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Care Management
• Long-Term Care Policy and Financing
• Workforce Issues
• Long-Term Care Facilities
The Nursing Home Administrator (NHA) Pipeline—Obstacles and Opportunities
As the baby boomers retire, the number of older Americans who require long-term services and support in an assisted living or nursing home (NH) is expected to increase.
Care Management
• Long-Term Care Policy and Financing
• Workforce Issues
• Long-Term Care Facilities
The Nursing Home Administrator (NHA) Pipeline—Obstacles and Opportunities
As the baby boomers retire, the number of older Americans who require long-term services and support in an assisted living or nursing home (NH) is expected to increase. Although much of the national attention has focused on the current and future shortage of direct care staff in these settings, there is also a shortage of a robust pipeline of experienced, qualified, licensed nursing home administrators (NHAs). All NHs and a growing number of assisted living facilities are required to have a licensed NHA. A licensed NHA is responsible for all aspects of managing and operating the facility (§483.70), requiring them to have business acumen related to accounting, finance, regulation, human resources, and customer relations, while at the same time having enough clinical knowledge to communicate effectively with physicians, nursing, physical therapy, occupational therapy, speech therapy, and case management.
Administrating a long-term care setting is complex, as the NH industry is considered one of the most regulated industries and operates on slim margins. Because of this, the turnover rates among NHAs is high. Data from the Care Compare for November of 2023 finds that nearly 48% of NHs had turnover of their NHA in a 1-year period, with 1 in 5 NHs having at least 3 or more NHAs in a 12-month period. A survey of Ohio's long-term care facilities found in 2021 that 21% of NHAs in NHs and 34% of administrators in assisted living facilities started their role within the past year.
These high turnover rates could have consequences. NHs with higher turnover have been associated with lower quality and worse financial performance. Therefore, there is a need for qualified, competent NHAs. Yet one of the main challenges to fill these vacancies is the high costs associated with obtaining the appropriate licensure.
Journal of the American Medical Directors Association, https://doi.org/10.1016/j.jamda.2024.105177