Assisted Living Administrator – A Day in the Life

The National Center for Assisted Living (NCAL) shows that more than 800,000 Americans are residents of assisted living facilities. To provide high-quality and compassionate care for the nation’s most revered citizens, assisted living administrators oversee the business operations, which offer a range of services, including daily living and memory care.

The Bureau of Labor Statistics (2023) predicted job growth of 28 percent for medical and health services managers in the decade preceding 2032—nine times faster than the average expected for all US jobs. Moreover, with the aging Baby Boomer generation, the need for facilities that provide a little extra help to elderly residents is projected to grow similarly.

When it comes to caring for our aging loved ones, assisted living administrators play a vital role. Assisted living facilities specialize in providing care for senior citizens, and assisted living administrators oversee all of the facility’s operations. As a result, these spaces are more community-focused than other medical institutions, and their administration requires keen business skills and compassionate human touch. In addition, assisted living administrators are responsible for a wide scope of responsibilities that vary from facility to facility. Still, the ultimate goal is to provide a secure and empowering environment for the elderly population they serve.

Read on to learn about where assisted living administrators work, who they work with, what they do, and what you need to become one.

Assisted living administrators work in assisted living facilities, which share some commonalities with nursing homes. Nursing homes and assisted living residences serve elderly residents by providing a secure environment, support services, medication management, communal activities, and meal preparation. But the critical differences between assisted living facilities and nursing homes lie in their medical services and structural appearance.

Nursing homes provide round-the-clock medical care and monitoring. This could mean the staff includes speech pathologists, specialized nurses, respiratory specialists, or physical therapists. As a result, a nursing home can appear more institutional than an assisted living facility. It may resemble a hospital where residents sometimes share rooms and are cared for by full-time medical professionals.

Assisted living facilities provide a group living environment for aging citizens. As a result, the staff is better equipped to respond to minor and less life-threatening issues like impaired mobility and memory loss. In addition, professionals teach movement classes such as pilates and yoga and offer esthetician services such as hair and nail care. As a result, resident life is more community-focused and empowering for the residents, who often have their own suites and a strong sense of agency in their day-to-day lives, with assistance always close by should they need it.

While an assisted living administrator is tasked with overseeing the overall operations of a facility, they often manage a team of directors that take charge of individualized areas. The precise composition of such a team typically depends on the residence’s size and specialties.

An activities director may be responsible for community events that keep residents fit and engaged. A nutrition director ensures that residents eat healthy and nutritious foods and that each individual’s particular dietary needs are met. Depending on the level of medical care required for the resident population, an administrator may also work with a medical director who manages care teams of assistants and technicians and refers out for follow-up support.

In some facilities, an administrator will report up to a board of directors. In every case, the coordination between directors and administrators is critical for an integrated system of care.

An assisted living administrator is charged with overseeing all the operations of an assisted living facility. This top-level management position comes with a customized routine that must adapt each day to the needs of the facility’s staff, residents, and families. While the responsibilities will vary based upon the size, scope, and population of the residence, some overarching responsibilities include:

• Planning a facility’s budget
• Hiring and maintaining staff
• Conducting meetings with department heads
• Marketing the facility’s services to the wider community
• Implementing policies and goals
• Coordinating logistical functions such as food service
• Monitoring a facility’s compliance with state regulations

While solid business management responsibilities make up the bulk of an administrator’s daily schedule, another essential aspect of the job is to serve as the face and leader of the facility, which requires less quantifiable and more human directives, such as:

• Acting as a liaison between residents, families, staff, and community
• Engaging with residents and staff via facility walkthroughs
• Developing a culture of compassion throughout the facility
• Ensuring a safe, equitable, and engaging living environment
• Keeping the facility pivoted towards resident-centric operations

To be an assisted living administrator is to be engaged in a constant juggling act. As the administrator of a 24-hour facility, one must always be on-call. Furthermore, as the leader of a community of residents, administrators must be consistently attuned to the personalized needs of those under their care.

Assisted living administrators need two contrasting but critical skill sets: rational business acumen and compassionate human touch. Each facility is a business and needs to be treated as such. For this reason, administrators have a full scope of knowledge about record-keeping, budgeting, and other financial instruments.

However, an assisted living residence is also a community of individuals and thus requires proper attention to the personalized needs of each resident and their family. While not as medically intensive as a nursing home, assisted living facilities need to tend to the needs of an aging population, which requires some knowledge of gerontology and end-of-life care.

A bachelor’s degree in healthcare administration could be considered the bare minimum for work as an assisted living administrator. However, to truly meet the needs of an assisted living facility, a graduate-level education is strongly recommended. An MBA with a healthcare focus, an MHA with a gerontology focus, and other specialized educational options can flesh out an administrator’s skills and empower them in the right combination of social, medical, and business knowledge.

Most states require licensure of assisted living administrators, with each state having different eligibility requirements. The National Association of Long Term Care Administrator Boards (NAB) maintains a list of states that require licensure through the Residential Care Assisted Living (RCAL) exam.

For some states, the NAB administers the RCAL exam to measure entry-level knowledge and competent skills for the profession, which can act as a component of state licensure. Applicants can find pricing, eligibility, and other state-specific requirements in the NAB’s Candidate Handbook.

The American College of HealthCare Administrators (ACHCA) offers the Certified Assisted Living Administrator (CALA) credential as well as the Certified Nursing Home Administrator (CNHA) credential. Applicants can find pricing, eligibility, and other state-specific requirements in the ACHCA’s Professional Certification Handbook. Those with current CALA or CNHA credentials can maintain them every three years. To renew this credential, applicants must submit either an executive portfolio or complete an executive-level course in addition to a signed affidavit.

The Senior Living Certification Commission (SLCC) offers a Certified Director of Assisted Living (CDAL). There are two eligibility pathways depending on education and experience. The first eligibility route requires a bachelor’s degree from an accredited institution plus one year or 2,000 hours of work experience as an assisted living community executive director or at least three years (6,000 hours) of management experience in an assisted living community.

The second eligibility pathway requires applicants to prove 6,000 to 10,000 hours of work experience in an executive director or equivalent management capacity in an assisted living community. Once approved, applicants must take the exam within 12 months and pay a fee ranging from $750 to $875.

States have unique requirements for assisted living administrators, and certification exams that align with state standards are offered. An example of this is the ALF/RCF (assisted living facilities/residential care facilities) Administrator Training Program provided by LeadingAge Oregon. Starting January 1, 2022, all ALF/RCF administrators in the state of Oregon must be licensed to work legally. The fee is $750 for LeadingAge Oregon members and $1,100 for non-members.

Matt Zbrog

Writer

Matt Zbrog is a writer and researcher from Southern California. Since 2018, he’s written extensively about emerging issues in healthcare administration and public health, with a particular focus on progressive policies that empower communities and reduce health disparities. His work centers around detailed interviews with researchers, professors, and practitioners, as well as with subject matter experts from professional associations such as the American Health Care Association / National Center for Assisted Living (AHCA/NCAL) and the American College of Health Care Executives (ACHCA).