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What Is a Nursing Home Administrator and How Can You Become One?

What Is a Nursing Home Administrator and How Can You Become One?

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nursing home administrator

Last Updated on July 20, 2022 by ashley.davis


The role of a Nursing Home Administrator is similar to that of a general manager. They are involved in most departments of the Nursing Home Facility—managing operations, coordinating the staff and improving the overall quality of care that the home offers. They work hard to keep the whole organization afloat and running smoothly.

These days, you need a Bachelor’s degree or Master’s degree to get a job as a Nursing Home Administrator (NHA) because of how complicated the job has gotten. But extensive experience in health care might be considered in smaller nursing home facilities.

Would you like more insight into Nursing Homes? You’re welcome to browse through our articles related to Nursing Homes.

What Is a Nursing Home Administrator?

Nursing Home Administrator

A Nursing Home Administrator runs a facility’s day-to-day operations and supervises the business and organizational side of the Nursing Home. Their responsibilities depend on the size of the facility. In smaller nursing homes, the administrator may do many of the things on their own. Large Corporate Administrators often supervise a large staff by delegating. In the end, all responsibilities fall upon the administrator’s shoulders.

What Are the Main Responsibilities of a Nursing Home Administrator?

A Nursing Home Administrator’s job description is more than just supervising the entire facility. It involves the huge responsibility of keeping the organization running smoothly and building connections with the staff, its patients, and external stakeholders.


With Nursing Homes open 24-hours a day and having staff coming in and out of shifts, a strong leader is essential to keep the facility from breaking out into chaos. And a Nursing Home Administrator (NHA) provides such leadership.

As leaders, the Nursing Home Administrator creates an environment that allows the staff to perform at their best. They establish department directions and strategies, plan programs, and instill in each employee a strong sense of identity and purpose within the facility. It is about taking care of the people.

The administrator needs to inspire trust, consider long-term perspectives and challenge the status quo. They have to be able to cope with change or even inspire it to push the organization forward.

To be a great leader, an NHA needs to be a great manager. And as a manager, they need to make sure all systems are running smoothly. They take care of maintenance and short-term perspectives and watch the bottom line to ensure the facility stays profitable.

The NHA needs to be the face and spokesperson of the facility. They need to represent the facility in front of the press, in board meetings, and when families of residents visit.

As leaders, the Nursing Home Administrator creates an environment that allows the staff to perform at their best.

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A Nursing Home Administrator keeps the facility out of the news by ensuring that it delivers the care it promises. They stay aware of the needs of the residents by being involved on a personal level and developing personal relationships with them. 

To achieve this, the NHA has to have a physical and psychological understanding of the aging process and be empathetic and communicative enough to provide counseling when needed. 

Another aspect of an NHA that can land the facility in the news if mishandled is culture. Part of the NHA’s job is to keep the staff happy to deliver the best service to the residents. And culture plays a significant role in the performance and happiness of the team.

Organizational culture has multiple elements, including values, vision, systems, norms, beliefs, and habits. All are difficult to articulate and even harder to measure. But no matter which senior living facility you go to, one thing is constant. Culture and climate leave an imprint on the organization. 

And so, NHAs need to acknowledge their role in managing their culture and know how to use it to steer the organization towards success. They have to set the tone and influence the staff to create a culture of love, unity, and interconnectedness. They also need to shift the climate, as determined by historical forces, behavior standards, communication, and trust.


Nursing Home Administrators take care of the day-to-day issues, directing the activities of the staff across all departments.

These responsibilities vary depending on the size of the facility. Nursing Home Administrators in smaller facilities may do a lot of the work on their own. In contrast, large corporate administrators are likely to supervise a large staff by delegating. In the end, all responsibility falls on the shoulders of the administrator.

