“What did you learn at school today?”  My dad used to ask me that almost every night at dinner.  My responses varied from, “Nothing” to “Today, we dissected an earthworm, and I learned that it has like five sets of hearts!”

At the end of each day, lifelong learners should be able to answer, “What did you learn today?” with at least one concise concept.  This blog will answer the question from the perspective of what I’ve learned how Amazon uses the 6-page memo to maximize the effectiveness of their meetings.

What if every major agenda item at your business meetings were thought through extensively and thoughtfully in advance, researched thoroughly, and summarized in an easy-to-understand six page memo?

That’s the status quo at an Amazon senior executive meeting . . . and it’s not a new fad or phase they’re going through.  In fact, CEO Jeff Bezos sent this memo in 2004 to explain why he then wanted to replace the standard “PowerPoint presentations” with 4-page memos.



So, why is this 4-6 page memo concept effective in improving meeting outputs?

  • It forces deep thinking. The 6-page data-rich narratives that are handed out are not easy to write.  Most people spend weeks preparing them in order to be clear. Needless to say, this forces incredible, deep thinking. The document is intended to stand on its own.  Amazon’s leaders believe the quality of a leader’s writing is synonymous with the quality of their thinking.
  • It respects time. Each meeting starts with silent reading time.  When I asked why they don’t send out the narratives in advance, the response was, “we know people don’t have the time to read the document in advance.”
  • It levels the playing field. Think of the introverts on your team who rarely speak during a meeting.  Introverted leaders at Amazon “speak” through these well-prepared memos.    They get a chance to be heard, even though they may not be the best presenter in the organization.
  • It leads to good decisions. Because rigorous thinking and writing is required – all Amazon job candidates at a certain level are required to submit writing samples, and junior managers are offered writing style classes – team members are forced to take an idea and think about it completely.
  • It prevents the popularity bias. The logic of a well thought out plan speaks louder than the executive who knows how to “work the halls” and get an idea sold through influence rather than solid, rigorous thinking and clear decision making.

I’m going to implement a tailored version of this 6-page memo concept for our key buying or process change decisions within our Learning team. What are you doing to improve the outputs of YOUR meetings?  I’d love to read your ideas . . . and to learn from you.

Keep Learning!

For more information about the Amazon 6-page memo concept:

Who is Number One?

At Signature HealthCARE, our caregivers are #1 . . . because the people we serve are #1.

Who is #1?

It’s the “chicken or egg” question that companies struggle with:  “Who comes first, our customers or our employees?”  The answer at Signature HealthCARE is:  both.

Our caregivers truly put the people we serve first.  That’s why our Learning team decided to put those stakeholders first when we created the “Show ‘em Some Love” campaign, designed to shower the staff members of our local long-term-care facilities with acts of kindness.

The list of ideas we created to thank the care teams for their positivity and resilience ranged from delivering White Castle crave packs to sweet treats delivered, to showering them with personal care baskets.

“This means more to me than money,” said one CNA, as she enjoyed some special treats.  “It’s the little things that mean so much to us!”

Our Learning team would love to challenge other teams who support those who care for others to create their own “Show ‘em Some Love” campaign.  It’s a fun team building activity that helps to serve our incredible, loving and compassionate caregivers.

Another “Show ‘em Some Love” our Signature Learning team was for our residents.  The team went out and worked with our colleagues, at Jefferson Manor, and put in raised flower and vegetable beds for everyone to enjoy.  Jayne Bishop, SSD Success Navigator says, “Being a part of the life of the facility is my favorite part about our “Show ’em Some Love” campaign.  I miss being a part of the hustle and bustle of facility life and it’s great to give back.  I’m looking forward to visiting later in the summer to share a salad from their new garden!”


Another “Show ‘em Some Love” initiative was at our Prestonsburg facility.  When our team toured their facility, we saw the hard work CEO, Lynn Watts, and her team had personally accomplished to serve our elders.  We were impressed they rolled up their sleeves and went the extra mile to create a homelike environment.  When we took a peek into their employee breakroom, we saw a cool opportunity for our team to serve her team.  Brian Mueller, CEO Success Navigator and Nicole Carter, Director of Learning, worked side-by-side with Lynn, Cindy Porter (Quality of Life)  and Michael Crider (Plant Ops) and invested a day of painting, putting up fixtures and installing a snow cone machine to serve those who serve our elders.


