NAB and ACHCA Urge WHO to Recognize Leadership as a Distinct Global Long-Term Care Quality Standard

WASHINGTON, Nov. 6, 2026 — The National Association of Long Term Care Administrator Boards (NAB) and the American College of Health Care Administrators (ACHCA) have submitted recommendations to the World Health Organization (WHO) urging the inclusion of Leadership for Quality Long-Term Care as a distinct standard in WHO's proposed Global Standards for Long-Term Care framework.

The WHO consultation draft seeks to establish internationally adaptable standards for the planning, delivery, monitoring, and improvement of long-term care for older people. Although the draft addresses workforce training, supervision, governance, and quality improvement, the two national associations believe it should also directly recognize the leadership competencies and responsibilities needed to translate those expectations into daily practice.

"Competent leadership is a critical part of building and sustaining quality long-term care and services to older adults," said Eric Hadley, Chair of NAB. "Recognizing leadership as a distinct global standard would affirm the importance of clearly defined expectations, continuous professional development, supportive organizational cultures, and continuity in the people entrusted with leading care services."

NAB's submission proposes adding a new Standard 17 within the workforce chapter, supported by three quality statements: defined leadership competencies; leadership for organizational culture; and leadership continuity and resilience. Its proposal draws on NAB's experience defining professional competencies, including the organization's 2026 Professional Practice Analysis, which identifies leadership and organizational strategy as separate domains of professional practice.

"Quality standards do not implement themselves," said Mark Prifogle, FACHCA, National Board Chair of ACHCA. "Post-acute and aging services executives and leaders are responsible for connecting workforce support, ethical decisions, resources, and quality improvement to the everyday experiences of the people they serve. A distinct leadership standard would recognize that responsibility and make it more visible in efforts to improve care and quality of life around the world."

ACHCA's submission supports NAB's three proposed quality statements and recommends an additional statement addressing organizational leadership accountability, appropriate decision-making authority, professional judgment, and ethical stewardship. ACHCA also proposes practical guidance on demonstrated leadership competence; safe escalation of care-quality concerns; resident-directed outcomes and workforce conditions; and responsible oversight of resources, contracted services, care transitions, and continuity during emergencies.

"Leadership accountability must be matched with the authority to act, the ability to raise concerns, and the obligation to follow through," Prifogle added. "Our recommendations are designed to strengthen professional practice without imposing a single country's licensing or organizational model on long-term care systems worldwide."

Both organizations emphasize that the proposed standard should be adaptable to nursing facilities, assisted living and residential care, home- and community-based services, and countries with differing resources and regulatory systems. Their recommendations are intended to complement WHO's existing draft provisions—not establish a universal credential or prescriptive staffing requirement.

WHO's public consultation closed October 30, 2026. Submitted feedback will inform revision of the proposed standards prior to their finalization and official publication. The associations encourage WHO to incorporate organizational leadership explicitly into the final framework.

Contact Michelle Grachek
Phone: (202) 712-9040
Email: [email protected]
Website: https://www.nabweb.org 

SOURCE National Association of Long Term Care Administrator Boards