Mr. Sedgwick speaks truth – the industry would fare better under a decentralized leadership structure. However, while some providers are out pioneering the model, there are many other stakeholders who have yet to get on board. Regulators in particular seem to struggle with it, as they like the “comfort” of knowing that some smart person in a remote corporate office is pulling all the strings – and they can go to that person if they perceive a problem.

That’s fair, but how much easier, more logical and more efficient would it be for that regulator to go directly to the facility with their perception, and discuss it directly with the ultimate decision makers – the facility leaders? If it’s real results they want, that’s where they’ll usually get them best and quickest -- as long as those leaders have real authority and are accustomed to using it.

I applaud those who are moving the industry toward a more empowered, decentralized leadership paradigm. While such a structure is not for everyone, those who are charged with overseeing the industry should give full consideration to the tremendous opportunities for improvement that such a system represents.