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Who Runs the Nursing Home? CNA's

Posted Nov 11 2011 11:11am



The following is a guest post from Elizabeth O’Malley

With the advances in healthcare and surgery techniques, more adults are living into their eighties and beyond. Many are able to live independently or with families. However, for those who are physically unable to care for themselves, a nursing home may be considered. Oftentimes a nursing home will take many people cooperating together in order to run successfully, from a certified nursing assistant to various social workers. So who are the people who will be running the care of loved ones in these facilities?

The organizational structure of most nursing homes includes a nursing home administrator at the helm. The administrator may be a clinical professional such as a bachelor's level nurse, or an individual with a degree in health administration. This individual oversees the total operation of a facility. Administrators oversee the hiring and training of employees and develop policies and procedures to assure that the facility complies with federal and state regulations. A nursing home administrator administers the budget, reports to state and federal agencies as often as necessary. He or she convenes and participates in meetings with families, staff, vendors, and insurance providers. The nursing home administrator also has responsibility for direct supervision of department heads in other disciplines such as nursing, social work, various therapies, dietary and environmental services.

The nursing home administrative team usually includes the following professionals: a finance officer or bookkeeper, director of social work who serves as a liaison between families and the facility. The social worker may also double as a community relations director, meaning that he or she promotes the facilities services in the community. Nursing homes may also have a medical director and nursing director. The medical director is a local physician responsible for the clinical or medical aspects of care including examining patients; writing prescriptions for medication, and writing other orders for care.
The nursing director is usually a registered nurse who has total supervision of all nursing staff. Under the nursing director is an assistant director of nursing. This positions supervises other staff including registered nurses, and licensed practical nurses/licensed vocational nurses. These staff nurses provide supervision for nurse’s aides or certified nursing assistants. Other staff working in nursing homes include dietary workers, housekeeping and environmental services employees, occupational, physical and speech therapists; and volunteers.
Each of the aforementioned positions or professions is essential in the successful operation of nursing homes, however, who runs the nursing home? All it takes is a visit to a nursing home to determine who really "runs" the facility. In the day to day operation of any nursing home, one will observe that certified nursing assistants make up the bulk of staff providing direct care to patients. Nursing assistants are the "backbones" of nursing homes. According to the U.S. Department Health and Human Services , there is a shortage of nursing assistants in every community.
Certified nursing assistants work under the direct supervision of a registered nurse or licensed practical nurse. According to the U.S. Bureau of Labor Statistics , certified nursing assistants are responsible for direct care duties, including bathing patients, helping them get dressed, feeding, and caring for the hair. Certified nursing assistants assist patients in toileting and in situations where patients are bedridden, they must change soiled bed linens and clothing. They also assist patients who have mobility issues. This may include lifting, carrying, pushing a patient in a wheel chair, or helping one to remain stable or steady while walking.
To accomplish their work, certified nursing assistants must be in good physical health, with the ability to lift and move patients. Certified nursing assistants must be trained to care for patients through an approved program of study. Nursing assistant training may be sponsored by nursing homes, community colleges or junior colleges, high schools, and online training programs. Training requires a minimum of 50 hours, but some programs may require as many as 90 hours of training. Students in certified nursing assistant training programs must take course work in basic anatomy and physiology, medical terminology, basic nursing, communication, and infection control.
In addition to classroom courses, students must be successful in completing a clinical program that gives them opportunity for hands on application of skills learned in the classroom. Upon successful completion of the classroom and clinical components of the training program, graduates are able to sit for the certification examination administered in the state in which they plan to practice. If a passing score is received, an individual is permitted to wear the title certified nursing assistant and may be employed in a nursing home if desired.
While all of the individuals who work at nursing homes contribute to residents' well-being the organizational structure is at its best, the fact remains that without qualified, caring nursing assistants working in harmony with the nursing directors, most nursing homes and similar health care facilities would be forced to close their doors.
Bio: Elizabeth graduated with a degree in Public Health Administration before relocating with her family to Seattle. She is currently writing, and her favorite topics include health care, work-life balance, and travel.
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