Saturday, November 2, 2013

Nursing Home Administrator / NHA

About Extendicare

Extendicare REIT, through its wholly owned subsidiaries, operates 235 long-term care facilities across North America, with capacity for over 26,800 residents. As well, through its operations in the United States, Extendicare offers medical specialty services such as subacute care and rehabilitative therapy services, while home health care services are provided in Canada. The Company employs 34,000 people in the United States and Canada.

SUMMARY OF POSITION: Responsible for overall facility management, profitability, operations, and direction in all aspects. Accountable for, but not limited to, census development, management of accounts receivable and collections, maximization of Net Operating Income, resident/patient care, state and federal survey compliance, positive employee relations, a positive return on investment, an effective business plan and implementation of Extendicare core programs. Is the Extendicare representative in the facility and community. Follows all Extendicare policies and procedures. Completes rounds of entire facility premises at least daily to ensure compliance with all policies, procedures and regulations.

POSITION RESPONSIBILITIES: The responsibilities of this position may involve physical activities including standing, lifting, bending, stooping, pushing, pulling and twisting. The tasks on this position description marked with an asterisk (*) are those that regularly require these physical activities. All employees of nursing homes may be required to provide lifting and transfer assistance to residents. Lifting and/or transferring some residents will require use of a lifting device and /or assistance of other staff.


1. Supervisory Responsibilities

  • Makes daily work assignments.

  • Directs the work of employees.

  • Schedules lunch and rest breaks.

  • Authorized early departure from work.

  • Authorizes overtime.

  • Reassigns employees from one area to another area as facility needs dictate.

  • Prepares written evaluations of assigned employees.

  • Enforces facility policies with authority to issue Disciplinary Action Reports as needed.

  • Initials time records to authorize variances.

  • Interviews applicants that will be assigned to his/her area of responsibility.

  • Receives and handles employee complaints

  • Participates in training programs and assists in orientation of new staff.

2. Business Plan

  • Annually develops and implements a sound business plan that results in provision of quality care and a maximum return on investment.

  • Reviews business plan with department heads at least quarterly to ensure that goals are attained.

3. Census/Mix Management

  • Ensures maximum census development.

  • Establishes and reviews Census and Mix objectives in conjunction with the budget and business plan.

  • Oversees the placement of prospective residents to ensure that residents’ physical, mental and psychosocial needs are met by the facility and who meet the financial requirements.

4. Accounts Receivable

  • Ensures the maximum collection of accounts receivable.

  • Reviews Aged Trial Balance (ATB) and oversees the collection of Accounts Receivable by the business office manager.

5. Compliance

  • Ensures an effective Performance Improvement (PI) process is in place to identify and resolve facility problems.

  • Ensures facility PI programs achieve compliance expectations as measured by state, federal, and Quality Validation (QV) surveys.

6. Net Operating Income

  • Responsible for control of labor and supply expenses on a Per Patient Day (PPD) basis.

  • Responsible for maximization of revenue opportunities including ancillary opportunities.

7. Labor and Workforce Planning

  • Directs workforce of the facility.

  • Controls labor expenses for dollars and hours on a PPD basis.

  • Ensures effective workforce planning and recruits quality candidates.

  • Ensures Employee Survey is conducted annually and develops an action plan to correct issues identified. Plans meetings to address issues identified.

  • Participates in Affirmative Action Plan development.

  • Receives and handles employee complaints.

  • Attends meetings and conferences as required.

  • Authorizes early departure from work.

  • Authorizes overtime.

  • Enforces facility policies and issues Disciplinary Action Reports as needed.

  • Suspends employees for disciplinary violations as required.

  • Reviews and approves facility payroll and time records.

  • Participate in the interview and selection process for key positions.

  • Participates in training programs and assists in orientation of new staff.

8. Reimbursement

  • Ensures all reimbursement opportunities are fully attained.

  • Ensures proper and timely completion of all paperwork required for reimbursement.

9. Patient Trust Accounts

  • Supervise administration of patient trust accounts.

  • Audits patient trust accounts quarterly.

