The Nursing Home Administrator’s Role

Note: This is a brief excerpt from the HCPro book The Comprehensive Guide to Nursing Home Administration, by Brian Garavaglia, PhD, FACHCA. For more information about this book or to order, call customer service at 800/650-6787 or visit

The administrator is responsible for leading, planning, controlling, and organizing the facility. He or she is the CEO of the facility, ultimately vested with the responsibility for ensuring that the day-to-day operations comply with state and federal regulations as well as lead the facility in a manner that promotes the provision of optimal healthcare. The administrator has to answer to the owner(s) or other members who comprise the governing body. Federal regulations state the following in regard to administration:

A facility must be administered in a manner that enables it to use its resources effectively and efficiently to attain the highest practicable physical, mental, and psychosocial well-being of each resident (483.75).

Although that statement is ambiguous, from it you can derive that administrators help to plan and lead the facility in a direction that promotes workers to provide sound care to all residents in all phases of their life.

It is difficult to state everything that an administrator does, but given that much of the job entails the business, financial, and regulatory sides of healthcare, administrators have to be sensitive to these important areas, areas which owners and the board often will question them on as they relate to the company’s daily business affairs. For example, ensuring that all quarterly Medicare credit reconciliations are submitted to the Centers for Medicare & Medicaid Services (CMS) in a timely manner is important. Administrators often will rely on assistance from billing agencies or accountants whom they employ to help them fill out this documentation. The administrator should then accurately document any credit balances to the best of his or her knowledge, based on the information provided by the billing agencies or accountants. You must remember that the administrator signs these documents, attesting that the information is correct and therefore certifying this process.

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