Loretto’s Innovations in Leadership Strategy Maximizing Clinic and Operational Expertise in Today’s Changing Healthcare Environment

By: Becca Taurisano

L-R Lori Sakalas, COO and Dr. Joelle Margery, CNO

In response to the evolving and complex changes in a post-COVID healthcare world, Loretto Health and Rehabilitation installed two members of its leadership team in new roles to guide the future of eldercare in Central New York. Dr. Joelle Margery has been promoted to Chief Nursing Officer of Skilled Nursing, bringing her experience as the former Vice President of Skilled Nursing and newly achieved Doctorate of Nursing Practice to the role. Lori Sakalas was hired in February 2022 as Chief Operations Officer, bringing her extensive healthcare administration and operations expertise as the former Vice President of Operations for Guardian Healthcare in Pennsylvania. Together, Margery and Sakalas will work collaboratively to ensure seamless operations and efficient care, while maximizing their clinical and operational expertise in today’s changing environment.

Sustaining Healthcare in Challenging Times

The healthcare industry is facing a significant staffing shortage, thanks to the pressures of the COVID-19 pandemic, but Margery and Sakalas are prepared to meet the challenge in new ways. Part of that is keeping recruitment and retention plans at the forefront of their focus and empowering Loretto employees to be part of the solution. “Our employees are vital to running a successful referral program,” says Sakalas, ”potential employees are more likely to respond to someone they know.” Loretto is seeing an increase of applicant flows when their employees are fully engaged in the recruiting process, such as higher numbers of employee referral submissions and an increase in candidates attending hiring events. In May, Loretto launched the “Amazing Race” program which asks employees to give leadership 4 or 5 names of potential employees they know personally who would be interested in hearing about Loretto’s services and benefits. Reaching out to the community for potential employees is part of the plan as well. Loretto recruiters go on college campuses, work with nursing programs for clinical rotations, seek out high school students and reach out to local refugee centers. “We try to work with individuals who have that heart for healthcare and want to work in our industry,” says Sakalas.

“The critical workforce shortage is the biggest challenge we are facing today,” says Margery. To combat this, Margery and Sakalas are looking at growing and promoting Loretto employees from within, mentoring them for success in their current role and assisting them to advance into other roles. Loretto offers mentoring programs for employees to pass their Certified Nursing Assistant (CNA) or Registered Nurse (NCLEX-RN) exams and leaders encourage employees to seek out opportunities in other areas like social work, dietician, operations, and administration. “We recognize that individuals want to be part of a career path,” says Margery, “we guide them on how to move forward in their career.”

Many of Loretto’s 2,500 employees are single mothers or support extended families and are unable to attend school full-time without an income. To meet their needs Loretto, offers a Licensed Professional Nurse (LPN) apprentice program, the first in New York State to be approved. While attending the program, employees attend classes as well as receiving on-the-job training at the Loretto facility while earning a paycheck. “Our program gives them support while they are in school so they can be successful, we incorporate emotional intelligence and leadership traits which are not taught in schools,” says Margery, “they can support their families while advancing their career goals.”

Supporting the Community

Loretto is always looking to support Central New York and surrounding communities with innovative ways to provide care, including a recent expansion of their sub-acute care units. Having found a need to care for a more clinically complex patient than they have in the past, Loretto has opened their Restorative Care Unit (RCU). “Hospitals are under duress with a shortage of beds and staff ”, explains Margery. If Loretto can take those patients and provide a hospital-level of care, hospital community partners benefit. “We are working to ensure those individuals can get a hospital bed in the community where they live,” says Margery, “when we can step in, it helps the community, it helps the hospital partners, and it helps healthcare in general especially with cost.”

Loretto’s 19 locations offer a continuum of care to their nearly 10,000 residential and home-based patients, whether that is skilled nursing, assisted living, independent living, or in-home care through their PACE program. “Our services allow patients to stay in their home if they so choose, while receiving the community-based care they need,” says Sakalas.

In December 2020, Loretto opened a COVID-only building that served many surrounding communities with a little over 300 admissions. “When there is a need in the community, we are often the first reach. If we are able, we will provide the support,” says Margery.

