As the population ages, the demand for health care services for older adults will grow, particularly for high-quality care in retirement and nursing home settings.
In 2020, an estimated 17% of people in the U.S. were 65 or older, according to a 2022 report by the Administration for Community Living. By 2040, the report projects that figure will rise to 22%. It also estimates the number of people 85 years old and older will increase from 6.7 million to about 14.4 million between 2020 and 2040.
The increasing need for well-prepared health care workers will go far beyond doctors and nurses. After years of working and raising families, many people approach their later years with the expectation of living in a comfortable and well-kept home designed to meet their changing needs and wants. The best facilities for the aging population will offer a variety of amenities and care staff, led by competent and caring nursing home administrators.
Understanding how to become a nursing home administrator, including the associated educational and licensing requirements, is an important aspect of pursuing a career in the growing field of assisted living and elder care.
What Is a Nursing Home Administrator?
Nursing home administrators coordinate care services and support to ensure their facilities run optimally and provide the best possible level of patient care. Their decisions are critical to the mission of providing care that preserves the integrity and the dignity of nursing home residents.
Nursing home administrators work in a range of health care environments. These environments include facilities that specialize in providing care for older adults, such as nursing homes or retirement communities. They may also work in long-term care or assisted living facilities.
Because the role is administrative, those in the position typically work in office settings. However, administrators may occasionally need to assist in clinical settings when a facility is short-staffed. While they commonly work regular business hours, nursing home administrators may need to work evenings and weekends due to the around-the-clock nature of their care delivery facilities.
What Does a Nursing Home Administrator Do?
Ensuring a nursing home’s smooth operation requires more than a concern for sick and older adults. What a nursing home administrator does is broad in scope. However, it can be broken down into the following three general practice domains.
- Care, Service and Supports: The quality of the care residents receive and their standard of living are two primary areas of focus for a nursing home administrator. Making sure that each individual receives complete and appropriate medical and nursing attention should be of chief concern at the top levels of management. Additionally, management should ensure residents have access to their health records and care plans as well as appropriate nutrition, transportation, social services and mind and body care.
- Operations: Administrators must keep track of both facility and resident finances, which can be time-consuming since revenue is received from a variety of sources and payments take meticulous oversight. In addition, nursing home administrators must make sure their facilities comply with changes in federal and state law.
Administrators must also ensure that Occupational Safety and Health Administration (OSHA), Health Insurance Portability and Accountability Act (HIPAA) and other legal and mandatory reporting issues are handled in a timely and thorough manner. They also keep staffing, professional development and diversity awareness protocols up to date. - Environment and Quality: Ensuring patient safety by providing a safe living environment is another important responsibility of nursing home administrators. This may be accomplished by carefully managing factors like infection control, emergency plans and building equipment maintenance. A nursing home must be ready at any time to pass inspections and assessments, which are all designed to keep residents secure and comfortable. In addition, nursing home administrators may work with other administrative professionals like hospice medical directors to ensure quality care continues if a patient’s health requires a transfer to palliative care.
How to Become a Nursing Home Administrator: 4 Steps
As is true with many other health care professions, the path to becoming a nursing home administrator may not be the same for everyone. However, for those just starting out, or for those with a health care background, the traditional approach has four basic steps.
1. Undergraduate Education
The first major milestone is earning a bachelor’s degree. Choosing a program in nursing, nursing administration or another field of administration such as business, health care or public health administration can be beneficial when pursuing an upper management career.
2. Graduate Education
To succeed at the highest levels of management, a master’s degree is almost always required. A rigorous program in health care leadership — such as the Executive Master of Health Administration (EMHA) degree program at USC Price — can prepare prospective nursing home administrators for the responsibilities of this important position.
3. Work Experience
Gaining the experience required to move ahead in the health care industry can be accomplished in several ways.
- At the undergraduate level in a nursing program, clinical experience is required by the Commission on Collegiate Nursing Education. As students acquire knowledge and skills, they are placed in settings in which they can practice what they have learned and continue to learn from professionals around them.
- Clinical and work experience are also required when applying for many postgraduate programs. Then, as part of the master’s degree curriculum, in-residence experiences that integrate administrative as well as academic theories can give you a well-rounded and practical introduction to health care operations.
- Lower-level positions in health care settings can also provide experience in clerical or assistant roles or as administrators in other smaller venues.
4. Licensing
Most high-quality nursing home facilities require a license in nursing home administration or long-term care administration. The National Association of Long Term Care Administrator Boards oversees a national exam to obtain a nursing home administrator license, which is required by most states.
Although many states also require additional testing to become a nursing home administrator, the application and testing processes vary from state to state. Additionally, successful completion of undergraduate and postgraduate degrees in health care or closely related fields is usually included in the licensing process. Prospective job applicants should check with their state and local agencies and facilities to determine what is required for employment.
Nursing Home Administrator Salary and Career Outlook
The median nursing home administrator salary as of May 2023 was approximately $96,300, according to the salary aggregator Payscale, with the top 10% making a median salary of around $134,000. Factors that can affect salary include experience, the type of facility and geographic location.
There is a steadily increasing need for qualified health care professionals. The U.S. Bureau of Labor Statistics (BLS) projects that the number of jobs for medical and health services managers, including nursing home administrators, will grow by 28% between 2022 and 2032. This is significantly higher than the 3% average growth projected for the U.S. job market as a whole during that same period.
Embark on a Rewarding Career by Becoming a Nursing Home Administrator
A career as a nursing home administrator can prove to be a richly rewarding and challenging one. If you are an experienced health care professional with an educational foundation in the field, consider the USC Price online EMHA degree program.
Learn how this comprehensive program can help you achieve your goals and assume a leadership position in contemporary health management while you provide quality life experiences for the aging population.
Recommended Readings
Health Care Administration: Lasting Impacts from COVID-19
Leadership Styles in Health Care: Executive Leader Development
What Can You Do With a Health Administration Degree? Careers Overview
Sources:
Administration for Community Living, “2021 Profile of Older Americans”
California Department of Public Health, “Licensing and Certification Program”
CareerBuilder, “Nursing Home Administrator Career Spotlight”
Centers for Disease Control and Prevention, “Communication of Possible Healthcare-Associated
Infections and across Healthcare Settings”
Experience.care, “The Journey of Becoming a Nursing Home Administrator
KFF Health News, “Caring for an Aging Nation”
National Association of Long Term Care Administration Boards, “Nursing Home Administrator (NHA) Domains of Practice”
Occupational Safety and Health Administration, “Nursing Homes and Personal Care Facilities”
National Association of Long Term Care Administration Boards, “State Licensure Requirements”
Payscale, “Average Nursing Home Administrator Salary”
U.S. Bureau of Labor Statistics, “Medical and Health Services Managers”