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Good morning, and happy Sunday.  Over the past decade, I’ve had the privilege of supporting multiple teams across various organizations and communities within the skilled nursing and senior living space. One of the greatest advantages of this role is the unique perspective it provides—I get to see how different teams face and overcome challenges in real-time. This exposure accelerates my experience exponentially, giving me insights equivalent to 60 or 70 years of leadership in just ten. It's a front-row seat to best practices, strategies, and lessons learned across the industry.

Of all the factors that influence a team's success, the most critical one I've observed is a leader’s ability to directly address and engage with their weakest performers. Leaders who confront these challenges head-on, rather than avoiding them, are the ones who consistently drive their teams toward achieving their goals.  

Elevate your Leadership

Research consistently highlights the impact of performance gaps on healthcare organizations. According to the Journal of Healthcare Management, approximately 15-20% of healthcare employees perform below expectations, resulting in a 30% increase in operational costs compared to organizations with high-performing teams.

But there's good news—by implementing strong performance management systems, you can drive measurable improvements in patient care, financial outcomes, and employee retention.

Consider these industry findings:

• Facilities with effective performance management report a 25% increase in patient satisfaction scores (Healthcare Finance News).
• Addressing bottom-performer issues leads to a 40% reduction in staff turnover (Journal of Healthcare Leadership).
• Organizations with structured performance management achieve 35% better financial outcomes (Healthcare Administration Quarterly).

Performance gaps aren’t just numbers on a spreadsheet. Let me share a real-world example that illustrates just how impactful leadership and accountability can be.

A Case Study in Leadership Accountability

At one comunity I led, we faced a leadership challenge familiar to many of you: an experienced administrator with a stellar resume struggled to engage the team and build trust. While their credentials were impressive—15 years of experience and advanced certifications—their leadership style created barriers to team collaboration and morale.

Here’s what we documented:

• 30% vacancy rate
• Below-benchmark resident satisfaction scores
• Financial performance falling short of budget targets

After careful assessment, we implemented a leadership change, prioritizing relationship-building and team engagement. Within six months, the results were undeniable:

• Vacancy rates dropped below 5%
• Resident satisfaction scores improved by 40%
• Financial performance exceeded budget by 8%

Leadership isn't about qualifications on paper—it's about creating a culture of accountability, trust, and continuous improvement.

Strategies to Identify and Address Performance Gaps

So, how do you effectively tackle this issue? Here are key steps I recommend based on years of experience leading and advising teams:

1. Take a Monthly Performance Step-Back

As a leader, set aside time each month to assess your team with your core leadership group. Ask yourself:

• "Who are the 1-2 individuals furthest from meeting expectations?"
• "How is this impacting other areas of our operations?"

Be honest in this assessment. Often, you already know who these individuals are. So does your team. In fact, they might be wondering why the issue hasn't been addressed yet.

2. Focus on the Gap, Not the Person

One of the best ways to create a constructive conversation is to shift the focus from individual shortcomings to performance gaps. Instead of saying, “You’re not doing a good job,” frame it as:

• "Here's where we are right now in relation to our goals."
• "This is the gap we need to close. Let's work on narrowing that together."

By doing this, you avoid making team members feel attacked and instead engage them in problem-solving.

3. Build Clear Development Plans

Once you’ve identified the gap, meet with the team member to establish a clear, measurable plan for improvement. This plan should include:

• Specific examples of where performance has fallen short.
• Well-defined expectations for improvement.
• Consistent touchpoints to review progress, provide feedback, and adjust the plan as needed.

4. Leverage One-on-Ones and Team Feedback

Regular one-on-ones are critical for maintaining open lines of communication. These meetings allow you to gauge team sentiment and align your perceptions with theirs.

You can also gather broader feedback through anonymous surveys or open-ended team discussions. Questions like, “Which areas of the operation are furthest from our goals?” can provide valuable insights without singling out any individual.

Realigning Your Team with Accountability and Support

Attacking the problem—not the person—fosters trust and collaboration. By creating a culture where underperformance is addressed through clear communication, strategic coaching, and shared accountability, leaders can close performance gaps without alienating their team members.

Remember, addressing the bottom 20% isn’t about punitive action. It’s about giving your team every opportunity to succeed and ensuring that no one issue—whether it's a person, process, or department—holds your organization back.

Let’s commit to identifying those gaps and closing them today. Your team, residents, and community will thank you for it.

Partners We Love

Assisto

Assisto has developed an AI-powered search engine that, for the first time, allows you to search and filter CMS survey data.

If you are an operator looking to stay updated on where your state surveyors are and what deficiencies they cite in your state, Assisto is for you.

For a short time, we are offering access to the portal for $18.90 per month after a 30-day free trial.  

Click here to sign up for early access and claim your free trial.

Whenever you're ready, there are a couple of ways I can help you.

1. Leverage our partnership with CEUSrEZ and purchase NAB-approved, online, self-paced, continuing education courses at a 20% discount here.
2. Check out our free AI Chatbot trained on thousands of pages of regs and industry best practices.  It's like having a surveyor on your team.  Try it out here.
3. Sign up for Assisto and keep track of the regulatory environment in your state.  Know what deficiencies surveyors cite in real-time and ensure you're not at risk for the same tag.  Sign up here.
    

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Thanks for reading.  Have a wonderful day.

Kevin Goedeke, Publisher and Founder