In December 2021, the Department of Health asked Loretto to take short-term rehabilitation patients because the hospitals needed to free up beds to take additional COVID patients. Based on Loretto’s proven track record to be able to implement plans effectively with positive outcomes, the Department of Health allotted 18 National Guardsmen to serve as Certified Nursing Assistants at Loretto during this time. “I am always open to initiatives to promote the well-being of the communities we serve,” says Margery, “as a nurse it’s about the patient, the community and the employees.”

Recently, Loretto evaluated the need in surrounding communities to provide care for patients with both dementia and a psychiatric diagnosis. “This is a very specific population of patients to care for,” says Margery, “and no center of this kind currently exists in our area.” Margery says Loretto is planning to open a center to care for those patients in 2023.

Leading By Example

Sakalas began her healthcare career 25 years ago as a nursing assistant working her way through King’s College in Wilkes-Barre, Pennsylvania. She grew up in a close-knit family and seeing the challenges her grandparents faced, inspired her to help make the last years of their life as enjoyable as possible. After working her way through various administrative and operational roles with Genesis Healthcare, Guardian Healthcare, and Golden Living, she never lost sight that care for the patient comes first. Sakalas says Loretto’s history in the community, starting in 1926, and mission to provide exceptional care to families, aligned with her personal and professional values. Sakalas says, “We cannot expect from our team what we do not expect from each other. Our team needs to feel we are right there with them, that we believe in them and respect their opinion. At the end of the day, we know we can get through anything.”

Margery came to Loretto 15 years ago as Assistant Director of Nursing. She holds an Associate’s in Applied Nursing from St. Elizabeth College of Nursing in Utica, a Bachelor of Science in Nursing from Southern New

Hampshire University, a Master of Science in Nursing – Clinical Nurse Leader from Southern New Hampshire University, and in March 2022, awarded the Doctorate in Nursing Practice (DNP) from Capella University. “I’ve always been a caretaker,” says Margery, “the ability for us to provide care that is not typically done in the post-acute care world, that’s empowering. I want to push the limits and do at Loretto what nobody else in the community does. We are afforded the ability to think outside the box here.”

Both Margery and Sakalas are hands-on leaders, stepping in whenever their team needs their help. Leaning on their experience in the healthcare industry, they can relate to the challenges their employees face. “As leaders, we respect everyone no matter position or title,” says Sakalas, “we are motivators and inspirational leaders to our team because we have done what they do and we are right there with them.”

When New York State Department of Health regulatory requirements required employees to be COVID-tested twice a week, Margery stepped in to help with testing. “Knowing my team had their own fears, I couldn’t have my team test staff without me being there,” she says, “I was part of the team doing testing for a year. If your employees see you alongside them, they are more likely to do it also.”

Adapting to Change in Creative Ways

Creativity and thinking outside the box are critical to sustaining the healthcare industry during these challenging times.
Part of that is being flexible with their workforce, says Sakalas, working with the unions on scheduling and listening to their employees on what work-life balance they need. Loretto is embarking on a new Diversity, Equity, and Inclusion (DEI) initiative after surveying employees at the end of 2021. Earlier this year, senior leaders engaged in a 10-week comprehensive DEI training program. Next, training will be delivered to managers and they will initiate learning circles with frontline employees. Once education is complete, Loretto leadership will formulate action plans to improve employee experience with regards to DEI.

In order to provide leaders with the skills they need to lead teams during this time of tremendous change, Loretto is providing a manager training program, as well as investing in certification programs for frontline workers to develop specialized skills in areas like dementia care and food service to create career paths to improve retention.

Margery and Sakalas are dedicated to continuous improvement and look forward to collaborating on initiatives to support patients and employees. With four decades of experience between them in the healthcare industry, their combined operations and clinical experience gives them a solid foundation for building a bright future at Loretto. 

“This partnership between our clinicians and operations will be the key to operating smarter, innovating faster, and creating a cohesive care environment that grows our staff while providing the highest quality of care.” Lori Sakalas, COO