Nursing Home Administration

The practice of nursing home administration has been embodied in five domains of practice developed in the 1980s by the National Association of Boards of Examiners for Long Term Care Administrators: (1) organizational management, (2) personnel, (3) financial management, (4) environmental management, and (5) resident care. These five domains are updated every five years. A license issued by a state government body is required for every administrator of record in all U.S. nursing facilities. Each state sets the requirements that must be met for licensure, usually setting education requirements, an internship requirement, and examination requirements. The majority of states require that an administrator obtain a college degree and complete an internship in a nursing facility of twelve to fifty weeks in length. There is one national examination required of all who become nursing home administrators. However, reciprocity among states varies. Usually state boards or agencies will allow a person to receive a license in a new state by taking any required test on the receiving state's regulations.

Nearly one hundred colleges and universities across the Untied States offer curricula in long-term care administration. There is a national website www.longtermcareedu.com that provides state-by-state information on the requirements for licensure set by each state, how to contact the state licensure authority, and which colleges offer long-term care administration. This site provides extensive background information on nursing home administration as a profession and provides resource contacts and access to publications in the field.

About six thousand of the roughly thirty-four thousand licensed nursing home administrators in the United States belong to a professional organization, the American College of Health Care Administrators. Most nursing home administrators, through their facility, are active members in a state level association of the American Health Care Association, which has both for-profit and nonprofit facility members. Nonprofit facilities may also belong to the American Association of Homes and Services for the Aging.

Salaries for nursing home administrators range from $40,000 to $100,000 per year. Because turnover is often high among facility administrators, there is usually an opportunity to enter the field and find a job quickly. About 70 percent of the 16,400 Medicare-certified nursing homes in the United States are owned by for-profit corporations. Typically, about 70 percent of the residents in a nursing facility pay for care through Medicaid, another 10 to 12 percent through Medicare, and the rest pay privately or through insurance.

There is a trend among nursing home administrators to move more and more easily between job assignments in assisted living facilities and life care communities. Assisted living administrators receive about the same salaries as nursing home administrators while life care communities salaries run higher, $60,000 per year and above. Current requirements for licensure in assisted living and life care communities are available on the web at www.ltcedu.com.