Licensed Nursing Home Administrator

CABG patch kid, BSN, RN · Feb 2, 2009

The economy is rough but are you still looking for other work? This sounds like an unsafe environment to me and has a lot of red flags.... My heart definitely goes out to you and the patients there. I can't answer your original question, but if you feel the place is unsafe to the patients, you can always call your local Omsbudsman (spelling) or the state to investigate. Run away from that place if you can :heartbeat

CapeCodMermaid, RN · Feb 2, 2009

You do NOT have to be an RN to be a nursing home administrator. There are several ways to do this....if you have a Master's Degree you need to do an Administrator in Training Program for 3 months (I think) and then sit for the administrator's exam. With a Bachelor's Degree I think the AIT program is 8 or 9 months. Lots of companies are hiring Administrators who are also RNs because it makes sense.

herecomestrouble · Feb 2, 2009

"any tips on how to survive in LTC is greatly appreciated...my background is psych, detox, hemodialysis, and home health."

I just want to tell you this is not typical of LTC.This sounds horrible,my best suggestion would be to find a new job.

Hope things get better for you

Terry

debRN0417 · Feb 2, 2009

Bless your heart. I remember praying in my car before I went to work, so I can certainly feel your pain...LTC is NOT like that...most are calm and well run, and although people have a lot of work to do, they do not feel like they are risking their license when the step in the door. I hope things get better for you, or you find somewhere that you feel comfortable....

TheCommuter, BSN, RN · Feb 4, 2009

The administrator at my place of employment is an LPN. So, yes, virtually anyone can become a LNFA in my state if they have the acceptable training.

CoffeeRTC, BSN, RN · Feb 6, 2009

In PA and NHA does not need to be a nurse. I think it is a 120hr class and Adm in training "clinicals". Not sure on the hours. I'm sure it will vary from state to state, but for the most part, no they do not need to be nurses. Yes......it would be awesome to have someone with a nursing background that actually worked as a nurse. I've had some ADMs that went to school for nursing (never passed or didn't sit for the exam) and a few that were BSNs but never really worked the floor..still...that is different and not the same as walking the walk. I've had others with just a business background that were excellent! All depends

Tips....sounds like a high ratio for a sub acute unit. Most sub acutes staff higher than that. Now if it is just a typical LTC...depending on the shift..that might be legal. Is is right...no. I seem to have a limit of 25-26 residents max. I've worked in places with more and I just can't seem to get my head around it. I've been doing LTC for about 13yrs now and like I said...I know my limits.

It has to be against some labor law working OT and not getting paid for it. I'd look that up in your area or state. Some days you just can't seem to get it done in 8 and staying over to chart or finish little stuff happens. Not getting paid..Nope, not in my book.

Pt load..I have a lot of GTubes, o2ers with pulse ox, diabetics, crushes, complex wound care, multiple IV abtxs, infections (mrsa, cdiff, vre) but probably only about half of my pts are kinda sub acute material..the other half are intermediate or LTC with dementia and behavior issues. If I'm lucky, I will get a A and 0, independant walky talky soon to be d/c'd.

Still..sounds like a rough situation...I'd start looking around. Hiding in rooms to chart, not having a nursing station or at least some breaks........BURN OUT.

Aviationurse · Feb 7, 2009

Thanks for the info..i now know that the power and control of LNHA is because of the different background they have and that they dont have to be RN ...in the nursing home where i worked, LNHA is a MD in eastern country....former boss is a RN/LNHA in home health. ..so basically i learnt that any dingbat can be a LNHA....our don is a fairly new grad and hiding in her office most times and closing the blinds...the cna working there are her people from other nursing homes where she got fired.

Pt. load and no breaks.....the other day i had no lunch break and worked 2 hours extra to catch up...our census in subacute was 72 ...3 nurses..me and other new grad and slapped with admission. our social worker comes to work with a loud and aggressive dog and constantly barking and scaring the living daylights out of me. i was told by the cnas that only the social worker can bring dog to work and nobody else . i came home vomiting bile,and undigested food and massive watery diarrhea x 10 times, feeling nauseous... i called the supervisor and called in sick and told the office i quit. she said "give me x2 weeks notice" . yesterday , i came to work and still the same...no lunch break, no help,no pee break, have to do massive wound care, po medsx 35 patients , sliding scale, g feeding, bolus , nebs tx, look for o2 tank, etc. . had to stay over for free to do charting.

i ran out of paper to type in my resignation letter from home. at work, we bring our own office supplies, so i wrote my resignation letter in a scratch paper and gave it to nursing office. i said that sorry it was written in scratch but we dont have any paper available in unit. i decided to do home health for the time being...i dont want to kill myself in nursing home...i have reached my max.....i dont have any bennies and dont want to spend money to go to doctor.

THANKS guys for your kind support...michelle126 ...you make me laugh.....thanks again....

kwvath · Dec 24, 2009

RUN. I work in a very poor facility but it is not even close to being as bad as the one you were in. Glad you got out.

I am an ADON in a LTC facility and am getting ready to start the AIT program. It varies from state-to-state but if you have a bachelor's degree it is a 9mo program/preceptorship and 9mo program for a master's. I wanted to go into the AIT track because I saw the flaws and wanted to make the facility better. I didn't feel like I could ever make the changes I would want to make, even if I advanced to DON. Our admin has no nursing degree and is fabulous. She has made a ton of good changes. Keep your chin up.

Lovely_RN, MSN · Dec 24, 2009

That sounds like the worst facility ever. Thank the good Lord that you got a HH job. How does a place like that manage to remain open?

husker_rn, RN · Dec 26, 2009

I have worked in a couple states that did not require that you have much of a degree of anything at all; you just took a test to license you as an administrator and if you passed you were considered qualified. You might check to see what your state requires to start.

Neats, BSN · Dec 27, 2009

I have been a Licensed Nursing Home Administrator for many years. I am also a Registered Nurse new grad less than one year. I love being both.

To get my NHA license I had to have a bachelor degree in Health Care Administration. I also have a Masters in Health Care Administration. In some states you do not have to have a BS degree but can have any Bachelor degree. You then must get a sponsor or Administrator in Training (AIT) program which usually last approx 6 months or more, mine lasted approx one year.

Then you apply for license in what ever state you want to practice, take a national exam much like the NCLEX in fact there are alot of nursing questions on this exam. In some states you must take a state exam as well. I had a state exam as well. It is difficult just like the NCLEX, it does not have the ability to cut off at 75 questions, you must answer all questions.

You are then a LNHA after you pass the exam. The job requires you to be married to your job. The responsibilty is great and sometimes the rewards are long time comming. There is really no job security, you must be politically correct at all times, participate in community events, participate with staff development and be great with budgets. Juggling your skills and abilities is a must. My first job I came in with thinking I have arrived and I am boss. The staff had longevity and were kind enough to take me by the hand and taught me how to be a good leader and invite staff with decision making. I was smart enough to listen to this staff and have excelled with my profession.

I think all nursing home administrators should have at the very least a BSN degree along with business degree.

Good Luck if you choose this route.