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    Nurse Leadership Project  
  Nurse Leadership Project  

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“Ohio Medicaid ‘Invests’ in Long Term Care Nurse Managers”

The phrase ‘this is how we have always done it’ died on December 3, 2017 when the Ohio Department of Medicaid awarded Tobin & Associates, Inc. a $1,049,124.00 Civil Monetary Penalty Grant to train nurse managers on leadership techniques and philosophies. This project is not going to operate on ‘this is how we have always done it’; this project is going to go above and beyond. It will consist of five phases and will stretch over four and a half months per session with six sessions offered throughout the state of Ohio over the next three years.

Tobin & Associates, Inc. is a national leadership connection firm located in Canal Winchester, Ohio. This unique nurse leadership program was created to offer hope to nurse managers who chose to serve in leadership roles, and to give line staff a voice in the operations of their units and in their assigned residents’ care delivery. The goal is to improve the long term care industry by giving nurse managers mentors they can turn to for direction, eventually leading to decreased nursing turnover and improved resident care outcomes.

To become further invested in the industry they serve, Tobin & Associates requested this monetary grant from the Ohio Department of Medicaid to offer leadership training to registered nurses in leadership positions in Ohio nursing home facilities. Tobin & Associates designed The Nurse Leadership Project, a training project that concentrates on the development of nurse leaders, focusing on leadership abilities that affect engagement and retention of direct care staff, such as effective communication, managing expectations, accountability, delegation and mentorship.

The Ohio Department of Medicaid reviewed Tobin & Associates’ proposal and granted funding from the Resident Protection Fund, made of the state’s share of Civil Money Penalties imposed on nursing facilities. The message from Ohio Medicaid Department came back loud and clear to Tobin & Associates: Ohio Medicaid recognized there is a turnover issue definitely affecting the residents in nursing homes, and they wanted to do their part and “Invest in LTC Nurse Managers!”

Regarding this training program, Tobin & Associates president Peg Tobin said, “We need to change our approach on how we train our nurses for leadership. We cannot stay in the past. If the past is so right; then why do most of us have cell phones and not continue to use rotary phones?  The reason the rear view mirror in a car is small and the windshield is so big, is because we are to use our past to build our future, but not dwell on it, we are to focus forward on our future and venture new paths.”

    Project Phases  

Phase I:

  1. Facilities will apply for participation.
  2. Once facilities are chosen Tobin & Associates will send onboarding paperwork.
  3. The facility/organization and nurse participant will sign an agreement of participation and commitment to the success of the program.
  4. Resident and Family Surveys will be conducted.

Phase II:

  1. Two day training conducted by Tobin & Associates, Inc. and held at Tobin & Associates Corporate Headquarters. Subjects to be covered effective communication, accountability, attracting and hiring the right candidate, delegation.
  2. Materials will be distributed: Book Delegate or Suffocate, Leadership Connection Workbooks, Orientation Workbook, Book Start With Why, Book 7 Highly Effective Habits, Book Who Moved My Cheese, Book How to Wind Friends and Influence People, Book Zapp the Lighting of Empowerment, etc.
  3. EFOHCA will provide for CEUs for participants.

Phase III:

  1. Mentorship and continued leadership training based on issues each participant is encountering in their facilities.  
  2. 1 day training conducted and held at Tobin & Associates corporate office, focusing on the Core Values of nurse Leadership.
  3. Reiterate what has already been taught, use scenarios on applying leadership practices, identifying stages of leadership, 5 elements needed to function efficiently. Write Vision, goals, objectives and action.
  4. Discuss application of time management and accountability. Share how different cultures affect a leaders approach.
  5. Facility visit by mentor.

Phase IV:

  1. Mentorship via personal phone conversations or zoom video conference (every week with each participant to discuss real life leadership challenges in their facilities)
  2. Core of Knowledge for Nurses Mangers – trainer/mentor will attend with participants in order to discuss and further explain the information shared in this program. The Mentor will also ask questions of the participants to help them get started with thinking of solutions rather than focusing on issues. This three day seminar will be held at the Ohio Health Care Association’s Corporate Office.
  3. Tobin & Associates representative conducts final resident survey and family survey mailings.

Phase V:

  1. Assignment of a personal Mentor to each participant to be available for two more months for guidance regarding leadership issues that will arise. At the end the participant will be assigned a nurse for them to personally mentor, guide and share the knowledge they have gained in this Leadership Training.
  2. Final onsite visit to observe implementation of leadership approaches and techniques taught in the training project.
  3. Nurse Leadership Executive awarded if all qualifications are met.

