Do the Right Thing

Growing up in a small farming community on the banks of the Ohio River, all Tracey Moorhead could think about was horses. She attended riding camp every summer, and she convinced herself that a horse would be her gift when her parents decided to build a new home on a piece of property with an old barn just before her 9th birthday, never considering that the barn’s dilapidated state made it unfit to house one. It seemed natural, then, that when Tracey reached high school and was presented with different educational opportunities, she wanted to attend a boarding school in Pennsylvania that allowed her year-round access to riding.

Tracey’s mother, however, had other ideas, ones that would send Tracey far beyond a neighboring state and change the trajectory of her life more than she could understand at the time. Tracey instead enrolled at a Switzerland boarding school at 15,and while she often felt out of place among the children of monied families from around the globe, Tracey returned home with fresh appreciation for all the world outside Portsmouth, Ohio, had to offer.

“My mom wanted to get out of Ohio, and she felt stuck having kids. She was not going to see me make the same mistake,” Tracey says. “Her tactic worked. My worldview completely changed. I said, ‘I want more than this,’ and I started to think about how to get out.”

Tracey was happy to re-immerse herself in the more traditional high school experience upon her return to Ohio, taking a part-time job at a hair salon, attending football games and even serving as class president. But upon graduation, she followed through on her promise to herself and became one of just a few students from her graduating class of 1985 to pursue college out of state. She moved to Washington, DC to attend George Washington University, sight unseen. After graduation, Tracey discovered a passion for non-profit work that persists today after taking a temporary job at the National Association of Attorneys General (NAAG) to get by for a few months after graduation.

“I loved their mission, and I loved the cycle of work they did, the annual meetings and the budget development for the coming year,” Tracey recalls. “These are really arcane things that happen in non-profit organizations, but I found them fascinating, interesting and invigorating. Of course, they wanted to make a profit every year and build up their reserves and ensure they were a fiscally sound organization, but they weren’t focused on shareholder value. They weren’t focused on financial return on investment. What they were focused on was doing good for their members, and they did that in many ways – through advocacy, communications and other work that served communities at multiple levels.”

Now over 30 years into a career in non-profit leadership, Tracey serves as the President and CEO of the American Association of Post-Acute Care Nursing (AAPACN), an association providing developmental resources and continuing education to more than 20,000 post-acute care nurses in over 7,500 facilities across the country.

Though Tracey had manned the top job at healthcare-related associations for the better part of the past three decades, landing her role at AAPACN did not come easy. Some on the board insisted that the leader of the organization comprised of nurses needed to be a nurse themselves, but it did not take long for them to soften their stance once Tracey strolled into AAPACN’s Denver headquarters and simultaneously laid out her vision for the organization and deftly fielded the board members’ thoughts on the changes they wanted to see within the association.

“I don’t have a good poker face,” Tracey admits. “I tell people what I think. I basically said, ‘Here’s what I’ve observed about your organization. Here’s what I think you need to do and here’s how I would do it and here’s why I would be a good person to do this.’ “I had to demonstrate that I could lead and think strategically for their members despite not being a nurse. But the role of an association CEO is not to tell, it’s to listen and lead. It’s to gather information and put the organization on a path to accomplish the goals of the board. My plan is ultimately irrelevant. You tell me the what, and I’ll show you the how.”

The interview experience at AAPACN is a perfect encapsulation of the leadership philosophy Tracey has embodied throughout her career: “visionary servant leader.” 

“A lot of people say you can either be a servant leader or you can be a visionary leader,” Tracey says. “In the association world, the belief is that you're either a servant of the board or a leader of the industry association. I find that to be a false premise, because my role is to help the board envision the future they want to achieve and then work with them to make it happen.”

Such has been her task at AAPACN, where she’s worked with the board to implement a shift in organizational strategy upon taking her position in 2018. Founded in 1999, AAPACN quickly became a leading force in post-acute care nursing education and credentialing. The association grew to more than 10,000 individual members by the time Tracey came aboard, giving her the difficult task of balancing growth with preservation of the association’s sterling reputation among its close-knit members.

“How do we make this organization sustainable?” Tracey asked herself. “How do we grow beyond the vision of the founder but recognize the legacy in the community of nurses and the quality of education that at the end of the day is focused on improving patient care? The board really endeavored to serve the broader nursing community that served other post-acute care settings including home health, hospice, inpatient rehab and hospitals.”

Tracey set out to tweak AAPACN’s business model, shifting focus from individual memberships to incentivizing facilities to provide its nurses training and education via AAPACN membership. The change led to explosive post-pandemic growth beginning in 2021, and the association is now represented by more than 20,000 members in more than half of all skilled nursing facilities nationwide.

“We now go to the facilities and say, ‘Here is the quality improvement of patient care that you can realize through giving your nurses our education,’” Tracey explains. “We can demonstrate that having AAPACN-certified nurses in the building improves Federally-monitored quality measures. It’s also a recruitment and retention tool. If you are a high-quality building, more people are going to want to work there. And if you want to keep those people, you will continue to give them educational resources and you will pay for them to get it. In the current environment in which there is an unbelievable shortage of nurses who want to work in skilled nursing facilities, you want to do everything you possibly can to get and keep your nurses. Giving them education is the way to do that.”

Long before she sat at the helm of national organizations, Tracey was a familiar face throughout her childhood in the Ohio-Kentucky border town of Portsmouth due to her parents. Her father was the third-generation town dentist and formerly the valedictorian, senior class president and basketball team captain at East Portsmouth High School, where Tracey’s mom was the homecoming queen and head cheerleader.

“I always imagined them as quite the power couple of their time,” Tracey says.