“Study after study shows that job satisfaction and retention are closely linked to feeling appreciated. The better we care for our staff, the better they can care for the people we serve in our facilities.  A little kindness goes a long way in showing appreciation and support,” Signature Learning’s Instructional Designer Elizabeth Gangal said.  “And, the bonus is that it’s a fun way for us to get to know our stakeholders better.”

We can never have too many ideas for investing in our stakeholders and showing them appreciation.  I would love to hear yours!

All in,

Mary McNevin

Chief Learning Officer

Are YOU a Leader as Teacher?

It was 10 p.m. and he was still going strong. What fascinated me was there wasn’t a sleepy eye in the room, and this was the fourth night of our CEO class.


Who was teaching this late at night?

It was Signature’s CEO teaching a rigorous and challenging module on healthcare innovations, policy, and how to build an enterprise for the future. Joe Steier, CEO of Signature HealthCARE, is an example of a leader who truly teaches. Joe has set the stage for all Signature Stakeholders to be leaders as teachers. By modeling this, he:

  • Inspires everyone, from housekeeper to CEO, to radically change the landscape of long-term care forever.
  • Sets high expectations for all of us to research, prepare, and teach each other, and makes this a priority for all leaders at Signature.
  • Creates a mindset for everyone to not just teach, but to help people put on a different lens and solve problems with a higher level of thinking across the organization.

Really? Your CEO teaches a class?

Yes, all the time. He teaches all the time. Here are just two examples:

  • During our biannual CEO meetings, he teaches for at least one day. He surveys the CEOs to understand what is on their minds, tailors the agenda to their requests and the latest research, and works day and night to help our CEOs be the best in the industry. He is the consummate leader as teacher. He stays up late to prep – he never wings it with an audience, and I admire that in him. He brings the latest healthcare thought leadership to us and challenges the lens in which we see the world by diving into controversial, provocative topics.
  • Every two months, we have a senior retreat meeting where he teaches his key leadership team for two days straight. Joe poses a question on a key business issue, models it out on a white board, and shares evidenced-based research with us. He pulls us together to come up with creative, innovative, and unique solutions to problems.


Joe Steier teaching during CEO School

Joe Steier teaching during CEO School

And, he isn’t the only one!

At Signature HealthCARE, all of our leaders are teachers. Yesterday, Kathy Owens, our Chief Nursing Officer, was a leader as teacher for our Staff Development Community of Practice. Kathy prepped, prepared, and discussed clinical updates and priorities to over 50 educators across our network.

The week before, Missy Highley, our Business Development Director was a leader as teacher for our Marketing and Admissions Community of Practice. Missy brought her thought leadership on Community Partnerships and Competitor Analysis to 70 stakeholders across the Signature enterprise. What I love about Missy is how quick she was to jump in and teach – even though she is fairly new to the Signature Revolution!

I’m blessed to know a rare and gifted genius, Stephen Stocksdale, who has graciously offered to mentor the Learning Pillar team. Stephen meets with our team, usually two hours at a time, and helps us understand the intricacies, complexities, and nuances of our multifaceted business model. He is patient, thoughtful, and very skilled at taking a complex topic and simplifying it for a newcomer to healthcare to understand. He is truly one of a kind.

One of my favorite leaders as teacher is our Urban CFO, Tiffany Hoback. When I first started at Signature HealthCARE, she sat down and helped the Learning Team revamp how we teach our business model to new leaders. As we take this business model (our Data Points) to all stakeholders, she puts in countless hours as our subject matter expert. She never complains when we ask her to critique our drafts or edit our tests. She is quick to respond, eager to help, and truly a subject matter expert who is willing to teach.

There are so many leaders as teachers at Signature – I could go on and on – but there are simply too many to mention them all.   I am thankful to all of them for the preparation, delivery and willingness to share across the organization.  It takes courage, determination and a commitment to be a leader as teacher.

How about you? Are YOU a leader as teacher?

