Healthcare Administration

How to Become a Nursing Home Administrator

November 05, 2020 |

AdventHealth University

Updated December 1, 2025.

Nursing homes provide essential medical care and support to individuals who don’t need to be in a hospital yet can no longer take care of themselves at home on their own. Older adults, with nearly 85% of residents over the age of 65, and individuals with disabilities are among the patients cared for in this context.

According to U.S. News and World Report, 1.2 million people live in nursing homes in the U.S., and that number is expected to grow as the Baby Boomer population continues to age. Nursing homes require a variety of trained staff members, but nursing home administrators play a uniquely important role as the managers who ensure everything runs smoothly.

What Does a Nursing Home Administrator Do?

Nursing home administrators are the central points of contact for residents, families and staff. They are responsible for the facility's overall success, from patient care to financial performance.

Key responsibilities of nursing home administrators include:

Resident and Family Relations: They communicate with prospective residents, explain services, and help new residents make a smooth transition. They also advocate for resident care needs, arrange for specialized services like occupational therapy and keep families informed.
Day-to-Day Operations: Administrators oversee the daily functions of the facility, instituting policies that protect residents and staff. This involves planning social events, classes and other activities for residents.
Staff Management and Leadership: A primary duty is hiring, training, and managing new staff members. Administrators also report regularly to a board of directors or corporate executives.
Financial Oversight: Administrators must be financially savvy. They are tasked with creating and managing the facility’s budget, overseeing employee payroll and handling resident billing.

4 Steps to Becoming a Nursing Home Administrator

Nursing home administrators share similar skills with other medical and health services managers. They have clinical and managerial experience as well as an educational background in the field.

Keep these steps in mind to help you understand the process to become a nursing home administrator.

1. Earn Your Bachelor's Degree

Many nursing home administrators begin their careers as nurses, but the most direct educational path is earning a Bachelor of Science in Healthcare Administration (BSHA). A practice-based curriculum like the one at AdventHealth University prepares students for the diverse duties of administration, from finance to patient care management. Other relevant degrees include public health administration or nursing.

2. Complete an Administrator in Training (AIT) Program

After earning a bachelor’s degree in the field, you must complete a supervised Administrator in Training (AIT) program. Most AIT programs take 6 to 12 months to complete or require 900 to 1,800 hours of training.

Different states have various licensure requirements. They also offer AIT programs through a board chosen by their departments of health. You can find your state’s specific requirements at the National Association of Long Term Care Administrator Boards (NAB) website.

3. Gain Experience and Develop Key Skills

Employers look for candidates with demonstrated skills and experience. Previous work in administrative or clinical roles in hospitals, clinics, or physicians’ offices is highly valuable. The most competitive job applicants are skilled in:

Personnel management
Leadership and decision-making
Financial acumen
Communication and interpersonal skills
Analytical thinking
Technology, including Electronic Health Records (EHRs)

4. Pass Your Licensing Exam and Maintain Your Credentials

To become a licensed nursing home administrator, you must pass the national Nursing Home Administrator exam administered by the NAB. Some states may also require a separate state-level exam. Once you become a licensed nursing home administrator, you will need to participate in continuing education to stay current with industry standards and regulations.

Nursing Home Administrator Salary

Individuals who become nursing home administrators usually work 40-hour workweeks that may include evenings and weekends, depending on the needs of residents and staff. The U.S. Bureau of Labor Statistics (BLS) places nursing home administrators in the category of medical and health services managers. As of May 2024, the average salary of a nursing home administrator is $117,960 annually.

Nursing Home Administrator Job Outlook

According to the BLS, employment of medical and health services managers is projected to grow 23% between 2024 and 2034, which is much faster than the average for all occupations. The growth is driven largely by the aging Baby Boomer population, which will increase demand for all health care services, including long-term care facilities.

Explore a Career as a Nursing Home Administrator

Working as a nursing home administrator allows you to combine your empathy and interpersonal skills with sharp business acumen and leadership responsibilities. It’s a good career-fit for those who are passionate about helping patients and their families.

AdventHealth University offers an Online Bachelor of Science in Healthcare Administration (BSHA) program that can serve as your first step toward this rewarding career. Our program offers courses that include:

Principles of Financial Accounting
Healthcare Strategic Planning and Decision Making
Legal Aspects of Healthcare
Principles of Healthcare Finance
Patient Care Management

Learn how earning your degree in healthcare administration from our faith-based institution can prepare you for a rewarding career as a nursing home administrator.