Tracey enjoyed an idyllic childhood and filled her time riding bikes, listening to music and playing in nearby nature with friends, but things changed when her parents divorced when Tracey was 10 years old. Tracey was forced to grow up quickly.

“It was an era where parents weren’t hyper concerned with their kids,” Tracey remembers. “The stereotypical first-born child is the one who gets stuff done and figures things out, and that was definitely me. I could do for myself and didn’t need help. From the time I was 12, my brother and I were pretty much on our own. I started driving at 14. We had a charge account at the grocery store, and I did my own grocery shopping. I’ve really been in charge of myself since then.”

Tracey made the most of her time in Ohio after her return from boarding school in Switzerland. She threw herself into any and every activity she found interesting, from 4-H baking and sewing competitions to editing the high school yearbook. She also spent many hours at her grandparents’ house, and her object of greatest personal importance is a set of ceramic giraffes once perched on her grandmother’s mantle that now sit in a similarly prominent place in Tracey’s home.

“These giraffes are so important to me not just as a reminder of my grandmother, but as a reminder of all of the times in that house,” Tracey says. “That was the house where we had Thanksgiving and Christmas Eve every year. As a child, this house is where I spent almost every Saturday night and almost every holiday. That house was really my happy place as a child. It’s where I felt safe and happy and loved and had this routine that I absolutely cherish. These giraffes are part of that.”

Dead-set on spreading her wings after her experiences in Europe, Tracey did not apply to any Ohio colleges and instead landed at George Washington University in Washington, DC. She had never visited the nation’s capital before her dad packed his car with her belongings and made the drive east to drop her off at school, and while she enjoyed her studies and activities, she found the people off-putting compared to the friendliness of those she was used to back home.

“I have no recollection of how GW came onto my radar, but I got in and there was just no doubt in my mind that’s where I was going to go,” Tracey says. “It was not the right school for me in retrospect. I wanted to leave Ohio, and I was more focused on leaving than the destination.”

Tracey picked GW in part because her sights were set on a post in the foreign service, another wish inspired by her time spent living abroad. She devoured the copies of The New York Times and The Washington Post that were delivered daily to her dorm room, and she was passionate about her studies. But when the time came to apply to the foreign service, she was not conversational enough in Russian to pass the language exam.

“The demoralizing and depressing reality for me that I wasn’t going to pass the foreign language exam necessary to become part of the foreign service corps was really life-altering for me,” Tracey says. “I had to find a job, and I didn’t know what I was going to do. I had a degree in International Affairs with a focus in Soviet foreign policy, and at the same time, the Berlin Wall was coming down and the Soviet Union didn’t really exist anymore. I had a degree that wasn’t entirely applicable to a lot of things happening in the world then.”

Tracey came close to throwing up her hands and returning to Ohio given her discouraging career prospects, but her father made clear that was not an option and that she needed to stay in DC and figure things out. Soon after, she landed a temporary job for a secretary on maternity leave from the National Association of Attorneys General.

The job proved a turning point for Tracey. She was tasked with working under the executive director and the second-in-command who oversaw federal legislative affairs, both of whom were women. Such an opportunity was rare in the 1980s, and Tracey ultimately stayed for more than a year when the woman for whom she temped did not return to the firm.

“This was my first exposure to the federal government at this level, because I’d been so focused on international relations in my studies,” Tracey says. “This was learning how the federal government developed policy and how the states influenced that policy. It was so educational. I probably learned more in my one year at NAAG than I did in my four years of college. This was the real world.”

Tracey jumped from NAAG to become a legislative assistant at a law firm where she was tasked with roaming the halls of Capitol Hill attending hearings and meeting with members of Congress, and she parlayed that experience into larger roles at other firms where she spearheaded legislative work at the state, federal, and international level for each firm’s association clients.

Tracey draws on her own early career experiences when giving advice to young people entering the workforce today.

“The most important piece of advice ever given to me is to be a duck. Let it roll off your back like water off a duck’s back,” Tracey says. “Keep it focused on the work. But, at the same time, stand up for yourself in a way that is appropriate, not in a way that is reactionary. I took things personally early in my career. Just let it go. You cannot fixate or dwell or carry or respond.”

Her first opportunity to lead an association came in 2000 when Tracey headed a coalition of 40 healthcare organizations advocating for Medicare prescription drug coverage. Though passage of the bill was delayed until 2003 by the Sept. 11 terrorist attacks, the prescription drug law championed by the coalition brought about the first major change to the Medicare benefit since the program’s inception in 1965.

“It was invigorating and exhilarating work,” Tracey recalls. “To understand the impact that benefit had on seniors across the country who previously had to pay out of pocket for every prescription they had and suddenly had up to $2,300 per year for prescriptions was amazing. I had old ladies cry in front of me when we told them their co-pay was now $5 per month.”

Tracey then jumped at the opportunity to build an association from scratch for the first time, and she dedicated the next eight years of her career to the mission. She and the association parted ways, however, when she became frustrated by how some members were putting their own company’s profits ahead of the organization’s mission. Walking away from the work she had put proverbial blood, sweat and tears into was a professional gut punch for Tracey, one she credits her husband Mark for helping her persevere.

“He made me see that it wasn’t me, that I was not the problem,” Tracey says. “His unwavering support of me was one of the things that convinced me that he was the person I was meant to marry. I had never had that level of partnership or support from anyone in my life before.”

Every setback has a corresponding lesson to be learned, and for Tracey, the lesson is one she sums up in only four words and carries with her through her daily work on behalf of AAPACN members across the country: do the right thing.

“My right thing might not be your right thing, and I recognize that,” Tracey says. “But for me, if I’m in a situation in my career or in my personal life, I always come back to, ‘I might not want to do this, but the right thing to do is this.’ It may be harder than the easy thing, but the right thing is still the right thing.”