  • If you are asked to be a “leader as teacher” for a Community of Practice session, do you say yes?
  • Do you put in the rigorous preparation Joe Steier does for his sessions?
  • Do you show us, even when you are as busy, like our Kathy Owens our CNO?
  • Do you eagerly jump in to help convey new thinking to other stakeholders, even if you are new yourself, like Missy Highley?
  • Do you put in countless hours to make sure our content has rigor, is well-designed and properly delivered like our CFO, Tiffany Hoback?

If not, I’m challenging you to be a leader as teacher!   Why?  Well, there are so many benefits to your organization, your peers, and your personal brand.

So what is holding you back?
If time is your concern, I would argue that if our CEO, Joe Steier, or our CNO, Kathy Owens, has the time to teach, then you have the time to research, prepare, and deliver messages to your team, your facility, your coworkers, and your peers.

Dianne Timmering, Alicia Heazlitt, and myself in a panel presentation during CEO School

Dianne Timmering, Alicia Heazlitt, and myself in a panel presentation during CEO School

If you don’t consider yourself good at teaching, consider teaching in a format that is comfortable to you! Set up your teaching as an interview format, a panel presentation, a small group storytelling session. All of these modes can be more comfortable and more interesting than an hour long presentation. Start small, look for spontaneous moments when you can begin to teach. Don’t be afraid to work with your team and begin to teach, think, and solve problems – whether it is on a bar napkin, an excel spreadsheet, or a whiteboard! Whether you know it or not, you are always teaching!


When you are a leader at Signature, you can learn more about being a Leader as Teacher during our learnFEST Virtual Conference on November 4th from 4 – 4:50 pm. We will have Ed Betof, author of Leaders as Teachers, facilitating a thought provoking discussion on how you can be a Leader as Teacher!

Ed Betof

Ed Betof

I find every time I am a Leader as Teacher, I learn more than I ever imagined!

“When leaders master the art of teaching, they’ve laid a powerful foundation for an enduring great company.”
Jim Collins, Good to Great


CNAs are Unusual Blessings

I picked up the phone after I accepted my job offer and told my mom, “Guess what, Mom, I’m going to become a CNA!”

My mom, Ruby, was a CNA for most of her career. I remember her working third shift and coming home in time to make me breakfast before school. She was also insistent that I go to college, so when I called her to tell her I was becoming a CNA…  I really surprised her! She had already watched me go to school, then go back to school for my masters – and then go back a third time to earn my doctorate in education. So hearing I was going to be a CNA seemed unusual to her.

She was right. It is unusual. I work for Signature HealthCARE and we are an unusual company. We are unusual because our President and CEO, Joe Steier, requires ALL executives to become a CNA. Watch this video to see why I’m passionate about this “CNA Mandate” and how it is revolutionizing the way we serve our residents. As Joe Steier, President and CEO says, “This is the one thing that will make us a true servant leadership organization.”

Signature HealthCARE is unusual in that each year, the home office employees go out to work in our facilities during our Days of Service. In my experience, this is simply unprecedented. At Signature, our home office leaders work hand-in-hand with our fellow CNAs and give patients and residents care at their point of need. As our VP of Spirituality, Dianne Timmering says, “…this really ties in not just the faith piece but the works piece…we’re really walking in our people’s shoes.” I agree! To me, it is not only a chance to demonstrate servant leadership, but is a great opportunity to learn, grow and put my faith into action. I’m thankful my job at Signature HealthCARE gives me that opportunity!

At Signature HealthCARE, we recognize that our Certified Nursing Assistants (CNAs) are the primary point of care. They spend more time with our patients and residents than any other member of our care team. As leaders, we need to truly understand, empathize and respect the challenges, sacrifices and joys our CNAs face daily on the job.

