By midmorning, a nursing home administrator may already have reassigned a short-staffed wing, reviewed overnight incident reports, and met with the kitchen manager to adjust menus for residents with new dietary needs.
Whether they are walking a family through a resident’s care plan updates or troubleshooting a delayed medication delivery, nursing home administrators play a key leadership role that can have a big impact on nursing home residents’ quality of life.
Those considering pursuing this role should explore what nursing home administrators do, the nursing home administrator salary, and the various healthcare management degrees that can prepare individuals to enter this growing field.
Overview of the Nursing Home Administrator Role
Nursing home administrators manage the day-to-day operations of skilled nursing facilities, also known as nursing homes. These facilities provide medical and personal care to individuals, often older adults, who need assistance over an extended period. Administrators ensure their facility runs smoothly while complying with state and federal regulations. These professionals often serve as the intermediary among nursing home residents, staff, families, and regulatory bodies.
Nursing home administrators make key decisions about staffing, finances, and resident care. For instance, they may work with a clinical team to redesign the meal plan for a resident with special nutritional needs, implement a new scheduling system to avoid staff burnout or lead a quality improvement project that enhances infection control procedures.
Nursing Home Administrator Responsibilities
While nursing home administrators’ responsibilities can vary according to the type and size of their facility, the following tasks are typical for the role.
Regulatory Compliance and Quality Assurance
Administrators ensure their facility meets state and federal regulations, such as those set by the Centers for Medicare and Medicaid Services (CMS). They help the facility prepare for inspections, make sure records are complete and accurate, and step in quickly to address any issues.
For example, if a routine survey finds gaps in medication documentation, an administrator may create new charting protocols and conduct staff training to improve compliance.
Financial Management and Budget Oversight
Nursing home administrators manage their facility’s budget and finances. They keep a close eye on where money comes from — Medicare, Medicaid or private payments — look for ways to reduce unnecessary costs and adjust spending plans when the number of residents changes.
For example, if occupancy drops, an administrator may work with the admissions team to build relationships with hospital discharge planners to increase referrals.
Human Resources and Staff Leadership
Nursing home administrators build and support the teams that keep their facility running, from nurses and maintenance crews to dining and housekeeping staff. That includes hiring new employees, offering ongoing training, and finding ways to keep great people on board.
Administrators may set up peer mentorship programs to help new hires adjust or work with leadership to improve pay and benefits to attract top talent.
Resident Relations and Care Coordination
Though they are not involved in direct clinical care, administrators monitor the well-being of their residents. If a resident’s family expresses concern about fall risks, for example, the administrator may investigate, adjust staffing levels during high-risk hours and coordinate environmental modifications such as installing grab bars.
Common Work Settings
Nursing home administrators primarily work in the following environments:
- Skilled Nursing Facilities: Providing round-the-clock care for residents recovering from surgery or living with chronic conditions
- Assisted Living Communities: Supporting residents who need some help with daily living but don’t require full medical care
- Continuing Care Retirement Communities: Offering a range of services from independent living to skilled care
- Veterans Homes or Public Facilities: Overseeing nursing homes operated by the local, state or federal government
- Consulting and Management Firms: Advising multiple facilities on compliance, budgeting and care standards
Facilities differ in their mission, scale, and culture. Many are privately operated by large national chains, while others are operated by small nonprofit community organizations or government entities. But they all require leadership focused on resident care and operational efficiency.
How to Become a Nursing Home Administrator
Becoming a nursing home administrator typically involves a combination of formal education, on-the-job experience and licensure. Here’s a closer look at the steps involved.
Step One: Earn a Bachelor’s Degree
Most states require individuals to have at least a bachelor’s degree in a relevant field to work as a nursing home administrator. Two common options are a bachelor’s in healthcare management or a bachelor’s in healthcare administration.
The programs for both of these degrees cover foundational topics such as health systems, finance, and regulatory policy. However, a healthcare management degree often focuses more on business operations and leadership strategy, while a healthcare administration degree emphasizes the structure and delivery of healthcare services.
Both degree programs provide a strong foundation for a career in long-term care administration.
Step Two: Gain Experience
Working in a long-term care facility in entry-level roles such as administrative coordinator, social services assistant or admissions representative can help individuals become familiar with the day-to-day operations and residents’ needs relevant to nursing home administrators.
This experience can be invaluable when applying for administrator roles.
Step Three: Complete an Administrator-in-Training Program
While not always required, many states recommend or mandate participation in an administrator-in-training (AIT) program. These supervised internships — usually lasting six to 12 months — allow aspiring administrators to gain hands-on experience in areas such as budgeting, quality assurance, staff supervision and resident engagement.
Even in states where they are optional, completing an AIT program can boost individuals’ employment prospects.
Step Four: Obtain a Long-Term Care Administrator License
Licensure is required in all states for nursing home administrators. In addition to earning a degree, candidates must pass the National Association of Long Term Care Administrator Boards (NAB) exam, which consists of the national Core of Knowledge exam and a state-specific section.
States may also require a background check, ethics training, and continuing education to maintain licensure.
Step Five: Pursue Advanced Education
Earning an advanced degree, such as a master’s in healthcare management or a master’s in health administration, or a healthcare management graduate certificate can prepare professionals to oversee larger facilities or assume regional leadership roles. These programs help individuals deepen their knowledge in healthcare strategy, policy and financial management, all of which are essential for a healthcare management career.
How Much Does a Nursing Home Administrator Make?
According to the U.S. Bureau of Labor Statistics (BLS), nursing home administrators fall under the category of medical and health services managers. They had a median annual salary of $117,960 in 2024, with top earners making over $219,000 a year. Individual salaries vary by job location, experience, and type of facility.
The job outlook for these professionals is very promising. The BLS expects positions in these occupations to grow an impressive 29 percent between 2023 and 2033 — around seven times the projected average job growth rate. With an aging population and a need for qualified leaders in long-term care, demand remains strong, particularly in underserved areas.
Lead the Future of Long-Term Care
As the healthcare system continues to evolve and the need for care for older adults expands, the work of nursing home administrators becomes increasingly vital. With a unique blend of operational leadership, regulatory expertise, and people skills, these professionals play a central role in ensuring quality care for some of society’s most vulnerable individuals.
Professionals interested in pursuing a healthcare management career can prepare themselves for success with the right education by earning a targeted degree or a healthcare management certificate.
SEMO Online offers a range of options, including the following degrees:
Find out how one of Southeast Missouri State University’s online programs can help you pursue a rewarding career in healthcare management.
Recommended Readings
How to Become a Health Informatics Specialist
How Long Does It Take to Get a Bachelor’s Degree Online?
Can I Get College Credit for My Prior Training and Experience?
Sources:
American Health Care Association, Facts & Figures
Indeed, “How to Become a Licensed Nursing Home Administrator (LNHA)”
MedBest, “How to Become a Nursing Home Administrator”
Minnesota Board of Executives for Long-Term Services and Supports, What Is a Nursing Home Administrator?
National Association of Long Term Care Administrator Boards, AIT Program Manual
National Association of Long Term Care Administrator Boards, Exam Information
U.S. Bureau of Labor Statistics, Medical and Health Services Managers