healthcare

We sat down with KVH Senior Finance Analyst Jason Adler and Accounts Payable Specialist Deborah Connors, to try to get a handle on the mystery that is healthcare finance.

How is the work divided between the team in your department?

Jason: Accounting is a part of finance, and finance is also the whole revenue cycle. They all partner together.

Deborah: And you do a lot of budgeting.

Jason: I do the budget and it rolls into accounting to compare the budget or financial plan to the actual accountings.

Deborah: I have a very small part of the whole accounting department. Pretty much just paying the bills.

Jason: Well, I think she has a really big part. How much money did you spend last year?

Deborah: You know, I don’t remember, but I did hear Kelli [Goodian Delys, Finance Director] say that I wrote over 10,000 checks. One night I was here until 7:30 doing checks and someone’s like, wow, you’re here late. I’m like, I’m just trying to keep the lights on.

Jason: Literally.

If you were to give a really high level of what your teammates do, what are the different roles? Kelly Winters does payroll.

Deborah: Kelly does payroll. I pay the bills. Vicky Sterkel pays the bills. She enters employee deductions and things like that. She also sorts the mail that comes in and helps do a lot of data entry in Cerner for matching invoices to purchase orders.

And Sharoll Cummins?

Deborah: Sharoll does just about everything else.

Jason: She puts in journal entries to account for things like bills we haven’t paid yet, like when a company bills us about a month behind, but we need to expense it at the time of service to ensure we have the money for it.

Deborah: Sharoll also keeps track of all the fixed assets, whether it’s a new computer system or a building.

What program do you use for all of this work?

Jason: We probably use Excel the most. Multiview is our general ledger software. So that’s where everything comes together in our general ledger, which is like the book of truth, I guess you would say.

What’s different about working in finance in healthcare?

Deborah: I had to learn a lot of terminology. My first six months I googled a lot of things, many of which I wish I’d never looked up. But, accounting is accounting. The basic principles are the same. It’s just the terminology that is a little bit different.

I just know from my perspective in marketing, but marketing in a healthcare environment has that layer of ‘it’s for a greater good.’

Deborah: That is actually part of what drew me to wanting to come to work here. You know, being part of an organization that does good things for people.

Jason: I guess one of the biggest differences with healthcare is learning how we actually get paid, and what we can charge for. Every payer pays us differently.

Deborah: Incredibly complicated.

Jason: Yeah. And contracts with insurance companies will conflict. You might have a contract with one insurance company where a service is allowed and paid for and another company that is complete opposite.

Deborah: There are a lot of things that are very negotiable.

How do you keep all of it straight?

Jason: It takes the whole team. There’s little things like with Medicare and Medicaid where location is really important on how you get paid. We can do the exact same service in two different areas and what we get paid for the services can be significantly different.

Deborah: And even things like the utility bill. Engineering absorbs most of the utility bills into their department, but not all. The ones for the Rural Health Clinics get charged to the clinics, so they can be included on the Medicare Cost Report reimbursements.

I think that’s the single biggest thing that I learned since coming here, is how complex the entire finance system is.

Jason: We do the cost report, so we’re paid on cost from Medicare and Medicaid, which is about 60 percent of our business, but pays about 33% of our costs by the time we factor out all non-allowable expense. It’s just accuracy with the most basic things such as square footage of my office compared to a patient room. Just the square footage makes a huge difference on payment for services.

Speaking of having numbers right, how often do audits come into play?

Deborah: Two a year.

Jason: The state audit, and the independent audit.

Deborah: It’s my understanding that government agencies whose revenue exceeds a certain dollar amount are required by law to have independent audits done on an annual basis.

Jason: It’s required that the board choose a firm for the independent audit. Our firm is DZA and they just did the report out at the last board meeting. We have a state audit every fall.

Deborah: We don’t just go, “Hey, it’d be a great idea to get audited.” It’s required by law.

