Wellington is very excited to be part of the ReadersMagnet’s Author’s Lounge, as she uses this opportunity to reflect back on her road to becoming a writer. Early in her career as a Licensed Nursing Home Administrator, Nora Wellington was very fortunate to be hired in 1996 to help a teaching hospital in Washington, DC open a brand new hospital-based skilled nursing facility (SNF). The hospital had as part of its strategic plan the goal to expand its continuum of care to include post-acute care in the community. As the licensed nursing home administrator hired specifically to work with the hospital’s project Director to accomplish this project, Wellington needed to ensure that she knew the Centers of Medicare & Medicaid Services requirements of participation for the Medicare & Medicaid programs, the Federal Long term Care Regulations, the District of Columbia Long Term Care Regulations, The Fire and Safety code and requirements and other related laws and regulations. The three pivotal people in the team working on this project were the hospital Assistant Chief Nurse, who was the project director for the project, a newly hired director of nursing for the skilled nursing facility (SNF) and Wellington.

This was an exciting time, as the licensed nursing home administrator, Wellington needed to prove that she knew her regulations (federal and state), that she can write administrative policies and procedures related to the regulations, and that she can work with the director of nursing who wrote the clinical policies and procedures. They also brought on board the medical director for the SNF because by law and regulation the hospital’s medical director cannot serve as medical director for the SNF. All Federal and State long term care regulations must have corresponding policies and procedures, and as Wellington was supposed to have the expertise in this area of long term care, she was the go-to person so she needed to know her stuff. Three of us, the newly hired director of nursing, the project director of the hospital, and her were developing all these policies and procedures, and the clinical resident care policies were also reviewed by the medical director. They did not use pre-written policies and procedures. It was a lot of hard work, and they successfully completed the task, presented the policies and procedures to the State Department of Health Certification and Licensing Agency for review and approval. The team also made sure that the SNF distinct part of this hospital-based facility met the building and fire code for the Fire Marshall.

In addition to developing and writing the policies and procedures, Wellington also developed training materials on LTC Federal regulations for education purpose to present to acute care physicians, resident physicians (as this hospital was a teaching hospital with a medical school), and the acute care nurses who were slated to work in the hospital-based SNF. The skilled nursing facility was in a distinct part of the hospital, and as the designated administrator for this SNF distinct part, Wellington made sure all participation requirements for Medicare& Medicaid program was met for the initial state survey. Through team work and hard work, all requirements were met and the brand new hospital-based SNF facility opened its door as a Medicare/Medicaid facility in 1996. This became one of Wellington’s greatest accomplishments as a nursing home administrator. It is gratifying to read other authors’ stories in the “Author’s Lounge” and to know that ReadersMagnet resources contribute to some of the authors’ stories including mine. Wellington served as a hands-on administrator at this hospital-based SNF for eleven years, working with the staff to provide quality care for the residents. A year after Medicare & Medicaid certification, Wellington went after Joint Commission (JCAHO) long term care accreditation. She again had to write policies and procedures, making sure the requirements for long term care accreditation were met. She trained the staff for administrative policies and administrative requirements. The director of nursing in collaboration with the clinical director of the Staff development did training for nursing staff. The facility successfully acquired its joint commission long term care accreditation. 

Through the years Wellington spent time on the unit interacting with the residents and the staffs, and this gives her the opportunity to observe first-hand the operational and clinical services and care the staff provide for the residents. Now as a long term care management consultant she develops and presents educational in-services for facilities needing to clear their survey deficiencies and meet the timeline for their plans of correction. As a consultant interim administrator she finds great satisfaction in working with corporate leadership and owners as well as working with the facilities department directors for operational efficiency. 

Looking back at all the educational in-services she had provided for staffs at all levels in facilities where she worked as a permanent administrator and in facilities where she consultant and interim administrator, becoming a writer on long term care regulations and on quality of care and life for the resident seem like a natural progression. Wellington is hard working consultant, she is caring, dedicated, and committed to developing facility leadership teams to focus on quality, teamwork, regulatory compliance, survey preparedness and customer service. She believes in personal growth and self-development. She has designed monitoring tools for use internally in the facilities. She trains staffs at all levels in addition to the facilities’ staff development programs, and she uses opportunities to help staffs as much as possible meet their personal and professional goals. She consults for national, regional, and local long term care organizations, and she and her company, N Wellington Associates, www.nwellingtonassociates.com receive positive feedback and commendations from owners and corporate leaders. She thanks “Authors’ Lounge” for the opportunity.

She completed MBA from George Washington University, Washington, DC; did course work on Gerontology, Ageing & Disability, and long term Care administration, etc. at University of Maryland, University College. Wellington is a member of the District of Columbia Health Care Association, LifeSpan Network, and American College of Health Care Association.

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