It's a long, tough climb to become a nursing home administrator (NHA). Even after earning an advanced degree in healthcare administration, long-term care administration, or gerontology, NHAs typically spend years working in nursing homes or assisted living facilities in mid-level administrative and management positions before they ascend to the top admin role. They aren't trained so much as seasoned by experience, and by the time they arrive, they are healthcare veterans. They understand the relevant regulations, assisted living administrator best practices, and the business of healthcare administration inside and out, and they are ready to oversee a facility.
That's why these professionals tend to be well-paid. They have the skills and knowledge to handle everything from facility operations oversight to regulatory compliance to okaying the menu for an upcoming holiday party. They have the confidence to make decisions that directly impact the lives of hundreds of residents. And they're willing to step into any role that doesn't involve direct patient care when there is a need because they understand that their number one job is to keep the facility running as smoothly as possible.
Does becoming a nursing home administrator mean taking on tons of responsibility? Yes, but in return, NHAs can make six-figure salaries. As an added bonus, the demand for capable NHAs is strong.
In this article about the average nursing home administrator salary and why you might make more or less, we'll cover:
Before we dig into how much nursing home administrators make, let's take a look at what they do in the nursing homes, retirement communities, assisted living facilities, and related facilities they oversee. On a typical day, an NHA might:
It's already a long list, but consider that any of the tasks above might be interrupted by a resident's unexpected issues, a question from the activity committee, or a family member who has concerns about the care their loved one is receiving. Nursing homes are open 24/7, which means that nursing home administrators are never really off the clock. They might go home, but they never stop being responsible for the well-being of their facilities' residents.
The first step on the path to becoming an NHA is to earn a bachelor's degree. Nursing home administrators are well-paid, in part, because they are experts in both business and healthcare. Some aspiring healthcare administrators major in business administration or become registered nurses, but getting a degree in healthcare administration, long-term care administration, or healthcare management is probably your best bet. If you're sure your future is in nursing home administration, look for schools with nursing home administration majors, like Kent State University at Kent, or nursing home administration specialization tracks.
Some licensed nursing home administrators stop there. In fact, only 38 percent have master's degrees, though there are compelling reasons to earn a Master of Healthcare Administration (MHA), Master of Long-Term Care Administration, or a related degree after working in healthcare administration for a few years. Look for schools, like Utica College, that offer nursing home administration concentrations. Also look at programs accredited by the National Association of Long-Term Care Administrator Boards.
You'll probably spend about two years studying to earn your MHA if you're studying on-campus and going to school full-time. It is possible to earn a master's degree in healthcare administration more quickly, however. Some schools offer accelerated one-year master's degree programs in healthcare administration, among them Stony Brook University and Indiana University - Bloomington.
You can also earn an online MHA from a number of reputable schools, including:
You may be wondering why you need a master's degree when over 50 percent of NHAs are working successfully without one. The answer is money. Experience matters a lot when your goal is to become an NHA. Still, the fact is that the average nursing home administrator salary range is lower for NHAs with undergraduate degrees. You'll make more money as an entry-level nursing home administrator when you come into the position with a master's degree, and you'll make more throughout your career.
Whether you need licenses and certifications to work as a nursing home administrator will depend on the state where you work. The exact licensure requirements for nursing home administrators vary from state to state, though national licensing is overseen by the National Association of Long-Term Care Administrator Boards (NAB). All 50 states use the NAB exam to vet NHAs. In some states, nursing home administrators must complete at least 400 to 1,000 administrator-in-training hours to get a license. They must also complete continuing education courses throughout their careers to maintain their licensure.
Certification isn't mandated in any state, but there are numerous healthcare administration certifications that can boost your hirability. You may find yourself fielding better salary offers if you earn one or more of these credentials:
The answer depends on whom you ask. According to Salary.com, the average nursing home administrator salary in the United States is $115,508. PayScale, on the other hand, reports that the average annual salary for a nursing home administrator is closer to $90,000. That's a pretty big difference. And the US Bureau of Labor Statistics paints a less rosy picture still. It reports that median pay for administrators in nursing and residential care facilities is about $84,000—which is a lot less than hospital administrators make.
This is a question worth looking into when your goal is to become a nursing home administrator because it could be years before you reach the higher end of the pay scale. Chances are that you'll spend a lot of time in lower-level administrative roles regardless of whether you get a master's degree, but you might actually earn more because of it in the long run. The average salary for entry-level nursing home administrators is about $72,500. The more real-world experience you bring to the table when you become an NHA, the higher your salary will be. In other words, don't pass up opportunities to work as a medical office administrator or human resources manager because you're fixated on becoming a nursing home administrator. You'll get there eventually, and when you do, the administrative experience you gained in those roles will pay off.
Many factors determine nursing home administrator salaries. The most important are:
The role of nursing home administrator is not the end of the line in terms of career advancement in healthcare administration. You could, after working as an NHA, become the CEO of a sizeable assisted-living facility system (where you'll make more than $400,000 annually) or work as a consultant for many long-term care facilities or nursing home systems.
If you want to stay in this role, however, chances are that you'll have not only a respectable salary that increases regularly but also the kind of job security most people only dream about. Turnover in nursing home administration is relatively high, and replacing the administrators who leave can be difficult. In an interview with McKnight's Long Term Care News, Paul Gavejian, managing director of Total Compensation Solutions, said that "it's pretty difficult to recruit new people at the executive level. There's the suggestion if you give decent increases, you're not necessarily going to see them jumping ship."
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