Crisis Management

Over the last few weeks, as you might imagine, the number one, two and three topics many of my “coachees” wish to talk about is the Coronavirus (Covid-19). Many of the leaders tell me that there is not a rule book for this and that things are moving so quickly. Their teams and staff are looking to them for guidance, advice and direction. They have been in countless meetings with clinical leaders, constantly watch and read the news and updates and are calling other leaders for reassurance and confirmation that the steps they are taking are in line.

Do we cut travel? Do we let people work from home? Should we pay those who cannot come to work? Have them take “Paid time off”? How do we protect our staff visiting clients in nursing homes? In patient homes? With patients who have the virus. What if we cannot pay all our bills as revenue decreases?

These are just a sample of the questions many of the leaders and I have discussed.

Over my almost 40 years as a leader (about 25 as a President or CEO), I learned a lot of lessons. Many the hard way (through mistakes). And my teams and I faced some significant and unplanned challenges over those years.

Events that come to mind include the impact of Superstorm Sandy in New Jersey, tornadoes in Oklahoma and Texas, Hurricane Katrina in the south, Earthquakes in California, Y2K preparation, Hurricanes in Florida, EBOLA, SARS, 9/11 and the advent of AIDS in America. In addition, we tragically lost key staff and their family members to various accidents, illnesses and even suicide. Financially, we took over bankrupt companies to try to save them, had our main funding source fail one week before payroll and lost key referral sources.

These were all challenges we had to face. Some like Y2K allowed us to build contingency plans while most were events that suddenly happened over the course of days or weeks, with no warning. Our business lives were turned upside down via a phone call, letter, text, email or by CNN “breaking news.”

As I think back on all of these and I counsel my leaders via coaching today, I learned many lessons while facing these challenges. Here are a few of my lessons learned (remember that some were as a result of mistakes I made early on):

Be Visible! Constant communication is critical.

Be Transparent. Share good and bad news. Your staff can handle bad news. People fear what they don’t know.

Be Consistent: We set up update calls on a regular basis at consistent times.

Self-Sacrifice: This is good time to remember that leaders “eat last”. There were times when the leaders postponed or even skipped their paychecks so that all employees could get theirs.

Provide Vision: People in a crisis need to be able to see what you see. They need to know what steps are being taken and where they are headed. I recently read a quote from a book entitled Canoeing the Mountains that said, “There is perhaps no greater responsibility and no greater gift that leadership can give a group of people on a mission than to have the clearest, most defined mission possible”.

Remember your values: This is the time to stay true to your values. We had two main values: “Treat every patient like a loved family member” and “Always Do the Right Thing”. Hold true to your values no matter how hard circumstances and challenges get during the crisis.

I end this leadership letter with an event that took place about twenty years ago. I took over the reins of the one of the largest home care companies in the United States. We had hundreds of locations and about 10,000 employees. Daily, our incredible staff visited thousands of home bound patients regularly across the country.

Unfortunately, due to reimbursement changes and various other prior leadership decisions, the company was bankrupt. The main “bank” hired us to either turn the company around or to close the doors. It was a daunting task.

Just a few months into my tenure, that same “bank” failed. Can you believe it? Could it get much worse?

One afternoon, we received an email followed by a phone call, saying that there we would no longer have access to our accounts including our payroll fund. We were locked out! No money.

Now this institution also served many other health care entities including hospitals, doctor practices, home medical equipment companies and the like. Probably close to 50 other different companies. We were all shocked by this development.

As if it were yesterday, I remember calling my leadership team into my conference room and after a few minutes of quickly working through the stages of grief, we developed a plan of action. It included all my key points mentioned previously. We had about 72 hours to figure out how we would get everyone paid on Friday. If we failed, not only would we probably lose many of our caregivers due to our inability to make payroll, but this would impact their families greatly. We may have had 10,000 associates but we were responsible for feeding 30,000 to 40,000 mouths! Not to mention the patients they served.

We finalized our plan and started executing on it. We called all the states who through their Medicaid program owed us money (many were not due yet). We talked with our vendors and landlords and asked for extensions. And we reached out to our incredible attorney and sought his help. He was and to this day someone I will always remember as a father-like figure, a strong believer and a cool head. He went to work petitioning the courts to get us emergency access to our funds.

Some of us did not sleep a few of those nights. It was stressful. We triaged who would get paid on the event we came up short. We would pay the hourly, low income staff first. Then the caregivers (nurses and therapists), then the corporate staff and finally the leadership team. I was last to get paid if we ended up short.

We kept a running tally on my white board as to where we were in cash versus where we needed to be (and by when) in order to make payroll.

With 3 am Friday morning deadline quickly approaching things looked bleak. We had done everything on the action plan, but we were still $300,000 short. We had heard from all the states except Kentucky. Their fax telling us how much they could send was delayed. My financial leader (Ellen) and I stood by the fax machine at 2:45 am as it sent over the letter telling us that they would only be able to wire us $50,000. We both put our heads down in disappointment. Tears flowed for both of us. We were going to miss payroll.

As we started to walk away from the fax machine and turn off the light in the room, we heard that glorious sound that a fax machine made in those days. It was a second fax from Kentucky. They had erred and were not wiring $50,000 but, they were wiring $250,000! That second fax changed everything.

We quickly realized that 99% of the workforce would get paid in just a few hours. (Some of the senior leaders delayed getting paid that week). We did it. We climbed an insurmountable mountain and survived.

The next week, our awesome attorney succeeded in getting our funds that were owed to us. Out of all those companies, only three of us survived. He was and is one of my heroes in my life. And so are the leaders who helped us not only to save that company but to help it to thrive. It is still in business and is even much larger and more successful today.

Be visible, be transparent, be consistent, provide vision, stay true to your values and most of all, breathe. This too shall pass.

Here are some lyrics from a 2012 song by country artist, Gary Allan.

He reminds us of this:

Every storm runs, runs out of rain

Just like every dark night turns into day

Every heartache will fade away

Just like every storm runs, runs out of rain….

Thanks for reading this.

With a goal to “help the next one in line”, Glen Cavallo, a 30+ year healthcare executive has chosen to share the many lessons he has learned with others. Glen does this by serving as a coach/advisor to leaders at all levels of organizations, as a board member and as he presents inspirational speeches at regional, national, annual and awards meetings.