The LPN as ADON myths and misconceptions,

Specialties LTC Directors


Specializes in Nursing Home.

I didnt work with an LPN-ADON until i became an LPN and took a job at a small 90 bed rural community nursing home in wich to this day i still work at it. Theres been alot of resitance to the practice but i can honestly say that lur ADON is the best. She knows alot about long term care and operations of it. And she is 25x more helpful than the RN/ADON at my first LPN job.

Alot of people wonder how it works. How can facilities legally get away with employing an LPN in a supervisory role? Simple. It varies from state to state. In the great stare of Lousiana, i have yet to meet one RN floor nurse in LTC. There is no law in louisiana that restricts LPNs from supervisng LPNs. I know different parts of the country are a different world, but here finding an RN floor nurse in ltc snf is like finding a four lead clover.

Next misconception, correct me if im wrong but i do not believe that CMS mandates an ADON position. Wich means the position is very abstract. I do believe that CMS only mandates a DON/RN be on dury 8 hours a day 7 days a week, and an ADON is an employer courtesy.

Next: The ADON is expected to be in charge of the facility when the DON is out ? Wrong. From my own observations the ADON position is a completely different one from that of the DON. ADON=Schedules, Hiring, Admits,Computer orientation whereas DON=I&As, Assessments, complaints, etc etc. So what happens in the abscense of the RN/DON ? Simple the ADON resposibities go on, and the Weekend RNs are happy to fill in for 8 hours as DON for extra money.

In summary there is no reason why an LPN cant legally serve as the ADON in a nursing home here in louisiana and similiar model states simply because they are not supervising RNs only LPNs. Again we just dont have RNs on the floor. I see no problem with a well rounded experienced LTC LPN supervising a team of LPN staff nurses and the fuctions of the LPN floor nurse under the guidance of an RN. Just my opinion. However, i do not feel that it would be wise like mentioned in other states to have an LPN ADON in a facility thst employs RN floor nurses.

Specializes in Gerontology, Med surg, Home Health.

Regulations vary from state to state.

You are exactly right! In the State of Indiana it is the same scenario- few RN's will ever cross into LTC- by a good majority, LPN's run the LTC Sector. IF by chance an RN ventures into a building, typically they are often on the floor for doing direct care- that's a reimbursement gain for the facility. Just being an ADON does NOT typically mean you are in charge when the DON is out- here it is often the MDS Coordinator who steps in that role. LPN's here have a very wide scope of practice. You can do anything you have been trained for skill-wise, and there are many certs out there to pick up. Teamwork is expected no matter your designation. Our purpose is to care for our residents to the best of our ability, as licensed nurses. But, that's LTC. Who's got time for anything else?? :)

Specializes in LTC, Education, Management, QAPI.

I was actually an LPN-ADON in a SNF in Virginia. I have not yet seen in any state a requirement for an ADON position. Since the majority of ADON positions that I've seen revolve around an HR type of supervision, it doesnt cross the scope of practice. Example: As an LPN-ADON, i couldn't supervise or delegate a clinical decision, judgment, or procedure to an RN Supervisor, but I could delegate, supervise, and judge staffing decisions and other non-clinical issues. As someone else stated, the RN-RAC stepped in when the DON was out as second in command and it worked very well.

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