Jason: We’ll have payers do audits, too. We hire a third party audit to audit patient accounts. Just at random, to check that we’re doing a good job.

Deborah: And that’s a big part of the audits. It’s not just “What are you doing wrong?” It’s like, “This is the way we’ve been doing things. Can we do it better?”

What are the challenges of finance?

Deborah: I have a huge volume of work that comes through. It never stops.

Jason: Yeah, the volume’s a big one. I’ve just learned that even though I’ll have some periods with tighter deadlines, I do what I can, and at the end of the day I go home, because it’s never really done.

Rewards of working in finance?

Deborah: I like solving puzzles. Accounting’s a big puzzle. Sometimes you don’t know what it’s supposed to look like, and I like that part of it.

Jason: Being part of a community hospital and community health care. I know that I need health care, my family needs health care, and it’s great to be a big part of this and then know the numbers, the behind-the-scenes of why we do everything.

We try to keep it improving continuously for the small community. It feels like I’m actually helping friends and neighbors, unlike a big city where it’s thousand people I don’t know. I see patients I know every day. It’s really rewarding.

What would you tell a new teammate to bring with them for a successful day on the job?

Deborah: I’d say patience and a sense of humor.

Jason: Ditto. Especially patience.

For many of us, being in a hurry with our work can create more problems than we’re solving.

Deborah: Yeah, that’s true. I usually find when I’ve made mistakes, it’s because I’ve got rushed through something.

Jason: I like to try to have a second set of eyes on things.

Any misconceptions that folks tend to have about finance that you would like to dispel here or anything that people might find interesting about your work?

Deborah: Well, I don’t think accounting is boring, but a lot of people do.

Jason: Yeah, I don’t think a lot of people are going to find accounting interesting.

Well, but they’re seeing it from the outside, right? Getting directly involved in it might make it interesting.

Deborah: I think people might be surprised to learn that just because you work in accounting doesn’t mean you don’t have to be able to relate to people really well, because a lot of what we do is talking with people. Even if most of it’s in emails and spreadsheets, you still need to be able to communicate really well to do accounting.

How does your department’s work support the KVH mission of quality care?

Jason: Well, there’s access and financial sustainability too, right?

Oh yes. Our core values. If you couldn’t afford to have the doors open. You said something before about the lights being on.

Jason: Well, timely bills keep supplies coming in and the lights on.

Deborah: And monitoring those expenses in addition to the revenue, just to make sure that we’re not paying more than we need to, that we’re not getting taken advantage of.

You also are making it so that there’s a future here. We have, like, rainy day funds and we have operating costs and, I mean, all that stuff is all, you know.(Because clearly, I don’t know.)

Deborah: And in that way it’s not a lot different than your household budget. You always have to put a little money aside because you never know when that money coming in might slow down.

Just on a much larger scale here.

Jason: Exactly.

It’s pretty important work you all do. I still don’t understand a lot of it, but I’m really glad you’re here to take care of it all.

We sat down with KVH Commissioners Matt Altman, President, and Erica Libenow, Secretary, to learn more about the work and role of the five-person board in serving and representing the community.

What is the Board of Commissioners at KVH?

Matt: It’s easy to say what we’re not, right? We are not running the hospital. We don’t hire and fire anybody except the CEO. We task the CEO with running the organization. We form the strategic goals of the organization, and oversee the administration as they accomplish or implement those goals.

Do you have different areas of focus or interest?

Matt: We take on areas based on our interests. Erica’s is community engagement. As a local doc with a small business, Bob Davis has perspective on how the business is run. And with my background in medical ethics and health care policy, I bring that interest to the board. So we each bring a certain expertise, with different perspectives.

Being able to follow your passions must make it more rewarding to serve.

Erica: It does, and the amount of material that we have learned—it’s been an education in and of itself. Just looking back on how far I’ve come is gratifying. It’s been a long process.

Matt: You learn a bunch of stuff, then you figure out that there are five other things you don’t understand, so then you go and learn that stuff. And then each one of those has five other things…

Erica: Rabbit holes in every direction.

