I am guided by a consistent interpretation of long-term care standards, whether I am addressing a group of long-term care clinicians and executives during a conference, or whether I am conducting a legal review for the plaintiff or defense.

No group of long-term care professionals has more influence on care-giving than "Administrators." They hire key facility executives and determine or have a significant influence on resident rights, employee morale, productivity, recruiting practices, wages, benefits, training, in-service education, survey compliance, resident acuity, outside contractors, accounting practices, safety and security, and quality assurance. Administrators determine or have a significant influence on revenue, cash flow and operating budgets, which drive staffing levels, food purchases, supplies, equipment, and capital improvements. In essence, they are the "chief architect" of a care-giving community. The importance of department manager positions like the Nursing Director cannot be over emphasized. However, their success as care-giving "builders" is based largely on the quality and quantity of resources "at their disposal," and support from the Administrator. Although clinical experience has tremendous value during legal reviews, these perspectives alone are too narrow to form an opinion about the operation of a facility.