What Does a Nursing Home Administrator Do?

Nursing home administrators maintain the business and organizational side of long term care facilities. But they are also involved on the personal level, focusing on resident care. Above all, the top priorities are quality and safety. To achieve them, NHAs must pair leadership and financial skills with a thorough understanding of the aging process and medical industry.

The need for nursing home administrators is increasing. The Bureau of Labor Statistics projects the field of healthcare administration to grow three times faster than the national average over the next ten years—and long term care is a critical part of that sector. The CDC estimates there are already roughly 1.4 million nursing home residents. And according to the US Census Bureau, the number of people aged 65 or older is projected to double over the next four decades.

While the minimum level of education necessary to work in this field is a bachelor’s degree, many NHAs go on to earn master’s degrees—usually an MBA or an MHA—to gain the executive level knowledge necessary to run a large and specialized, healthcare organization. They’ll also need to be certified and licensed by federal and state jurisdictions. Continuing education and professional development are also critical in staying up to date on the vast range of evolving issues involved in the management of long term care.

Nursing home administrators take care of a cherished, fragile, and growing segment of the population. They do so with a mixture of warm compassion and keen intelligence. Read on to learn more about how this job looks in practice.

Nursing home administrators oversee a wide landscape of differing terrain. They manage a long term care facility’s staff—from hiring, training, and evaluation, to scheduling. They also take control of the organization’s finances and design budgets, manage billing and reimbursement, monitor payroll, and report to board-level governance. And they ensure that the facility is complying with federal and state regulations in the delivery of care, in the safety of the building, and in the security of patient data.

But a career as a nursing home administrator is not all business. It’s primarily about people. As a resident’s primary advocate, NHAs often serve as a liaison between staff, residents, families, and doctors. This goes beyond the purely physical aspect of caretaking, as social and emotional dynamics, as well as the grieving process, must be taken into account during an individual’s transition to a long term care facility.

Nursing home administrators are often expected to know and do it all, but where one chooses to focus their education can provide a form of specialization. Some typical areas of expertise may include:

• Healthcare Financial Management. The numbers have to add up. Keeping a long term care facility viable requires shrewd financial ability and a prudent distribution of resources. Juggling the balance sheet between shifting reimbursement plans and fluctuating operational costs is critical for the consistent delivery of care.
• Legal Issues in Healthcare. The legal landscape of healthcare is always changing. Nursing home administrators are responsible for keeping a long term care facility in compliance with state and federal regulations. With higher levels of education such as doctorate or law degrees, they can also advocate for nuanced and impactful changes at the highest levels of the industry.
• Gerontology. Nursing home administrators need a thorough understanding of the aging process, both in physical and psychological terms. They need to be well-versed in the technical jargon of the medical field as well as speak the compassionate language of the counselor, while acting as a bridge between patients, families, and staff.
• Personnel Management. Some understanding of human resources is a prerequisite for nursing home administrators. Hiring, training, scheduling, and evaluating staff is just one aspect of that. Leadership and mentorship are crucial to the ongoing success of a long term care facility.
• Healthcare Informatics. An increasing reliance on electronic health records means that nursing home administrators already need some modicum of IT ability at their disposal. But more long term facilities will be seeking out subject matter experts in data management, utilization, and securitization as this trend continues.

Nursing home administrators are generally employed by long term care facilities. Broadly speaking, that includes nursing homes. But it can also include more specialized long term care such as facilities for patients with Alzheimer’s or other conditions that require a specific environment. In some cases, nursing home administrators might even be employed by nonprofit or public sector organizations to lead policy changes and advocacy efforts for long term care facilities and their residents on a broader level.

The day-to-day tasks of a nursing home administrator can vary depending on the size, setting, and exact type of facility. However, even in the same facility, administrative needs can differ from day to day. Here are some typical activities a nursing home administrator might perform:

• Implementing facility-wide policy
• Overseeing quality assurance protocols
• Interfacing with residents, families, and staff
• Coordinating between care and organizational departments
• Updating processes to comply with state and federal regulations
• Representing the facility in professional and community activities
• Interpreting resident needs and collaborating with families

This is a job that centers around people. Long term care facilities are often smaller than hospitals, and that means that nursing home administrators can dig in to every aspect of operation with a personal and hands-on approach. While they often work out of an office, nursing home administrators might not spend a majority of their time there. Instead, their time may be spent walking the halls, talking to patients and families and staff members, meeting with other community organizations, and reading and writing reports on the go from a smartphone or tablet.

Long term care is a 24-hour endeavor. Many nursing home administrators will take their work home with them and be on call at all hours. It can be taxing on not only the body but also the heart as the job requires nearly inexhaustible levels of compassion. But the reward for all this involvement is a personal relationship with and visible impact on a vibrant and invaluable segment of the population. Nursing home administrators get to see and feel the results of their hard work. They look into the eyes of the people they serve, and hold their hands when most needed.

Matt Zbrog

Writer

Matt Zbrog is a writer and researcher from Southern California. Since 2018, he’s written extensively about emerging issues in healthcare administration and public health, with a particular focus on progressive policies that empower communities and reduce health disparities. His work centers around detailed interviews with researchers, professors, and practitioners, as well as with subject matter experts from professional associations such as the American Health Care Association / National Center for Assisted Living (AHCA/NCAL) and the American College of Health Care Executives (ACHCA).