Recently, I was honored to join other members of Signature HealthCARE’s leadership team in this brief video to express how proud we are of our CNAs:

So, what did I take away from the experience of earning my CNA certification? There’s not enough space in the blogosphere to share everything I learned, but here are the top three things:

  1. CNAs are masters at blessing others with their empathy and compassion. CNAs provide intimate care for people during challenging situations and make their lives more comfortable. They often provide assistance with bathing, dressing, eating, and toileting to people who cannot do these tasks alone. The ripple effect of the CNAs’ caregiving flows not only to residents but to coworkers and residents’ families.
  2. The CNA’s job is challenging – both mentally and physically. Our elders depend on our CNAs who change the lives of our residents as they care for them. When I came home from my clinical training, I called my mom and told her that I was too tired to talk with her. I was simply exhausted… drained… and worn out! My mom simply chuckled; she understood exactly what I meant.
  3. You can really “fall” for the people you care for. I got to meet some amazing elders in our Louisville South facility. I listened to their stories, learned about their children and absorbed their personal histories. Their stories intrigued and fascinated me. I simply “fell” for the people I had the opportunity to care for during my clinical training! I now know that the blessing between CNAs and the residents they serve is mutual.

photo (8)My CNA graduating class

I consider myself blessed. Blessed to be a CNA; blessed to be part of an unusual and remarkable company that values CNAs and, most of all, blessed to have a mom who was a CNA.


Servant Leadership by Example

Management expert and author Ken Blanchard says, “Servant-leadership is all about making the goals clear and then rolling your sleeves up and doing whatever it takes to help people win. In that situation, they don’t work for you, you work for them.”

In my first year with Signature HealthCARE, I’ve been blessed to see this concept lived out in countless times and in many ways.  Here are three examples that highlight this in action.

Welcoming Our New Facilities

In May, SHC purchased several new facilities to join the Revolution.  Our Learning team hosted a “Progressive Dinner” one summer evening for the CEOs and Directors of Nurses from these facilities.

Our chefs were Matt Clark, our Regional Dietary Director and Mike Jewelson, from Cherokee Park. Together, they created a menu that would make Emeril Lagasse envious.

Progressive Dinner edited

The “restaurant designers”– Nicole Carter,  Learning and Development Director; Pam Christian, Creative Programs and Events; and Ericka Holbert, HR Generalist – transformed a plain conference room into an exquisite private dining experience that would rival a 5-star restaurant.  Each table featured table-topic questions to keep the conversation engaging, and guests were pampered with professional quality wait service.

Progressive Restaurant edited

I came in early the next day to help with clean up (since cooking isn’t my forte) and met three wonderful SHC staff members Michelle Anderson, Debra Hoffman and Tamberly Bush, from our Centralized Billing Office. They eagerly pitched in and helped me clean up what one of them called a “hot mess” in no time.  Sleeves rolled up to our elbows, we were blessed with getting to know each other better . . . while serving.


Pulling Together to Make it Work

SHC’s facility CEOs relentlessly serve our elders every day.  Last August, we invited these leaders –all 87 of them—to our home office for a semi-annual CEO meeting.  Wow, what a huge opportunity this was for me to witness Servant Leadership as our team prepared for this big event.

meeting edited

Due to unforeseen circumstances, we needed to adjust our programming the Sunday night before the CEOs arrived.  This meant we had to modify our handouts and presentation materials . . . not a fast or easy task.  Paul Reid, Director of Learning Development and Technology, was at the office until 3:00 am combining, editing, and adjusting the presentations.  Working alongside him was Nicki Balz, Project Manager and Nicole Carter, Learning and Development Director, who orchestrated the compilation of binders and tested the technology.  All who worked way past closing time were a group of leaders whose job descriptions don’t include “copying and collating.”  Cheri Glass, our VP of HR, walked by the assembly process on her way home; she graciously and enthusiastically volunteered to stay and rolled up her sleeves to help assemble.  Our VP of Talent Development Jennifer Huth (who was in her first month of employment at SHC!) stayed to join the “fun.”  I can assure you that this was not the type of work we told her she’d be doing when she joined the Revolution.We also had other key leaders like Laura Brown, our CEO’s executive assistant and Tiffany Blackwell, a director from our recruiting team – all of whom stayed to ensure a successful experience for the CEOs.

