How Much Do Nursing Home Administrators Earn?

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:

• What are the responsibilities of a nursing home administrator?
• How do you become a nursing home administrator?
• What are the leading industry certifications for healthcare administrators?
• What is the average nursing home administrator salary?
• How much do entry-level healthcare administrators make?
• What are the main factors that influence nursing home administrator salaries?
• What will my prospects look like when I become a nursing home administrator?

What are the responsibilities of a nursing home administrator?

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:

• Supervise the work of a facility’s entire staff
• Manage mid-level administrative personnel
• Assess and adjust budgets for different departments
• Schedule equipment maintenance and upgrades
• Review records to ensure they comply with federal and state regulations
• Update procedures to ensure they comply with federal and state regulations
• Approve resident care protocols
• Process resident admissions
• Meet with prospective residents and their families
• Settle staff disputes
• Find new vendors and order supplies
• Meet with representatives from insurance companies and care agencies
• Research the latest best-practices in long-term care
• Hire nurses, aides, medical specialists, and administrative personnel

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.

How do you become a nursing home administrator?

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:

• California State University – East Bay
• Central Michigan University
• Colorado State University – Global Campus
• Des Moines University – Osteopathic Medical Center
• George Washington University
• Ohio University (Main Campus)
• Seton Hall University
• Stony Brook University
• Texas Woman’s University
• University of Central Florida
• University of Maryland – Global Campus
• University of North Carolina at Chapel Hill
• University of Scranton
• University of Southern California

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.

What are the leading industry certifications for healthcare administrators?

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:

• Certified Medical Manager (CMM)
• Certified Healthcare Financial Professional (CFHP)
• Certified Healthcare Access Manager (CHAM)
• Certified Professional in Healthcare Quality (CPHQ)
• Certified in Healthcare Compliance (CHC)

What is the average nursing home administrator salary?

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.

How much do entry-level healthcare 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.

What are the main factors that influence nursing home administrator salaries?

Many factors determine nursing home administrator salaries. The most important are:

• Education: As shown above, this is the big one. While it’s possible to become a nursing home administrator with just a bachelor’s degree, know that NHAs with bachelor’s degrees lag behind their colleagues with master’s degrees for the entirety of their careers. People say that having a graduate degree is worth five years of professional experience. This may or may not be accurate, but the data does show that nursing home administrators with advanced degrees start with higher salaries and their lifetime earning potential is also higher.
• Location: Nursing home administrator salaries vary significantly based on geographical location. You’ll probably make a lot more than the average nursing home administrator salary if you work in San Francisco, Washington, DC, Boston, or New York City. You’ll make less if you land a job at a nursing home in a small town or in a rural area.
• Facility size and type: In general, larger facilities pay their NHAs more than smaller ones. Surprisingly, nursing home administrators who work at nonprofit assisted-living facilities sometimes make more than their counterparts at for-profit facilities.
• Responsibilities: Every facility and network has unique ideas about what NHAs should handle. Nursing home administrators at larger facilities may have more responsibilities and be paid more as a result.
• Work experience: An early-career nursing home administrator might make about $83,000. A mid-career NHA could make closer to $96,000. And a late-career administrator in a nursing home facility could make as much as $143,000.

What will my prospects look like when I become a nursing home administrator?

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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