You’re both busy individuals, why add board service to your lives? And how do your feel your backgrounds have prepared you to do this work?

Erica: I saw a need for a new perspective on the board. I asked my friends who I thought would be really good at it, but they were all very busy or had other interests they were pursuing. I thought, somebody has to do this. And then I realized that I was somebody! So I put my name in the hat.

You have your own health care background, Erica?

Erica: Not clinical, but I worked in dental and oral surgery for several years in patient relations, billing, and insurance. Now I’m going to nursing school. When I graduate in December, I’ll be looking at emergency care. Making a difference for someone in their time of need is a soul moving experience. 

And you, Matt?

Matt: I teach medical ethics to premed students at Central, and occasionally to med students at Pacific Northwest University of Health Sciences. I have an interest in issues around doctor-patient relationships, healthcare, and various other medical ethics topics. I was on the ethics committee at KVH for six years. I’ve also published a bit on healthcare. But personally, I realize how important the hospital is to the community. Both my kids were born here. I want to support it as best I can. This is my community and I want to invest my time and energy in contributing to the community; this seemed like the best way I could do that, given my background.

What does it mean to you to serve in an elected position?

Erica: I’m constantly listening. I try my hardest to be a voice for all who approach me. It’s about representation and working with my fellow board members to encourage improvement across the organization. We always strive for improvement.

Matt: We have things like Coffee with a Commissioner, where people can come and talk to us about concerns that they have. We try to represent their views as their elected representatives. But we also do what we can to shape the organization, to serve the needs of the community. We do our best to maintain high quality and keep KVH as a strong, independent community hospital.

One of our strategic plan areas is access. And so we’re trying to expand the number of services and access to those different services. We opened the clinics to new patients for the first time in many years. We’ve expanded therapy services. We have dermatology now, and occupational health and wound care. These are all attempts to serve the needs of the community as best we can.

Having all clinics open to accepting new patients is a major, visible accomplishment.

Erica: I’ve heard community members say they’re happy we’re accepting new patients. My perception is that we are approachable as commissioners and people seem to feel at ease talking with us. That’s so important, to remain receptive to people’s thoughts and ideas. It’s important to keep our ears open.

Matt: When we’re talking about fiscal responsibility, there are a couple of different ways to do it. One is to cut back and reduce expenses. But another is to expand services to meet needs and to try to keep people in the community getting quality care here rather than going elsewhere. That’s our approach, and that’s Julie’s (Petersen, CEO) approach – to tap into an untapped market, and try to keep people in the community, getting the high quality healthcare that we can offer.

How does the board help to fulfill the mission of KVH?

Matt: Well, one way is to establish the mission, right? A couple of years ago, we put together a new mission, vision, and values. The four pillars of that mission really encapsulate what the board is interested in. (1) Providing access to the community with new services and access to existing services. (2) Overseeing the financial sustainability of the organization so we can remain independent and focused on the community, as opposed to just an outpost of some larger organization. (3) Collaborating and partnering with all local providers rather than competing with them. Working together to provide the community with what it needs. (4) Engaging with the community, finding out their needs and then serving them as best we can.

Erica: When we did strategic planning and formed the mission, we sought input from the organization and community. People are invested in their ideas, so it just naturally flows that they would uphold a mission they helped create with their input. That’s a lot easier than determining a mission with no outside input and then hoping people will embrace it.

Matt: And each member of the board is tasked with overseeing one piece of that mission. We get together regularly with our partners in the administration who are carrying out the specific tasks that will accomplish those things.

What are the challenges of being a commissioner?

Erica: On a national level, health care is a bit of a swinging pendulum – it can be hard to keep up with the changes. On a local level, we must consider how change affects our organization and what we do as board members, while remaining nimble. It is a real challenge.

Matt: You have to have some decent grasp of finances, but you also have to have a decent grasp of politics and where healthcare policies are going, as well as a decent grasp of good science and what care we should be providing. You need to have some sense of HR and hiring practices, too.

