There is a consensus that high-performing communities have really good executive directors and underperforming communities have less skillful executive directors.

By Steve Moran

Over the last few weeks, I have had the opportunity to have some deep conversations with a bunch senior living leaders and a lot of these conversations has been about leadership, which has lead to a discussion about the difference between high-performing and underperforming communities.

Across the board, there is a consensus that high-performing communities have really good executive directors/administrators and underperforming communities have less skillful executive directors/administrators.  

Before you go off on me I want to offer some caveats:

  • We are talking very specifically about senior living and skilled nursing. While the fundamentals of this article apply to skilled nursing it is a level of senior living where in most markets there are way too many beds and so this is likely a bit less true.  

    The other factor with skilled nursing is that many of the best performing buildings don’t have high census numbers because they are focused on high revenue short-stay rehabilitation residents. And yet it is still true that the highest performing skilled nursing facilities have the best administrators.

  • In rare cases, a market is so overbuilt or the corporate organization is so dysfunctional that the best executive director in the world could not turn the building around. Mostly though when this is the case, the really good leaders are smart enough to jump ship and find a better place to work.


I have thought a lot about this problem and why it is so persistent. Mostly senior living leaders are as good or as bad as the people who led them, munged in with how their parents parented them. Naturally, we model what we know.   

On top of that, most organizations are so busy running their operations that they just don’t spend very much time on leadership development. It is not surprising because again, they mostly grew to be leaders in organizations that did not focus on leadership development.

Finally becoming a great leader is really difficult. It requires a huge dose of humility where one is willing to admit that their old ways of leading where just plain wrong. That they did damage to others, not purposefully but in ignorance.

Fixing It

The good news is that while there are some executive directors who need firing, this is mostly a fixable problem.

  1. If you are someone who thinks your leadership skills need some work there are two moderately easy things you can do. Read great leadership books. Every single great leader I know has 2-5 leadership books going at any given time and they will read 10-40 leadership books a year. Here are just a couple of my favorites: Daniel Pink’s “DRIVE” and Adam Grant’s “Give and Take.”

    Watch TED talks on leadership, there are dozens or more likely hundreds of them. They are all less than 20 minutes long and almost always really good. Just Google “Best TED Leadership Talks” and you will get dozens of lists.

  1. Mostly what happens is that at some point on their own, the underperforming executive director moves on to the next place they underperform, hoping it will be different. Or something happens (or exasperation sets in) and management fires the underperformer and hopes for something better (which sometimes works).  

    The problem is that revolving door executive directors have almost no upside for occupancy, resident or team satisfaction.  

    I find myself wondering if the right solution is to pay for some one-on-one coaching for executive directors who are struggling. Imagine how much better it would be to spend a couple of thousand dollars a month for some personal coaching for a few months to move them from mediocre to great or at least growing.

This article didn’t start out to be a commercial and it really isn’t. But if someone is interested in saving someone worth saving, I have some resources who might be able to help in this area. Shoot me an email at [email protected] and put “coaching” in the subject line. I will get back to you within a few hours.