10. Consumer Satisfaction

  • Responsible for overall consumer satisfaction.

  • Reviews Consumer Satisfaction Surveys to ensure that the facility is meeting customer expectations.

  • Ensures that the facility’s PI committee reviews the Consumer Satisfaction Survey results and develops appropriate action plans to correct problems identified.

11. Performance Planning and Review Guide (PPRG)

  • With RDO, establishes annual goals and objectives.

  • Annually develops performance objectives for each department head.

  • Quarterly evaluates the status of objectives and performance of standards.

  • Annually makes salary recommendations based on performance.

  • Ensures department heads provide fair and accurate evaluations of their employees on a timely basis.

12. Risk Management

  • Ensures that the facility has an active, effective Safety Committee and Employee Care Coordinator.

  • Reviews lost days to ensure facility safety programs and claims management are effective.

  • Ensures facility’s compliance with all safety requirements and OSHA regulations.

  • Follows all federal, state, and company reporting requirements.

  • Implements transitional duty policy for the facility (for individuals with an Extendicare on-the-job injury).

13. Environmental

  • Oversees the proper maintenance of the building, grounds and equipment to ensure a safe, sanitary, and attractive environment for residents/patients and employees and to protect company assets through proper preventative maintenance.

  • Ensures Major Expenditure Authorization (MEA) process is followed.

14. Budget

  • Participates in development of facility budget.

  • Operates the facility within budgetary guidelines. Provides department heads with departmental budget and holds department heads accountable for operating within their budget.

15. Treats all residents, visitors, and staff with courtesy.

16. Ensures compliance with laws and regulations applicable to position and acts in accordance with Extendicare Health Services, Inc.’s Corporate Compliance Program.

17. Attends and participates in inservice training, performance improvement (PI) committees and other meetings as scheduled and directed.

18. Safety

  • Knows and follows facility rules.

  • Demonstrates proper use of equipment. Reports equipment needs or repairs.

  • Follows facility smoking policies.

  • Reports and documents any incidents or accidents of resident/patients, staff or visitor to the appropriate facility personnel.

  • Performs duties, which may include transportation or residents/patients, as assigned in Facility Disaster Plan.

  • Follows infection control standards, policies and procedures.

19. Resident Rights

  • Knows Resident Rights. Helps the residents/patients exercise and/or protect their rights.

  • Ensures that resident/patient complaints are addressed.

  • Maintains confidentiality of resident/patient information.


  • Follows and adheres to Extendicare’s policies and procedures implementing HIPAA requirements for the privacy and security of protected health information.

  • Uses and/or discloses only minimum amount of Protected Health Information necessary to complete assigned tasks. (Applies only if position requires access to PHI under Role Based Access Grid.)

  • Reports all suspected violation of company’s HIPAA policies or procedures to Facility Privacy Designee.

Other Duties

  • Performs other duties as assigned and consistent with level of preparation and experience.

  • Participates in all hands dining.

  • Participates in marketing events.

The designation of “essential functions” and “other duties” is for purposes of compliance with the Americans with Disabilities Act. Employees holding this position will be required to perform all job duties, consistent with law. In addition, employees must meet applicable health requirements imposed by law.

This description has been prepared to assist in evaluating various classes of responsibilities, skills, and working conditions. It indicates the kinds of tasks and levels of work difficulty required of positions given this classification. It is not intended as a complete list of specific duties and responsibilities. Nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under supervision. Nothing contained herein is intended or shall be construed to create or constitute a contract of employment between any employee or group of employees and the Employer. The Employer retains and reserves any and all rights to change, modify, amend, add to or delete from any section of this document as it deems, in its judgment, to be proper.


  • Licensed or eligible for licensure by the state in which the facility is located.

  • Education or experience sufficient to meet position requirements.

  • Ability to make oral presentations.

  • Has effective communication skills.

  • Ability to speak, read, write, and understand English.

  • Ability to relate positively, effectively, and appropriately with residents, families, community members, volunteers, and other facility staff.

  • Possess special interest in working with long-term care residents and the elderly.

  • Meets all health requirements imposed by law

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