The next day our amazing culinary leaders put on a spectacular dinner for over 200 guests! These leaders included Al Ales – VP Dietary Services;  Matt Clark, Regional Dietary Director;  Steve Chapman, Chef/Dietary Director – Signature HealthCare of Nashville; Mike Jewellson, Chef/Dietary Director – Signature HealthCare of Cherokee Park; Chris Farrel, Dietary Director – Rockcastle Health and Rehab; Cathy Lee, Dietary Director – Chautaqua  Rehab and Nursing;  Matt Griffith, Dietary Director – The Bridge at Monteagle; Joe Perdue, Chef – The Bridge at Highland;  Sharon McGowan, Chef/Dietary Director – Signature HealthCare of South Louisville; and Melissa Aultman, Chef/Dietary Director – Signature HealthCare of Gainesville.   The team served the same types of food we offer in our facilities and showed us how creative and ingenious our culinary experts are in the field.

Dinner edited
None of this would have been possible without a wait staff.  A host of SHC staff volunteered to serve dinner to our CEO guests – in the blazing Louisville August heat.  The service, like the temperature, was over the top.

Waitstaff edited

What I saw later in the evening helped to explain why there’s such an overwhelming environment of servant leadership at SHC.  Joe Steier, our CEO, was out there with the wait staff, scraping plates and bussing tables.  Servant Leadership by example.

No Such Thing as “Not My Job”

Our Signature Learning team recently moved into a new office space.  The learning team has a “creative team” that designs learning for our stakeholders/employees.  Paul Reid, the head of this team, has been working tirelessly since he joined SHC in January—yes, this is the same Paul mentioned earlier who stayed in the office until 3:00 am copying and collating.  That didn’t stop him from staying until midnight the night before the move in to paint the creative team’s office space!

Washing dishes, waiting tables, copying/collating, painting walls – servant leaders at SHC do whatever it takes to help people win.


Learning: It’s All About Execution

I have an amazing job.  As the Chief Learning Officer at Signature HealthCARE, I get to see our stakeholders (employees) learn and grow, every day.  What I really enjoy watching is how some people really respond to what they have learned and implement changes in their lives, operations and teams.  That ignites my passion for learning.


Have you ever been to an outstanding training session?  What made it special?  Was it the extra special touches, the content or the delivery?  I believe training experiences are only special if they compel you to implement something new or sharpen a skill.


Sure, there are many “one hit wonder” training events out there that are very entertaining.  In fact, some trainers are what I would call “eductainers.” They care about educating you and entertaining you at the same time.  These sessions can be fun and inspiring.  However, as a CLO, I’m more focused on what makes a difference for the business.   I don’t care how glitzy, jazzed up, or emotional the training was….if you are simply entertained and you go back to life as usual, then I’m disappointed that you wasted your time. … and our company’s resources.  However, if the session compels you, the learner, to do something new, then I’m impressed.

Yesterday, I got a call from one of our CEOs, Nicolle Meade, who shared with me how she is implementing several frameworks she learned in our CEO School.  I’m impressed with Nicolle because she is not a passive learner – she is a leader who is learning and applying what she learns to make a difference in how she runs her business.


Excellent leaders and learning professionals are concerned with making sure the learner actually implements what s/he commits to during the session.  As a leader of someone attending a training session, your job is to coach, encourage and expect the training participant to implement what s/he learned.

At Signature HealthCARE, our learning team builds in follow- up systems in order to help the learning get implemented, especially when the learning is new and most fragile.  We also expect leaders who sent their stakeholders (employees) to training to follow up as well.

So, when does the magic happen?  When the Learning Team and the Senior Leaders work together – this is when we truly find ways to help people implement what they learned and truly impact the business.


Leaders and learning professionals who follow up are the ones who see the highest ROI for training with their participants.  Many leaders think follow up takes a great deal of time.  It doesn’t.  It could be a quick stop to see the learner after the session and ask him/her  what s/he plans to do differently on the job.  Then, a week later, the leaders could simply sending off a quick email to ask how it’s going with the changes that were implemented.  Or, it could be asking the learner to put together an action plan and present it to his/her team at the next team meeting.  For the leader, this doesn’t take much time.  Our Signature Learning Team does follow up webinars so our cohort teams can continue to learn, hold each other accountable and continue to grow.

The commitment and understanding of Signature’s senior leaders to the value of great learning – where follow up and execution intersect—is one of the reasons I have an amazing job . . . and for that I’m very grateful.