The term nursing home usually makes people think of what are called skilled nursing facilities. These facilities provide 24-hour nursing care, meals, and living space to residents. Many nursing home administrators work at skilled nursing facilities. However, other types of nursing or care facilities also exist. For example, intermediate-care facilities, which provide residents with meals and shelter and may also provide regular medical care, although not on a 24-hour basis, employ administrators. And administrators work at residential care facilities, also called assisted living facilities. These facilities provide residents with meals and living space but offer only limited medical supervision and care.
In addition to these three distinctions (skilled nursing, intermediate care, and residential care facilities), nursing homes can also be grouped into three categories based on their ownership. Not-for-profit nursing homes are run by voluntary organizations, such as fraternal or religious groups. Proprietary facilities are those run for profit by individuals, partnerships, or corporations. And government facilities are run, of course, by the government and include such places as veterans' homes and state-run nursing homes.
However, no matter what type of facility they work for and no matter who owns the facility, all nursing home administrators are responsible for every aspect of maintaining and operating that home. Their many duties range from management of personnel to public relations. Depending on the size of the facility, administrators may have one or more assistants to help with the daily responsibilities.
If the nursing home is part of a large corporation, then the administrator must meet with the governing board or other administrators from different facilities within the company. They take an active role in helping plan budgets and programs. For example, if staff resources are low or new equipment or remodeling is needed, then the administrator must explain the situation to the corporate office in order to get proper funding for the project. They may also help set fee schedules for patient services.
Administrators oversee every department in the nursing home from dietary to medical records. Some departments may have their own managers, but these managers must report to the administrator. Many times, administrators interview and hire department managers; they also have a voice in how staff members are trained and supervised. Administrators also work with the medical director and nursing director to plan medical policies and procedures that will ensure the best health care for all the residents. They also work with the activities director in planning recreational events, holiday parties, and other year-round entertainment for the residents.
Administrators are responsible for dealing with different government agencies that monitor health care. Nursing homes must meet strict guidelines before becoming Medicare and/or Medicaid certified by the federal agency Centers for Medicare and Medicaid Services (CMS). Without CMS approval, Medicare and Medicaid will not pay for any services rendered at the facility. In addition, every nursing home facility undergoes an annual inspection by the state's health department. Any discrepancies or violations found are directed to the administrator for explanation. Many nursing homes also participate in voluntary quality assurance programs that measure the performance of the facility and its staff.
If there are problems with the staff, or complaints regarding a client's treatment or well-being, the administrator must intervene. A good administrator should be able to listen, assess the situation, and act accordingly. Administrators should not only be visible to patients and their families, but be approachable as well. They must work closely with their staff to make sure every resident is well cared for and happy. Usually, if the resident is treated well, then the families are satisfied.
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