Erica: It’s really highlighted to me how important it is to be a part of a team that you can trust. I’m very grateful that we have expertise in all our departments, people who know what they’re doing and can convey their understandings to the board in a way that makes sense to us.

What are the rewards of being a commissioner?

Matt: You’re actually doing something that has an impact on the community and on people’s lives. Personally, it’s rewarding because I’m learning so much and can bring my academic interest to bear on my work at KVH. What I learn here also informs the work I do on campus with students and other faculty and in my research. But the main reward is in serving people.

Erica: Serving patients, staff, and our community, knowing that the board is a way that they can have their voice heard. That’s why I set out to do this; to put it into action is rewarding.

Matt: It feels really good to work with competent people. If the board has questions, we’ll get those questions answered, clearly, in a timely manner. We know that when things come down from the CEO or the board that the people involved are going to do a good job of carrying those things out. And that amount of trust is really valued by the board.

What does it take to be a commissioner? What advice would you give on that?

Matt: Listen to what people have to say. Be inquisitive, and if you don’t understand something or you don’t agree with something, be ready to ask questions. You don’t want to be overbearing, but you also don’t want to be passive, because we do have a role to play as an elected board. Negotiating that balance can be difficult.

Erica: I agree with Matt.  Also, don’t be afraid to ask about “alphabet soup.” Maybe more than anybody else on the board, I’m like, “What does this acronym mean?” There are acronyms for acronyms! 

That’s something you have in common with many of us.

Erica: You just need to keep an open mind, ready to fill it with information. There’s so much to learn, and I don’t anticipate that that’s ever going to change. Every encounter I have as a commissioner, there’s tons of learning going on. And that’s the way it should be.

How would you like people to remember this board’s accomplishments and your service here?

Erica: As the board that was devoted to serving the community. I hope we are remembered for improving and increasing opportunities and services so people can stay local for care. We have a lot of talent here that people outside of KVH might not be aware of. When I was running for commissioner, there was this concern that KVH was going to be swallowed up by a larger entity. The community was very clear that we should stay independent, and I intend to hold that banner up as long as I serve.

Matt: One of the things that’s been a guiding principle from the beginning is an appreciation of what people do on a day-to-day basis. Those who do the work to give patients the excellent care that they deserve. Nurses and housekeeping and doctors and lab technicians and everybody else – the organization can’t function without them. So, one of the things that I want to accomplish as a board member is to turn the focus back on staff and away from administration, who are also important but already pretty visible in the community.

Erica: Can I cosign that? It’s true. And I feel that deeply – an appreciation for frontline staff and less visible heroes of the organization.

Matt: If we want to talk about strategy, I think the board is going to be remembered for being able to operate in a financially responsible way, and, as Erica said, maintain that community focus and the independence of the hospital in a time of great challenges in health care.

I was just at an American Hospital Association meeting in DC, and there are independent community hospitals all over the country that are closing. It’s incredible. There’s this great pressure to consolidate, to be swallowed up by large organizations, but we’ve hired a CEO with a very good strategy for growth and financial sustainability. We’ve increased the footprint of KVH in the community with some strategic building purchases, and we’ve increased and expanded services. So I think that our big legacy is maintaining independence while growing services in a challenging time.

Not just surviving, but thriving. Right?

Matt: Yes. And if you want to attribute that line to one of us when you write up this interview…

Anything else that you would like to add?

Erica: Just an expression of gratitude for this organization. I feel fortunate that of all the places to serve, this is the board I serve on.

It is a great place to work. Thank you both for your service.

We recently sat down with HIM employee Cindy Ness to discuss the history and value of medical records management.

Photo: Her coworkers affectionately refer to Cindy as “mother hen,” texting her when they they’re late or not coming in to work. She’s also the only HIM staffer who can keep plants alive, as evidenced by the row of (everyone else’s) plants on her desk.