Other responsibilities of the facility include:

  • Use of Technology – The NHA needs to use technology to manage the operations of the business and track progress more efficiently. They need to use special software to manage department finances and automate systems like staff scheduling and resource management for the office.
  • Resident Care –  The NHA ensures that the Nursing Services, Food Services, Medical Services, Social Services Programs, therapeutic recreation, rehabilitation, and quality assurance programs are planned and out to maximize the residents’ quality of life in the facility.
  • Human Resources – The NHA handles compensation and benefits programs as well as implements health and safety programs. They must open up communication lines between staff and management and create programs to meet their cultural diversity needs. 
  • Finance – Management of the financial side of the Nursing Home is a big part of the job. The NHA needs to be financially adept at doing the annual operating and capital budgets, managing financial audits, negotiating contracts, and ensuring the safety of the facility’s assets. 

What Are the Necessary Traits of a Nursing Home Administrator?

Nursing Home Administrator

While the sheer number of responsibilities a Nursing Home Administrator has is overwhelming. Success in this position is easier achieved with certain behaviors and competencies.

The ‘need to have’ versus ‘nice to have’ model can be applied to this list of competencies excellent administrators will have. It is simply not realistic to expect an administrator to be equally competent in all areas.

However, it is reasonable to expect that the administrator would reach the minimum standard, if not above average, competence in several areas.

The following Health Care Leadership Alliance (HLA) model of 2004 demonstrates the qualities that are crucial for a Nursing Home administrator to have:

1. Communication and Relationship Management 

  • Effective communication
  • Relationship management
  • Influence of behaviors
  • Ability to work with diversity
  • Shared decision making
  • Community involvement 
  • Medical staff relationships
  • Academic relationships

2. Knowledge of the Healthcare Environment

  • Clinical practice knowledge 
  • Patient care-delivery models and work-design knowledge 
  • Healthcare economics knowledge 
  • Healthcare policy knowledge
  • Understanding of governance
  • Understanding of evidence-based practice 
  • Outcome measurement
  • Knowledge of and dedication to patient safety 
  • Understanding/utilization of case management
  • Knowledge of quality improvement and metrics
  • Knowledge of risk management

3. Leadership 

  • Foundational thinking skills
  • Personal journey disciplines 
  • The ability to use systems thinking
  • Succession planning 
  • Change management

4. Professionalism

  • Personal and professional accountability 
  • Career planning 
  • Ethics
  • Evidence-based clinical and management practice
  • Advocacy for the clinical enterprise and nursing practice 
  • Active membership in a professional organization

5. Business Skills and Principles

  • Understanding of healthcare financing
  • Human resources management and development
  • Strategic management
  • Marketing 
  • Information management and technology 

What Makes a Good Nursing Home Administrator?

Nursing Home Administrator

A good Nursing Home Administrator has good decision-making skills and clinical experience. Plus, they should have a physical and psychological understanding of the aging process to ensure that each resident maintains their dignity during the process.

How Much Is a Nursing Home Administrator’s Salary?

As of April 2021, the average salary of Nursing Home Administrators in the United States is around $118,908 and can range between $105,757 and $132,347. Salary ranges can vary depending on many important factors; these include education, certifications, skills, and experience.

Massachusetts    $115,988
Rhode Island$111,012
North Dakota$109,058
New York$107,147
South Dakota$105,873
New Hampshire$103,474
South Carolina$98,781
West Virginia$93,133
New Jersey$92,150
New Mexico$85,095
North Carolina$84,177

What Do You Need to Become a Nursing Home Administrator?

To become an Administrator, one must have effective communication, leadership, and business skills and a thorough understanding of the aging and medical industry.

  1. Get a degree – A bachelor’s degree or masters in healthcare administration/management or nursing courses in accounting and management. It will show your ability to handle the business side of the job.  
  2. Gain some experience – It is crucial to gain some field experience. Most health care programs provide the opportunity to get experience while studying.
  3. Get licensed – The final step is getting a state license and passing the National Association of Long term Care Administration Board exams.


Nursing Home Administration is not a job for just about anyone. Keeping a nursing home running is mentally and emotionally challenging work. Burnout is common among home administrators. Between the workload, emotional strain, and the fact that Nursing homes are open 24/7, it can feel like a neverending job.

It is, however, not an impossible one. Passionate, licensed administrators with organizational skills often enjoy the organized chaos and unpredictability of the profession. They take pleasure in bringing relief and comfort to residents and trying to create a home for them. The financial rewards can also be substantial and provide an additional incentive and motivational factor for some.

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