2018 Nurse Leadership Training - First Session
(January to June) will be held at the Tobin & Associates headquarters in Columbus, Ohio.

2018 Nurse Leadership Training - Second Session (July to December) will be held at the Tobin & Associates headquarters in Columbus, Ohio.

2019 Nurse Leadership Training - First Session (January to June) will be held at the Tobin & Associates headquarters in Columbus, Ohio.

2019 Nurse Leadership Training - Second Session (July to December) will be held at the Tobin & Associates headquarters in Columbus, Ohio.

2020 Nurse Leadership Training - First Session (January to June) will be held at the Tobin & Associates headquarters in Columbus, Ohio.

2020 Nurse Leadership Training - Second Session (July to December) will be held at the Tobin & Associates headquarters in Columbus, Ohio.

    Cost For Facilities  

The Nurse Leadership Project will cover all educational costs and hotel costs as well as freely distributing educational texts and providing the nurse with a digital device with which to access the program when away from Tobin & Associates’ facilities. For a facility to participate they will agree to cover the participant’s salary while they are working on the project, time for travel, meal costs, and time away from their position to attend all trainings.

The nurse leader should only be out of the facility for two days of intensive and interactive training at Tobin & Associates headquarters. Four and eight weeks later, an additional one day intensive and interactive training will be held at Tobin & Associates headquarters. Once those training sessions are finished, the participant will be required to participate in a one-hour, one-on-one video conference through the Zoom application. Finally, they will be attending the three day class for the Core of Knowledge Training which is held at the Ohio Health Care Association headquarters in Columbus, Ohio.

The facility/organization and nurse participant will sign an agreement of participation and commitment to the success of the program. This means that both parties will be held accountable throughout the course of each section. The facility is guaranteed the spot but should the nurse leader not be able to continue with the program no other candidate can be substituted once the program has started.


Facilities will be chosen based on the following criteria:

• Limited to 12 facilities per session
• Maximum of one participant per facility
• Limited to 4 facilities per organization
• Limited to facilities of 75 to 130 residents
• Facility participation is not limited to members of OHCA
• Facility is experiencing a turnover rate of greater than 30% in nursing staff
• Facility has a score of less than 85% on the 2015 Ohio Department of Aging resident satisfaction survey
• Facility has a score of less than 85% on the 2014 Ohio Department of Aging family satisfaction survey
• Applicants must be a registered nurse (RN) with at least 2 years of experience in a long term care. The RN will sign an agreement of understanding and commitment to the training program

    Why The Need?  

In preparation for the grant proposal, Tobin & Associates contacted six top nursing programs in Ohio to determine if their nursing curriculum included training in leadership and management skills. Tobin & Associates found that nursing students on a whole receive one quarter or one semester of leadership classes that included human resources, interviewing, FMLA, worker’s compensation and unemployment. There were no classes in these six nursing programs specifically teaching nurses how to engage, direct or lead colleagues in the workplace.

Therefore, Tobin & Associates asked, “If the nursing schools do not teach leadership skills, where do the nurses go to get leadership training?”

With that thought, Tobin & Associates, decided to conduct a specific survey of the Direct Care Associates who attended the Ohio Health Care Association 2016 Direct Care Conference to see what associates looked for in their nurse leader. The outcome was:

  1. 98% want their leaders to hold all staff members equally accountable, but also take into account extenuating circumstances. Not everything is black or white.
  2. 93.5% want to receive more training with different viewpoints from leaders in Long Term Care from outside their company.
  3. 89% want their leaders to include them in the care plan development and shift report.
  4. 84% stated their leader as the reason they would leave or stay with a company.

Additional insights:

28.9% of new registered nurse (RN) hires will leave their position within one year, accounting for 51.4% of total turnover of RN’s, according to the 2016 National Healthcare Retention & RN Staffing Report.

“In general, people leave their jobs because they don't like their boss, don't see opportunities for promotion or growth, or are offered a better gig (and often higher pay); these reasons have held steady for years,“ the Harvard Business Review reported: https://hbr.org/2016/09/why-people-quit-their-jobs

Regarding these nursing challenges, Tobin & Associates president Peg Tobin said "If we want to attract and retain nurses in the Long Term Care Industry it is my belief that we need to stop 'throwing them into leadership positions’ with no tools, no support and no training. It is not fair to the associates they are leading and it is not fair to the nurse. Our new nurses deserve a chance and to me that means giving them the tools and the training they need to find that success for all parties in the nursing department."

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Contact:  Natalie Holliday
Office:  614.890.8724 ext. 1111


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