Okay, let’s talk shop. What is health information management?

First we were Medical Records (MR, or “mister”). Now we’re Health Information Management (HIM).

We’re responsible for coding charts, which are turned over to the insurance companies, then returned to us as revenue. Our coders play a huge role in financial wellness of the organization. And I don’t know if enough people really understand that part of it.

Three techs on our team analyze charts to make sure they’re complete before they get to the coders. If there’s something lacking, like the provider forgets a progress note or didn’t sign something, we apply a deficiency to ensure the provider completes what they need to.

Then we’re able to pass things onto the coders. They can do their job and just code. Back in the day when we had paper charts, the coders would flag all the deficient places and hand wrote the codes. We didn’t have computers. Everything was done on ledgers, on paper. When the hospital got its first fax machine, it was in our department. They wanted a secure location for it, to protect privacy.

And that’s another part of what we do. Privacy. Cynthia Kelly, our department director, is the KVH privacy officer. She investigates potential health information breaches. Plus, she keeps us ducks going down the stream in the right direction.

Release of information. That’s another big thing we do. A patient asks for copies of their record, they fill out a release of information and we provide the copies.

I also do birth certificates. That’s really changed over the years. Before you had this big long form, you put it on a typewriter and typed it out. If you made a mistake, you start over. Now there’s a website where you securely submit the information.

Health information management is multi-layered. There’s a lot to us. We’re small, but we’re mighty.

So things come to you from various areas, departments, clinics, including external clinics?
 
Yes. If they have privileges here, we often process their paperwork, because they don’t have an electronic connection with us, so to speak. External providers can chart here in the hospital electronically, but if they have office notes that come over, we scan those in. Also, any external provider who wants lab or imaging work done and their patient chooses to have it done here, those are paper orders also, so they need to be scanned in. Anything that comes from the nursing home or even from providers from Seattle or Yakima or Spokane, if the patient lives here and their specialist wants specific tests done, we can do them here. Saves the patient from having to go out of town.

Where is HIM in the flow of patient information? You’re the last stop?

Pretty much. We really are.

And you’re housing the information, so it needs to be complete because you are retaining the record?

Right. And, if something happened incorrectly upstream from us, we catch it and then we have to figure out what happened and how to fix it, and hopefully get everybody on board in the same direction.

Now, am I misremembering that you used to do transcription?

You are correct. I used to do transcription. That was what I was hired for originally.

And was that within medical records?

I’ve been in the same department my entire career here. Which is 31 years and two months.

But who’s counting?

Exactly.

Transcription was done with a typewriter and a transcriber and a micro cassette. The providers could use the telephone. There was a series of tapes. One would kick over for recording, it would get four dictations on it and then it booted over to the ready to transcribe side. And so they were able to call from pretty much anywhere, into the dictation system.

Then it progressed to a display typewriter, and then to our first computer. Then we ended up with speech recognition. We’d read along to make sure we caught everything, cleaned it up, made sure it was accurate and everything was spelled correctly, and then that was the final product. So basically we were the gatekeeper, making sure everything was pretty and nice and correct. Then we went to physician documentation, and my role was to create the templates that the doctors used and set them up to gather all the information that was needed to make the record complete for coding and other purposes.

I miss doing transcription. It was always a challenge. I learned something new every day and I enjoyed it very much. And I know the doctors really appreciated the quality of work that we put out. That’s really rewarding, providing a product that’s correct and accurate and readable, and even though we weren’t providing direct patient care, we were that checkpoint to make sure it was accurate.

From your perspective, what are the challenges of health information management?
 
Accurate and adequate documentation. For the coders to do their job, they need to have specific items within a document in order to assess the appropriate level of care that the provider provides. And so if they miss one of those pieces, it lowers the level of care value.

What would you consider the rewards of working in health information management?

