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Nursing Home Administrators
Prepare Nursing Home Administrators for Leadership

Forty years ago, no standards of practice existed in long-term care facilities like nursing homes. There were no standards for education, training and continuing education when the federal government mandated the licensure of nursing home administrators.

Today, in order to meet the needs of individuals, providers, and educators, leading efforts conduct and create new and update the credentials for executives responsible for the multiple lines of service within long-term care. Several national long-term care associations write the standards that enhance the administrator's licensing,

The hope is to recognize and accept a broad base license that meets state-specific licensure requirements. This would allow administrators to practice in all 50 states plus the District of Columbia without having to meet each specific state's licensing requirements. Once this occurs, it opens the doors to attract and prepare more leaders.

Nursing Home Administrators Job

Administrators in nursing home facilities direct the operations and have responsibility for cultivating the culture. Because of the long-term care and accountable care organizational changes, now more than ever, leaders need to step-up.

Long-term care facilities or community-based setting offers medical, health, psycho-social, habilitation, rehabilitative, or personal care services provided to individuals on a post-acute care or long-term basis.

A nursing home administrator is an individual who is responsible for planning, organizing, directing, and managing the operations of the facility, and the functions performed by one or more people.

Management and Leadership

Nursing Home Administrators
Nursing Home Administrators

There are two types of admissions for skilled nursing facilities; short-term and long-term.

  • Short-term is for people needing rehabilitation services.
  • Long-term is for people who need 24/7 care and live at the facility full-time.

The primary function of the nursing home administrator: To help the resident feel at home and to make certain all the departments run efficiently and effectively for them.

The administrator oversees all departments:

  • Nursing
  • Meals and special diets
  • Social services
  • Resident activities
  • Housekeeping
  • Laundry
  • Building maintenance
  • Admissions
  • Business office

(If a multi-facility organization runs the nursing home, they have regional staff who consult and guide each department.)

Since the administrator oversees all departments, manages residents, family and the staff, the role requires a wide range of skills; to balance the needs of all people who come in contact with the nursing home.

It's challenging, but the work is rewarding.

What is a Nursing Home Administrator?

A nursing home administrator, a licensed health care professional, is the chief executive officer for the skilled nursing facility.

They manage a facility that operates 24/7/365 that gives continuous care for residents who are critically ill. Depending upon the facility size, the administrator also manages the budget, the staff, operations, and departments.

The administrator develops and executes the policies and procedures that drives compliance with federal, state and local government requirements and fulfill certification standards.

Since the older adult demographics is growing, and health care is changing and drives the accountable care initiative in our country, the demand for new nursing home administrators grow too.

The Steps to Become an Administrator

Education or background - state requirements differ but most require at least one of the following:

  • Hold a bachelor's degree
  • Hold a master's degree in nursing home administration or related health administration field
  • Have 5 to 10 years of full-time work experience in a nursing facility and a current registered nurse license with experience (most recent years) in a supervisory or director position.
  • Have 10 years of full-time work experience in a nursing home department
  • Have at least 60 hours of semester units at a university along with 5 to 10 years experience as a department head in a nursing home
  • Have a doctorate in medicine and have a valid physician's license with 10 years of work experience

Administrator's Responsibilities

  • Monitors and directs execution of policies and procedures
  • Analyzes operations
  • Evaluates the environment and equipment that's necessary for functioning
  • Executes needed procedural change
  • Ensures budget conformance
  • Maintains high occupancy rate
  • Participates on advisory committees
  • Discusses care of residents with the Medical Director
  • Acts as the liaison between the nursing home, residents, families and larger community
  • Oversees the decisions on facility maintenance problems, equipment replacement, repairs and redecorating
  • Executes the fire and safety program
  • Retains a high-quality reputation
  • Monitors the industry's regulations and standards and makes changes appropriately
  • Oversees the volunteer hours and charitable donations
  • Pans and oversees capital improvements
  • Compiles with budget projections, revenues and expenses
  • Represents the nursing home to the Board
  • Meets with community groups and hospital administrators
  • Develop admission criteria, special unit policy and procedures

Operations Responsibilities:

  • Staffing
  • Payroll
  • Benefits administration
  • In-service education
  • Budget review
  • Analysis of capital expenditures

The administrator also makes recommendations directly to the Board for policy changes, salary increases, staffing increases, annual budget amendments, resident rate increases, outside contractual services, major capital improvements, and grants.


Salaries include bonus programs and a benefit package with ties to meeting the company goals. A new administrator starts out with a salary ranging from $50,000 to $80,000 per year. And experienced administrators can expect from $70,000 to $100,000.

The average salary for a nursing home administrator in the United States is $89,932. The salary depends upon the locale of the facility and the services offered by the nursing home. Other factors that contribute to the salary:

  • Credentials
  • Type of facility
  • Years of experience

Career Advancement:

Here are a few examples of career opportunities for nursing home administrators.

  • Professional Consultant
  • Supervisor of other nursing home administrators in a larger community
  • Specialization in Alzheimer's care or Hospice

Suggested Resources relating to Administrators

Aging Services

American Health Care Association

Leading Age

National Association of Examiners of LTC Administrators

Quality Care Health Foundation

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.