Nursing home administrators work in long-term care facilities, assisted living facilities, and retirement homes

What will I be doing all day?

As the person in charge of all of the non-medical operations in the facility, a nursing home administrator has a wide range of responsibilities and roles. Some of these include:

1. Hiring, training, and managing staff,  and ensuring that they follow the policies for safe care

2. Meeting prospective residents and handling admissions, planning and overseeing the residents’ care together with the clinical staff, and maintaining communication with the residents’ families

3. Creating a budget, finding vendors for medical and other supplies, overseeing the billing, and marketing the facility

4.  Managing the facility’s support staff, such as the food and janitorial staff

5. Keeping abreast of current state and federal regulations for the nursing home industry, including regulations about health insurance, cleanliness and residents’ safety, and ensuring that the facility is in compliance with those regulations

What kinds of settings can I work in?

Nursing home administrators work in long-term care facilities, assisted living facilities, and retirement homes.

What kind of schooling do I need?

To become a licensed nursing home administrator (LNHA), you must have a bachelor’s degree; it’s common to earn a master’s as well in healthcare administration, business administration, or another related field.

In addition to a degree, you must receive certification to work as a nursing home administrator. Each state has its own requirements for licensure, which generally include completing specific coursework, an internship working as an AIT (administrator in training, typically an unpaid position), and passing a licensing exam.

Do I have the personality for it?

A good nursing home administrator should have excellent leadership and interpersonal skills, and be organized, efficient, and good at business management. He must be able to work well under extreme stress, and be good at multitasking and conflict management between staff members.

What can I expect to earn?

Salary varies depending on factors such as the size of the facility and its location.

National average salary: $117,500

Salary range: from $80,000 to an upper limit of $275,000

TALES FROM THE TRENCHES

ELIE SCHIFF, North Woodmere, NY
Administrator at Brooklyn Center for Rehabilitation and Residential Home Care, Crown Heights
Graduated from: FDU (M.A. in Accounting), completed nursing home administration studies at Touro College
Years in Field: 8

MY TYPICAL DAY AT WORK

An administrator’s goal is to run the best possible facility, in every aspect of its operation, in each department. I see myself in the role of orchestra conductor, putting things into place, constantly trying to implement systemic changes and make sure everything that goes on in the nursing home day to day is running smoothly.

This includes overseeing all of the departments: admissions, rehabilitation, nursing, social work, activities, dietary, housekeeping, maintenance,  financial, marketing, etc. I communicate with the department heads each day during morning meetings and throughout the day. On a typical day, I’ll also spend time purchasing equipment and supplies, updating and implementing new policies, and doing rounds on our resident units. I try to be as visible as possible on the resident floors, to the residents and line staff, and when I’m in my office, staff members are constantly coming in with questions.

Another important responsibility is to make sure we’re adhering to all the continuously changing regulatory requirements in the industry. For example, our nursing home’s family-visitation policy has been in flux due to COVID; one day, we can allow supervised visits, and another day we can’t, based on the facility’s COVID testing results.

HOW I CHOSE THE PROFESSION

While studying for my master’s in accounting, I realized that I needed to find a field that provides more social interaction. Nursing home administration offered a great balance between desk work, leadership, interacting with and supporting a team and — the best feeling of all — being able to make a positive difference in residents’ lives.

WHAT I LOVE MOST ABOUT THE FIELD

I love that no two days are the same; each day presents a different challenge and opportunity.  I love the feeling of being able to work with a great team and support them in any way I can to help them be successful in their roles.

I also enjoy getting to know our residents, many of whom have unique and inspirational stories to share. Speaking to them also allows me to get direct feedback from the people we’re here to serve.

WHAT I FIND MOST CHALLENGING ABOUT THE FIELD 

Our biggest challenge is finding enough nursing staff who are committed to the long-term care industry. Continuity of care is so important for patient care; unfortunately, there aren’t so many LPNs (licensed practical nurses) out there, and not everyone is cut out for working with the geriatric population.

WHAT IT TAKES TO BE A SUCCESSFUL LEADER

While leadership skills can be cultivated, in my opinion an administrator needs to be a people person and someone that people gravitate toward. If you aren’t liked and respected, and people (whether staff, families, or residents) don’t feel comfortable relying on you and giving feedback, it’s going to be difficult to have your finger on the pulse, especially in a large facility.

I’LL NEVER FORGET WHEN

The stories that really stick are the ones that remind us of why we got into the healthcare industry to begin with, like seeing the joy on the residents’ faces when we run a special event for them. For example, this past Veterans Day, we went to each veteran resident and handed them a medal, a flag, a card, and some other items and thanked them for their service, celebrating each one individually. Seeing their smiles and, in some cases, tears, puts things into perspective and reminds me how fortunate I am to be on the giving end despite how challenging it can be on some days.

SOMETHING I WISH PEOPLE KNEW ABOUT NURSING HOME ADMINISTRATION

The imprint a nursing home administrator can have on a facility, by improving the quality of care, outcomes, and overall work environment. For example, it’s a proven fact that the first 24 hours are the hardest for a new resident and their family.  So we created a new position and hired an admissions concierge, whose job is to ease the transition from the hospital to the rehab facilty.  It’s a great feeling knowing that your new policies can have a positive impact on so many people.

MY ADVICE FOR PEOPLE STARTING OUT 

To be successful in this job, you need to be really committed. It’s not the kind of job where you can just clock out at 5 p.m. and forget about it until the next day.

The most important lesson I learned from observing my own mentor was that a successful administrator doesn’t need to be the most knowledgeable in the industry regulations.  If a question arises, there are always resources available.  The key to success is good leadership and supporting your staff by making each feel like a valued and essential member of the team.  You must also know when to delegate and when to step in and show them that you’re not afraid to get your hands dirty.

HOW WE WERE AFFECTED BY COVID-19

COVID was a very difficult time for our industry.  There were times where we were really pushed to the limits trying to successfully provide the best possible care for sick residents at a time when staff and resources were limited — especially last April, when NYC was heavily affected. However, on a positive note, we’ve become more knowledgeable about infection control and we’ve grown closer with one another as a team, whether it was through grieving the loss of a family member or individuals stepping up with heroic efforts to battle this pandemic.