interested in geriatric medicine,” said Long.

As residents, the rotating physicians also provide primary care for many of the patients at Davis. “We get the services we need here, and we help educate future geriatricians,” Long explained. The program just began this summer, but Long said he’s seen this type of program work well in other communities.

Recruiting nurses is a problem across the country and no different for CND, but Long said Davis’s reputation for being a good place to work helps ease the situation. The facility’s emphasis on teamwork helps increase retention: Davis’ rate is about 50%, well below the industry average. Not surprisingly, Long said he has plans to try to lower the rate even more. “I’d like to get it down to the single digits, and that’s one of the goals of our new campaign, which looks at how we can make the employee even more of a focus.”

Providing training and opportunity for the staff is another retention booster, Long noted. “You want to be on the cutting edge of services and provide training so people can continue to learn. We’re working on clinical ladders here, which will allow people to grow in their employment so they don’t feel they’re in a dead-end job.”

Some of the classroom training is provided by physicians as they rotate through. “Part of their AHEC requirement is they have to teach our clinical staff about a variety of subjects,” said Long. Both RNs and certified nurses aids (CNAs) are welcome to attend courses in such topics as drug interactions, delirium and dementia, elder mistreatment, and care of pressure sores.

A less straightforward subject CND is addressing is the generation gap between older and younger workers. “One of the biggest problems we’re running into is the ‘me’ generation’s work ethic,” said Long. “Older workers are frustrated with younger workers who call in because they just don’t feel like coming to work that day.” Long said training and new policies are in development to ensure proper staffing without alienating younger workers. He also reminds department heads and board members that they’re the ones who raised this generation. “That’s a sobering moment,” he said.

Patient comfort
Going forward, Long and his team are looking into expanding the Davis facility, adding a wing of semi-private rooms and converting some existing rooms to private. Patient comfort was also the driver behind a wireless nurse-call system installed 18 months ago to eliminate overhead paging. “If you’re not feeling well and are laying in bed, the last thing you want is a speaker coming on every five minutes over your head,” said Long, adding that the next technology purchase will be an electronic medical record system.

New services are also being planned, including a rehab and wellness center that will provide physical, occupational, and speech therapies, as well as space for outpatient therapies and wellness programs.

One thing that won’t change is the organization’s emphasis on teamwork. “We have a very open management style here; I share everything I possibly can with the leadership team,” said Long. “That’s one of the things people like about working here. They don’t have someone in another state telling them how to run things here in Wilmington, and it doesn’t take six months to get something changed. We just sit down and work out the logistics—and if something needs to be changed, we can change it the same day.”
 
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