I work with an absolutely fabulous team. Everybody is so positive and upbeat. We have a real cohesiveness and it’s fun to go to work. It’s neat to watch my younger teammates grow in their careers. To see people grow and learn new things. Health information management is not static. That’s for sure. It’s ever changing. And it keeps changing.

What qualities does it take to do well in HIM? Is humor important?

Oh, yeah. When we’re reviewing charts, some of these things are pretty sad. And if you don’t have a sense of humor to balance that sadness, you’re going to be in trouble.

I would think attention to detail is important.

Yes! You have to really be on it, and don’t be afraid to ask questions to find out what’s going on.

Working in HIM, seeing all this patient information you have, you have to be a trustworthy group. You have to keep things confidential.

Let’s put it this way. My husband quit asking me, “How was your day at work?” Because I couldn’t tell him.

You were here when HIPAA laws went into effect. Was that a big change in how you did things?

No, because we already worked hard to protect our patients’ privacy. Prior to HIPAA, if you had a friend who was admitted to the hospital, they’d say “Come by and see me.” So, I’ve explained to people, “I’m trying to respect your privacy.” You have to be very careful. I’m not on Facebook anymore, but when I was, I never said anything about anybody that I saw in the hospital. You just can’t. It’s a fine line of working in a healthcare facility and being a member of a community; it can be difficult at times.

We recently sat down with KVH Medical Staff Coordinator Kyle West to learn more about the work of his department. Also present was Kyle’s predecessor, Mandy Weed, now Executive Assistant for KVH Administration.

What is your role at KVH?

I’m the Medical Staff Coordinator, which reports to Dr. Martin, the Chief Medical Officer. I serve the providers who provide care at KVH.

A lot of what I do involves helping providers apply for privileges to work here. Honestly, the more interesting angle is not what I do – which is a lot of gathering paperwork and data – but why I do it. You want to have providers who are well qualified, who’ve been checked out and are going to provide good care for the patients and the community.

We go through a thorough screening before providers come here, and a rescreening every other year when they come up for reappointment, making sure they’re still a solid provider, well-trained and doing a good job.

Are you part of the provider hiring process?

For KVH positions, candidates talk first with provider recruiter Mitch Engel. They interview, he makes an offer, and they sign a contract before he refers them to Medical Staff. Then I help with the privileging process. HR does the standard HR drug and background check, and I do an additional check of references, past employment, claims history and other hospital affiliations.

You previously worked at Community Health of Central Washington.

I was the Residency Program Coordinator for the rural training site of the Central Washington Family Medicine Residency Program. I would work with Mandy to coordinate orientation for the residents, when they would come in, and make sure that they weren’t doing rotations with the same KVH provider at the same time. I did a lot of other things, too. It was a multifaceted job, just like this one.

What are some of the other things that you do as the MSC?

I help coordinate medical staff department meetings.

Mandy: Which also involves 14 different committees.

(Gasp!) Do you sit through all of those meetings?

I do. And take minutes, and help the meeting leader put together the agenda.

Anything else?

Mandy: Kyle coordinates the medical students that come into the facility, working with the school, with Pam Lutz for current contracts, and with another person who does our insurance credentialing. He funnels all that stuff and sends it off for processing. And he’s the point of contact, as well.

Kyle: Say you’re a patient who goes to a KVH clinic, and you have Premera insurance. KVH wants the provider who sees you to be able to bill Premera. Each insurance company has their own process, so I facilitate getting the information to the companies’ credentialers.

Mandy: Kyle also coordinates provider liability insurance.  He also gets the pleasure of the on-call schedule.

Sounds busy. Do you ever get time off?

(Laughs) I’ve only been here 90 days, so, no. Not yet.

What are the major challenges of medical staff coordination?

There are a lot of demands. It requires being good at prioritizing, and a lot of attention to detail. So far, prioritizing has been the most challenging, when several people are all saying, “this is urgent, I need this now,” and there’s only one of me. I can’t do it all.

How do you keep track of your work?

I’ve got a program to manage provider privileging, and a tracking whiteboard in my office. Mandy has been super helpful in training and helping me prioritize, and gives me feedback when I miss something.

Mandy: So in Washington, providers use a WPA, Washington Practitioner Application, to apply for privileges. It’s 16 pages, sometimes more. All of that information, Kyle then takes and enters into this program, so that he can then send out peer references, hospital affiliations, insurance verifications…

Any other challenges that come to mind?

There’s a lot to learn.

What are the rewards?

It’s a nice team of folks to work with. Everybody’s easy to get along with. It’s a rewarding job, because I feel like I’m making a difference for the community and KVH.

What would you put in a go-to bag to succeed in a typical day on the job?

Mandy: Lots of patience. You’re always going in different directions. You have to be able to shift gears quickly and then get back to what you were doing. It’s very fast-paced. There’s a lot going on.

Kyle: Have a sense of adventure, and don’t be afraid to ask questions!

We recently sat down with CNO Vicky Machorro to learn more about House Supervisors at KVH Hospital. 

What exactly is a house supervisor?
The main role of a house supervisor is to ensure patients have adequate care coverage by coordinating staffing, while monitoring the flow of patients in and out of the hospital. That also includes managing employee injuries and sick calls, and even managing visitors at times.

During the day shift, the house supervisor works in collaboration with department directors. At night and off-shift/holidays, house supervisors also take on an administrator role.

When we hear a “Code Blue” or “Rapid Response” call overhead, what does that mean for the house supervisor?
The house supervisor is expected to responds to every code called at the hospital. They ensure we’ve got adequate people that can handle the situation. Sometimes they delegate tasks, depending on the code. They also set up staffing for code response, which means at the end of each shift, house supervisors assign staff to respond to codes for the next shift.

What kind of qualifications are needed to be a house supervisor?
You have to be a registered nurse, and stay up to date on certifications including Advanced Cardiovascular Life Support, Pediatric Advanced Life Support, and Basic Life Support. You also have trauma education, and neonatal resuscitation certification. Bottom line, house supervisors are expected to be able to perform to some extent in any clinical area.

What’s challenging about being a house supervisor?
It’s a multifaceted role. Boss, customer, supervisor, mediator – so you have to be able to adjust to all the different hats you may wear. And in that position they take on a large amount of responsibility, which means having broad shoulders when something doesn’t go as expected or people are discontented.

You have to be very diplomatic, you have to listen, you have to allow people to vent – and sometimes that’s all you do is listen, because you don’t have a solution. There are times when you just roll up your sleeves and get to work in uncomfortable situations. It’s part of the job.

What’s rewarding about the position?
Every day is a new day. Nothing is the same two days in a row. There are always new challenges.

What would you pack in a House Supervisor “go bag” to get through the day?
Food. A lot of times house supervisors don’t get lunch if things get busy at mealtime. Keep snacks handy to eat when you’re hungry. And I’m sorry, but sometimes it’s challenging to get to the bathroom during busy times. Or you have your phone on you but you miss calls.

You learn to be prepared and aware to take care of your daily needs as best you can. Because you’re also in a counseling type role, you need good coping skills to manage your own emotions while being there for patients and colleagues throughout the day.

We support each other, like when someone needs time to recover after a tough situation. It’s a little more challenging after hours or on weekends, but there are resources and we do back each other up.

Is it true that one of your crew also enjoys decking out the office for holidays?
Yes – and that’s great for our morale! Valentine’s Day is coming, so I’m sure we’ll see those decorations in the next week or so.

What’s it like, being the house supervisors’ supervisor?
Oh, wow. They’re a great bunch. This group has been consistent for quite some time. We haven’t had a lot of new people, so that’s good. They love what they do, they enjoy it, they’re professional, they’re very competent. And they know when to call to me about something – that’s so reassuring to me.

Did you ever do work as a house supervisor?
Yes, I did it for four years! It was my most favorite job, because you had your finger in everything. You got to know the staff. And every day is a new day.